Previous literature has established the connection between drinking water contaminated by arsenic (As) and uranium (U) from uranium mines to serious health complications in Native Americans (Hoover 2018; Lin et al. 2020; McGraw, Fox 2018). Despite lack of public data directly measuring heavy metal levels in drinking water on tribal lands, there is some success using proxy variables in a GIS- MCDA model to assess the potential risk of exposure to harmful contaminants on tribal land (Lin et al. 2020). This project uses a Multi-Criteria Decision Analysis approach to combine unconventional pathways of potential exposure to As and U in drinking water for Native Americans living in Utah, Arizona and New Mexico. In addition to GIS-based research, this project uses institutionalist theory to analyze political foundations and cultural factors potentially increasing the exposure to contaminated drinking water for Native Americans. Institutions are important channels for political power and sovereignty, there is a long history of institutions in the U.S. being used against Native American sovereignty to profit off of the extraction of U and hard rock in the Southwest (Diver 2018). This project offers evidence there are political, social and cultural factors directly impacting the level of exposure to contaminated drinking water Native Americans in the Southwest experience by using advance GIS methods. The results from the Multi-Criteria Decision Analysis indicate county subdivisions with a high population of Native Americans are also in areas with a high potential exposure to arsenic and uranium.