Share Public Health Transcript: Tackling Equity, Native American Health

Season 1 Episode 22

Hannah Shultz Welcome to Share Public Health, the Midwestern Public Health Training Center’s podcast connecting you to public health topics, issues, and colleagues throughout our region and the country, highlighting that we all share in public health. Thank you for tuning into this ten-part series on health equity. Over the course of this series, we will discuss a broad range of topics connected to health equity. For additional resources and information, be sure to check the podcast notes or visit mphtc.org/healthequity.

Felicia Pieper Hi, I’m Felicia Pieper and I’m a Masters of Public Health student at the University of Iowa College of Public Health and today I’ll be serving as host in this podcast episode dedicated to Native health as a part of the Tackling Equity series. With me I have Dara Jefferson and today we’re going to tackle describing Native populations in the US and our region and understanding how tribes differ. We’re going to identify historical injustices and how these events and systems influence health today, and identify some individual level action steps to move towards equity in Native populations. So, today with me is Dara Jefferson. She is a US Army veteran. She currently serves the Native Center for Behavioral Health as a graduate research assistant while she’s enrolled as a doctoral student with the University of Iowa’s College of Public Health. She has 11 years of experience working with tribal programs with over six of those years as a domestic violence and sexual assault advocate for Native women, children, and their families. Ms. Jefferson is a Northern Arapaho and Meskwaki. She was raised in the Wind River Indian Reservation in Wyoming. Her current home is in the Meskwaki Settlement in Tama, Iowa. So to start off today, Dara, could you walk us through some of the language and the key terms we’ll be using throughout this podcast episode?

Dara Jefferson Sure, I think some of the main terms people kind of get confused with or have questions about is American Indian. That term is mainly used by the American government in reference to, like you just stated, the Wind River Indian Reservation. We also have boarding schools like Flandreau Indian School or when it refers to Indian country. Native American refers to all Native people to the United States and its trust territories. Another term is Indigenous, which refers to people that are indigenous to this continent or, you know, this area.

Felicia Pieper So now that we’re on the same page and understand the language we’ll be using throughout this episode, Dara, could you explain the U.S. Native population today?

Dara Jefferson Well as of 2017, there were an estimated 5.6 million people who are classified as American Indian and Alaska Native, alone or in combination with one or more other races. So if their mixed that’s usually what that refers to. There were 2.9 million who identified as American Indian or Alaska Native alone. Population makes up about 1.7 percent of the total U.S. population. There are 573 different tribes in the United States. They’re scattered throughout 35 states and about 229 of those tribes are in Alaska. Each tribe is diverse. They each have their own language, they each have their own customs, traditions, everything from hairstyles to the way they dress so they are, you know, diverse, and that’s what we see today.

Felicia Pieper Could you tell us a little bit about our Midwestern region in Iowa, Missouri, Nebraska, and Kansas and what the Native population looks like?

Dara Jefferson Well I’ll start with Iowa since that’s where I’m more familiar with. There’s only one resident tribe in Iowa today. They go by the name of Sac and Fox Tribe of the Mississippi n Iowa, or Meskwaki. They live on a Meskwaki settlement and Tama, Iowa. Historically, there’s been a lot of other tribes in Iowa. Some of those are Omaha, Ioway, Potawatomi, Ponca, Kickapoo, Sioux, Otoe, to name a few. There is some land owned by the Winnebago, but they don’t have any residents that live there. I believe it’s a casino for the most part. In Iowa there’s about 11,000 Native people in Iowa or that identify as being American Indian, but they’re so spread out into all these different counties. So every county in Iowa, all 99 counties have somebody that identifies as American Indian. Nebraska is home to Omaha Winnebago, Santee, Sioux, and Ponca. Again, same as Iowa and all the other states pretty much in the United States, there are historical ties to the land by other tribes. Some tribes that have moved through or lived in Nebraska are the Cheyenne, Arapaho, Lakota, Pawnee, and Otoe tribes. In Kansas today who have reservations or live there are Kickapoo, Potawatomi, Sac and Fox, and Ioway. Again, some of the original inhabitants of that land are the Arapaho, Comanche, Kanda, Kiowa, Missouria, Osage, Otoe, and Pawnee tribes. There are no federally recognized tribes today in Missouri. I believe there may be a state-recognized tribe, but again this, you know, tribes that have originally been there or have lived there, moved through there, are the Chickasaw, Ioway, Missouria, Osage, and Otoe tribes. So we’ve had a lot of tribes move in and out of these states. A lot of tribes have historically moved around, followed food sources, had summer camps, had winter camps. That’s why you kind of see the big number of different tribes in this area.

Felicia Pieper So you mentioned that some populations are not federally recognized or recognized by the state. Could you talk about the benefits and the challenges with being recognized?

Dara Jefferson Well benefits of being federally recognized is you get a lot of different grant money and funding streams allocated to federally recognized tribes. State recognized tribes would get state funding and everything like that in state recognition, so there are a lot of benefits. It also creates a lot of tension, I think, for some of the Natives who aren’t able to be enrolled in those tribes. So an enrollment is something or is a topic that a lot of tribes are discussing today, with the issue of blood quantum, you know, how much Native blood a person has is usually one of the factors that weighs in with whether somebody is enrolled or not.

Felicia Pieper When you say enrolled does that refer to on the individual level or are we talking about groups of people being enrolled and recognized?

Dara Jefferson No, that’s an individual level. So usually enrollment comes through – it depends on the tribe – but parents are able to enroll their children as long they meet a certain blood-quantum for that tribe and then meet whatever other criteria that tribe holds. Every tribe has their own criteria. Every tribal is sovereign, they’re their own sovereign nation. They will have their own Constitution and rules and policies that go by what an enrollment means. So take Meskwaki, for example, they are patrilineal, so the fathers, if they’re enrolled are able to enroll their children as long as they meet the other criteria such as blood-quantum. My tribe of Northern Arapaho, both the men and women, so the mothers and the fathers are able to enroll children. We also have to meet a blood-quantum for that tribe. But yeah. So with the tribes where the mothers and fathers are able to enroll their children, you’ll see a bigger number of Natives for that tribe. So there’s over 10,000 Arapaho people enrolled right now in comparison to the Meskwaki, where there’s a little over 1,400.

Felicia Pieper So we’re here today talking about health equity and public health and Native people, but before we get there, let’s lay a little more groundwork. Could you tell us some more of the historical context that has to do with Native people in the United States?

Dara Jefferson Sure. There’s a bunch of different numbers, but it’s estimated to be anywhere between 1.5 million and 20 million people that resided here on this continent before Europeans. This number fell dramatically to below 250,000 by 1890 due to a bunch of different periods throughout our history. The proliferation of European colonies created a dominant presence on the North American continent and America’s east coast, so the eastern tribes are really affected by this. These colonies acquired Indian lands under the so-called Discovery Doctrine and signed treaties with the tribes. A lot of the tribes lost their land through these treaties and a lot of these treaties they didn’t understand because of the language differences. 1828 saw the removal reservation and treaty period, so as the U.S. population and military strength grew, so did the US government’s pressure on eastern tribal nations to move west, resulting in forced migration. Seeking to obtain more Indian land, the government embarked on an aggressive military campaign throughout the West, relocating tribes to Indian reservations. In general, reservations were established with treaties which [inaudible] Indians to trade large tracts of land for the continued right of self-governance under the protection of the United States. So this period saw, like I mentioned before, a lot of those treaties that tribes didn’t understand, a lot of them were forced upon tribes. Tribes were threatened, tribal leaders were misled into signing various treaties, so we lost a lot of land. With the reservation period you saw a lot of tribes that were moved from their homelands, so lands that they have lived for centuries of years. They’ve adapted to the land, they’ve adapted to the food that was provided by that land. Native people’s spirituality was tied to the land that they were from, and so being forced to move away from that land – they lost a lot of that along their way. There’s also a lot of massacres that occurred in this period, a lot of different wars that occurred in this period. So when you see that big drop of the population in the Native people, it’s because of all this different stuff. I mean, disease came right away and took out tribes. Some tribes don’t even exist anymore because of the disease after European contact. So you just see all of this happening throughout their westward expansion. There’s diseases, there’s massacres, there’s wars and so the population is dwindling and the people are being forced to move. The allotment and assimilation period also saw a lot of the settler’s increasing desire for the land within reservations. So after we were already forced onto reservations, settlers continued to want that land so it was taken, you know, again by force or coercion. In the push to assimilate Indians into mainstream American life, it led to the General Allotment Act of 1887. This act, also known as a Dawes Act, dictated the forced conversion of communally-held tribal lands into small parcels for individual Indian ownership. More than 90 million acres, so nearly 2/3 of the reservation land were taken from tribes and given to settlers, and most often without compensation to the tribes. Then in 1887 you had the allotment and assimilation period and in that period you saw the boarding school era, where children were taken from tribes, usually by force, and placed into different boarding schools throughout the U.S.. There are about 100 different boarding schools. One of the first ones is the Carlisle Indian School, which was ran by General Pratt and his mindset then, at that time, was to “kill the Indian, save the man”. So what you saw in a lot of these different boarding schools wasn’t to educate us, but it was to try to take the Indian out of the Native students. They weren’t allowed to speak their language, they had to cut their hair, they weren’t allowed contact with their families, they were disciplined very harshly. There are a lot of different reports of the abuse that happened in these boarding schools. Children in boarding school suffered from malnourishment, they were beaten, they were forced to do heavy labor. In the 1960s, a congressional report found that many teachers still saw their role as civilizing American Indian students, not educating them. The report said the school still had a major emphasis on discipline and punishment. So you’re gonna see a lot of what happened during the boarding school era manifest into what now becomes health disparities. We’ll touch on that a little bit later, but I just really wanted to point out how important this period was in the development of the Native population today. In 1934 to 1945 was an Indian Reorganization period. The federal government, under the Indian Reorganization Act of 1934, ended the discredited policy of allotment. It began to restore Indian lands to tribes and attempted to help tribes reform their governments. The federal government created programs and projects to help rehabilitate Indian economic life. In 1945 to 1968 you saw the termination period where Congress decided to terminate federal recognition and assistance to more than 100 tribes. Throughout our history, the government played a major part of shaping in who we are today. A lot of it wasn’t great history, in the termination period, in the relocation period, in addition to the loss of millions of acres and valuable natural resource land. Another strategy the government used was to move Native people from reservation land to urban areas and that they promise them jobs, a different way of life, education, technical assistance, stuff like that, but this also removed tribal people from their culture, what culture and traditions Native people are able to hold on to and take with them to these different reservations. Reservations have a bunch of different issues that urban Indian areas don’t see, and urban Indians have a lot of different issues that reservation Indians don’t see. I think a large part of that is that disconnect from their tribal cultures and tribal lands. 1968 to 2000 is a self-determination period, a resurgence of tribal government involvement in federal government development ended the determination era and prompted the development of a policy of self-determination and self-governance. Tribal governments were then able to manage many federal programs serving Indian people. From 2000 to the present day, you’ll see the nation-to-nation period. Tribes progressively utilized federal policy and their own economic success to strengthen the nations. So while we went through all of these different terrible periods in our history, today you see a lot of different tribes trying to strengthen their nations using their economic pull, so using their sovereignty to build casinos, or using their sovereignty to claim the natural resources that are on their lands and use all those funding that comes [inaudible] and use all of the resources and money that comes from that to feed back into the tribal programs. Just take, for example, most tribes have their own language program, so language revitalization is happening. Meskwaki community has their food sovereignty initiative. We’re seeing a lot of traditional foods being brought back into our everyday life, so the food sovereignty initiative is reintroducing a bunch of different strains of plants that haven’t been seen in this area. In this program they’ll host recipe nights or they’ll have different feasts for the tribes. The last one was like the Hunters feast, where they made dishes that are historical to the tribe and not a lot of people really make anymore . . . just trying to introduce, reintroduce that the game meat, some of the corn recipes. So you’re seeing a lot of that within the tribes now. Throughout our history, too, you also saw a lot of the mistrust starting to build within Indian communities. A large loss of language, traditions, and cultural customs, you saw a large loss of connection to tribal areas and traditional food sources, abuse, substance abuse.

Felicia Pieper So now that we have a better understanding of some of the history and the events that have happened to Native people in the United States, how does some of those events affect health that we see today?

Dara Jefferson So to go into the diabetes, obesity, and heart disease epidemics that we see, we’ll start with naming off a few facts from the CDC. According to the CDC, Native Americans have a greater chance of having diabetes than any other US racial groups. Native Americans are twice as likely than whites to have diabetes. American Indians and Alaska Natives now have the highest diabetes prevalence rates of all racial and ethnic groups in the United States. More than 16% of the members of this population have been diagnosed compared to 8.7% of non-Hispanic whites. There’s a bunch of different factors that contribute to the higher rates of diabetes in our population. They include genetics, environmental and behavior issues, which may include a genetic predisposition toward insulin resistance, exposure of fetuses to hypoglycemia during pregnancy, sedentary lifestyles, obesity, and effects of living in environments that are stress-producing from both a social and physical standpoint. Native Americans no longer had access to the foods that they had traditionally eaten in the pre-reservation era, which included wild game, berries, other fruits, and root vegetables. So as is true for Americans of all ethnic groups, American Indians and Alaskan Natives now consume a diet that is highly processed, foods are higher in fat and higher in sodium, added sugars, and dietary cholesterol. As part of moving Native people to reservations, the government said that they would quote/unquote “kind of take care of us”, so there’s a lot of different programs that they try to create to implement that. So when we were moved to reservations, at first they started out really big. They were really huge tracts of land. As I said before, like settlers wanted more and more of that land and the U.S. population grew, so what they wanted and what they took was mainly like the good land. So what we were forced to move on to was land that you couldn’t grow crops on, land that was barren, land that we really couldn’t sustain that way of life, especially for the tribes that relied on crops. Then a lot of the Plains Indians, who tended to follow like the buffalo herd or they followed their food sources, they weren’t able to move around like that anymore to find their food, so that really affected them. The loss of the buffalo herds was one of the most devastating events to happen to the Native people. A lot of the tribes in the Plains area are, you know, they’re not really great for growing anything, but like in Nebraska and Iowa you see a lot of corn being grown, wild rice is still grown in a lot of different tribal areas. So with the [inaudible] like what I talked about before, with the tribal economics getting a little bit better, nowadays that’s something that tribes do look into is trying to be more self-sustainable as far as creating and growing their own food. There was a big push for the government to move Indians away from their reservations and into urban areas. So you see huge populations of urban tribal communities. You see it Minnesota, over in the bay area they have a large population, up in Seattle they have populations, so you just see huge Native communities in these different cities. They’re like communities. They didn’t just move there and then they got spread all over. I mean, I’m sure some of them have, but a lot of them today live in one area, you know, of that city. And because I lived on a reservation that wasn’t a part of like what I knew about and I didn’t really live in any cities living in Wyoming. There’s not many cities near us, so I wasn’t aware of that until I moved to Iowa and was a domestic violence and sexual advocate for about seven years with the Meskwaki tribes. Through that experience where I learned more and more about the different Natives in this area and then in urban areas and what kind of issues that they face.

Felicia Pieper Could you give us examples about some of those differences?

Dara Jefferson Oh well, you know, like the connections to the land, connection to who they were I suppose, connection to their language. I think a lot of it – okay so I kind of talked a little bit about how tribes are spiritually connected to their lands and through that forced migration and as we were forced onto reservations, we lost a lot of that, but then when Indians moved into urban areas, they lost even more of that because whatever little bit that we held onto or a lot that we held onto depending on the tribe . . . the health of a tribe varies too from different tribe to different tribe. Some are huge and some have stayed really really connected into their . . . take for example, Navajo. They’re huge, they’re the largest tribe in the US and they were able to stay generally in their homelands that they are from, so down south. They’re able to stay connected to a lot of their ways whereas some other tribes like, you know, like the Meskwaki, they originally came from the east coast. They made their way here and so they’ve adapted to this area for the most part really well I would say, but I think urban Indians being away from that, being away from reservation lands, I think they lost a lot more than we did, I think on our reservations. A lot of what we’re trying to do today in healing our communities is relying on our traditions and relying on everything that we’ve had or what we used to have in the past and try to bring it forward to now and be able to like rely on that – it’s part of our healing process. I think where I see how the urban Indians are affected – and I can’t really speak for them because I’m not an urban Indian – but from what I see is that they’re struggling to reclaim that too or they’re not struggling but I think they just have to make bigger efforts to reclaim that and establish that within their communities. I think Native people that don’t live near tribal areas, don’t live by their tribes feel alone a lot of the time and they don’t really have any of that to connect to and I think they struggle with that. I think it affects their mental health, I think it affects how they see themselves in this world, I think it affects their sense of belonging because that is definitely one strength that I see as somebody who grew up on a reservation, as somebody who grew up within their tribe. What I always felt was I felt like I belonged somewhere, you know, and so when I went out into the world and did all these different things like joining the army and stuff, I always knew where home was, I always knew where my people were, I always knew what it sounded like to hear somebody speak my language. So a lot of people that don’t have that, I think if we can reconnect them to that when we’re talking about our health disparities and our domestic violence and our sexual violence stuff, if we’re able to connect people to that I think that would do a lot as far as their healing goes.

Felicia Pieper So, Dara, you have extensive experience as a domestic violence and sexual assault advocate and were at one point the only Native advocate in the state of Iowa. What do you want listeners to understand about violence in Native communities?

Dara Jefferson I do want people to know how it’s related to the boarding school era. So we have all these children that were forced to go into boarding schools and they were disciplined, they were abused, they went through all this these traumatic events at these schools and then they’re sent back to the communities. They’re sent back without coping skills, they’re sent back without a way to deal with that trauma and so that plays out on how they continue to live in that community. They come back without any coping skills, so they start to rely on substance abuse, they start to rely on alcohol, they start to rely on drugs. Then that becomes a cycle of its own, but then the violence that they experience while at boarding school continues on its cycle. So they raise their families, they perpetrate domestic violence on to their families, they perpetuate sexual assaults or sexual abuse on other people. They become perpetrators of domestic violence and sexual violence, so that’s just a continued cycle, you know, and it’s having to stop that cycle is where we’re at now. According to a National Institute of Justice funded report more than 4 out of 5 American Indian and Alaskan Native women and men experience violence in their lifetime. That’s 84.3% of women in and 81.6% of men. More than 1 in 3 experienced violence in the last year. The stats for women show that 56.1% experienced sexual violence, 55.5% experience physical violence by an intimate partner 48.8% experience stalking, 66.4% experience psychological aggression by their intimate partner. For men the stats are 27.5% experience sexual violence, 43.2% experience physical violence by an intimate partner, 18.6% experience stalking, and 73% experience psychological aggression. Of the estimated 1.5 million Native women who have experienced violence, 97% of the violence was committed by a non-Native perpetrator. As a domestic violence advocate, in preparation for Domestic Violence Awareness month, I put out a really small Facebook survey geared towards my community. You’re limited to like a hundred responses on Facebook, so I got the 100 responses. Of those 100 responses, 80 of them were Native people that lived in the community, so tribal members. 93% of those 80 people had stated that they had experienced domestic violence themselves or knew somebody who had experienced domestic violence. So I think those numbers kind of match like what all these different reports show is that a large part of Native people experience violence.

Felicia Pieper When Europeans came and colonized the United States, they not only brought their people, but they also brought their values which have been imposed on Native culture. Could you speak a little bit to how those values have influenced Native people in the United States?

Dara Jefferson While colonization and the boarding school era introduced to Native communities non-traditional values, another large part of the continued violence in Indian country is jurisdictional issues. In 1978, the US Supreme Court ruled that tribes did not have criminal jurisdiction over non-Indian perpetrators. This meant that federally recognized tribes had no authority to criminally prosecute non-Indian offenders, even for crimes committed in Indian country. This essentially provided immunity to non-Indian offenders and compromised the safety of American Indian and Alaska Native women and men. Okay, so the reservation has, you know . . . they’re sovereign, so a lot of reservations have their own court system, they have their own police force. When it’s a Native person perpetrating against another Native, they’re able to handle that in like a tribal court, but then you also have the state court and then you also have the federal court. So most violent crimes or major crimes on reservations are handed off to the federal government and federal court system but like . . . Take in Iowa, for example, since we have the Meskwaki Settlement. A lot of our domestic violence would go to the state court, but recently the state of Iowa decided that they weren’t going to, so a lot of the courts, well, Tama County I guess for example, refused to prosecute any crimes that occurred on the settlement, so even if it was something that happened at the casino and the tribe wanted to send it to state court or the county court, I suppose, they would refuse to prosecute. So then DCI, I don’t know what the status is now, but I know when I was still an advocate they had refused to test like the rape kits that were coming out of the Meskwaki nation or Meskwaki community, so I mean there’s just a lot of different jurisdictional issues that still need to be resolved. I mean, especially, like, specifically when it comes to the state of Iowa. I’m sure all the other states have their own problems too, but I’m familiar with Iowa I guess, yeah, I don’t know.

Felicia Pieper Could you talk a little more about what your work looked like when you were an advocate? What would you do on a daily basis?

Dara Jefferson In Iowa, we have seven culturally-specific programs for domestic violence and sexual assault. The program I worked for was Native-specific. We were a state-wide program, so me being the only Native advocate in Iowa, I had to travel wherever I was needed for the most part. I also did a lot of statewide training, trying to train other advocates in these mainstream programs on how to serve the Native population. As advocates, we did a lot of training. There’s only two of us, so what we did on a daily basis changed from day to day. A lot of our responsibility was serving victims of domestic violence, sexual violence, and human trafficking, stalking, dating violence. So whoever would come to our door, we would serve them as best we could with the services that we could provide. If it was counseling, if it was group counseling, we helped with things like gas cards. We helped get them to a shelter, we provided the basic household necessities for those that needed it, we helped with rental assistance. We also worked in the schools. The Meskwaki community has their own school, Meskwaki Settlement School. We would go there and we’d help with like the bullying curriculum and work with students and try to help them develop coping skills. We would bring journals, we would bring art supplies, we would just talk to them and have a conversation about it. We talked to the students about what bullying looks like and how to deal with bullies. We worked with both in South Tama and the Meskwaki Settlement School, so we had a lot of access to the elementary-age students. We also worked with state organizations, so the Iowa Coalition Against Domestic Violence and Iowa Coalition Against Sexual Assault. We also had a partnership with all the other culturally-specific programs in Iowa, so we would meet with them and have different kinds of meetings and plan what the next event would be. We organized events, we did a lot of awareness-raising in our community and throughout the state, we planned events for Domestic Violence Awareness Month, Sexual Assault Awareness Month. May 5th is the National Day of Awareness for Missing and Murdered Indigenous Women and Girls, so I helped organize a couple of events these past two years surrounding that issue.

Felicia Pieper Could you speak a little bit more about the missing and murdered Indigenous women?

Dara Jefferson So for the last few years it’s been like a growing movement. More and more people are becoming aware due to the MMIW movement, which is missing and murdered Indigenous women. You also see missing and murdered Indigenous women, girls, and two-spirits. We’re trying to be more inclusive of all the other people that have gone missing and are murdered in the country. I think families have been the biggest advocates for the people that are missing and murdered. They’re the ones who want questions answered, they’re the ones who are seeking justice. So we really rely on them to kind of help move this or push this movement forward. The Sovereign Bodies Institute has been compiling data and creating a database for missing and murdered Indigenous women, girls, and two-spirits. According to their website, SBI is a home for generating new knowledge and understandings of how Indigenous nations and communities are impacted by gender and sexual violence, and how they may continue to work towards healing and freedom from such violence. Through their database they offer a comprehensive resource to support community members, advocates, activists, and researchers and their work towards justice for our stolen sisters. So much of the data that we see today is thanks to SBI’s database. Some of the more recent numbers I’ve seen . . . in 2016 there are 5,712 incidents of missing American Indian and Alaska Native women and girls in the U.S.. This reflects the number of reported incidents by law enforcement and does not include murdered or deceased people. Of the 5,712 cases of missing and murdered Indigenous women and girls, only 116 were logged into the Department of Justice database, so that just kind of provides you a brief overlook of like what we’re dealing with as far as not getting attention that I think this issue needs. The CDC reported homicide is the third leading cause of death for American Indian and Alaska Native girls ages 1 through 19, and the sixth leading cause of death for American Indian and Alaska Native women ages 20 to 44. The rate for missing American Indian and Alaska Native women is 4.2 times higher than that for white women and this is only . . . a lot of the information that we have probably doesn’t reflect the number of people that are actually missing or murdered that are American Indian. The identity of the person is sometimes inaccurate so it’s, like, you’ll see that today, you know, you’ll see people listed as Asian or Hispanic when really they’re American Indian, so we’re not even able to count the people that aren’t recorded as American Indian. I think that kind of shows the inaccuracies for them, for the numbers. In Iowa specifically, Meskwaki Nation has a missing person of their own. In January of 2015, Rita Papakee went missing and she has yet to be found. It’s an ongoing case anyway. They don’t release all the information on it just because it’s still an open case. They respond to the tips that they still receive and try to work with the community and finding justice. But I know, like, just from my personal experience, I’ve been trying to help the family as much as I can as far as like raising awareness on the issue, on the fact that she’s still missing. I want to try to give them a voice if they want to speak out at different events and just remind people, you know, remind people that she’s still out there and that her family is still waiting for her.

Felicia Pieper So we’ve learned a lot today about historical events and current issues facing Native people in the United States. For the public health practitioners and public health students that are listening, what are some concrete steps that you’d like them to take to move towards inclusion in closing the Health equity gap in Native communities.

Dara Jefferson I think there’s a huge need for public health research and interventions to be tailored to Native communities and they need to be found at all levels, so like the individual level, community level, policy level. A lot of that work is still needed. I think researchers and funding agencies must involve the Indigenous communities. So we, you know, just to keep in mind that we’re the experts of our own communities and that we need to have a hand in our own healing, I think is important. I think we also need public health colleges need to recruit Indigenous students so that way we can work in our communities at this level. I’d encourage students to learn more about the tribes in your area, wherever area they’re from and encourage other students and colleagues to do the same.

Felicia Pieper So what would you want our listeners to know about Native people in the United States?

Dara Jefferson That we’re still here, that despite what they may have learned about us through the media or, you know, reports that they may have read, that our communities are thriving. We’re doing our best to make sure that our communities are healing and we’re doing a lot of good work out there. So I think it, you know, – the more that people are involved with us the more that they learn that.

Felicia Pieper Thank you. Thank you for talking with us today.

Hannah Shultz At the beginning of this episode, we shared that there were 573 tribes in the United States as of 2017. Since recording, we have seen new numbers that, as of January 2020, there are 574 tribes in the United States.

Hannah Shultz Thank you for joining us today. Special thanks to Rima Afifi, Anne Crotty, Alejandra Escoto, Paul Gilbert, Kaci Ginn, Mike Hoenig, Kathleen May, Felicia Pieper, Melissa Richlen, Hannah Shultz, and Laurie Walkner. Theme music for Share Public Health is composed by Dave Hoing and Roger Hileman. Funding for this webinar is provided by the Health Resources and Services Administration. Please see the podcast notes for an evaluation and transcript.

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