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Miles Away From Hope: The Struggles Experienced on Native American Reservations


From the moment European colonizers first made contact with the Indigenous peoples of North America, they sought to control and exploit them. Many colonists considered Indigenous beliefs and traditions inferior to their own, so they forced Indigenous peoples to accept European ideals and abandon their own. This included stripping them of the right to participate in cultural activities like dancing, cooking, and wearing traditional attire. They established abusive residential schools for Native children where they couldn’t speak their native languages, suffered sexual and physical abuse, and many died from disease. Worst of all, however, Indigenous peoples were removed from the only homes they ever knew and forced onto reservations void of equality and opportunity.

Colonial settlers and Natives fought gruesome battles over Indigenous territory because settlers wanted to usurp and use the land to grow profitable crops, like cotton [10]. Settlers used intimidation tactics like stealing livestock, raiding villages, and even murdering innocent people. Many state governments also made efforts to control Native American tribes through legislation, especially Georgia, who passed an act in 1830 that barred non-Natives from entering a reservation without a lisence and a previous pledge of loyalty to the state [1]. [White missionaries were arrested for in violation of this, working with Cherokee members to help defend their homes from settler encroachment. His case, Worcester v. Georgia, was argued in front of the Supreme Court in 1831, with SCOTUS deciding in favor of Worcester. Chief Justice Marshall had argued that it was unconstitutional for a state to attempt to take authority over “a distinct community occupying its own territory”[1], asserting that Gerogia could not enforce such laws on the reservation. This case was a step in the right direction, helping Tribes in their quest of sovereignty, but not everyone was on their side. The insatiable hunger for Indigenous lands eventually made its way to our nation’s capitol, with President Andrew Jackson signing the The Indian Removal Act in 1830, authorizing the federal government to give Native tribes unsettled land in the west “in exchange for their desirable territories within state borders”[11]. However, Natives did not agree to this exchange willingly, as multiple tribes were forced to vacate their homes due to threats of violence by the U.S. military. The most infamous example of this forced removal was the Trail of Tears, in which members of the Creek, Cherokee, Chickasaw, Choctaw, and Seminole tribes were forced to leave their lands during the winter of 1831 and forcefully marched into new territory in the west. Without basic necessities like food or water, thousands of Natives died on this journey.

Unfortunately, the torment to Natives did not end after the Trail of Tears. Soon after came the establishment of the reservation system; the Indian Appropriations Act of 1851 12 authorized the creation of Indigenous reservations in Oklahoma and many other states quickly followed suit, sectioning off “area[s] of land reserved for a tribe or tribes under treaty or other agreement with the United States”[1]. During this time, those that lived on reservations “suffered from poverty, malnutrition, and low standards of living” [13]. Indian Boarding schools were also in operation throughout the 17th to 20th centuries, funded by The Civilization Fund Act of 1819. These schools “implemented cultural genocide” [14] by erasing and suppressing ancient Native traditions in order to whitewash and “assimilate” Native children. An unknown number of children died in these schools due to the neglect and abuse of their racist administrators. This dark past has led to the conditions we see on reservations today.

To this day, 22% of Native Americans in the United States live on a reservation [1], “an area of land reserved for a tribe under treaty or agreement with the U.S.”, where the quality of life tends to be far below the rest of the country. This has led to numerous physical health problems for the Indigenous residents, including a higher likelihood of developing diabetes than any other racial group [2]. Additionally, the majority of Native Americans will experience some sort of mental illness in their lifetimes [4]. and they abuse alcohol significantly more than any other ethnic minority group in the country [5]. Native Americans are also socioeconomically disenfranchised; only 17% of Native Americans receive a post-secondary education [6], “unemployment rates [on reservations] have ranged from 20 percent to 80 percent” [7], and despite being only 2% of the U.S. population, Natives make up more than 10% of all homeless people in the United States[8].

Sherman J. Alexie, an author who grew up on Spokane Indian Reservation in Wellpinit, WA, argues that life on reservations has been subpar for decades. In his book, The Absolutely True Diary of a Part-Time Indian, he says that “we reservation Indians don’t get to realize our dreams. We don’t get those chances. Or choices. We’re just poor. That’s all we are.” [9]. The institutional barriers to opportunities force Indigenous peoples to lead lives of poor health, little education, and unrealized aspirations. Tribal organizations know best the problems their reservations face, but are denied the funding, resources, and autonomy to fix them. For generations, they were not given the tools they needed to escape the harmful cycles they suffered from. However, some have broken out of this loop, refusing intervention from outside forces and using their culture to create better futures for the next generation of Indigenous youth.

The remoteness of reservations further exacerbates the socioeconomic inequalities among Native populations. Residents usually have to drive long distances, some even leaving the reservation to access important resources like mental healthcare facilities or grocery stores. A study conducted by Eastern Washington University found that the average tribal headquarters on a reservation is 46 minutes away from the nearest Walmart [15], the “largest food retailer in the country.”[16] Such distances make these inequalities even worse for Natives who are low-income or don’t have a reliable means of transportation to access such resources.

Getting a high-quality education on a reservation can be difficult as well. Although reservation schools are funded by the federal government through treaty agreements, Indigenous students drop out of school more than any other racial or ethnic group in the country [17]. This is partially due to a lack of funding, poor quality of resources, and the difficulties of navigating the federal regulations of the Bureau of Indian Education [BIE]. The bureau was notorious for producing undereducated pupils, with their students “consistently perform[ing] below American Indian students in public schools on national and state assessments” [1]. This situation had reached dire levels by 2014 when the Bureau asked the Obama administration [18] for “more than $2 billion [to fund] facilities repairs… [and the recruitment of] private partners to help cover the costs needed to upgrade grossly-outdated technology infrastructures in many of the schools”1.

However, perhaps the most pressing issue for Natives on reservations today is a lack of access to quality health care. Native Americans have the right to receive health care services provided by the government, established by the Snyder Act in 1921 and the Indian Health Care Improvement Act8 (IHCIA) of 1976” [19]. Although these acts were created to both approve funding for Indigenous health care services and provide a system for the delivery of these services on reservations, the language in the acts was unclear and vague, creating a very unorganized healthcare system without uniform standards or guidelines. As a result, a lack of funding and poor management are two of the main reasons why the health of Indigenous people has consistently suffered for years. Congress has also refused to raise the budget of the Indian Health Service department, with the Indian Health Service per capita budget for health care services being less than half of what is spent on non-Native Americans nationally [20]. This problem is only compounded by a lack of adequate health care personnel, with a quarter of positions for health care providers in the IHS being vacant [21].

These disparities in health care can be seen particularly well in the case of Rosebud Sioux Tribe v. United States [2021]. In December 2015, the Centers for Medicare & Medicaid Services had placed the only hospital on the Rosebud Sioux reservation on “divert” status, meaning that incoming patients were rerouted to other facilities. They claimed this was due to the “deficiencies at the facility constitut[ing] ‘an immediate and serious threat to the health and safety of patients” [22]. Almost 30,000 Indigenous peoples were forced to seek emergency care at least 50 miles away [23]. As a result, the hospital’s hours of operation were reduced and those needing surgical or obstetric services were forced to find providers elsewhere. Their emergency department did not reopen until over 7 months later, and due to the persistent nature of these problems, Rosebud Hospital sought “declaratory and injunctive relief” [24] from the Indian Health Service department. The tribe alleged that the Government had a duty to both the Snyder and Indian Healthcare Improvement Acts to ensure that the members of the Rosebud Sioux Tribe were able to receive medical care. A South Dakota district court agreed with the tribe, declaring that the U.S. government owed the Rosebud Sioux a duty ‘to provide competent physician-led health care to the tribe's members.’” [25] The United States appealed this decision but was denied by the 8th Circuit Court of Appeals [26].

Poor structure, lack of funding, and vague language in federal policy have led to multiple Indigenous-used systems that are both difficult to use and navigate. These sentiments also ring true for the Indian Health Service system, when in 2019 the Great Plains Tribal Chairmen’s Health Board took control of Sioux San Indian Health Service Hospital. This came after multiple of its patients died due to “ inadequate care, often given wrong diagnoses and treated by staff members who [had] not been screened for hepatitis and tuberculosis.” [27] Things have gotten so bad that “in South Dakota, the life expectancy for Native Americans is 57, 24 years [less than] white residents.” [28] Because of this, many Indigenous peoples are compelled to seek health care services from hospitals outside of the Indian Health Service system, where their expenses are not federally paid for and they accumulate large bills. Byron Dorgan, a former Democratic senator from North Dakota, said that Native Americans “have been getting second-class health care, if any at all” [29].

However, many Indigenous peoples say that improving these systems is possible if they have the autonomy and help to do so. A study conducted by The Center for Comprehensive School Reform and Improvement found multiple strategies effective in raising the academic success of Native American Students, including “increasing local autonomy, actively valuing elders’ knowledge, and employing culturally responsive pedagogy” [30]. Across the “Zuni Public School District in New Mexico, Denver Public Schools in Colorado, and Klamath-Trinity Joint Unified School District in California”, researchers found that implementing these strategies led to a raise in standardized test scores, higher attendance, and more. Averages in the subjects of math, science, and reading also greatly improved [31]. Angelina Castagno, a researcher on indigenous education and teacher preparation, says that there would be better outcomes in Native education “if [Indigenous peoples] had systems of schooling…that were primarily locally and tribally controlled”[32]. This way, teachers would be allowed to incorporate classes into the curriculum that focus on the tribe’s history, language, and culture, making school a place where their identity is celebrated instead of ignored. An education that focuses on the students’ culture allows educators to teach lessons in ways that connect back to traditional beliefs and ceremonies, making Indigenous children feel accepted in academic spaces [33].

Similar effects are shown for hospitals run directly by tribes, best seen through the Alaska Native Tribal Health Consortium [ANTHC], which disconnected from Indian Health Service in 1998. It is often looked to for inspiration by other tribal hospitals who wish to become independent, as well. By “aggressively seeking grants, [partnering] with the [Department of Veterans Affairs], and billing Medicaid and Medicare”, they have been able to create different health programs that seek to teach their patients about “diabetes, elder health,” and more. They have also worked to provide their patients with healthy food and education on how to incorporate traditional meals and harvesting techniques into a balanced diet. With the Indigenous communities having direct authoritiy over what services and programs they provide, they can directly target the issues they know their communities face and seek the appropriate funds to do so. Two such examples of this are when the ANTHC received more than $5 million dollars from the 2022 Annual Interior Bill to provide clean drinking water for a rural Indigenous community [34] and almost $200,000 from the EPA to test the lead levels of drinking water in residential schools [35]. Another crucial way the ANTHC helps their communities is by directly targeting remote villages, training “community health aides” to provide care in regions that often lack local doctors [36]. t is clear to see that education and health care systems for Indigenous populations are much more useful and effective when operated by the tribes they serve. Indigenous people know the barriers they must overcome, leaving no confusion on how to solve their problems but rather how to acquire the necessary resources to accomplish their goals.

Although the United States is require to “support[ing] tribal self-government and economic prosperity” [37], as established in United States v. Mitchell [1983], it have failed to keep their promises. Health, education, and overall quality of life on Indigenous reservations have suffered for hundreds of years, leaving its residents poor, sick, and undereducated. As the original inhabitants of this land, they should not be subject to such conditions. The U.S. Government must work to ensure that these systems are updated, modernized, and well-funded to support the millions of Native Americans who rely on them, especially in the case of the Indian Health Service. Congress must work together to allocate more money to such a vital system that directly impacts the health of so many. It is imperative that they also establish coherent federal systems, particularly in the case of the Bureau of Indian Education, to help tribal community leaders find easier ways to get the resources they need to help their people. Lastly, and most importantly, the management and administration of Native reservation systems must be left to run by the tribes they serve. To deny them of this ability is to strip Indigenous people of their autonomy and identity. It is obvious that these systems thrive when incorporated with Indigenous traditions and beliefs, tailored to the specific tribes they serve. Indigenous people are capable of organizing these structures themselves and there is no reason to hold this right hostage. To do so would be to perpetuate the colonialist legacy and racist policies that have created the inequalities among Indigenous populations today.

 

[1] Office of Minority Health. American Indian/Alaska Native - The Office of Minority Health. (n.d.). Retrieved May 19, 2022, from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62#:~:text=22%20percent%20of%20American%20Indians,percentage%20of%20any%20minority%20population.

[2] Centers for Disease Control and Prevention. (2017, January 10). Native Americans with diabetes - vital signs - CDC. Centers for Disease Control and Prevention. Retrieved May 19, 2022, from https://www.cdc.gov/vitalsigns/aian-diabetes/index.html

[4] Mental health statistics in Native Americans: Numbers don't lie. Discovery Mood & Anxiety Program. (2019, September 26). Retrieved May 19, 2022, from https://discoverymood.com/blog/mental-health-statistics-in-native-americans-numbers-dont-lie/

[5] Alcohol abuse in the Native American population: Statistics & Risk Factors. American Addiction Centers. (2022, March 3). Retrieved May 19, 2022, from https://americanaddictioncenters.org/alcoholism-treatment/native-americans

[6] Postsecondary National Policy Institute . (2019, October). NATIVE AMERICAN STUDENTS IN HIGHER EDUCATION. Retrieved May 19, 2022, from https://pnpi.org/wp-content/uploads/2019/11/2019_NativeAmericanFactsheet_Updated_FINAL.pdf

[7] Miller, R. J. (2021, May 7). Establishing Economies on Indian Reservations. The Regulatory Review. Retrieved May 19, 2022, from https://www.theregreview.org/2021/04/08/miller-establishing-economies-indian-reservations/#:~:text=On%20some%20Indian%20reservations%20in,functioning%20economies%20among%20Native%20communities.&text=Tribal%20governments%20must%20play%20this%20important%20role%20for%20reservation%20economies.

[8] Griffith, C. (2019, March 14). Homeless in their homeland, a modern Native American struggle. Invisible People. Retrieved May 19, 2022, from https://invisiblepeople.tv/modern-native-american-homeless-struggle/

[9] Alexie, S. (2008). Why Chicken Means So Much To Me. In The Absolutely True Diary of A Part-Time Indian. essay, Washington State Library.

[10] History.com Editors. (2009, November 9). Trail of Tears. History.com. Retrieved May 19, 2022, from https://www.history.com/topics/native-american-history/trail-of-tears

[11] Encyclopædia Britannica, inc. (n.d.). Indian Removal Act. Encyclopædia Britannica. Retrieved May 19, 2022, from https://www.britannica.com/topic/Indian-Removal-Act

[12] Khan Academy. (n.d.). The Reservation System | Native Americans (article). Khan Academy. Retrieved May 19, 2022, from https://www.khanacademy.org/humanities/us-history/the-gilded-age/american-west/a/the-reservation-system

[13] Khan Academy. (n.d.). The Reservation System | Native Americans (article). Khan Academy. Retrieved May 19, 2022, from https://www.khanacademy.org/humanities/us-history/the-gilded-age/american-west/a/the-reservation-system

[14] US Indian Boarding School History. The National Native American Boarding School Healing Coalition. (n.d.). Retrieved May 19, 2022, from https://boardingschoolhealing.org/education/us-indian-boarding-school-history/#:~:text=There%20were%20more%20than%20350,they%20spoke%20their%20native%20languages.

[15] Scully, J. Y., Becker, Z. R., Hill, D. G., Hill, M., & Rolland, R. A. (n.d.). Mobility & Access on American Indian Reservations in the Western United States. Retrieved May 19, 2022, from https://cdn.ewu.edu/cahss/wp-content/uploads/sites/25/2020/02/Transportation-Research-Board-Committee-on-Native-American-Transportation-January-2018.pdf

[16] Who Are The Top 10 Grocers in the United States? FoodIndustry.Com. (2021, July). Retrieved May 19, 2022, from https://www.foodindustry.com/articles/top-10-grocers-in-the-united-states-2019/

[18] Brenna, S., & Castagna, A. (2014, December 11). Why are Native Students Being Left Behind? Teach For America. Retrieved May 19, 2022, from https://www.teachforamerica.org/one-day/magazine/why-are-native-students-being-left-behind

[19] Native American Health: Historical and Legal Context - NCBI Bookshelf. National Library of Medicine: National center for Biotechnology Informations. (n.d.). Retrieved May 20, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK425854/

[20] Native American Health: Historical and Legal Context - NCBI Bookshelf. National Library of Medicine: National center for Biotechnology Informations. (n.d.). Retrieved May 20, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK425854/

[21] Walker, M. (2019, October 15). Fed Up With Deaths, Native Americans Want to Run Their Own Health Care. The New York Times. Retrieved May 19, 2022, from https://www.nytimes.com/2019/10/15/us/politics/native-americans-health-care.html

[22] Rosebud Sioux Tribe v. United States (United States District Court, D. South Dakota, Central Division March 20, 2020).

[23] ERICKSON, C. J. (2021, August 25). Rosebud Sioux Tribe v. United States. Legal research tools from Casetext. Retrieved May 19, 2022, from https://casetext.com/case/rosebud-sioux-tribe-v-united-states-4

[24] ERICKSON, C. J. (2021, August 25). Rosebud Sioux Tribe v. United States. Legal research tools from Casetext. Retrieved May 19, 2022, from https://casetext.com/case/rosebud-sioux-tribe-v-united-states-4

[25] ERICKSON, C. J. (2021, August 25). Rosebud Sioux Tribe v. United States. Legal research tools from Casetext. Retrieved May 19, 2022, from https://casetext.com/case/rosebud-sioux-tribe-v-united-states-4

[27] Walker, M. (2019, October 15). Fed Up With Deaths, Native Americans Want to Run Their Own Health Care. The New York Times. Retrieved May 19, 2022, from https://www.nytimes.com/2019/10/15/us/politics/native-americans-health-care.html

[28] Walker, M. (2019, October 15). Fed Up With Deaths, Native Americans Want to Run Their Own Health Care. The New York Times. Retrieved May 19, 2022, from https://www.nytimes.com/2019/10/15/us/politics/native-americans-health-care.html

[29] Walker, M. (2019, October 15). Fed Up With Deaths, Native Americans Want to Run Their Own Health Care. The New York Times. Retrieved May 19, 2022, from https://www.nytimes.com/2019/10/15/us/politics/native-americans-health-care.html

[30] Jesse, D., Northup, J., & Withington, A. (2015, May). Promising Education Interventions to Improve the Achievement of Native American Students. Retrieved May 19, 2022, from https://files.eric.ed.gov/fulltext/ED585865.pdf

[31] Jesse, D., Northup, J., & Withington, A. (2015, May). Promising Education Interventions to Improve the Achievement of Native American Students. Retrieved May 19, 2022, from https://files.eric.ed.gov/fulltext/ED585865.pdf

[32] Brenna, S., & Castagna, A. (2014, December 11). Why are Native Students Being Left Behind? Teach For America. Retrieved May 19, 2022, from https://www.teachforamerica.org/one-day/magazine/why-are-native-students-being-left-behind

[37] American Indians and Alaska Natives - The Trust Responsibility. The Administration for Children and Families. (n.d.). Retrieved May 19, 2022, from https://www.acf.hhs.gov/ana/fact-sheet/american-indians-and-alaska-natives-trust-responsibility#:~:text=The%20trust%20doctrine%20is%20a,tribes%20and%20respect%20their%20sovereignty.



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