Food-Health Nexus of American Indians on Federal Reservations
Photo Credit © Stephen Walker on Unsplash.
For more information on Alaskan Natives
after the Alaska became a US state, see companion
article “Food-Health Issues among Alaskan Natives”
on www.conversationforsix.com
Pre-Covid-19 Demographics
Working from 2010 census numbers, 2.9 million people identified as American Indian or Alaska Native, equivalent to 0.9 percent of the total US population. [FN1] People who identified as American Indian or Alaskan Native in combination with another race, represent 1.7 percent of the US population, or 5.2 million people. [FN2] For the annual estimation of 2019, the gender ratio was around 50/50 for both profiles. [FN3] There is no separate count for American Indians or Alaskan Natives living on reservations or living in “villages” or “communities”.
Backdrop
Statistics bind these two different demographics together in the decennial US Census, but American Indians and Alaska Natives have had very different political experiences since their first contacts with Caucasian people. Both groups were decimated by diseases against which they had no immunity, and both relied on ancient cultural practices connected to the natural resources that provided their traditional foods from land and sea.
In both cases, compulsory settlement, economic migration or voluntary relocation to contexts offering better education and employment infrastructure have changed diets and markedly lowered levels of physical activity among both American Indians and Alaska Natives. These dietary and lifestyle changes are known to be responsible for heightened incidences of type 2 Diabetes and heart disease, leading to the last commonality: shortened average life spans. According to Indian Health Service factsheets on disparities, American Indians and Alaska Natives born today have a life expectancy of 73 years and 78.5 years, respectively, for an average of 5.5 years shorter than the U.S. all-races population. [FN4]
Native Americans
As of 2018, there were 326 federal Indian reservations in the US. [FN5] The amount of land held in trust is more than 56 million acres, a small fraction of the total land taken from the American Indian tribes over the last 400 years. Some reservations are the remnants of a tribe’s original land base; others were created by the federal government for the resettling of American Indian people forcibly relocated from their homelands. [FN6]
The Bureau of Indian Affairs (BIA) is the primary federal agency charged with carrying out the United States’ trust responsibility to American Indian and Alaska Native people, maintaining the federal government-to-government relationship with the federally recognized tribes, and promoting and supporting tribal self-determination. [FN7]
Most Native Americans do not live on reservations. This is partly due to forced assimilation efforts in the 1940s to 1960s (known as “Indian termination policies”), which relocated American Indians from reservations to urban areas to become “productive” members of society; [FN8 ]the other part was due to voluntary migration in search of paying work and education. As of 2017, 78 percent of American Indians lived off-reservation, and 72 percent lived in urban or suburban areas.
Health Factors
In 2018, the median age in the US was 38, whereas the median age on reservations was 29. Chronic diseases such as diabetes mellitus, chronic liver disease, heart disease and cirrhosis, along with lower respiratory diseases and suicide, were cited as major causes of death. [FN9] Food insecurity correlates closely with these problems, with type 2 diabetes complicating prevention and management, [FN10] as confirmed by a first national health/nutrition survey carried out between 1999 and 2002. [FN11] Covid-19 and its opportunistic targeting of co-morbidity factors complicates matters. [FN12]. The US Indian Health Service teaches prevention and tracks emerging health indicators of malnutrition, poor diet and abuse of alcohol, drugs and tobacco as well as the effects of “disproportionate poverty”. [FN13]
Food Assistance
As ethnic minority groups with full birthright US citizenship, American Indians living on reservations with low incomes (individuals who earn less than US$1354 a month and couples that earn less than US$1832) are eligible to apply for Supplemental Nutrition Assistance Program (SNAP) food assistance. [FN14] One of the problems for people living on reservations is that fresh vegetables and high nutrient foods are expensive and may be sold in supermarkets miles away from their community; the second problem is that shops in closer proximity tend to stock a preponderance of dairy and sugary foods. [FN15]
Evolving Research
In 2014, the USDA organized the first in-depth national enquiry into the effectiveness of programs such as SNAP on reservations. These surveys revealed that only 25.6 percent of people in tribal reservations lived one mile or less from a supermarket, which compared unfavorably with the 58.8% of US citizens in closer proximity. The USDA report further established that nearly half of all residents on reservations had incomes at or below 200 percent of the federal poverty level. [FN16] Other state-wide research surveys conducted on reservations in Montana, California and Oklahoma reinforced these findings. [FN17]
Some of the first on-reservation research solicited direct community commentary on these issues and was published in 2019. It built a case study of First Nation tribes in the Klamath River basin of Oregon and California, reflecting an American Indian view of the food available under food programs, the community’s yearning for “nourishing” native foods and their wish to reclaim tribal food sovereignty to regain their health. [FN18] To help communities reclaim their local food systems, the First Nations Development Institute developed a Food Sovereignty Assessment Tool, a framework for communities to assess food access, land use and food policy. [FN19]
“How food security is framed, and by whom, shapes not only our understanding of the experience and predictors of food security, but also the kinds of interventions or solutions that are proposed. Our results suggest that current measures of food security in the USA, which do not consider mixed economy food systems inclusive of native foods and cultural practices of food acquisition/exchange and knowledge transference, must be revised. Without consideration of the structural and historical causes of food insecurity, as well as culturally relevant indicators, interventions may continue to address symptoms of food insecurity (hunger) while denying more transformative change (food sovereignty as means to achieve food security and native foods security).” [FN20]
Resources and Additional Notes
1. Due to Covid-19 pandemic and concerns around the budget of the 2020 Decennial Census, compilation of data from self-responding questionnaires had not been finalized at the time of writing.
2. See U.S. Census Bureau. (2012, January). C2010BR-10: 2010 Census Briefs: The American Indian and Alaska Native Population: 2010.
3. Annual Estimates of the Resident Population by Sex, Race, and Hispanic Origin for the United States: April 1, 2010 to July 1, 2019 (NC-EST2019-SR11H), (see American Indian and Alaska Native) Excel Spreadsheet. See https://www.census.gov/newsroom/press-kits/2020/population-estimates-detailed.html
4. See https://www.ihs.gov/newsroom/factsheets/disparities/
5. Federal reservations are areas of land permanently reserved as tribal homelands under a treaty, executive order or federal statute. However, the federal government holds the legal title to the land in trust on behalf of the tribes.
6. See frequently asked questions on Bureau of Indian Affairs at www.bia.gov
7. The BIA also implements federal laws and policies and administers programs established for American Indians (and Alaska Natives ) under the trust responsibility and the government-to-government relationship.
8. Joe Whittle, published in Guardian (see https://www.theguardian.com/us-news/2017/sep/04/native-americans-stories-california
9. https://www.ihs.gov/newsroom/factsheets/disparities/
10. Jernigan, V., Huyser, K. R., Valdes, J., & Simonds, V. W. (2017). Food Insecurity among American Indians and Alaska Natives: A National Profile using the Current Population Survey-Food Security Supplement. Journal of hunger & environmental nutrition, 12(1), 1–10. https://doi.org/10.1080/19320248.2016.1227750
11. Seligman HK, Laraia BA, Kushel MB. Food insecurity is associated with chronic disease among low-income NHANES participants. J Nutr. 2010;140:304–310.[FN10] According to IHS literature, the greatest risks in the reservations are instability of local jobs and incomes, a prevalence of senior citizens and single-parent homes, as well as underinsurance or total lack of medical insurance.
12. Covid 19 adds complications to the health horizon, and it seems that cases and deaths involving American Indians and Alaskan Natives are not being aggregated over the whole US geography, or totals are not being made publicly available at the time of writing. The main numbers broadcast were those from the largest reservation, Navaho Nation, with a population of 172,875. As of November 10, 2020, there were 12,641 cases. and 594 deaths. These appeared in the US news of the Guardian newspaper. See https://www.theguardian.com/us-news/2020/nov/20/navajo-nation-women-leaders-coronavirus-matriarchy-new-mexico?
13. According to IHS literature, the greatest risks in the reservations are instability of local jobs and incomes, a prevalence of senior citizens and single-parent homes, as well as underinsurance or total lack of medical insurance.
14. For a general description of SNAP, please see our May 22, 2020 article “What is SNAP?” by Rachel Wilson at https://conversationforsix.com/conversations/what-is-snap
15. See O’Connell, M., Buchwald, D. S., & Duncan, G. E. (2011). Food access and cost in American Indian communities in Washington state. Journal of the American Dietetic Association, 111(9), 1375–1379.
16. Kaufman P, Dicken C, Williams R. Washington, DC: US Department of Agriculture Economic Research Service; 2014. [Accessed January 9, 2016]. Measuring access to healthful, affordable food in American Indian and Alaska Native Tribal areas. US Department of Agriculture Economic Research Service Economic Information Bulletin Number 131. Available at http://www.ers.usda.gov/publications/eib-economic-information-bulletin/eib-131.aspx. On Google Scholar. The US poverty line in 2014 was $11,670 for a single person and $15,730 for a couple.
17. See Food Insecurity and Obesity Among American Indians and Alaska Natives and Whites in California. Jernigan VB, Garroutte E, Krantz EM, Buchwald DJ Hunger Environ Nutr. 2013; 8(4):458-471. [PubMed] [Ref list]; Blue Bird Jernigan V. Healthy makeovers in rural tribal convenience stores as part of the Tribal Health and Resilience in Vulnerable Environments (THRIVE) Study. 2015. [Google Scholar] [Ref list]; and Brown B, Noonan C, Nord M. Prevalence of food insecurity and health-associated outcomes and food characteristics of Northern Plains Indian households. J Hunger Environ Nutr. 2007;1(4):37–53.
18. Jennifer Sowerwine and Megan Mucioki, et al (2019) “Reframing food security by and for Native American communities: a case study among tribes in the Klamath River basin of Oregon and California.” © International Society for Plant Pathology and Springer Nature B.V. 2019
19. First Nations Development Institute is a 501(c)(3) Nonprofit Organization based in Virginia. Its mission is to help Native American tribes by providing technical assistance, training, policy, and the awarding of grants. See https://www.firstnations.org/
20. Conclusion section of Jennifer Sowerwine and Megan Mucioki, et al (2019) “Reframing food security by and for Native American communities: a case study among tribes in the Klamath River basin of Oregon and California”. © International Society for Plant Pathology and Springer Nature B.V. 2019