Traditional Food Knowledge Among Native Americans

Building Trust, Healing Trauma, and Restoring Health

By Valerie Segrest, Janie Simms Hipp

AFT Health Care Fall 2020

On a 10-acre farm about 30 miles northeast of Minneapolis, Native youth and Elders together plant, tend, and harvest squash, potatoes, tomatoes, onions, peas, indigenous berries, and more. A dozen or more teenagers from Native nations in the region can often be found gathered around a Native American instructor who leads them in a workshop that cultivates cultural continuity, revitalizing the teachings and responsibilities of a Seed Keeper who cares for more than 200 indigenous varieties of corn, beans, squash, sunflowers, tobacco, and other traditional medicinal plants. The hum of dedicated pollinator meadows nearby is a constant reminder of the interdependence with the natural world that underlies all of these practices.

Thanks to a grant from the Native American Agriculture Fund (NAAF), Dream of Wild Health,1 a Native-led organization that has been working to restore Native health in the Minneapolis area since 1998, is expanding its reach and impact. Over the course of a year, nearly 100 Native youth will participate in Garden Warrior and Youth Leader programs, and they’ll teach what they’ve learned to 1,800 more. Just as important, through a combination of youth programs, farmers’ markets, a food share program, and donations, 13,500 pounds of fruits and vegetables cultivated on this farm will feed Twin Cities Native Americans this year. Through Dream of Wild Health, Native youth and Elders in the Twin Cities are reclaiming their food heritage—and they are striking back against the dual challenges of chronic disease and cultural annihilation that have threatened Native ways of life for centuries.

Native Americans today have disproportionately high rates of chronic diseases as a direct result of chronic stress, inflammation, and, most significantly, limited access to good nutrition. While there is some variance from community to community, diabetes, heart disease, cancer, and other obesity-related diseases are the top causes of mortality among Native Americans as a group, at rates that are higher than almost any other population group in the country.2

These health problems are a direct result of a painful history that has rippled through generations: federal policy and programs have systematically distanced Native people from their traditional lands, ways of interacting with the natural world, food cultivation practices, and diets. While many communities continue to fight to protect and to access their food systems, new generations still have little exposure to traditional foods and related teachings, creating a barrier to incorporating these foods into their modern lifestyles.

Feeding Ourselves: Food Access, Health Disparities, and the Pathways to Healthy Native American Communities describes some of the many challenges Indigenous communities face as they work to restore Native health:

When we were strong in our foods on this continent, we were stronger people—we were healthier…. [When] the foods of the settlers and [the federal government’s] rationed foods replaced the foods of the communities, … dramatic shifts occurred in the span of a relatively short period of time and the health of American Indian peoples throughout the United States has never fully recovered....

For example, there was no word for diabetes in traditional Native languages when the Europeans arrived on this continent…. In 1940 the occurrence of diabetes among Native Americans was almost unknown. Diabetes began appearing in 1950, until during the 1960s, it became a common condition. The incidence of diabetes exploded in the 1970s, becoming an epidemic. Beginning in the 1990s and through present day, nearly every Native American is involved either personally with diabetes, or with family and friends with diabetes. It has been called the new smallpox....

A community needs a grocery store every ten miles to ensure some measure of food security, yet there are only ten full-service grocery stores in the entirety of the Navajo Nation, which sprawls over 27,413 square miles—and the Navajo Nation is not alone in this problem. Almost the entirety of Indian Country resides in a food desert. This term is best clarified by saying that almost the entirety of Indian Country resides in a “retail food desert” as the important access to a food production land base creates unique opportunities for successful policy intervention.3

How did the situation become so dire? And what can be done to solve this food crisis and restore Native peoples’ health? Answering these questions, and bringing allies to our cause, is the heart of our work.

Many people across the country, including many healthcare professionals, are generally unfamiliar with the history of Indigenous communities and the rich and powerful traditions of what we and our colleagues call food and health curriculum. At NAAF, we work to support cultural and economic revitalization through a holistic approach to food, agriculture, and health education. NAAF is the largest philanthropic organization serving and supporting the success of Native farmers and ranchers, fishers and food people; we collaborate with Native nonprofits, community development financial institutions, educational organizations, and Tribal governments throughout the United States. Our primary work involves providing grants to support business assistance, technical support, agricultural education, and advocacy. Here, we want to take you on a journey of greater understanding.

We’ll start with our history, paying special attention to Native food cultivation and its relationship to Native Americans’ health and traditional knowledge systems. Some of this history may be uncomfortable to read, but all of it is important to your work as allies to Indigenous peoples. Then we’ll explore how you can help shift us from invisible to visible—and to greater understanding among and support from healthcare providers. As we’ll explain, embracing the importance of traditional foods and food knowledge for Native Americans’ cultures, health, and well-being is vital. As we work together to make sure Indigenous peoples feel seen and respected and live in a broader society where their contributions—and their knowledge systems—are recognized and valued, Native American people can begin to heal.

An American History

AFT Health Care Fall 2020Prior to contact with European settlers (generally referred to as precontact), America’s Indigenous communities thrived for longer than history records—according to many Native traditions, since the beginning of human existence. Archaeological evidence of food processing sites in the high elevations of the Pacific Northwest’s Cascade Mountains date back at least 10,000 years,4 and evidence of fishery management near the shores of Seattle dates back 10,000 to 14,000 years.5 In the Southwest, archaeological evidence traces food systems back 10,000 years or more.6 In the Southeast, archaeological evidence also traces agriculture production and communities with significant stability in food and health for thousands of years.7 In the context of time, woolly mammoths roamed lands as Native American ancestors dried berries in wild meadows. Rome and Athens, both ancient civilizations revered in history textbooks in the United States, were not even a thought at this time. Native Americans organized entire societies and assembled political structures around the management of food resources. Their societal fabric consisted of intricate storytelling that focused on ancient food systems.8

Each Native group has its own distinct traditions, languages, and belief systems, but there are many similarities among groups. Traditional food lessons were interdisciplinary, consisting of science, math, history, social studies, and social-emotional teachings. These lessons were anchored in creation stories, resided at the nuclei of ceremonies, and ultimately manifested the social dynamics of each community. Creation stories revolved around seeking, cultivating, preparing, and sharing the foods that were in many cases at the heart of those stories. Community contributions to and responsibility for foods were integral socioeconomic acts that not only shaped the food system but also upheld ancestral knowledge systems.

A family’s wealth was measured by their intimate knowledge of various resources. Each family’s understanding of their specific farming, hunting, and fishing techniques reflected their affluence. Preparation to become a contributing member of the community began in childhood. Children gained knowledge through hands-on, experiential learning without age segregation. The “curriculum” was written into the landscape, and the philosophy was propagated by cultivating relationships with the land. The first form of literacy was learning to read the land and the waters for the purpose of food resource management.

The lands and waters abounded with plant life, herbal remedies, mineral-rich sea life, and wild game. In many Tribal communities, the people traveled throughout territories to harvest foods as they became seasonally abundant. Food safety was practiced through deeply engrained norms of food handling, specific to geography and environment, so that food could be safely stored, prepared, and exchanged.9 The great diversity of foods consumed also provided a nutrient-rich diet that upheld health by addressing and preventing nutrition-related diseases. Our food systems focused on supporting the health of the land as well as the health of the people, each depending on the other to thrive. It was ordinary to live beyond 100 years old. For thousands of years, our societies thrived in this way. For thousands of years, our health was secure because the very cores of our societies were tied to foods that were deeply nutritionally robust.10

Cultural Cataclysm

With the arrival of European settlers came wave after wave of pandemics. Recorded history tells us that for more than 300 years, smallpox, measles, the flu, and many other deadly diseases swept through, reducing the Native population by an estimated 80 to 90 percent.11 This was not only a devastating loss of human life—it also meant the collapse of entire knowledge systems. In a matter of days, a disease like smallpox would wipe out an entire community, taking with it the intellectual wealth of understanding the people carried. Compare that with the sudden disappearance of all the world’s libraries, museums, or even the entire internet. Based on what we know today about the highly contagious nature of such droplet infections and the havoc they wreak on human immune systems, it’s nothing short of a miracle that there were any survivors.

This cultural apocalypse didn’t stop with the pandemics. Next came droves of pioneers moving through ancestral territories in the name of Manifest Destiny. Manifest Destiny is the doctrine supported by religious and political leaders that the expansion of the United States throughout the American continents was inevitable and just, part of God’s plan. Settlers came through Native lands seeking new business opportunities, fertile lands for farming and ranching, or simply escape from debt or the unfavorable living conditions of the East Coast (or the countries from which they arrived as immigrants to North American shores). With the infusion of these newcomers throughout Native lands, tensions and violent wars came as well. For hundreds of years, Native communities were in a state of war with settlers coming west.12 These wars caused countless deaths off the battlefield: the desperate social conditions they created (including malnutrition) catalyzed the spread of infectious diseases.13

By the late 1850s, most Tribal communities across the American continent had entered into some sort of treaty negotiation with the United States, resulting in the ceding of hundreds of millions of acres of land to the US government in return for Tribal sovereignty.14 While some Native peoples negotiated the right to fish, hunt, and gather foods in their “usual and accustomed areas,”15 many tribes were forcibly removed a thousand miles or more from their original territories and from their traditional harvesting grounds and food sources, severing ties to lands and knowledge systems and to the food and health teachings embedded in place. Witnessing this ongoing cultural apocalypse, followed by and sometimes simultaneous with open war as Native tribes resisted relocation while Americans attempted to seize more lands, wreaked havoc on Native knowledge systems. Immense amounts of intellectual property were nearly lost altogether.

As reservations were plotted out, Native people were forced to move to assigned lands and not allowed to leave. The reservation concept was an intentional act of forced assimilation that superimposed Euro-American values and models onto Native ways of life, disregarding the nomadic—and geographically specific—relationships many communities had with their food systems. Reservation-based land reform also sought to consolidate numerous village sites into confederated “tribes.” While Native peoples did what they could to maintain or adapt their food systems to new regions and ways of life, all of these acts diminished or damaged Native food and health curriculum, sometimes beyond salvaging.

The Trauma of “Civilization”

AFT Health Care Fall 2020The signing of the treaties, which under American jurisprudence are the supreme law of the land, came with a wave of federal policies that were intended to further disintegrate the culture of tribes across the country. Of greatest significance were the federal food distribution programs (referred to in the early years as rations programs). Food programs further solidified the cycle of dependence that forced relocation had initiated, moving Native people away from their interdependence with natural resources. The logic was that tribes would not need access to their traditional lands if they no longer consumed their traditional foods—foods about which they had deep and centuries-long knowledge and understanding. The supplied food rations consisted of lard, beans, flour, and sugar, which were both terribly unhealthy and nothing like their ancestral diets.

On the heels of the food programs came perhaps the darkest hour of this period for Native communities, the Indian Boarding School era. This immoral and highly damaging initiative went on for more than 115 years.16 During this time the US government used threats and coercion to extract Native children from their families, communities, ancestral lands, and food systems. The children were sent to boarding schools that aimed to indoctrinate them as “civilized” members of American society and compel them to fully assimilate into predetermined roles in non-Native culture. Richard Henry Pratt, the army officer who developed the first and most famous of the off-reservation boarding schools, Carlisle Indian Industrial School, proclaimed his desire to “kill the Indian [in each child], and save the man.”17 This phrase became the mission statement echoed throughout these so-called educational institutions, which numbered more than 350 across the United States.18

While it is unknown exactly how many Native children were taken in total, by 1926 nearly 83 percent of Native children were attending boarding schools. In 1925 alone, that number was estimated at 60,889 children.19 Over six decades, at least 600,000 Native children were subjected to the brutality of Indian Boarding Schools, which included vocational training that amounted to forced labor: domestic education for girls and backbreaking agricultural and construction work for boys. As A-dae Romero-Briones states, “Extracting children from their Indigenous food system essentially creates individuals devoid of an understanding of their land, environments, political systems, education systems and spiritual systems, and no understanding of collective resource management.”20

The Indian Boarding Schools were designed with a military mindset. Native children endured full-body makeovers, including military haircuts and Euro-American clothing. They were forced to adhere to rigid daily schedules and strict rules. Children were given English names, were forbidden to speak their Indigenous languages, and were unable to address their siblings or reminisce on their lives before boarding school. The punishments for breaking these rules were gruesome. Children were horrifically abused. Many didn’t make it out alive, and their remains never came home to their families.21 These systematic and extensive assimilation practices employed on innocent Native children created generations of Native people severed from their cultures, languages, lands, and traditional food systems.22

An important part of this militaristic approach was a rigidly enforced nontraditional diet: foods like cornmeal mush, bread, molasses, meat and gravy, and black coffee, with the occasional eggs or potato stew.23 Attempts to vary from this diet, such as by supplementing meager meals with fish caught in local streams or eating the fresh corn or apples the students themselves had helped to grow, were severely punished.24 These genocidal efforts negatively affected the health of Native communities, decimated cultural traditions, and impacted societal behaviors around food for generations. The diet ingrained through Indian Boarding Schools effectively assimilated certain taste preferences for generations, including the consumption of lard, fried meats and bread, starchy root vegetables, and beans.25 Native food and health curriculum was lost to entire generations of young children who acquired taste preferences for fat, sugar, and starchy carbohydrates, and knowledge of traditional food and health systems was nearly lost.

The economic and political upheaval of the early 20th century meant that food was even scarcer. Markets for food were distorted by the Great Depression and the Dust Bowl, as well as the impact of two world wars. In the post–World War II recovery and into the mid-1900s, poverty in significant portions of the United States and rising levels of food insecurity were a potent combination. During this time, several programs to provide some degree of access to food were created at the federal level,26 including the Food Distribution Program on Indian Reservations (FDPIR). While FDPIR was intended by Congress as an alternative to what was then known as the food stamp program, it was actually an outgrowth of those earlier, darker practices, the food distribution and food source substitution programs that had been forced on Indigenous communities for decades.

Today, Tribal communities still rely heavily on government commodities and state and federal food programs to feed their people. Over 80,000 people participated in FDPIR in 2019;27 those eligible (based on income) to receive food assistance who do not participate in FDPIR likely receive food assistance from another federal feeding program. The food provided has improved over the decades—the fresh produce, good-quality proteins, and healthy fats that were the foundation of traditional diets are now more available than in previous years—but much of it is still high in sugar, starchy carbohydrates, and poor-quality fats. And the standardized diet approach to these feeding programs bears little resemblance to the varied diets that Indigenous peoples had access to previously. Even the nutrition education programs sponsored by the FDPIR are minuscule in number, and Tribal governments are excluded from participating in almost all the federally supported nutrition education programs available through USDA.

The issue of limited access to traditional foods and teachings for generations of Native peoples is a significant one with serious repercussions. People’s (especially fetuses’ and young children’s) environments affect their development and health in positive and negative ways—and some of these impacts may carry down to future generations.28 For example, researchers are gathering more and more evidence that exposure to environmental toxins is having adverse health effects on individuals and, likely, on their children, too.29 But the human body is also remarkably resilient: when the environment changes in a positive way, say a stress is addressed and removed or more nutritious food becomes part of a person’s diet, profoundly positive changes can occur.30

For Native Americans, this isn’t a new idea. Traditional systems of ecological knowledge and ecological health hold that human beings are inextricably intertwined with their environments, and food systems are a significant part of this relationship. Ancestral wisdoms point to this lesson time and time again. Many Native Elders give testimony that “our culture is our medicine” and encourage the understanding that a society does not have a culture without its food traditions. Food and health teachings matter, and access to foods that are conducive to health within discrete cultures is incredibly important. What we eat matters as much today as it did to our ancestors.

Our Culture Heals Us

AFT Health Care Fall 2020Native people have always innovated, making the best of what was available at the time. They have always adapted to the environment in which they thrive, attuning themselves to the seasons.

Today, Native-led organizations work to ensure the resilience of their cultures. Some organizations focus on getting more Native learners into higher education, infusing culturally relevant mentorships and support along the way. Others cultivate advocacy so that Native American leaders can increase visibility and stand on platforms where they can share their voice and, more importantly, achieve significant changes that will positively impact communities more specifically. Some focus on Native youth and work tirelessly to develop curriculum centered on the living world that not only spans all disciplines but aims to address preventive healthcare and recovery from trauma, addiction, and incarceration. While many different approaches and community-driven interventions are taking place, Native American communities from every corner of this country stand together when saying “Our foods matter” and “Our culture is our medicine.”

While NAAF was not created to support health education per se, we provide funding and support to organizations within our communities who are seeking to restore and strengthen Native foods, food producers, and food cultures. One example is the Numu Allottee Association in Madras, Oregon, whose Three Sisters Project supports seasonal food gathering, the revival of Indigenous language, and supplemental food access for youth as ways of building community health; another is the Klamath Trinity Resource Conservation District, located in Hoopa, California, which maintains traditional ecological knowledge for the next generations of Native people, including proper techniques of gathering and preserving local traditional foods obtained through hunting, fishing, and harvesting. We also create new educational opportunities and fortify the role of educational institutions in the important tasks that allow Indigenous people to restore their health, culture, and well-being by restoring their food traditions and food systems. But within Indigenous cultures, these goals are not really separate from health education and reclaiming our abilities to feed ourselves healthy and nutritious foods. The organizations we support help to recast the idea of health education by weaving the work of today with the ancestral knowledge of yesterday and make deeper connections to where our foods are and how we can best support access to those foods.

Taking an approach that empowers local knowledge systems provides an opportunity for us all to deepen our understandings and the teachings of place. This is a tenet of Native knowledge systems, what has also been recently coined traditional ecological knowledge—the underpinnings of which are traditional diets. If we are to do the hard work of healing a dark history, we must collectively learn to be better stewards of the lands on which we all dwell.

Native knowledge systems embody relevant life teachings that are applicable to everyday life and can help individuals to find their ways as contributing members of society. This approach goes beyond providing culturally appropriate instruction to Native learners as interdisciplinary, localized, stewardship-focused instruction. Fusing Indigenous perspectives on ecology and the environment alongside Western understandings addresses the issues of invisibility and ongoing attempts of erasure in Native communities; it also contributes to relationship building across communities, genders, and races and helps close the gaps in crucial systems of economics, food, and health. Simply put, by creating a world in which Native people feel seen and heard with respect and with equality, where their purpose and contributions to society are acknowledged and celebrated, where society values the vast knowledge systems that upheld Native health for thousands of years and invests in that system wholeheartedly—people can begin to heal.

Cultivating Our Future

AFT Health Care Fall 2020It’s crucial that we all work together to re-energize traditional food knowledge and restore Native health. The work of NAAF, which brings together leaders representing nearly every region of Indian Country, supports the revitalization of Native American food systems, employing these four tenets:

  1. Cultivating Native American agriculture businesses and economy
  2. Expanding culturally based models and practices
  3. Strengthening educational pathways
  4. Promoting food security for Tribal sovereignty as well as community well-being

We know that by strengthening and restoring cultural values and practices, Tribal communities can heal. In order for that to happen, financial support must be in place for Native agricultural systems, traditional foods must be celebrated, food insecurities must be addressed, and Native agriculture must assume its important role as a model for sustainability and stewardship. The first year of grant funding allowed NAAF to seed over 100 projects in over 80 organizations, all driving toward improving our health and resiliency through our foods.

But NAAF cannot do this work alone. It will take many public health, healthcare, and education initiatives—grounded in Native traditions and focused on healing—to encourage participants to seek out and regain knowledge in how best to cultivate their health through traditional foods. Here are some ways others can be our allies in this work:

  • Build your knowledge. While we have focused on broad similarities across Native groups, there is wide variability among them. Cultural competence—which starts with listening to and getting to know the specific Native cultures in your region (and the cultures of people in your care) and understanding their needs and goals—is key to being able to provide effective support. Continue your education by learning about the original inhabitants of the lands you live on (who may be different from those who live near you now) and their food systems, and encourage others to educate themselves too.
  • Grow your community. Connect with local Native organizations, build relationships with Tribal leaders, and get to know your Native neighbors. Get involved in existing Native-led health initiatives.
  • Question your assumptions. When you think about Native Americans’ health, what comes to mind first? If you think about obesity, health disparities, and diabetes, do you also think about food deserts, forced relocation, and how to help solve the crisis of access to healthy foods?
  • Adjust your practices. The more culturally relevant knowledge you have, the more effectively you can inquire about and address challenges a patient may be facing that are reducing compliance.
  • Empower Native voices. Seek opportunities to include Native Americans in conversations across your workplace or organization, including in decision-making positions. Support and facilitate the enrollment of Native American students in health-related programs and provide employment opportunities and mentorship to recent graduates.
  • Make Native foods central to preventive care. In nutrition programs, public health campaigns, and educational efforts, empower Native people to take charge of their health by drawing connections between traditional Native foods and food systems and better health outcomes, and by showing them practical things they can do to build Native foods into their diets.
  • Consider the benefits of traditional healing. If there is no reason to suspect that a traditional medicine or healing ceremony may be harmful, then consider encouraging Native patients to integrate traditional methods with allopathic medicine.49 Native patients may experience real relief from healthcare providers’ open-mindedness.
  • Involve Native Elders. Multigenerational mentorship that creates space for Elders to share their cultural wisdom and experience with youth is key in healing Tribal communities; holding space for Elders also acknowledges the significant place Elders hold in Native cultures.
  • Advocate for Native self-empowerment. Push for greater Tribal control of programs and resources, including federal feeding programs. Direct funding for health initiatives to Native-led organizations.

Our work begins in places like classrooms and clinics; they can become powerful places where trauma is replaced with a remedy and where healing can begin. This important work must be done in ways that are intentionally focused on ensuring our rich food histories and cultures are celebrated, leading to a healthier and more sustainable future.


Valerie Segrest (Muckleshoot) is a nutrition educator who specializes in local and traditional foods. The founder of the Muckleshoot Food Sovereignty Project, she is also regional director for Native food and knowledge systems for the Native American Agriculture Fund.

Janie Simms Hipp (Chickasaw) is CEO of the Native American Agriculture Fund. She was the founding director of the Indigenous Food and Agriculture Initiative at the University of Arkansas and has spent more than 35 years as an agriculture and food lawyer and policy expert.

Endnotes

1. Dream of Wild Health, a Native-led organization located in Minneapolis, Minnesota, restores health and well-being in the Native community by recovering knowledge of and providing access to Indigenous foods, medicines, and lifeways. Learn more at https://dreamofwildhealth.org.
2. N. Cobb, D. Espey, and J. King, “Health Behaviors and Risk Factors among American Indians and Alaska Natives, 2000–2010,” American Journal of Public Health 104, no. S3 (2014): S481–89; and Centers for Disease Control, “Public Health Professionals Gateway: Tribal Health – Chronic Diseases,” December 21, 2018, www.cdc.gov/tribal/data-resources/information/chronic-diseases.html.
3. Echo Hawk Consulting, Feeding Ourselves: Food Access, Health Disparities, and the Pathways to Healthy Native American Communities (Longmont, CO: Echo Hawk Consulting, 2015), 47, 31, 33.
4. F.P. McManamon, L. Cordell, K.G. Lightfoot, and G.R. Milner, eds., Archaeology in America, Vol. 3 (Westport, CT: Greenwood, 2009), 317, 324.
5. “Significance of the Bear Creek Site,” City of Redmond, Washington, www.redmond.gov/1354/Significance-of-the-Bear-Creek-Site.
6. L. Cordell, “Rio Grande Prehistory: Prelude to Contact,” in W. Baldridge et al., ed., Fall Field Conference Guidebook – 35 Rio Grande Rift: Northern New Mexico (Socorro, NM: New Mexico Geological Society, 1984), 287.
7. M. Coughlan and D. Nelson, “Influences of Native American Land Use on the Colonial Euro-American Settlement of the South Carolina Piedmont,” PLoS One 13, no. 3 (2018): 3-4, https://doi.org/10.1371/journal.pone.0195036.
8. A. Romero-Briones, “Fighting for the Taste Buds of Our Children,” Journal of Agriculture, Food Systems, and Community Development 9, no. Suppl. 2 (2019): 35–43; G. Cajete, Native Science: Natural Laws of Interdependence (Santa Fe, NM: Clear Light Publishers, 2000); and G. Cajete, ed., A People’s Ecology: Explorations in Sustainable Living (Santa Fe, NM: Clear Light Publishers, 1999).
9. V.A. Romero, Maneuvering Challenges: An Overview of Food Safety for Tribal Producers (Longmont, CO, and Fayetteville, AR: First Nations Development Institute and Indigenous Food and Agriculture Initiative at the University of Arkansas, 2014, 2, www.firstnations.org/wp-content/uploads/publication-attachments/Maneuver....
10. This knowledge has been passed on by our Elders across many generations as part of our food and health curriculum.
11. B. Madley, “Reexamining the American Genocide Debate: Meaning, Historiography, and New Methods,” American Historical Review 120, no. 1 (2015): 98–139.
12. R. Thornton, American Indian Holocaust and Survival: A Population History since 1492 (Norman, OK: University of Oklahoma Press, 1987).
13. J. Ostler, “Disease Has Never Been Just Disease for Native Americans,” Atlantic, April 29, 2020, www.theatlantic.com/ideas/archive/2020/04/disease-has-never-been-just-di....  
14. R. Onion and C. Saunt, “Interactive Time-Lapse Shows How the U.S. Took More than 1.5 Billion Acres from Native Americans,” Slate, June 17, 2014, www.slate.com/blogs/the_vault/2014/06/17/interactive_map_loss_of_indian_....
15. Forest Service National Resource Guide to American Indian and Alaska Native Relations: Appendix B (Washington, DC: US Forest Service, 1997), B-8, www.fs.fed.us/people/tribal/tribexb.pdf.
16. “US Indian Boarding School History,” National Native American Boarding School Healing Coalition, https://boardingschoolhealing.org/education/us-indian-boarding-school-hi....
17. “‘Kill the Indian, and Save the Man’: Captain Richard H. Pratt on the Education of Native Americans,” History Matters, http://historymatters.gmu.edu/d/4929.
18. “Resources,” National Native American Boarding School Healing Coalition, https://boardingschoolhealing.org/education/resources/.
19. “US Indian Boarding School History.”
20. Romero-Briones, “Fighting for the Taste Buds,” 37–38.
21. C. Bear, “American Indian Boarding Schools Haunt Many,” NPR, May 12, 2008, www.npr.org/templates/story/story.php?storyId=16516865; A. Brown and N. Estes, “An Untold Number of Indigenous Children Disappeared at U.S. Boarding Schools. Tribal Nations Are Raising the Stakes in Search of Answers,” Intercept, September 25, 2018, https://theintercept.com/2018/09/25/carlisle-indian-industrial-school-in... and J. Gram, “Acting Out Assimilation: Playing Indian and Becoming American in the Federal Indian Boarding Schools,” American Indian Quarterly 40, no. 3 (2016): 251–73.
22. Romero-Briones, “Fighting for the Taste Buds.”
23. J. Reyhner, “American Indian Boarding Schools: What Went Wrong, What Is Going Right,” Journal of American Indian Education 57, no. 1 (2018): 60; C. Collins, ed., “Hard Lessons in America: Henry Sicade’s History of Puyallup Indian School, 1860–1920,” Columbia: The Magazine of Northwest History 14, no. 4 (2000–2001), 6–11; and Reyhner, “American Indian Boarding Schools,” 60, quoting from E. Brown, Stubborn Fool (Caldwell, ID: Caxton Press, 1952).
24. Collins, “Hard Lessons.”
25. Romero-Briones, “Fighting for the Taste Buds,” 39.
26. D. O’Brien, H. Torres Aldeen, S. Uchima, and E. Staley, Hunger in America: The Definitions, Scope, Causes, History, and Status of the Problem of Hunger in America, Hunger Forum discussion paper, 2004, www.hungercenter.org/wp-content/uploads/2012/10/Hunger-in-America-Americ....
27. “Food Distribution Program on Indian Reservations,” US Department of Agriculture, January 2020, https://fns-prod.azureedge.net/sites/default/files/resource-files/fdpir-....
28. H. Washington, A Mind Is a Terrible Thing to Waste: Environmental Racism and Its Assault on the American Mind (New York: Little, Brown Spark, 2019).
29. P. Grandjean, L. Abdennebi-Najar, R. Barouki et al., “Timescales of Developmental Toxicity Impacting on Research and Needs for Intervention,” Basic & Clinical Pharmacology and Toxicology 125, no. Suppl. 3 (2019): 70–80.
30. J. Alegría-Torres, A. Baccarelli, and V. Bollati, “Epigenetics and Lifestyle,” Epigenomics 3, no. 3 (2011): 267–77.
31. P. Krishna, “How Native Americans Are Fighting a Food Crisis,” New York Times, April 13, 2020, www.nytimes.com/2020/04/13/dining/native-americans-coronavirus.html.
32. Personal communication to Janie Simms Hipp from FDPIR, March 2020.
33. K. Goodluck, “Covid-19 Is Sweeping through the Navajo Nation,” Wired, May 23, 2020, www.wired.com/story/covid-19-is-sweeping-through-the-navajo-nation/; E. Warren and D. Haaland, “The Federal Government Fiddles as Covid-19 Ravages Native Americans,” op-ed, Washington Post, May 26, 2020, www.washingtonpost.com/opinions/2020/05/26/federal-government-fiddles-co... and L. Mapes, “As a Coronavirus Pandemic Sweeps the World, American Indian Communities Turn to One Another, Teachings,” Seattle Times, March 24, 2020, www.seattletimes.com/seattle-news/health/as-a-coronavirus-pandemic-sweep....
34. G. Shaw, “Neurologists on the Front Lines: The Burden of COVID-19 on Native American Communities,” Neurology Today, June 4, 2020, https://journals.lww.com/neurotodayonline/Fulltext/2020/06040/Neurologis... and L. Morales, “Navajo Nation Sees High Rate of COVID-19 and Contact Tracing Is a Challenge,” NPR, April 24, 2020, www.npr.org/2020/04/24/842945050/navajo-nation-sees-high-rate-of-covid-1....  
35. E. Ortiz, “Native American Health Center Asked for Covid-19 Supplies. It Got Body Bags Instead,” NBC News, May 5, 2020, www.nbcnews.com/news/us-news/native-american-health-center-asked-covid-1....
36. M. Walker and E. Cochrane, “Native American Tribes Sue Treasury over Stimulus Aid as They Feud over Funding,” New York Times, May 1, 2020, www.nytimes.com/
2020/05/01/us/politics/coronavirus-native-american-tribes-treasury-stimulus.html.
37. H. Silverman, K. Toropin, S. Sidner, and L. Perrot, “Navajo Nation Surpasses New York State for the Highest Covid-19 Infection Rate in the U.S.,” CNN, May 18, 2020, www.cnn.com/2020/05/18/us/navajo-nation-infection-rate-trnd/index.html.
38. L. Mapes, “Coronavirus Pandemic Sweeps the World.”
39. M. Kreider, “13 Grocery Stores: The Navajo Nation Is a Food Desert,” Planet Forward, December 10, 2019, www.planetforward.org/idea/13-grocery-stores-the-navajo-nation-is-a-food... and P. Kaufman, C. Dicken, and R. Williams, Measuring Access to Healthful, Affordable Food in American Indian and Alaska Native Tribal Areas, EIB-131, U.S. Department of Agriculture, Economic Research Service, 2014, www.ers.usda.gov/webdocs/publications/43905/49690_eib131_errata.pdf?v=0, 12.
40. L. Morales, “Coronavirus Infections Continue to Rise on Navajo Nation,” NPR, May 11, 2020, www.npr.org/sections/coronavirus-live-updates/2020/05/11/
854157898/coronavirus-infections-continue-to-rise-on-navajo-nation.
41. J. Lange, “The Navajo Nation Outbreak Reveals an Ugly Truth behind America’s Coronavirus Experience,” The Week, April 21, 2020, https://theweek.com/articles/909787/navajo-nation-outbreak-reveals-ugly-....  
42. L. Schneider, J. Sbicca, and S. Malin, “Native American Tribes’ Pandemic Response Is Hamstrung by Many Inequities,” The Conversation, June 1, 2020, https://theconversation.com/native-american-tribes-pandemic-response-is-....
43. E. Ortiz, “As the Coronavirus Strains Supplies, Native Americans Fight Food Insecurity,” NBC News, May 24, 2020, www.nbcnews.com/news/us-news/coronavirus-pandemic-strains-supplies-nativ....
44. T. Greenaway, “Food as Medicine on the Navajo Nation,” Civil Eats, June 4, 2020, https://civileats.com/2020/06/04/food-as-medicine-on-the-navajo-nation/.
45. World Central Kitchen, “Dispatch from José: WCK Activates in the Navajo Nation,” May 17, 2020, https://wck.org/news/chefsforamerica-week9.
46. M. Kakol, D. Upson, and A. Sood, “Susceptibility of Southwestern American Indian Tribes to Coronavirus Disease 2019 (COVID-19),” Journal of Rural Health, 2020, https://doi.org/10.1111/jrh.12451.
47. E. Hlavinka, “COVID-19 Further Strains Care Disparities among Native Americans,” MedPage Today, May 21, 2020, www.medpagetoday.com/infectiousdisease/covid19/86633.
48. “Obesity and American Indians/Alaska Natives,” US Department of Health and Human Services, Office of Minority Health, March 26, 2020, https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=40; “Diabetes and American Indians/Alaska Natives,” US Department of Health and Human Services, Office of Minority Health, December 19, 2019, https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=33; and “Heart Disease and American Indians/Alaska Natives,” US Department of Health and Human Services, Office of Minority Health, February 14, 2020, https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=34.
49. M. Koithan and C. Farrell, “Indigenous Native American Healing Traditions,” Journal for Nurse Practitioners 6, no. 6 (2010): 477–78.

[illustrations by Tommy Greyeyes, photos: Library of Congress, LC-USZ62-115045; 751 / iStock / Getty Images Plus; Balázs Benjamin / Pexels; Library of Congress, LC-USZ62-115026, Library of Congress, LC-USZ62-127591, Valentina Sheboltaeva / iStock / Getty Images Plus; Courtesy of NAAF, Serg_Velusceac / iStock / Getty Images Plus]

AFT Health Care, Fall 2020
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Cultivating Our Health in a Time of COVID-19

As COVID-19 has taken root, the impacts on Indian Country have been swift and harsh. Within a few short weeks of the first announcement of community lockdown and isolation, Native leaders began receiving calls concerning the exacerbation of already strained and ill-equipped food supply chains.31 Donated foods that were supposed to be delivered to locations within Tribal communities failed to arrive. Places where fresh fruits and vegetables had occasionally been present were devoid of such items, with no clear answer on when deliveries would arrive. Upon checking with the federal government, which has direct legal responsibility as the trustee for all Native American people, strains on food deliveries were confirmed but Tribal leaders were told that all is well.32

The Indian Health Service, already significantly underfunded, has been even more taxed by COVID-19.33 Native communities, many extremely remote, have no backups for the already low numbers of physicians and nurses in our communities; we have no extra ventilators (in many cases we have none at all), and needed medical supplies don’t make it to our communities.34 In one instance, one Native health facility in Seattle requested personal protective equipment and other medical equipment but received only boxes of body bags.35 And, in yet another episode of history repeating itself, Tribal leaders were forced to sue the US Treasury Department after it failed to provide $8 billion in aid that was supposed to be distributed in April.36 Such is the failure of the systems that are supposed to provide key support to communities with whom the federal government has a unique trust responsibility.

Among Native people, comparisons between COVID-19 and smallpox started being made early in the spring. By the middle of May, when the Navajo Nation surpassed New York as having the highest infection rate per capita,37 the comparison was all too real.

Health education cannot flourish in situations such as these, and the long-lasting impact of major food access disruptions occurring within communities (whose comorbidities are already among the highest of any population in the country38) will only deepen health disparities. Occasional absence of food here and there in grocery stores and periodic gaps in supply chains off Tribal lands is not what we are witnessing here. Grocery stores don’t even exist in our communities.39 As a result, people from dozens of different communities drive hours to converge on one grocery store, meaning any one person with COVID-19 could cause infections in several other communities across hundreds of square miles.40 This is taking a challenging and shameful situation and turning it into a catastrophe.41 All is not well.

Native leaders know what they must do—and they are doing it. First and foremost, they are working to protect the health of their people. They are closing borders and boundaries to their reservation lands and prohibiting access to or exit from communities except for the most essential activities.42 Some Tribal leaders are restricting residents to their homes. Many are also slaughtering their livestock herds so that they can store the meat for the weeks and months to come.

Almost every Native community is jumping into action, employing ancestral food system knowledge to enlarge existing gardens and small farm sites so that more food can be grown during the present growing season and stored for the winter months.43 Advocacy is underway to build and fortify infrastructure so that Native communities will not face food access emergencies that threaten their very existence. Tribal members are sewing personal protective equipment, creating new food distribution networks, and raising funds by selling artwork.44 Philanthropy and private sector and concerned individuals are donating foods to reservations in the most need, with noted international chefs arriving on reservations to bolster local efforts to feed people.45

As communities are responding, even when they have lost their own local economies, now is the time to enhance relationships with those interested in assisting, and now is the time to take actions small and large of resiliency and preparation. At the same time, health education is deeply important. But what we need isn’t one-size-fits-all health education grounded in choices that aren’t available to or relevant for our communities; we need health education grounded in who we are, what strengths our ancestors had, and how we must comport ourselves in the future to help us achieve true food sovereignty and community vitality.

The journey is underway in many Native communities as community gardens, farmers’ markets, community food delivery systems, and food production for Native consumption become more prevalent. However, the road will not be easy and time is of the essence because the health problems and food insecurity of our communities have reached crucial breaking points. Now more than ever, we are focused on our greatest asset in this fight for our health: our lands and our ability to grow ourselves out of these problems.

–V. S. and J. S. H.


Although there is still much to learn, early research indicates that people with obesity, diabetes, and cardiovascular disease are at greater risk of contracting and dying from COVID-19.46 Native Americans, having long been affected disproportionately by the first three, are now proving especially susceptible to COVID-19 as well.47

According to the US Department of Health and Human Services Office of Minority Health, there are stark disparities, shown in the chart below, between Native (American Indian/ Alaska Native) and white (non-Hispanic) populations.48