MN American Indians, Indian Tribes and Health Disparities 101

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1 MN American Indians, Indian Tribes and Health Disparities 101 Presenter Jackie Dionne MDH Director of American Indian Health Tribal and Community Liaison PRESENTED AT THE 2015 COMMUNITY HEALTH CONFERENCE

2 Minnesota Indian Reservations and Indian Communities Enrolled Pop. 1.White Earth 19,400 9,562 2.Leech Lake 9,372 10,660 3.Red Lake 11,422 5,896 4.Bois Forte 3, Grand Portage 1, Fond du Lac 4,044 4,250 7.Mille Lacs 4,414 4,907 8.Upper Sioux Lower Sioux 1, Shakopee? Prairie Island

3 Overview of Indian Tribes in MN There are seven (7) Anishinaabe (Chippewa, Ojibwe) reservations and four (4) Dakota (Sioux) communities. These are the lands retained by tribes after ceding large portions of the original homelands. Reservations were created through treaties, up to After 1871, they were created by Executive Order of the President of the United States or by other agreements. They were then called communities and not reservations. There are 567 federally recognized Tribes in the United States and over 40 state recognized Tribes.

4 History of American Indians Fur Trading is the earliest European/Indian relationship beginning in the early 1600s, until about 1840, the fur market collapsed, then land was instead sought for minerals, timber and farming. From 1805 to 1867 there were 41 treaties with the U.S. involving indigenous people/land within MN Territory. Treaties were the European concept of title to land. Why Treaties Matter a display developed as a partnership between the Minnesota Indian Affairs Council and MN Humanities Center. This website had good information on treaty making in MN. The good and the bad.

5 Brief History of American Indians Assimilation policies and boarding schools were devastating to Indians. In 1869, religious groups were given responsibility for running reservations. Allotments were also devastating and individuals lost their land through swindle and corruption. The General Allotment Act (Dawes Act) was passed in The allotment process ended with the passage of the Indian Reorganization Act (IRA) of 1934.

6 Minnesota Ojibwe (Chippewa) Reservations Date of treaty establishing reservation Original reservation acreage Acres allotted to individual Indians in Reservation area Acres of tribally owned land (2002 BIA numbers) Acres of individual trust lands (2002) Bois Forte April 7, ,863 56, ,284 31,620 11,506 30% Fond du Lac Sept. 30, ,800 40, ,000 23,077 16, % Grand Sept. 30, ,422 24,975 47,000 39,938 6, % Portage Leech Lake Feb. 22, ,163 75, ,880 15,762 11, % Mille Lacs Feb. 22, ,014 1,920 61,000 4, % White Earth Mar. 19, , , ,120 75,696 1, % Red Lake Oct. 2, ,528 Reservation not allotted 564, % % of original reservation now tribally owned Minnesota Dakota (Sioux) Community Date community was established Original Acreage Current Acreage Shakopee Mdewakanton ~ Prairie Island ,807 Lower Sioux 1887 ~ ,785 Upper Sioux ,218

7 Brief History of American Indians Indian did not become citizens until 1924 by an act of Congress. The Indian Reorganization Act of 1934 marked a major change in federal policy. It became the New Deal program for Indians. By the 1950 s, there was a sharp reversal in Indian Policy. Termination was seen as the final solution to the Indian problem, the way to get government out of the Indian business. Over 50 tribes were terminated.

8 Brief History of American Indians Indian Religious Freedom Act was passed in It was enacted to protect and preserve the traditional religious rights and cultural practices of American Indians. BIA Relocation Program of 1951, was another attempt at assimilation of American Indians, and was the main policy that lead to large number of American Indian moving into urban area across the country. Reclaiming Sovereignty in the 1960 s. The 1970 s Self- Determination and Education Assistance Act of 1975.

9 Brief History of American Indians Moving towards Self-Governance in the 1980 s and 1990 s. Taking on managing and control of their own programs and businesses. Establishment of Tribal run Casinos that has brought revenue to the Tribe that wasn t possible before gaming. Tribes have been able to provide general revenue funding for programs and services that was not available before gaming.

10 Brief History of American Indians For American Indians, between 1950 and 1980, the urban population had risen to 64% (of the total American Indian population) from only 8% in the 1940 s.

11 Urban American Indian communities in Minnesota The largest urban communities in Minnesota are Bemidji, Duluth and the Twin Cities Urban communities are inter-tribal American Indians living in urban communities can often feel isolated

12 MN American Indian Demographics The total American Indian population in the state is 101,900. Hennepin County s American Indian population is 21,206 Ramsey County it s 9, % of all American Indian live off the reservation in the U.S.

13 MN Indian & Poverty 39.5% of all American Indians live in poverty, a rate 4.4 times higher than Whites (2010) Poverty rate for White is 10.6%

14 MN Indian & Social Determinates 17.8 % of American Indians have less than a high school education, compared to 6.8% for White. That means that American Indians are 2.6 times more likely to have less than a high school education compared to Whites (2010)

15 MN Indian & Social Determinates 18.8% of American Indians are uninsured (2009) 2.4 times the White rate. The American Indian male unemployment rate was 26.9%, 3 times higher than the White male rate (2010)

16 American Indian Health Disparities in MN American Indians have the highest rate (73%)of being overweight or obese, of any single population group in Minnesota. American Indians have the highest rate (23%) of five or more ACES than any other single population in Minnesota.

17 American Indian Health Disparities in MN The Infant Mortality Rate for American Indians is the second highest in the state at 9.4 compared to white at 4.5 American Indians have the highest rates of smoking in the state at 60% American Indians have the highest rate of diabetes at 18.6%.

18 American Indian Health Disparities in MN Overall, American Indians (18.3) in MN have a suicide rate that is 1.7 times the rate of Whites (10.9) American Indian male and female mortality rates are 1.5 times higher than White mortality rates.

19 Federal Indian Policy and it s impact on the health of Tohono O odham & Pima Indians in the Southwest Federal and local water rights policies directly impacted Tohono O odham and Pima Indians in the Southwest U.S. and was a major contributing factor in the rise of diabetes in their community. Nearly half of the adult population have Type 2 Diabetes (show video Bad Sugar: Unnatural Causes produced by California Newsreel)

20 Policies that impact the health of Tribes throughout the county Treaties between the Federal Government and American Indian Tribes - most of the land that is now Minnesota was ceded to the U.S by Ojibwe and Dakota people over a 30-year period ( ). Many policies were made to terminate or assimilate American Indian, one that impacted the well-being of families the most, was the forced the removal of Indian children into boarding schools.

21 Promises of the Treaties American Indians were starving on reservations, due to the lack of ability to hunt, fish and gather in the ceded territory. Treaties included promise (guarantee) of certain provisions, one of the major provisions was food. War Department supplied rations and later commodities - high in fat and sodium; low in nutritional value American Indians had to make due Rise in diabetes and other chronic conditions related to commodities

22 Health care for American Indian is grossly underfunded.

23 Tribes and Indian Health Services Indian Health Service is the Federal entity responsible for health care on reservations. CHSDA Contracted Health Services Delivery Areas hs_requirements_chsda

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25 Tribes and Indian Health Services Three Ojibwe Tribes; Leech Lake, White Earth and Red Lake have an IHS run clinic/hospital and a contract for services. Eight Tribes only have a 638 contract for service. Four of the eight have a tribally run clinic. Three Dakota communities do not have a Tribal clinic. Only one Dakota Tribe, the Shakopee Tribe, has a Tribally run clinic.

26 Indian Self-Determination and Education Act of 1975 The Indian Self-Determination and Education Assistance Act of 1975 (Public Law ) authorized the Secretaries of the Department of Interior, Health, Education and Welfare and some other government agencies to enter into contracts with, and make grants directly to, federally recognized Indian tribes. The tribes would have authority for how they administered the funds, which gave them greater control over their welfare. The ISDEAA is codified at Title 25, United States Code, beginning at section 450

27 Sovereignty American Indians have a unique relationship with the US Government Nation to Nation Relationship No other cultural group has this relationship American Indian Tribes have the inherent right of selfgovernment. From the earliest years of the Republic the Indian Tribes have been recognized as distinct, independent, political communities by reason of their original tribal sovereignty. Entitlement vs. Special Treatment myth

28 Tribal Sovereignty and Self Governance Features of Tribal Governments Elected officials, voted into office by the Tribes membership, and their own constitution Civil and regulatory jurisdiction over their own lands and individuals who reside on tribally owned lands Operate and regulate on their gaming and businesses on their reservations without state regulation Example: The White Earth Nation is the process of under taking all the county human services for their population.

29 Current state policies that uphold the Government to Government relationship Governor Dayton s Executive Order Tribal-State Relations Training coming in 2014 The Minnesota Indian Affairs Council The Tribal Liaison/Tribal Affairs principle point of contact for 12 state agencies.

30 Protocols for Working with Tribes

31 Protocols for working with Tribes

32 MN Indian Tribes State webpage This link has a link to all 11 Tribes in MN with more information on each specific tribe. American Indians, Indian Tribes and State Government February 2014 Research Department MN House of Representatives Copies can be requested by calling (651)

33 Discussion and Questions Contact information Jackie Dionne Director of American Indian Health MDH