# Presentation: 144287

## “Understanding 

**American Indian/Alaska Native **
**Issues and Communities”**

**Notes:**
Good morning,  it is customary in gatherings like this  to begin with a prayer and I have asked Mr. Oliver Crow-Eagle, who is also from  the Rosebud Sioux Tribes to come up and do a prayer for us. 

Kenny Prays

Thank you Kenny.

I  was asked to give an “overview of American Indian Nations”  and after that I will talk about Field Epidemiology with the Indian Health Service.  
I will use the term Natives to refer to both American Indians and Alaska Natives in my presentation, and the old photographs I use are from the Smithsonian collection.

 I put together this overview from my own personal experiences.  It does not reflect the views of the Centers for Disease Control and Prevention or the Indian Health Service. 

## Native Communities

**RESPECT!**
**Respect for Culture**
**Respect for Family**
**Respect for Community Values**
**Respect for the Land**
**Demonstrate that you want to learn!**

## Tribal Sovereignty

-   Tribes/Villages have a Nation to Nation
- 	relationship with the US. Government
-   Tribes/Villages are Sovereign
-   Movement towards Tribal Self-Governance
-   Tribes can make and enforce your their Laws

**Notes:**
- Treaty Tribes have a Nation to Nation relationship with the U.S. government that was established by  treaties or federal recognition.
-Tribes are sovereign Nations that exist through treaties.  Each tribe has it’s own government and constitution, with a unique legislative process.
-States do not have jurisdiction on tribal lands.  In fact, states and Tribal governments are often in legal conflict over Tribal treaty rights.
-Through U.S. Congressional policy there is movement towards Tribal self-governance.   This means the U.S. government is allowing tribes to manage their own destiny- run their own programs, such a health programs 

The movement towards tribal self-governance is changing the way Native health care is delivered.  Approximately forty percent of the tribes now operate their own health systems. 

## Demographics, 1990 Census

**	****Natives**      	**All Races**
- 	  **24 yrs.****	****	**** 33 yrs.**
**	****$19,900****	****	****$30,000**
**	**** ****32%****	****	****  13%**
**      ****66%            75%**

**Median Age**
**Median Income**
**Below Poverty**
**High School**

**Demographics, 1990 Census**

**Notes:**
A few demographics on Natives.
Natives  have a median age of 24 years compared to 33 years for all U.S. Races. 
The median household income is $19, 900 compared to $30,000.
Thirty-two percent of the native population live below poverty compared  to thirteen percent of the total population.
Sixty-six percent of Native completed High School compared with 75 percent of the total population.*
A few additional facts: 
Three of the ten poorest counties in the U.S. are located within a reservation, and unemployment rates on reservations range from 25 to 85 percent.

* 1990

## Common Values Among Natives

-   Allegiance to family, community and tribe
-   Respect for elders
-   Non-Interference
-   Orientation to present time
-   Harmony with Nature
-   Respect for status of the Woman and the 	Child

**Common Values Among Natives**

**Notes:**
Some common Values among Natives are
Sharing and generosity
Allegiance to one’s family, community and tribe
Respect for elders
Noninterference- expand/example
Orientation to present time
Harmony with nature
Respect for the status of the woman and the child

## A belief in an unseen power, Great Mystery or 	Creator
All things in the universe are related
Worship reinforces bonds between the
		individual, family and community (our relatedness)
Spirituality is intimately connected to our
		health

- All things in the universe are related
- Worship reinforces bonds between the
- 		individual, family and community (our relatedness)
- Spirituality is intimately connected to our
- 		health

**Common beliefs related to Spirituality**

**Notes:**
An area that is difficult to talk publicly about is spirituality but I need to at least mention Traditional Native Spirituality.  Today, not all Natives believe in traditional ways.  Historically, although,  each tribe was unique in it’s way of life there were some common beliefs related to spirituality.   
Today traditionalist still hold a belief in an unseen power, Great Mystery or Creator.
We believe all things in the universe are related to each other and therefore we are related to the earth, animals and plants.  This may be why many people view Natives as caretakers of the earth- because Natives knows that when you create an imbalance it effects the earth and all it’s inhabitants. 
Ways of Prayer to the Creator or Worship reinforces bonds between the individual, community and our relatedness
Spirituality is intimately connected to our health and requires a balance among the  mental, physical, spiritual and emotional aspects of an individual. 

## Respective Core Values

- _Traditional Native_	_Main Stream Society, U.S._
**Cooperative****	****	****	****	****Competitive**
**Group/Tribal Emphasis****	****	****Freedom, Progress, Efficiency**
**Extended Family Important****	****	****Individualism**
**Modesty****	****	****	****	****Sexy**
**Patience/Passive (SW)****	****	****	****“Getting Ahead in Life”**
**Generous/Non-Materialistic****	****	****Material Comfort**
**Respect for Age****	****	****	****Youth**
**Spirituality****	****	****	****	****External Conformity**
**Indirect Criticism****	****	****	****Direct Criticism**
**Harmony with Nature****	****	****	****Conquest of Nature**

## Environmental Issues

_**“**__**Land is life” **_

- Threat to Subsistence Lifestyles; fish consumption, plants (medical purposes) and animals
- Threat to Cultural Practices; sweat lodges, basket weaving, pottery making
- Polluted Land and Waterways; environmental compensation

## Environmental Health Issues 

- Emotional Trauma
- Physiological Trauma
- Physical Trauma
- Spiritual Trauma

## Tribal Communication Outreach Strategy

-  Meet Tribal Groups on their own Turf
-  Have Food Available
-  Have Door prizes and Raffles
-  Contact the Community Health Aids, Public 	Health Nurses, not just the Physicians
-  Time is not a critical Element

## Tribal Communication Outreach Participants

-  Elected Tribal Officials
-  Traditionalist,
-  Business Community
-  Elders
-  Youth
-  Women
-  Trusted Source
-  Community Activist

## Tribal Communications Strategies

-  Tribes have a severe distrust of federal 	government and government employees
-  Don’t make promises you cannot keep
-  Always ask what is the respectful approach to 	implementing the sharing of critical or 	important information
-  Listen for Direction from interpreters and 	community members
-  Develop Health Education Message with the Tribe/village

## Tribal Communications Strategies

-  Watch for body style and facial expressions of 	your audience
-  Remember you are working with the tribes and not 	for the tribes
-  Be honest in building relationships
- (federal Shuffle)
-  Find an interpreter who is respected and 	recognized member of the community, not a 	stranger!

## Tribal Communications Strategies

-  Very circular thinking patterns
-  Tribal symbols, be Tribal Specific, Caution
-  Build your message with the tribal community
-  Be as graphic, picturesque and as visual as 	possible
-  Utilize the gossip community
* **Most of all Commitment Earns Respect*