Native Americans and Alaskan Natives have the highest mortality rate of all racial and ethnic groups in the United States.
Diabetes, alcohol-related deaths and chronic liver and kidney disease are notably high for adults of non-Hispanic Native American descent. While genetics and socioeconomic status significantly influence health outcomes, revitalizing Indigenous languages may offer preventative health benefits, according to researchers.
“Historic trauma and systemic racism along with the loss of land and the way of life increased
the risk of chronic diseases across Indian Country,” Dr. Setu Vora, the chief medical officer of the Mashantucket Pequot Tribal Nation, wrote to the News.
Nationally, Native American and Alaska Native adults are 1.5 times more likely than non-Hispanic white adults to be diagnosed with diabetes, according to the Office of Minority Health.
Diabetes and kidney disease have affected Indian communities since European colonial times and can be attributed to a combination of genetic and non-genetic factors, such as poverty, lack of education and limited healthcare access.
Vora explained that currently, the Mashantucket Pequot Tribe covers the majority of healthcare costs through its own resources while also providing primary and preventive care on-site with federal funding from the Indian Health Service, or IHS.
The IHS, a branch within the Department of Health and Human Services, provides comprehensive and culturally appropriate health services to Native American and Alaska Native people. Any individual enrolled in a federally recognized tribe is eligible for IHS services.
While IHS is congressionally funded, it is not an entitlement program like Medicare or Medicaid. The Indian Health Service is not an insurance program and does not provide an established benefits package.
Clan Mother Shoran Waupatuquay Piper, the tribal head leader of the Golden Hill Paugussett Tribe, wrote to the News, “We have come a long way and have succeeded in many ways but still struggle in so many ways and departments.”
The Golden Hill Paugussett Tribe’s reservation is located in the southwestern corner of Connecticut. Because the land only spans a quarter acre, many of the 100 members live throughout Trumbull and Colchester, Connecticut.
The Paugussett tribal system is structured around the clan mother, the tribe leader, who has the power to appoint or remove a chief and has veto power over the decisions made by the rest of the tribal council. In turn, a clan mother protects and advocates for the tribe, maintaining traditional beliefs and knowledge.
“We have to go to the state and apply for medical [care] through a state agency because there is no access to Indian Health Services for our tribe,” Piper wrote.
Piper explained that tribal communities around the country, not just in Connecticut, suffer from both short-term and long-term health issues and access to health care.
She added that for some members, medical care is not entirely free, as there are co-pays or monthly charges, and some may not be eligible for free healthcare at all. “Finding easy access to doctors who know how to care for you” is especially difficult for tribal members, according to Piper.
A 2023 analysis by the U.S. Government Accountability Office underscored issues with the IHS, including 61 percent of IHS facilities being in fair or poor condition. The report also noted the prevalence of incomplete or unreliable medical devices and equipment, suggesting that “broken medical equipment or having to refer patients to other facilities could lead to delays in care—potentially exacerbating patients’ medical conditions.”
Integration of culturally sensitive practices has been shown to have positive prevention for Native American patients.
The 2022 study led by Douglas Whalen, a linguistics researcher at Yale, indicates that language use and revitalization are protective factors that promote positive Indigenous health outcomes. Other factors, such as traditional food practices and consumption, community relationships and spiritual practices also relate to positive health outcomes.
Whalen is the founder and president of the Endangered Language Fund and an organizer for the Algonquian Conference, an annual event focusing on the languages of the Algonquian peoples. This year, the conference held a special session highlighting language and health.
“As a preventive measure, revitalization could be funded by health programs rather than culture programs,” Whalen said. “However, the medical system, at least in the U.S., does not emphasize prevention, so there are two hurdles to overcome: prevention as worthwhile in general, and the specific contribution of language maintenance and revitalization.”
Reviving Indigenous languages is one way preventative healthcare providers can better connect with the Native community, many of whom mistrust the medical system or lack familiarity around it.
Going forward, Vora believes coverage for health-related social services, including when Indigenous traditional wellness and cultural health practices are required, will be beneficial.
“Tribal Nations are sovereign political entities and not just racial/ethnic categories,” Vora wrote. “Tribal health sovereignty and upholding the US Government’s federal trust obligations are vital.”
Piper expressed her desire for her Paugussett Tribe members to have free access to all medical benefits and transportation services, including those provided by the IHS. Most importantly, she hopes tribal members “are not ignored or forgotten.”
The Golden Hill Paugussett Reservation is located at 427 Shelton Rd. in Trumbull, Conn.