Commemorated every year since August 9, 1995, International Day of the World’s Indigenous Peoples celebrates the 476 million Indigenous people living across 90 countries. The people of these 5,000 unique cultures make up less than 5% of the world’s population, but they account for 15% of the world’s poorest people on earth. (UN)
COVID-19 is bringing new challenges to already-marginalized Indigenous communities, due to subpar access to health care and sanitation, higher rates of pre-existing diseases, and a tendency toward multigenerational housing (UN). In the U.S., as of July 21, 1 in 1,650 Indigenous Americans had died of COVID-19, compared to 1 in 3,100 white Americans (APM Research Lab). When APM adjusted the data for age differences within race groups, Indigenous people were 3.5 times more likely than white people to die of COVID-19.
Disparities in access to health care stem from lower educational attainment, higher rates of poverty, and a shortage of American Indian and Alaska Native (AI/AN) providers within those communities (many people feel more comfortable with health providers of their same racial or cultural group). (AAMC) Discrimination and underfunding of the Indian Health Service (IHS) also play a role. (NPR)
Native Americans have good reason to be skeptical of the American health care system, after the sterilization campaigns of the 1960s and 1970s. The U.S. government admitted in 1976 that the Indian Health Service had sterilized 3,406 American Indian women without their permission just between the years of 1973 and 1976. (National Library of Medicine) This is a legacy that continues to have repercussions today, one of which is a lingering distrust of the American health care system.
Distrust around reproductive health providers is especially concerning because disparities in reproductive health outcomes are quite pronounced among Indigenous Americans. For starters, the Hyde Amendment, which prohibits federal funding of abortion for reasons other than rape, incest, or to protect the life of the pregnant person, applies to IHS, which all Native Americans are entitled to receive. This means that Native Americans who don’t have private insurance through employers must pay for abortions out of pocket. This is if they can even reach a clinic, which can be difficult given the remoteness of many reservations and other rural residences of many Native Americans.
AI/AN teens have the highest birth rate of any racial group in the United States, at 32.9 births per 1,000 girls ages 15–19 (compared to 13.2 for white teens). (CDC) Teen childbearing often leads to mothers dropping out of high school, with only half receiving a high school diploma by the age of 22. The children of teen mothers face elevated risks, including health problems, teen pregnancy, lower educational attainment, unemployment, and incarceration. (CDC)
Intimate partner violence is higher among Indigenous Americans—55.5% of AI/AN women have experienced it during their lifetimes, compared with 35% of white women. Sexual violence is higher among AI/AN women as well, although that disparity isn’t as dramatic—56.1% vs. 49.7% for white women. (National Institute of Justice)
In addition to IHS, many Native American-led health and education organizations operate across rural America. (Rural Health Information Hub) These organizations aim to build self-sufficiency in medicine, education, safety from domestic violence, and in career development.
In this current moment of racial reckoning in the United States, we should be thinking about how we can improve equity and inclusion for all people of color, including Indigenous people. The scars they bear from centuries of violence and injustice at the hands of white people are different from those borne by Black descendants of slaves, but they are just as real, and the damage that white colonizers caused them was just as detrimental. On this International Day of the World’s Indigenous Peoples, let us all vow to do better. We can’t change the ugly past, but we can forge a better future, and we should.