Katherine Goodlow, a 20-year-old member of the Lower Brule Sioux Tribe, has experienced firsthand the tragic loss of young lives in her community. She has mourned six friends and acquaintances to suicide, two to car crashes, and one to appendicitis. Four of her relatives died prematurely in their 30s or 40s from liver failure and COVID-19, and she recently lost a 1-year-old nephew. “Most Native American kids and young people lose their friends at a young age,” said Goodlow, who aspires to become a mental health therapist to support her community. “We’re basically used to it, but it hurts worse every time we lose someone.”
The alarmingly low life expectancy among Native Americans is a multifaceted issue rooted in social and economic inequities. Native Americans tend to die much earlier than white Americans, with a median age at death 14 years younger, according to an analysis of data from the Centers for Disease Control and Prevention. This disparity is even more pronounced in Goodlow’s home state of South Dakota, where Indigenous residents who died between 2017 and 2021 had a median age of 58, which is 22 years younger than white South Dakotans.
Dr. Donald Warne, a physician and co-director of the Johns Hopkins Center for Indigenous Health, attributes this low life expectancy to social and economic forces. He argues that addressing these issues requires investments in case management, parenting classes, and home visits, rather than solely relying on medical care. The Indian Health Service, which provides healthcare to Native Americans, should be fully funded, but it is equally important to invest in community-based prevention programs.
The Indian Health Service funds programs like Family Spirit, which aims to improve health outcomes for Indigenous mothers and children. Community health workers provide education and support to Native pregnant women during home visits, teaching parenting skills, family planning, drug abuse prevention, and stress management. They also incorporate cultural traditions into their work, using the tribe’s language and birthing traditions. These programs have shown promise in reducing infant mortality and improving maternal health outcomes.
However, access to these services remains a challenge due to lack of funding and transportation barriers. Many Native Americans live in remote areas with limited access to transportation, making it difficult to attend appointments or participate in programs. Additionally, some families struggle with poverty, which can make it difficult to afford healthcare or healthy food.
Misty Merrival, who works at the Sioux Funeral Home, has witnessed the devastating impact of premature deaths in her community. She attributes these deaths to poor living conditions, such as lack of access to healthy food, inadequate heating, and overcrowded housing. She has made a commitment to prioritizing her health and well-being by abstaining from drugs, driving safely, and having open conversations with her daughter about mental health and suicide prevention.
While rurality contributes to the health disparities faced by Native Americans, it is not the sole factor. Racism, personal trauma, and exposure to drugs and violence also play a significant role. Additionally, the legacy of historical trauma, such as forced removal from traditional lands and suppression of Native American culture, can contribute to mental health issues and substance abuse.
Experts emphasize the need for a collaborative approach involving federal, state, and tribal governments to address the complex factors contributing to the low life expectancy among Native Americans. Tribes should be empowered to manage their own healthcare facilities with federal dollars, as this can open up funding streams not available to the Indian Health Service.
Nonprofit organizations like Siċaŋġu Co on the Rosebud Reservation are working towards “wicozani,” or the good way of life, which encompasses physical, emotional, cultural, and financial well-being. Their programs include bison restoration, youth development, a Lakota language immersion school, financial education, and food sovereignty initiatives. They recognize that many individuals in their community have dreams and aspirations but may need support, training, and encouragement to achieve them.
