Health | Case Subject

Getting communities healthy is a major challenge facing Indian Country. Tribes and organizations that serve Indian people have struggled to alleviate disproportionate rates of health-related problems, both on the reservation and in urban areas. This case study introduces students to the ways health concerns of Native women are inextricably tied to colonialism, particularly in the area of prenatal and well-child care. Tribal health clinics working closely with community organizations can provide a promising way to improve Native women's health and empower tribes. Students will analyze a fictional meeting in which several characters identify health disparities and envision ways to work more closely together. They then critically evaluate possible outcomes of the meeting including challenges and successes, and suggest areas for further research.

Thousands of years ago the lands and rivers around Celilo Falls were huge trading areas where as many as 5000 people would come to trade for Salmon. It was a time for abundance and socialization. In the later part of the 1950s, after the development of hydroelectric dams on the Columbia, the tribal people lost the sacred falls, their Salmon, and their way of life. Today, the Columbia River is used as a major transportation artery as well as a source of hydroelectric power. The waters of the Columbia River are contaminated, dams have slowed the flow of the river, and in some cases the migration of the Salmon is impeded. The Salmon are contaminated with hundreds of toxins and the people who eat them are suffering from cancer and other ailments.

Those who provide social services in the homes of community members are oftentimes overwhelmed at the dysfunction in family systems. Personal experiences become a call to action both to bring attention to the issues, but also to find ways to address and resolve them. The impact of methamphetamine use and the way it harms children and families is one such social problem. While dealers have permeated the country with illicit drugs, the situation has become an epidemic in Indian Country. Looking at this problem through the eyes of a social service provider who works a local nonprofit social service organization in rural Thurston County, Washington, this case explores the roots of the methamphetamine problem in Indian Country, and shares various strategies at the federal and local level to deal with it.

The Gila River Indian Community (GRIC) of Arizona has the highest rate of diabetes in the world. Before white settlement of their homeland in central Arizona, their ancestors had an abundant water supply and a flourishing agricultural lifestyle. In the late 19th and early 20th century, non-Indian water use completely cut off their water supply. This depletion led to many years of starvation and then to a diet of highly processed foods that some say is responsible for the obesity and diabetes in the GRIC. After many years of negotiation, a water-rights settlement has been reached to return water to the ownership of the Gila River Indian Community. Research has shown that a diet that resembles the one that their ancestors ate when they were an agricultural people combined with increased physical activity can reduce the rate of obesity and diabetes. Will the return of their water enable the GRIC to return to their past agricultural practices? Can the members of this southern Arizona tribe again raise the kinds of crops as they did in the past? Can their previous healthy lifestyle of generations ago be restored?