Native Americans have been impacted at disproportionately higher rates from COVID-19 according to the Centers for Disease Control and Prevention (CDC). Native Americans, including Alaska Natives, are 1.6 times more likely than white Americans to be diagnosed with COVID-19, 3.3 times as likely to be hospitalized, and 2.2 times as likely to die from the disease.

Healthcare on Indian reservations is provided by the federal Indian Health Service. These health facilities are sometimes at locations that are far away from homes and communities in remote areas of vast reservation lands. If one could access healthcare, they might find the facility overwhelmed by high demand.

Following the recently concluded White House Tribal Nations Summit, Chairman Harold Frazier, Cheyenne River Sioux Tribe, shared his frustrations in a guest editorial in Indianz.com, over the inability of his people to access healthcare services.

“I waited two days for the opportunity to inform someone about what is actually happening here on the Cheyenne River Reservation to no avail,” Chairman Frazier said of his participation in the White House Summit. “Currently, my people are sitting in Indian Health Service hospital waiting rooms for more than 36 hours. . .and cannot even be admitted to a bed. The last tribal member sent off the reservation, was sent to another state hundreds of miles from family and familiar faces.”

Such has been the experiences of Tribal reservation communities across the Country. Sometimes remote and isolated Tribal communities have no other healthcare options aside from the Indian Health Service. These communities are often far removed from population centers where local government public health agencies assist with facilitating healthcare services.

Historically, delivery of healthcare to Indian Tribes and their people has been a federal trust responsibility. Trust services like healthcare, education, law enforcement, and others are sacred obligations owed to Indian tribes for ceding millions of acres of land to the United States.

However, the levels and quality of health services to Indian Tribes have not kept up with the needs of growing tribal populations. The U.S. Census Bureau reports that, “In 2020, the number of people who identified as Native American and Alaska Native (AIAN) alone and in combination with another race was 9.7 million, up from 5.2 million in 2010.”

There are 574 Indian Tribes recognized by the federal government today. Although the federal trust responsibility is clear, Congress has failed to provide enough funding to provide adequate healthcare services despite the growing Native American populations.

President Biden’s proclamation of November as National Native American Heritage Month is a good sign that this White House may be willing to take a different approach in their dealings with Indian Nations. Although Chairman Frazier has a valid point based on repeated failures of the federal government to fulfill its trust obligations, we may have reason for hope.

The fact that for the first time in U.S. history, we have an enrolled member of a federally recognized Indian Tribe serving as Secretary of Interior could help to sway the balance in favor of tribes.

Secretary Deb Haaland, Laguna Pueblo from New Mexico, is just a few months into her term, but she has made efforts to reach out to Indian Country with, at minimum, a promise to consult with Indian Tribes on issues that impact them.

Despite this great development, Tribes must remain vigilant in advocating for their rights to federal services. As dedicated as Secretary Haaland may be, she oversees only one federal department. There are other federal departments that also have trust obligations to Indian Tribes, and we must remain active in our advocacy and representation of our issues across the federal government.

Indian Tribes should not have to face the COVID-19 pandemic without adequate healthcare to deal with the health challenges. It is a duty of all Americans to ensure that trust obligations are fulfilled.

Lynn Valbuena is chairwoman of the Tribal Alliance of Sovereign Indian Nations, and former chairwoman of the San Manuel Band of Mission Indians in Highland, CA.

To learn more about issues facing Native American populations, please visit the National Congress of American Indians.

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