The Medicine Stone Health in Bismarck, North Dakota

The Indigenous peoples living in the urban Bismarck-Mandan area

North Dakota is home to five federally recognized Tribes: the Mandan, Hidatsa, & Arikara Nation (Three Affiliated Tribes), the Spirit Lake Nation, the Standing Rock Sioux Tribe, the Turtle Mountain Band of Chippewa Indians, and the Sisseton-Wahpeton Oyate Nation. The largest urban Native American population of North Dakota lives in the Bismarck metropolitan area. 
Though widely diverse, with different beliefs, languages, and rich cultures, one of the common traits of American Indigenous Peoples is that collectivism is an essential aspect of identity. 

Settler Colonialism

Before the first contact with European settlers, the Indigenous Population of the Americas was around 60 million, according to estimates. A century later, the period of the Great Dying took about 90% of those lives to genocide by warfare, infectious diseases, forced removal, enslavement, imprisonment and boarding schools. Many of these traumatic events resonated and changed guise in the following centuries. Though the 60s and 70s of the 20th century saw the rise of Native American activism, today, the Indigenous Peoples of North America are still very disproportionately disadvantaged. 

Historical Trauma & Contentious Relationship

Scientists from the field of epigenetics have uncovered how our genes carry memories of trauma experienced by our ancestors and how that impacts our mode of being. The effects of historically traumatic events are transmitted intergenerationally, meaning youth continue to identify emotionally with their elders' suffering. This cumulative emotional and psychological harm from consecutive traumatic events perpetrated on a community over generations takes a tremendous toll. Compounded with other factors, this has meant the rates of mental health problems, substance use disorders, post-traumatic stress disorder, suicide and attachment disorders are disproportionately higher for Native Americans than for the rest of the US population. Moreover, differences in worldviews and concepts of development still make for very contentious relationships between Natives and non-Natives. Land and natural resource issues are only two of the many factors of contention between Indigenous peoples and settlers.

Economic Disadvantage

"Across metrics of economic well-being, Native Americans are disproportionately underserved, economically vulnerable and limited in their access pathways to building wealth," according to this report by the Joint Economic Committee. "These long-standing inequities have left Native communities much more vulnerable than their counterparts to the negative impact of economic shocks and public health crises." 
The Indigenous population living in metropolitan areas faces many barriers to accessing services and achieving housing stability. Not only very few housing services are intended for Indigenous peoples in urban areas, but because of a lack of cultural competence by social services staff who often fail to deliver effective and culturally respectful work, Indigenous peoples living in urban areas generally feel a significant distrust of these agencies.

Multiple Impacts on Health and Deficient Care Services

Settler colonialism, historical trauma and economic and social disadvantage have had extensive ramifications on the health of North American Indigenous Peoples, such as, for example, the loss of the right to define their own food according to custom and production through traditional methods; poverty and the consequent lack of access to nutritionally relevant foods; the cultural changes that dictated new sedentary lifestyles. All of these factors have meant a much higher risk of developing type 2 diabetes, high blood pressure, depression, arthritis, and heart disease for Native Americans. 

Additionally, although the Indian Health Service fulfills treaty responsibilities to provide health care for members of recognized Tribes, Congress has consistently underfunded the IHS, forcing severe limitations on the services offered. Indigenous Peoples living in urban areas share the same health problems as their communities living in reservations. However, their health problems are further exacerbated by mental and physical hardships stemming from a lack of family and traditional cultural environments and the fact that many Indian Health Services are limited to those living on reservation and in adjoining counties.

In North Dakota, the Tribes had a history of being physically fit and healthy. Diets consisted of buffalo and venison meat, other wild game, and berries and plants such as wild turnips and onions. However, years of unhealthy government rations, food deserts, poverty relationships with food, and lack of access to adequate and preventative health care have led to a perfect storm of vulnerability to a public health threat. 

The Urban Tribal population does have physical access to healthy alternatives in cooking, but the ideological barriers, however, are the more significant issue, especially when the palate is used to high-carb, high-sugar, poverty or comfort foods.

Sacred Pipe Resource Center

The Sacred Pipe Resource Center (SPRC) is a North Dakota- and Native-based non-profit 501(c)3 organization. SPRC's mission is to address and support the sociocultural, emotional, mental, spiritual, and physical needs of Native people of all Tribes living in the Bismarck-Mandan and surrounding area to foster strong, self-sufficient individuals and families and to provide liaison services between Native and non-Native people for a cohesive community. It was founded in 2007 by a group of long-term residents of the area committed to SPRC's mission of maintaining a home-away-from-home for the off-reservation Indian population in the Bismarck-Mandan area.

The Sacred Pipe Resource Center is embedded in the community through mechanisms designed to raise the voices of Native people themselves.

We conduct annual visioning sessions and monthly Community Council meetings and host regular events that inform and engage the Native community. Through the use of data (both quantitative and qualitative), SPRC seeks to help the Native community enhance existing services, address service gaps (which may be met by partnering with organizations already providing similar services), or seek funding to fulfill gaps in services.

This "Voices from the Ground" introduces Sacred Pipe Resource Center's frontlines work with the Native American Urban Tribal population in the Bismarck-Mandan area of North Dakota. 
Founder Cheryl Kary tells us about starting an organization focused on community engagement, Sacred Pipe's innovative model based on community councils, and the importance of funding opportunities that allow Indigenous organizations to design and implement creative and pioneering solutions:

The Medicine Stone Health in Bismarck, North Dakota

With the funds we were able to fundraise and Azimuth's grant, SPRC is going to implement an innovative project in which the collectivist approach is one of the essential aspects for bringing on behavior change.

The project is named in honor of Diane Medicine Stone, a community member who succumbed to cancer but was an integral part of the Health & Wellness Community Council until her passing. We honor her memory and her wish for improved health for all Native people living in this urban Tribal area.

This project will engage the Native population to:

1. Recruit approximately 100 American Indian participants to make substantive lifestyle transformations through progressive changes in practice and awareness. The project will provide materials (e.g., food diaries, pedometers) and data (e.g., measurements) to track progressive changes each month for each participant.
   
   
2. Provide a trained Health Equity Coach to conduct monthly training to American Indian participants recruited into the program.
   
   
3. Facilitate progressive behavioral change opportunities by providing food alternatives, traditional food gathering events, and cooking practices unfamiliar to participants.