MISSOULA, Mont. – It was when Annie Belcourt was having her own children that she realized some of the insidious ways health disparities for Native Americans reveal themselves.

Belcourt, a psychologist and University of Montana professor who grew up on a Blackfeet Reservation, now studies the care inequities in Native American communities.

Statistics show these communities face greater risks than the general population in just about every health-related category, including cancer, diabetes and suicide.

Belcourt recalls during her own pregnancy, she had to drive four-and-half-hours for prenatal care – a situation not uncommon.

"For people who need dialysis or different types of care, having to travel two to three hours one way to access services is a real barrier, and leads to a lot of people making very difficult decisions, sometimes not being able to afford transportation to medical care,” she points out. “And that has an impact on the whole family and the community."

Even the drive can be dangerous. The rate of motor vehicle deaths for Native Americans is about 2.5 times higher than the general population.

On average, Native Americans live 20 fewer years than whites in Montana, according to state data.

The Indian Health Service (HIS), the primary health care provider for these communities, is in a position to change these trends.

But Belcourt says lack of funding and mismanagement have gotten in the way.

As an example, she says the IHS didn't provide her uncle a follow-up for two years after a spot was found on his lung. By then, the cancer had spread to his brain and he died shortly after.

"I know a lot of people who sometimes wait for years for surgery that's needed or different types of needed interventions, and are told that they're going to have to wait, or they don't have the funding to do it, or they don't have the resources at the hospital to provide the needed medical care," she states.

Belcourt adds that Native American communities also rely on other federal programs and agencies threatened by funding cuts, such as the Children's Health Insurance Program (CHIP), Medicare and Medicaid and Veterans Affairs.

To fill the gap, some are turning to traditional healing methods, and using traditional culture to heal as well.

"There's a lot of hope with regard to thinking about the future and tribal colleges, and bringing back languages and practices, and thinking about how that can improve some of the health inequalities that we see," Belcourt says.

Belcourt wrote about health disparities for Native communities for the website The Conversation.




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Next week, Native American leaders from the Midwest will go before a United Nations panel with their concerns over a controversial oil pipeline they say is trespassing on tribal lands.

Enbridge's Line 5 operation in the Great Lakes region is expected to be a topic when the Permanent Forum on Indigenous Issues convenes Monday in New York.

In the Midwest, the law firm Earthjustice represents some Tribes contesting the rerouting of Line 5 in Wisconsin. There, managing attorney Debbie Chizewer said climate change is affecting the region and tribal nations' ability to exercise their treaty rights.

"The perpetuation of this fossil-fuel infrastructure will only worsen that," she said, "and will affect their special tribal resources, like sugar maple and loons, and whitefish and other species that are an integral part of Bay Mills and other tribal nations."

The pipeline runs through Wisconsin and Michigan, traversing the treaty-reserved territory of tribal nations, including the Bay Mills Indian Community and Bad River Band of Lake Superior Chippewa. Enbridge rejects those claims and has said it isn't trespassing on tribal lands.

Similar cases have been filed in other parts of the Midwest. In Michigan, opponents have said they're worried about Enbridge's plan to construct an oil tunnel beneath the Great Lakes. The company has claimed it would be safer than the existing pipeline, but Native American Rights Fund senior staff attorney Wes Furlong said he sees it as a disaster waiting to happen.

"There is a likelihood that if a leak happened within that tunnel, it would cause a catastrophic failure," he said. "Essentially, the tunnel could explode underneath the Straits of Mackinac, pumping crude oil into the strait and into the Great Lakes."

Furlong said pushing back against Line 5 aligns with calls to reduce the use of fossil fuels, citing its connection to climate change and the impact on treaty-reserved resources in the Midwest, on which Tribes rely.

"There's pending litigation over the State of Michigan's order to shut down the pipeline, and ordering Enbridge to vacate the state-owned bottomlands of the Strait of Mackinac," he added. "So, that would spell, I think, the end of Line 5 as we know it."

The Nebraska Winnebago Tribe's Ho-Chunk Community Development Corporation, or HCCDC, has been awarded $2 million through MacKenzie Scott's Yield Giving company.

Some 6,300 nonprofits applied to Yield Giving's open call for grants. The HCCDC was among 279 to receive a top tier rating. In the next-highest tier, 82 organizations each received $1 million.

Kristine Earth, executive director of the corporation, said the Tribe has a lot to be proud of but a lot of work left to do.

"We're so excited and are so thankful for this generous gift for our community," Earth stated. "We do have a lot of issues; we have a lot of health disparities. And so, a donation like this really is going to make an impact for our entire Tribe as a whole."

HCCDC marks its 20th anniversary this year, working to improve economic, educational and social opportunities for tribal members. Earth pointed out they have five key initiatives: housing development, commercial development, financial services, quality of life and food sovereignty.

The Winnebago Tribe has experienced huge growth in its middle class in the past few decades but roughly 30% of its members still live in poverty. HCCDC created a farmer's market, which Earth says is helping them address both health disparities and food sovereignty.

"Through our farmers market, now we're able to touch on not only agriculture and tribal farming, but also our health care system," Earth outlined. "Offering the fresh fruits and vegetables and the Indian corn; things that will restore the health of our people."

Earth added Winnebago is in a "food desert," making food security a major focus for the Tribe.

"It's hard for people to access fresh fruits and vegetables, and we have such a growing community," Earth stressed. "We are all coming together to grow our own food and to feed ourselves, so we can be sustainable in the future."

On the website, MacKenzie Scott called all the open call grant winners "vital agents of change." Scott's Yield Giving organization has donated more than $17 billion to 2,300 nonprofit organizations since 2019.

Billings-based Western Native Voice is holding its annual membership conference in Great Falls starting tomorrow, and members are discussing democratic participation but also cultural issues affecting tribes.

The conference is called No Vote Left Behind and will focus on helping Indigenous people register to vote and know where and when to cast ballots.

Just as importantly, workshops will discuss cultural identity and what it means to be Native.

Western Native Voice communication's director Tracie Garfield is a member of the Assiniboine tribe, and said more than 50% of Indigenous people in Montana live off reservations - which leaves many wondering where and how they fit it with their culture.

"Participants and members of the workshop will be able to talk to each other - talk about what it means to be Native, how they grew up," said Garfield. "Some grew up on a reservation. We'll have people who grew up in urban areas. We'll also have people who grew up in rural Montana - off the reservations."

Cultural identity was the number one topic requested by members for this conference. Western Native Voice has over 13,000 members from Montana and across the U.S.

The conference starts tomorrow morning in Great Falls.

Garfield said Western Native Voice will hold its Expanding Horizons: Beyond Survival youth conference next Monday and Tuesday in Bozeman - where they will be learning about native history, traditional knowledge and cultural identity.

The conference will bring together students from both urban and reservation high schools. She said true native history and cultural identity weren't always taught when she was young.

"When we were growing up, we weren't really taught the true history of our tribes," said Garfield. "Say I'm Assiniboine. I didn't know my own tribal history. Even though I felt Native I didn't really know what it meant to be Native."

Garfield said cultural identity is a complex issue with so many people living in urban areas, and Western Native Voice wants to create a space for people to talk about it by training youth early on so they understand what it means to be Native in today's world.