IA2 Prepared Remarks for CDC Foundation Webinar
By Dave Baldridge (Cherokee), Executive Director
Our organization was honored to receive funding from the CDC Foundation to help us implement direct service and capacity-building initiatives for American Indian and Alaska Native families and communities.
The COVID-19 pandemic has opened the public’s eyes to a number of significant issues for American Indian and Alaska Native communities that have existed for decades. Issues around transmission, infections, and death rates related to the COVID-19 pandemic are really just the tip of a very big iceberg.
I know many of you have heard of the many struggles facing American Indian and Alaska Native people that COVID has only exacerbated. While they seem to face insurmountable issues, I want to begin by acknowledging some of the positive stories that have come out of this experience over the last two years.
Resilience is a concept that has been studied and acknowledged in American Indian and Alaska Native communities for years but emerged of late in the mainstream, and while it at times is overused, it really does continue to reflect tribal communities’ responses to the pandemic.
For instance, during COVID:
- Tribal senior center staff who typically offer congregate meals at their center quickly shifted to the distribution of food, supplies, medicine, and water directly to the door of tribal elders.
- One tribal leader in Oklahoma shared his personal story about helping dialysis patients left stranded by paid providers who refused to transport patients to dialysis appointments because of COVID concerns. He taped a shower curtain up in his SUV and purchased supplies like masks, gloves, and gowns on his own, and drove patients to and from their appointments.
- Some tribes prioritized vaccines for elders who were speakers of their Native language in an attempt to preserve their culture.
- The real emerging heroes in this have been the community health staff who stepped up to take on new and different roles and responsibilities. They did not walk away from the frontlines. In some tribes, the community health staff were the first and main connection for all sorts of things – from guarding tribal borders and monitoring curfews to delivering medicine and doing safety checks on elders and tribal members with disabilities.
The focus of our work has been on bringing services, support, and training to American Indian and Alaska Native people and the professionals that serve them, especially as they’ve faced a number of challenges during COVID.
For individual Native families, difficulties addressing COVID-19 stemmed from 1) multi-generational and high occupancy households, 2) homes without running water, 3) families lacking basic supplies such as food, 4) lack of or limited access to health care… all of which drastically affected COVID infection rates for Native people.
Challenges of COVID-19
COVID-19 has devastated Native people who have been disproportionately impacted by virtually all measures related to COVID-19.
The number of AI/AN people infected by COVID was 3.5 times higher than the White population.
Middle-aged American Indian and Alaska Native people (often elder caregivers) were nearly twelve times more likely to die from COVID.
And specifically, Native elders and their caregivers have suffered and continue to suffer disproportionately within the American Indian and Alaska Native population due to COVID-19 shutdowns in their communities.
Social isolation, physical and mental decline, lack of respite care for, and impact on caregivers have come up as issues in our ongoing discussions with tribal and federal partners, listening sessions, and engagement with elders.
Universal beliefs and practices of American Indian and Alaska Native people, such as traditional ceremonies and cultural practices, have been negatively impacted by COVID.
It is important to acknowledge the tremendous diversity of the nearly 600 federally recognized and 200 other tribes recognized by states or local communities when it comes to identifying solutions to overcome these issues.
We know from experience that each sovereign Nation differs, and no single solution exists to address this diversity. Moreover, that as sovereign nations, tribes must and should be engaged differently than other minoritized and historically marginalized populations.
Long-standing historical, structural, and social injustices perpetuate these inequities.
- Caregiving is deeply embedded in tribal communities, and it isn’t seen as a role someone takes; rather, it’s just the thing you do for your family. Though, according to the CDC, 1 in 3 American Indian and Alaska Native adults are caregivers
- Almost half of the caregivers who provide help to older adults are doing so for someone with dementia or Alzheimer’
- As a concept, American Indian and Alaska Native people often don’t think of themselves as “caregivers,” a term that is used a lot. We address that by using words to explain what caregiving means.
Pandemic-related caregiving challenges, including the shutdown of most tribal facilities and services like the few adult daycare centers, meal sites, and senior centers on tribal lands, have led to barriers for families connecting and communicating.
In closing, in the bigger picture, there has been a noticeable shift in the recognition and acknowledgment of existing health inequities driven by social determinants of health and health access problems.
Our hope is that we are soon able to move from awareness to action on these issues, and make meaningful changes to help alleviate these issues of inequality and inequity experienced by American Indian and Alaska Native people.