Food Insecurity Among Native American Communities

No other group in the United States lacks reliable access to affordable, nutritious food to the same extent as our Tribal Nations.

I took this photo of a metal sculpture at the Colville Tribes' food bank warehouse a block away from our IHS clinic in Nespelem, Washington, the other day. It is sobering to think that one of the biggest buildings in town is the food bank warehouse.

I recently saw a new onset diabetic in our clinic and I made a faux pas when we were discussing the dietary component of addressing his diabetes. I said something to the effect "I don't want you looking into your fridge unsure of what to choose to eat" to which he responded "No worries, Doc, there's not much in my fridge to begin with".

Boy did I feel like a shit-ass.

Food insecurity is defined as the state of being without reliable access to a sufficient quantity of affordable, nutritious food. One in eight Americans experiences food insecurity, but the Native Americans experience the highest rates of food insecurity of any group in the United States- one in FOUR.

Of the 28 counties of the United States that have a majority Native American population, 18 of those counties are considered "high food insecurity" counties. Much of this stems from the poverty, unemployment and poor economic development of many communities among our Tribal Nations. In Oregon, 92% of Native American households experience food insecurity and the statistics are similar for Washington as well.

Part of food insecurity among Native Americans stems from lack of grocery store access let alone a retail establishment offering fresh fruit and vegetables. For many on the Colville Reservation where I am right now, it is easily a one hour to one and a half hour one way drive to the nearest grocery stores. On the Navajo Reservation in Arizona, that distance becomes a three hour drive one way to a grocery store.

Historically, our Tribal Nations had highly-developed community systems in place that were in harmony with nature. Beginning with the first forced Indian removals in the 1830s out of the US Southeast and into the early 1900s, federal policies and the reservation system forced Native Americans into unfamiliar lands. This institutionalized forced relocation underlies much of the food insecurity issues we grapple with from a health care standpoint in the Indian Health Service.

Imagine a thousands of years old society suddenly uprooted and forced to rebuild in an unfamiliar land.

That's what the United States has done as a matter of policy for generations of Native Americans.

Until just in the last ten years, restrictive state and federal laws impeded the tribal rights of Native Americans to subsistence hunt outside of the reservations. The meat from one deer or elk can provide for a multi-generational household for up to six months. Even to this day, there are still jurisdictions that restrict Native American subsistence hunting and this also has been happening in Canada as well as many of the Colville Tribes' ancestral lands extend far north into Canada.

Government assistance with food distribution programs have long been underfunded and what was delivered to the reservations were of poor nutritional value that has exacerbated the obesity, diabetes and cardiovascular disease rates in our patient population.

Here in the Pacific Northwest among the Plateau Tribes I work with, the construction of hydroelectric dams on the Columbia River from the 1930s to the 1950s not only impeded the natural migration of salmon to the traditional fishing grounds of the tribes, but the impounded water that formed reservoirs also flooded out many of the those same traditional fishing grounds.

Prior to the construction of the Grand Coulee Dam in 1943, the Colville Tribes harvested 2-3 million pounds of salmon each year for the tribe from their traditional fishing grounds at Kettle Falls. Those grounds were flooded out when Lake Roosevelt was created behind Grand Coulee Dam. Many tribal elders have told me that prior to the construction of the dam, diabetes and heart disease was rare among the 12 tribes that form the Confederated Tribes of the Colville Reservation.

Similar impacts affected the Confederated Tribes of Warm Springs in Oregon and the Yakama Nation in Central Washington when the fishing grounds at Celilo Falls were flooded over with the completion of The Dalles Dam on the Columbia in 1957.

“If you are an Indian person and you think, you can still see all the characteristics of that waterfall. If you listen, you can still hear its roar. If you inhale, the fragrances of mist and fish and water come back again.”

-Ted Strong, Inter-Tribal Fishing Commission, on the loss of Celilo Falls

At the Yakama Nation’s museum, there is a part of the exhibit dedicated to the loss of Celilo Falls in 1957. Visitors are asked to refrain from photography and show reverence as the loss of traditional fishing grounds was much more than a loss of a food source.

To the tribes up here, the very act of fishing was a spiritual expression that connected you with nature and the thousands of years of history that proceeded you.

When a fire devastated Notre Dame Cathedral in Paris in 2019, people worldwide called for the rebuilding of the landmark.

The loss of Kettle Falls and Celilo Falls to the tribes of the Pacific Northwest was their Notre Dame fire and much more.