Reflections on Native American Heritage Month from the Menominee Reservation

Lauren Lamers, MPH

Population Health Service Fellow

Menominee Tribal Clinic

Keshena, Wisconsin

Shawano-Menominee Counties Health Department

Shawano, Wisconsin

 

 

On October 31, President Obama declared November 2013 to be National Native American Heritage Month - a time to celebrate Native American culture and recognize the rich contributions Native Americans have made to the United States.  Prior to beginning the fellowship, I would likely have given this month little more than cursory notice. Since beginning my placement with the Menominee Indian Tribe of Wisconsin, however, Native American heritage has taken on a whole new meaning for me. 

As the president acknowledged, along with celebrating the culture and traditions we might typically associate with Native American heritage, “we must not ignore the painful history Native Americans have endured - a history of violence, marginalization, broken promises, and upended justice.”[1]  Unquestionably, coming to understand some of the more painful events in the history of the Menominee Tribe has been one of the most personally challenging learning experiences of my fellowship so far.

In the early 1800s, the Menominee Tribe resided on a land base of approximately 10 million acres in what is now Wisconsin, Michigan, and Illinois.  Through a series of treaties in the nineteenth century, the tribe’s lands were reduced to the 235,000 acres of its present-day reservation.  Menominee children were separated from their parents and sent to boarding schools where they were forbidden to speak their language or practice traditional elements of their culture.  In the 1950s the Menominee Termination Act removed federal recognition of the Menominee as a sovereign American Indian tribe.  In addition to losing their tribal status, the Menominee suffered severe economic hardships and lost portions of their land and many of the healthcare and educational services the government provides to federally recognized tribes.  Although the Menominee fought for and eventually won back federal recognition in 1973, the effects of termination were devastating.

Perhaps the most disconcerting part about this history, however, is that the Menominee, like American Indian and other historically marginalized communities around the country, are still struggling with the impact of the injustices they experienced.  This phenomenon is known as historical trauma, which has been defined as the “cumulative emotional and psychological wounding across generations, including the lifespan, which emanates from massive group trauma.”[2]  In other words, experiences like forced relocation, assimilation, and termination so profoundly disrupted the lives of American Indian people and caused such emotional and psychological damage that their effects still plague American Indian communities. 

This historical trauma manifests itself in clear and tangible ways among the Menominee Tribe today.  Menominee County is the poorest county in Wisconsin and one of the poorest in the United States.  Rates of obesity, diabetes, teen pregnancy, and substance abuse are high, and according to the County Health Rankings, the county ranks last for health outcomes in Wisconsin.

Yet when I think about American Indian heritage and my experiences on the Menominee Reservation so far, one theme resonates more powerfully for me than past injustices or historical trauma:  resilience.  The Menominee Nation has shown incredible determination, innovation, and passion for improving lives in their community.  They have fought to preserve their language and culture, and several programs currently work to pass traditional teachings and practices to Menominee youth.  They have carefully protected their natural resources and have been nationally recognized for their sustainable forestry management.  They have also made great strides toward improving the health of their community.  Just a few of their recent efforts to improve community health include:

·         Convening a community engagement workgroup that brings stakeholders together from numerous sectors of the Tribe and county to address youth obesity, teen pregnancy, and school readiness

·         Providing school-based preventive dental services to Head Start, elementary, and middle school children

·         Planting a community orchard

·         Expanding opportunities for physical activity in the community and implementing healthier nutrition guidelines in schools

·         Holding Bridges out of Poverty trainings to help health and social service professionals better understand how to work with clients struggling with intergenerational poverty

·         Identifying innovative ways to address adverse childhood experiences and implement trauma-informed care in local health, education, and social service agencies

 

While the social, economic, and health challenges in Menominee are great, the dedication and passion of local leaders and community members to address these challenges is truly awe-inspiring. I am humbled and privileged to have the opportunity to work in this community. 

So this November as the nation recognizes Native American heritage, I would challenge us all not only to learn more about traditional American Indian culture or the historical injustices American Indians have faced, but to truly celebrate the legacy of strength and resilience that enables tribes like the Menominee to continue striving to improve lives in their communities.    

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[1] The White House. Office of the Press Secretary.  Presidential Proclamation – National Native American Heritage Month, 2013.  Available online at http://www.whitehouse.gov/the-press-office/2013/10/31/presidential-proclamation-national-native-american-heritage-month-2013

 

[2] Brave Heart, M.Y.H., Chase, J., Elkins, J., Altschul, D.B.  2011.  Historical trauma among indigenous peoples of the Americas:  Concepts, research, and clinical considerations.  Journal of Psychoactive Drugs 43 (4): 282-90.

On Your Calendar: Health Literacy Month

Mallory Edgar, MPH

Population Health Service Fellow

City of Milwaukee Health Department
Diverse & Resilient

Milwaukee, Wisconsin

Image by Health Literacy Consulting
via Health Literacy Month

In case you haven’t heard, October is Health Literacy Month! Started in 1999, this awareness month exists to bring attention to the topic of health literacy and what it means in people’s lives. Many folks in the public health field, myself included, are very interested in health literacy and spend a great deal of time thinking about how it impacts an individual’s health and well-being. For those outside the health professions (and, unfortunately, even many who are in this field), this topic may be something entirely new to think about. Not sure you understand this “health literacy” business? Read on!

Minus the “health” part, “literacy” refers to a person’s basic ability to read and write. This, in and of itself, is an issue of great concern in the U.S. According to the U.S. Department of Education and the National Institute of Literacy (2013), 14% of U.S. adults are unable to read and 21% read below a fifth grade level. Literacy is a skill that is vital for a person to function easily and effectively in so many settings, from work to school to – you guessed it – health systems. When we’re thinking about that last setting, however, our concern becomes about more than just basic reading and writing. Health literacy is more complicated. According to the National Network of Libraries of Medicine (2013),

“Health literacy […] requires a complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations. For example, it includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor's directions and consent forms, and the ability to negotiate complex health care systems.”

Adequate health literacy also includes health numeracy, which involves understanding numbers, quantitative words (e.g., “small” or “increase”), and quantitative images (e.g., charts and graphs) related to health topics. It “encompasses the numerical knowledge needed to understand and act upon directions and recommendations given by health care providers” and includes a multitude of skills “such as arithmetic and use of percentage as well as higher-level concepts like estimation, problem-solving, error in measurement, probability, and risk concepts” (Apter et al., 2009, p. 386).

Image by U.S. FDA via Wikimedia Commons

Examples of how health literacy and numeracy affect a person’s health and well-being can be found everywhere in our daily lives. Nutrition facts on food products are a great illustration of how both literacy and numeracy can impact an individual’s ability to make healthy choices about what they eat. This means we have to think of ways to educate people about how to interpret nutrition facts, or come up with creative ways to explain or simplify this information.

Take a minute to think about how many times you interact with health-related information on a given day. Do you always understand all of it and/or the action steps you’re supposed to take based on that information? If you’re reading this blog, the odds are good that your answer is generally “yes.” Unfortunately, this isn’t the case for many people, including individuals of lower socioeconomic status, and those with low education levels and/or decreased cognitive ability. (Sound familiar? See shor’s post about health disparities and health equity.)

In short, poor health literacy negatively impacts a person’s ability to fully and effectively manage and advocate for their own health and the health of individuals in their care. The bottom line is this: Health information – no matter how accurate, comprehensive, or up-to-date – is useless if those who need it cannot understand and act upon it. Public health and medical professionals must be sure to remember this when designing and delivering health communications.

Find out more about health literacy and related resources here.