General Disparities? Or Data Genocide?

How do we improve community health, when community health statistics are completely ignored? American Indian and Alaska Natives are experiencing the disproportionate impact of COVID in their populations. Can we draw attention to this? And how can we empower people? Join our hosts Justin Beck, Catherine Delcin and Deepti Pahwa, as they speak with Abigail Echo-Hawk, Chief Research Officer at Seattle Indian Health Board and the Director of the Urban Indian Health Institute. Together, they’ll discuss “the oppression of data” – and solutions that help all people. We’ll also talk with Sarah Anderson, an American Indian working on the front lines while also experiencing first-hand the effects of COVID on her family and Native community, and as always, we’ll talk about how to help our local health departments – and encourage innovation and technology integration – all while remaining empathetic, plus keeping an eye toward health equity for all.

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Episode Transcript

Speaker 1 (00:02):
I've seen a lot of the impact of COVID nineteen
of my own personal life. I've had both family and
friends who have died. I remember when a tribal leader,
a mentor of friend, he passed away and I was
sitting on the couch in my house, you know, tears
running down my face, and I thought about it, and
I know that he was also eliminated in the data.
There's no way they captured him as a Native man,
and he even lost that dignity to tell his last

(00:24):
story in the data, and it was devastating. That's Abigail
Echo Hawk, chief research officer at Seattle Indian Health Board
and the director of the Urban Indian Health Institute, carrying
the torch for her community. Abigail's mission, alongside the ui
h I is too decolonized data for Indigenous people, by

(00:45):
Indigenous people. Abigail directs the team of researchers, evaluators, and
epidemiologists dedicated to restoring Indigenous scientific knowledge systems. She's a
true agent of change despite all of that tragedy. As
Indigenous people's we are strong, resilient people and we have
had the ability to take actions. And I've been so

(01:08):
proud to see my community leading. We were the very
first to have masking orders and comply, we were the
first for stay at home orders, and now we are
leading the country and vaccinations. I'm Justin Beck, founder and
CEO of Contact World. I'm here with my co host

(01:28):
Katherine Nelson and DT Pava and over the coming months,
we'll be talking to scientists, researchers, celebrities, experts, anyone who's
been affected by COVID and getting to the bottom of
how we can improve public health together. We may not
have all the answers, but you deserve to understand what
goes on in your neighborhood and the decisions that will
affect you and your family's health. Welcome back everyone to

(01:52):
Contact World Truth and Health. So today we're talking to
Abigail Echo Hawk and one of the things that you
know really struck me as we forget about the history
of the oppression of American Indians and Alaska Natives in
this country, and I also think that it's a system

(02:13):
that we have designed to continue to oppress data. She
actually uses the term data genocide, which is a really
powerful term. I'm curious to know what you think about
the things that have happened to the American Indian community
broadly in the United States, justin hearing her, and also,
you know, there was one of the reports that I

(02:33):
was reading that said that CDCs raised it in December.
According to that, fourteen states show that COVID nineteen mortality
among American Indians and Alaska Natives was one point eight
times higher than the white people. Indigenous people must feel invisible.
Health equity, in my opinion, cannot be achieved until and

(02:55):
unless we have this complete and transparent data collection and
the disegregation no data. But that's also to do with
the fact who is the one who is responsible for
deciding what data to be collected? Right, That's exactly the
oppression that you're talking about. And the scope of the
data collection is inherently about the funders interest or the

(03:15):
state's interest, or the people who are making policy their interest,
but the community level interests and needs are often not
at all taken care of. Catherine, I would love to
hear what you have to say about it. I appreciate
what you said about them being invisible, but I think
it's more of them being ignored. On top of being invisible,
there's a deliberateness I think to the policies and things

(03:39):
that we're doing, they're not being fairly represented. I mean
it becomes an afterthought, which it should be at the forefront.
I think a lot of times when we think of
minority groups and maybe not intentionally, we don't include them
as part of the oppressed minority groups that are not
being represented, that are not being given a voice or

(04:00):
being adequately protected. It's a long history, and we can
make strikes to acknowledge where we are and take actual
steps to remedy those effects in the long term. I
think you're right, and I hate to say it, but
I think it's pretty deliberate. What we're seeing is the

(04:21):
continued oppression of the people that have been oppressed since
people colonize this country. And unfortunately, it takes a complete
change in the way that we're doing things to fix this.
Because if the data doesn't exist, then people can't highlight
the issues that affect them. We need to change the

(04:43):
way that we collect data nationally. We need to define
multi ethnic groups and making sure that we're not just
checking other and things like that, and we also need
to inform people why that's important, because I think that
sometimes people get afraid of sharing information and thinking that
it's for the wrong reasons, when in reality, this data

(05:04):
we're trying to collect is actually to empower and shed
a light on the racial disparities that exist in this country.
I agree with both of you guys, and you're really
bringing a very interesting perspective again of the same things
that we kind of talk about every time, which is
building trust, right, and how do you build trust in
a system where people have been oppressed for so long?
And also justin you bring a very interesting perspective on

(05:27):
how to solve for this right, and there are various
ways that we can actually think about. You don't have
to always depend on government for this. This is my
personal opinion. There are other ways like having an open
data initiative that publishes aggregator sets right, or building capacity
for researchers, administrators, community participants to work together on equity

(05:47):
data collection, building that literacy among community members and engage
them through public activities like community based participatory research actions.
And also the policy level, you know, that's a of
fun to get into, but definitely help mandate data collection
from minorities at a very granular level and really have

(06:08):
population based strategies and communications. I think all of these
things are missing. There is a way to implement a
lot of these things even without going at the national
and federal level, but getting support from organizations and communities
who are willing to invest in this kind of data collection.
We're joining the Health Equity Tracker Project at Stature Health

(06:28):
Leadership Institute and to your point, deep de with the
Health Equity Tracker Project, you know, starting with a mission
to reduce health disparities by shedding light on data. Really,
there are things that we can do as a private company,
for instance, with smart Health RM that we're deploying the
health agencies. We're actually using standards by which the Health

(06:49):
Equity Tracker Project recommends us to identify and report data
to them so that we can be part of the solution.
Because the reality is the reason we're here is because
government has designed it in a way to oppress the data.
So we have to create systems as a private company
that will help aid in the collection of this data
if the government continues to fail to do so. Right,

(07:12):
and there are companies that I'm aware of who are
actively seeking minority participation and research. They try to offer
some type of compensation and it goes back to what
dto is saying about trust. There are initiatives out there
they are taking that step of how do we mend
the gap? How do we get these people to be
adequately represented and have their data information available? Yeah? I agree.

(07:37):
So I think the concept of vaccine tracking is really
interesting because on one hand, our motivation as a government
and our country is really just trying to get shots
in arms right, And we also know that there are
not a lot of standards by which data is being
tracked on vaccinations. But we also know that going forward,

(08:00):
there's going to be some serious ethical questions and there's
gonna be some serious issues surrounding Okay, how do we
reintegrate normalcy, how do we get back to work, how
do we get back to commerce, and you know everything
that that entails. One of the things that we're gonna
do is we're gonna be validating whether people have been
vaccinated or not, and there's going to have to be

(08:21):
infrastructure for that. There are issues of equity though, because
we can't do that too soon, because we know that
not enough people have had access to vaccine. We also
need to make sure that when we do things like
that that we can't exacerbate existing equity issues because if people,
for one reason or another haven't had access to vaccine,

(08:43):
then we're making a problem worse. So what do you
think about how we're going to validate vaccines equitably. My
post opinion is that it needs to be done for sure,
But at the same time wild vaccination is being done.
As in terms of distribution, we have to make extra

(09:03):
efforts at this point in time to make sure that
those communities are reached and are getting in the line
for vaccines. And I think we did cover this in
our last podcast with Dr Brown where we talked about,
you know, having those community health workers to go to
these places and get them informed and get them on
board for vaccination. At the same time. The second part
of it is that when you were talking about how

(09:26):
that would be actually converted into a vaccine passport, right
in the US, people are talking about it and you
they've moved ahead with plans for vaccine passports as well. Internationally, Israel,
Saudi Arabia, Iceland, all of these places have actually started
integrating technological vaccine passports. We need to design for a

(09:47):
hybrid system where we cannot just depend on technology as
vaccine passport systems. That's how I think about it. But
there is definitely no right or wrong way to do
it because we do not know what we do not
know yet. It has to still come and it has
to still unfold. Yeah, I think the legal implications are scary.

(10:07):
I think there are lots of complications and how this
is done. I understand Justin's point about if people want
to participate in the economy, but if you're going to
exclude someone, then it has to be because they've had
access to the vaccine readily and they for whatever reason,

(10:27):
absent or religious or other suitable reasons that are valid,
they decline to take it if they're not having access,
and then we're declining. We're saying, as they've just announced,
if you've taken the vaccine, you can now congregate with
others who have taken the vaccine without a mask. So
that's like a small step of having certain privileges for

(10:48):
people who are vaccinated that others who are not are
not gonna get. So it's gonna be interesting to see
how it unfolds, and I think there's going to be lawsuits,
is gonna be road testing, and hopefully we come out
on the right side of this, I think we need
policies that are sensitive to the needs of the minorities
of the people who really don't have access. Justin I

(11:12):
understand we're going to hear from two people from the
American Indian community. Can you tell us who we're going
to hear from next and what to expect. Yes, we're
going to hear from Abigail first. As I mentioned in
my introduction, Abigail is a force to be reckoned, with
full of passion and pride, with a laser focus on
helping and elevating her community. I'm excited for everyone to

(11:33):
hear what she has to share. So we really appreciate
the opportunity to have you here today. Can you tell
us more about the Urban Indian Health Institute and your
role there. So, I'm Abigail at Cohawk, I'm an a

(11:53):
rolled citizen of the Ponty Nation of Oklahoma, and i
am the director of the Urban Indian Health Institute. The
Urban Indian Health Institute is one of twelve tribal epidemiology
centers located across the country. The other eleven focus on
regional areas where there are federally recognized tribes and ui
h I as we call it, is a little bit unique,
and that we are focused on the urban dwelling American

(12:15):
Indian Alaska Native population, which currently represents about seventy of
all Native people live off reservation and tribal lands in
large urban settings across the United States, and we work
to ensure that they are represented in data, in research, evaluation,
and right now is one in the midst of COVID nineteen.
We are fighting to ensure that they're recognized and our
data is being captured about the impact of COVID nineteen

(12:38):
and other kinds of diseases and viruses as they sweep
across this nation. You just released a report called data
Jettocide of American Indians and Alaska Natives in COVID nineteen data.
What did you and your colleagues learn from that experience
and that publication. I always get those words are so harsh,
data genocide, and I tell people, yeah, it's real harsh,

(13:00):
because we are experiencing a genocide right now in the data.
What we have found is that American Indian Alaska Natives
are never represented where either nobody captures our information or
there's this cute little asterix underneath a data chart that
will say not statistically significant. And as a result of that,
the resources that we have a right to through our treaties,

(13:21):
our agreements with the United States governments, we are getting
the resources we're supposed to as a result of being
eliminated in this data. And this isn't just happening in
COVID nineteen data. This has been happening for years. So
I've been calling it a data genocide for more than
twenty years. But now as we have the impact of
COVID nineteen, we have seen an even deeper result of that.

(13:41):
So what we learned is that more than half the
states in the nation are doing a terrible job on
capturing and reporting American, Indian, Alaska Native data in COVID
case studies. So these are the reports of people who
have been infected the COVID nineteen and this information means
that when we go to the federal government, when we're

(14:01):
working with our states in our counties and we say
there are Native people dying, there are Native people who
are being infected at higher rates, they say to us, well,
where's your data, And they're not directing the resources that
we need by eliminating us in the data. They're actually
increasing the disproportionate impact that COVID is having in our communities. So,
for example, the state of Texas is the worst they

(14:26):
scored about the worst in the nation where they have
a large urban Indian community, and they also have state
and federally recognized tribes in the state of Texas. That
is a huge impact on those communities. And so by
not reporting us in the data, they are effectively perpetuating
the genocide that started five years ago is happening today

(14:48):
and we're seeing it in the data. I really appreciate
the powerful words that you're using, because sometimes you you
need to get people's attention, and COVID nineteen has been
the great revealer of disparities in our country. Now, some people,
you know, including maybe by your terminology of data genocide,
have called you a troublemaker, and I like and admire

(15:09):
that what inspires you as an individual? Well, I both
appreciate being called the troublemaker and also wish that when
you make trouble it wasn't seen as trouble. People should
see me as a justice seeker. And that's what I want.
I want justice for my community. I want our babies
to live. I want our elders to have fulfilling, full

(15:30):
lives so they can share their rich information and traditions
with our communities. And that's what inspires me. I come
from a long generations of ancestors who fought so that
I could thrive in the environment that I'm in right now,
and so I'm inspired by my relatives, by my aunties,
by my mother, by my grandmother's and I know I

(15:52):
have a responsibility to my community, and we're seeing that
in COVID Night Team. That just not with myself, but
our community as a whole. As Native people, we are
raised to understand that we are individuals who have a
responsibility to contribute to our whole community. That's what public
health is. So when we talked about masky mandates and
getting people to do stay at home quarantine orders, tribal

(16:14):
communities did it before any other communities in the United
States because we knew we had a responsibility to protect
our next generations and our elders. That's the incredible legacy.
I come from generations of people who survived so that
I could thrive, so I could contribute to the next generations.
And I see my responsibility to be a good ancestor

(16:34):
for those next generations. Your report on data genocide talks
about a need to improve public health surveillance data. How
do we ensure that politicians actually take aggressive steps to
do the things that you're proposing, Because in my experience,
and I'm not from public health, I've seen that public

(16:54):
health folks want improved health surveillance systems, but unfortunately they're
often not the ones make the decisions. So how do
we bridge that gap? Communities elected these politicians. They have
a responsibility to fulfill the needs of their constituents, the
people that elected them, and if they're going to do that,
they have to make sure the resources that they need.
In COVID nineteen and pretty much everything is represented. However,

(17:17):
there are some groups who don't have the same political power.
Native people, like the people I am blessed to be
a part of. We're a small population in this country
because of genocide and now ongoing genocide, and so we
don't always have the political power to push those politicians
to make the right decisions. And that's where we rely
on the rest of the country. Acknowledging that the health

(17:38):
of a native person impacts the health of the person
sitting next to them on the bus, in the office,
next to them when their kids cool. It's all of
our health, and so these politicians need to be working
to understand their constituents, and that means we have to
talk to them. Sometimes we gotta yell at them. Sometimes
it's an email, sometimes it's a phone call. But we
as citizens of this country have to be at toively

(18:00):
engaged in this process and ensuring that our folks know
those who are supposed to represent us truly are and
if you don't think they are, tell them that makes
a lot of sense. Do you feel like we are
starting to make any progress in health equity in this country?
And how do we continue the momentum. The momentum we're

(18:20):
seeing is the recognition that there are disparities that exist.
We know that the African American community, the Latin X community,
the Native community are being disproportionately hit by COVID nineteen
and the impacts of these health disparities cannot be ignored anymore.
And so we're seeing that it's being recognized that yes,
these people are dying, they are in desperate circumstances and

(18:41):
how did that happen? So we're starting to have these conversations,
and these conversations have to continue and they can't stop
with just the recognition. So that's what I'm afraid of.
Be Like everybody says, oh, yes, it's happening. Was like, well,
you could have come to me twenty years ago and
I would have told you the exact same thing I'm
telling you now, what are you gonna do about it?
And oh that focuses on individual communities, looking at how

(19:03):
you can volunteer, where you can donate, how you can assist,
how you can look at yourself and be like, hey,
I'm not actually part of any people of color communities.
Why is that acknowledging our own participation in systems that
have marginalized and created these health disparities. And we also
need to work, just like we're talking about earlier, with
our policy makers, you know, push them to do what

(19:25):
is right. There is possibilities with its momentum, and I
see hope, but I am also hesitant because I need
to see more than just a conversation. We have to
see action. My people are dying. Yeah, So I mean
looking at President Biden's recent executive orders, he's actually making
several mandates that we finally improve public health infrastructure, and

(19:48):
coming from, you know, outside of public health, I was
just so piste off at the lack of funding that
our public health infrastructure has seen, and I see disparity
between public health funding and provider care funding. And I
always like, how is it that we're surprised that we're
in this position if we're actually tasking public health agencies

(20:11):
to keep us safe, but we're not giving them any money.
So I'm really anxious to see and I'm also scared
that we're not going to see the politicians implement the
things that are coming from the top. I mean, I'm
at least encouraged that we're starting to see a little
bit of traction, but I have the same fears. What
are we gonna do about it? You know, I think
for a lot of folks, they didn't really understand what

(20:32):
public health was for most of the nation until COVID hit.
I'm an etive person. I was raised in a public
health community. My parents said everybody, they took people the
doctor's appointments. My dad, I would say like he was
the first tiny house builder, although its little tiny places
where be able to live on the property in which
I was raised on. That's public health, that's taking care
of a community, recognizing we have responsibility to everybody. That's

(20:55):
what public health is. It looks at the health of
the population. People didn't even know what it was, and
as a result of that, we saw the chronic underfunding
of public health systems, the infrastructure around data where I
talk about the data genocide. I've been saying this for
twenty plus years, as have many many other people. But
because nobody really cared about public health, we hadn't seen

(21:15):
a pandemic since you know, nineteen fifteen. People kind of
ignored it. And now it cannot be ignored anymore. This
is not going to be the last pandemic this country
experience or this world experiences. How are we going to
ensure this infrastructure is put in place so folks like myself,
the work that I've done for my native community, I've
been juggling little, tiny pieces of scarce resources to do

(21:39):
the best I can to halt the deaths and the
infections in my community. I shouldn't have to do that.
That should be this country's priority to stop the death
of its citizens. But until we see the full funding
of public health, it's not going to right. And then
one of the things that I think it's really complicated.
But when we talk about public health surveillance and when

(21:59):
you think about people you know may not be as
familiar with public health and what that means, and you
also talked about participation in the system, I feel like
we have an educational process to go through where people
need to understand that public health surveillance is actually intended
to provide them the resources because if we don't have
data on the disproportionate effects of disease, politicians are going

(22:21):
to try to avoid the problem. So I feel like
there's a practical gap where people sometimes say, oh, my gosh,
I'm afraid that the government is spying on me and
I don't want to give any of my information. How
do we resolve that? Yeah, I feel like before COVID nineteen,
when I would say I direct an epidemiology center, people
their eyes would kind of cross and they'd be like,

(22:42):
what's epidemiology? And then I'd have to go in this
long explanation. Now I feel like most of the country,
you say epidemiology and they're like, oh, your job is
so important, Like, yeah, it was important twenty years ago.
So we're seeing more of a bridged understanding of what
this is. You know, an epidemiology is looking at diseases
over time. You need to look at what happens over time.

(23:05):
So as we look at what's happening right now. With
COVID nineteen, we were looking at a month a month basis.
Now we're getting to having a year's worth of information,
and that's where we're seeing the disproportionate impacts on communities
of color, where deaths and infections are much higher, being
hospitalizized is much higher, all of those things. And we
wouldn't have it without these surveillance systems and policy makers

(23:27):
and those who are directing resources. If they don't have
this information, we're not going to end this pandemic. We
need this information to target where resources need to go
so we can end this pandemic. So, yes, you know
it sounds really scary, um, but I think now that
people are getting an understanding of we need this information
to end this pandemic. Hey, I also need this information

(23:49):
to end diabetes, to end cancer, to end heart disease.
It encompasses everything. This is a little bit out there,
but we have certain types of people that use this
whole privacy. Excuse us than oh gosh, my personal privacy.
But it's almost like you're using your phone for twenty
five different things at any time, and you can order
food in twenty minutes, and you want to tell me

(24:09):
that you're afraid that your public health officials, who are
the last people in the world that want to use
your information for something to farious they shouldn't have access
to your information. It's crazy, it's exactly. It's kind of
funny when you think about it that way. And also,
you know, for people to know, there's a lot of
regulations about how we can use the data. There's more
regulations for me than Facebook as Okay, we have so

(24:31):
many regulations and they're necessary needed, and we follow every
single one of them. Again, our whole goal is improve
the health and well being of all people. I look
at and work with Native people because we do experience
some of the worst health disparities, and when we improve
and have better health in the Native community, your whole
community has better health. So that's our goal with public

(24:52):
health again, is how do we have a healthy, well
community of thriving people across this country. You say equity
will not be achieved in COVID nineteen response or vaccinations
until public health surveillance systems properly collect and report race

(25:15):
and ethnicity. One of the other things I've been surprised
about is that there's no connection between provider care and
public health agencies. It's something that Contact world is looking
to innovate. But I also think that we have this
crisis in this fire drill. I hope that we can
continue to innovate and we can actually take steps to

(25:35):
do that, because one thing is to make a mandate
to improve public health systems, but I think that there's
another thing, and that you're actually trying to incorporate the
source of the information, Like how do we connect the
data from healthcare providers to public health agencies. Yeah, that's
a really big issue, and one of the problems is
there's not any real official mandate. So let's talk about

(25:56):
vaccinations like you were just talking about. I'm deep in
the vaccination world and the cline I'm sitting in right now.
I'm helping to direct our vaccination clinic, which I can
see people outside lined up to go in and get
their vaccinations. But we know a study came out of
the CDC at the beginning of February that showed that
forty eight point one percent of all of the races
and ethnicity data is missing from the CDC data that

(26:18):
the states are reporting. It's missing, which means those people
are missing. And one of the things we found with
the data that exists is that the people who are
most at risk to being put in the hospital, having
major complications and of death are not the ones getting
the vaccinations. The Trump administration really focused on how many
vaccinations can we get out the door. My answer back is,

(26:42):
it's not about how many arms you put them in,
it's about what arms are you putting them in. It
needs to go into the arms of people most at risk.
And so when we talk about connecting with these providers
and you know, folks going into pharmacies who are getting
you know, at Walgreens or CBS or whatever they're going,
and then hospital systems, all of these folks need to

(27:02):
have the same standards and the same accountability put into
place that requires them to gather the information we need
in order to end this pandemic. And that linkage right
now doesn't exist and it's not happening, and as a result,
this country is failing and getting people who need the
vaccinations the most, the vaccine. Yeah, I think that we're

(27:25):
wasting the opportunity to fix the problem too, because if
we just had a mandate and some consistency across where
we're putting these shots, I mean, we'd actually be in
a better position to fix it next time. It's shocking.
Right now, I have a provider out with some of
our homeless service providers, and two of them will vaccinate
about fifteen people today in homeless encampments where they're the

(27:48):
most at risk. If they were in our clinic, they
could vaccinate hundred or more people. It's not about the number,
it's about the impact when you vaccinate somebody who's been
staying at home, works from home, or as in all
their groceries, or you vaccinate somebody who's homeless, who is
you know, in the community and could get COVID or
spread COVID or die from COVID. That's where we need

(28:09):
to concentrate, and unfortunately this country is doing a terrible
job on making those equity based decisions. I do like
that there's a commitment that they're starting to send vaccine
to community health centers and to sending them to you know,
pharmacies and hard hit communities. But The other thing I
think we're missing is that if you're sending it to
a hard hit community and the only way that people

(28:29):
can register is if they have internet access and their
computer proficient or whatever, that we're missing the point. Actually
just got a note from somebody saying, Hey, go to
this place in this town and they're not checking anytime. Like,
I'm not going to go jump the line just because
these companies don't have the right systems in place to
equitably distribute vaccine. But it's just an example of like

(28:52):
how mess the situation is. Yeah, and I've seen it.
We actually had it happened in our clinic here when
we opened up, and we opened up sooner than the
rest of the state of Washington to anybody over the
age of fifty, of any race or ethnicity. We are
fairly qualified health center, community health center. We serve everybody.
And what we found is really rich, wealthy people who
have never stepped into our clinics before. We literally had

(29:14):
people who shoved their way to the front and we
had to call security because they felt that they should
be prioritized over our current patients. And we're like, oh no,
that is not how this works. It is embarrassing. Recently,
I heard a story from Congresswoman Maxine Waters of California,
and she was talking about going into the hard hit
areas in California and seeing the exact same thing. And

(29:37):
also all of these African American elders who were not
able to make scheduled appointments because they don't have the internet,
they don't know how to work it on their mobile phones,
and they're not getting those resources. We also need some
more morality in this country. We need people to recognize
they are not the most important, and they need to
see that as a whole, we need to come and
surround and protect those most at risk. And that's not

(30:01):
the person who can stay at home, who can order
Amazon in it's those folks who don't have those same opportunities.
So how do you think that we verify vaccinations and
things like that in the future. You know, first of all,
we have equity issues of distribution and access. But then
I'm scared that we're going to have systems in place

(30:21):
that actually require you to be vaccinated. And I think
that it's a double edged sword because I can understand
the logic behind it, but I also can see the
pitfalls of it. What do you think about how that's
going to be done in the future where you're actually
like going to an event, you know, the event might
need to know that you're either tested or that you
have been vaccinated. We're seeing some of these testing mandates

(30:42):
already certain states, for example, Hawaii, when you fly in
you had to have had a test within the past
three days to ensure that you're not currently infected with
COVID nineteen. We're seeing things like that right now. When
it comes to the vaccination, you know, this is gonna
have to be done very thoughtfully, if at all. For example,
we were just implement something like that. At this moment
in time, it is a majority of middle class and

(31:06):
upper white people who are vaccinated, which means you are
going to create systems that oppress and marginalize and police
people of color, which we have seen how that results,
and it is not good exactly, And so these things
cannot be done in the snap of a moment. It
needs to be thought out very thoughtfully on whether or

(31:27):
not it's even worth it. And instead, what we should
really be concentrating on is vaccinating this country to the
point of hurt immunity and hurt immunity is where there's
enough people vaccinated to where the virus does not spread
and does not impact at the same level. And they're
estimating that to be about in between seventy to eight
of the population needs vaccinated. But we need to get

(31:49):
those who need it the most first and then look
towards that hurt immunity is where we want to be
and that opportunity, you know, kind of cancels out the
show your vaccination car kind of thought that is happening everywhere, right,
you know, what are the silver linings to this experience
from your perspective, I know that it's been a disaster,
and I know that there's a lot to be frustrated about.

(32:11):
What gives you hope? Personally, I've seen a lot of
the impact of COVID nineteen of my own personal life.
I've had both family and friends who have died. I
remember when a tribal leader, a mentor of friend, he
passed away and I was sitting on the couch in
my house, you know, tears running down my face, and
I thought about it, and I know what state he's from,
and I know that he was also eliminated in the data.

(32:32):
There's no way they captured him as a Native man,
and he even lost that dignity to tell his last
story in the data, and it was devastating. And I
know that my experience is not unique, that many other
Native people are experiencing the same thing. Despite all of
that tragedy, as Indigenous people's, we are strong, resilient people
and we have had the ability to take actions. And

(32:56):
I've been so proud to see my community leading. We
were the very first to have masking orders and comply,
We were the first for stay at home orders, and
now we are leading the country and vaccinations. We are
doing a better job of reaching Native people than any
other place in the country. And in fact, there are
communities the Bay Mills community in Michigan, they have fifty

(33:16):
percent of their adults who are eligible for vaccinations. More
than fifty percent to them are vaccinated. We have villages
in Alaska where they are completely vaccinated and they got
that vaccination to them by snow machine and dog slate.
We are seeing our communities come together and take those
public health parts of us that were always part of us.

(33:38):
We always took care of our communities and apply them.
The rest of the country should be learning from us.
So I see not only this piece of hope, but
also the strength of my community and taking care of
each other, and seeing the rest of the country actually
turning to us for the very first time, not because
they think we have all the problems. They're coming to
us because Native people have the answers right now, and

(34:00):
that is a beautiful silver lining. And also the elevation
of public health to the rest of the country. We
need them to acknowledge that the continuous support needs to
be invested and it's going to take this country saying
we can no longer have this underfunding of public health systems.
We want to do more than survive in the next pandemic.
We need to be able to overcome it much more

(34:22):
quickly than we did in COVID nineteen. Yeah, I have
to say that I am humbled by the passion and
the resolve of just public health professionals, And I mean
it grinds my gears to see the disrespect sometimes that
public health professionals have seen and the way that we've

(34:42):
underfunded public health. And whatever I can do and our
company can do to improve public health, we see it
as this area to improve. I just can't believe the
way that our country has treated the public health system
for so long. Well, I appreciate all the support as
public health professionals need it, and know there are some
public health professionals who in the beginning of the pandemic

(35:03):
ended up having to quit their jobs because when they
put these maskings in place, people threaten them and threaten
their children. When all we're trying to do is protect
our communities, and we saw what happened when people didn't
follow through. So I am in gratitude to them and
know that all public health professionals were taking a lot
of risk right now and we will continue to do
so because the health of our community matters that much. Yeah,

(35:26):
we've talked about how strange it is that our country,
you know, rightfully so celebrates its healthcare providers, but somehow
our public health professionals get death threats and it's just ridiculous. Yeah,
I'll tell you just a quick story of my community
here in Seattle. So sitting in my office here at
the Seattle Indian Health Board, and when COVID came, our

(35:46):
folks who are out living outside without homes, they were
experiencing a lot of people taking advantage of them, and
also of the increased stress and tragedy that was happening
as a result of COVID nineteen. So our clinic is
in an area where a lot of people are experiencing
a lot of trauma. As a result of that, we
started to have a lot of gun violence, and so

(36:06):
in the ben a pandemic we're having outside of my
window that I can look out right now, I was
having numerous shootings that were happening six ft from me.
And as a result of that, I had to move
my team of some of the best epidemologists in the country.
We had to move all of our desks because we
still come into work every day at our clinic. We
had to move them away from the windows because I

(36:28):
was afraid of my team getting shot and so not
I'm only concerned about them getting COVID, making sure we're
getting out the resources to our community as a small
community health program doing work for people of color, and
I was also having to worry about my staff getting
shot and how far I was sitting away from my window.
The stress that we've had to experience and then our

(36:48):
community has had to experience as a result of COVID,
particularly for public health professionals who are people of color
has definitely much higher than other people are experiencing. And
so my poor team who had to do multiple evacuations
as we had this gun violence outside of our windows,
you know, they went right back to work fifteen minutes

(37:09):
after it was cleared and started to get to work
to serve our community. And that's the dedication that exists
not only my organization but nationwide. So I want to
go a little bit off topic before I let you go.
We talked a lot about your other work, but can
you talk about the Reclaiming Native Truth project that you've
been involved with. Yeah, so, a Reclaiming Native Truth was

(37:31):
a project of Illuminative, one of the leading organizations in
the country that is focused on bringing visibility of Indigenous
peoples to the rest of the country. So Illuminative and
the research study that was led by Dr Stephanie Freiburg
looked at and did research on what people knew about
Native people in this country. And what we found is

(37:53):
they didn't know a lot and in fact, there were
a lot of people who didn't even know we were
still alive. And so pretty disappointing but not surprising, and
Illuminative continues to focus on undoing this invisibility by making
sure that we are represented in the media, that we're
represented well in TV and radio and all of these

(38:14):
things that are really focused on educating people and what
it means for us to have modern Native people in
this country. So people always ask me, did you grow
up in a TP or they find out it from Alaska,
like was there an Egglook, It's like, no, there was
a house with a kitchen and a bathroom and all
of the things everybody else has. And I am blessed
to have more than you had, and that I had

(38:36):
deep cultural traditions to also grow up in that have
allowed my people to not only survive this pandemic, but
to thrive. And so that's the kind of education that
Reclaiming Native Truth and Illuminative have continued to do, is
raise the visibility of Native people so that we can
have a great understanding of we are sitting next to
you on the bus, we are your coworkers, we are

(38:57):
your friends, and together we'll create a thriving community here
in the United States. Well, I really appreciate all your
time today. You're just such a powerful woman and an inspiration,
and I hope we can have you back sometime. Thanks
for having me. It was still fun and I would
love to come back. Throughout this series, Contact World, Truth

(39:18):
and Health, we featured many experts from the field of
health equity, doctors, researchers, authors, all sharing a message that
is often difficult yet necessary to hear. We've also shared
stories of those directly impacted by these inequities, specifically during
the pandemic. So it was such a nice moment to
speak with our next guest, Sarah Anderson, an American Indian

(39:42):
working on the front lines in Seattle, Washington. Sarah's message
is one of resilience and in spite of the injustices
she and her community face, there's a collective sense of hope.
My name is Sarah Strong Horse Anderson. I am a
and roll member of the Slin Tribe of Monterey County.

(40:04):
I am an employee of the Seattle Indian Health Board
for over ten years and I work in patient care
coordination and Seattle Indian Health Board is a federally qualified
community health center. It's a medical home. We serve everyone,
all walks of bifile populations of patients, but we have

(40:24):
a focus on American Indian, Alaska native and a lot
of our services are tailored to everyone, but are lead
in integration with traditional medicine and how you're looking at
healthcare as a whole person versus just a system of medical,
system of dental, a system of behavioral health. So we

(40:46):
have multiple departments medical, dental, behavioral health, domestic violence advocation,
We have an Elder's department, youth programs, We have our
Urban Indian Health Institute that collect data and we just
try to wrap around care for everyone that walks through
our doors, but particularly focusing on American, Indian and Alaska

(41:09):
Native people and uplifting them in the urban communities. So
traditional integrated medicine is robust, but it is simple. It
is traditional medicine. It is sitting and listening and healing.
It is looking into traditions that are practiced with all

(41:29):
tribes and centering a way of caring for people in
the way that they feel is connected to their cultural
beliefs and tying that into medical care. So you may
be looking at one health disparity and realizing that westernized
medicine is not everything that is going to service the

(41:50):
care of that person. Their well being requires medicine tied
to their culture and It's really beautiful because it is
utilizing all of the resources our ancestors have always given us,
and then integrating those medicines to treat the whole self
and improve those health outcomes in ways that standard western

(42:15):
medicine won't always tackle. But we're also trying to bring
that traditional medicine to everyone in the safest way possible
for people who don't understand share it with them in
a good way. So I contracted COVID. I'm not internally
sure about my connection to getting sick, but it happened,

(42:36):
and I live in a multi generational household. I have
my children, my family, but also my parents in my
home and working every day and thinking for others. I
didn't necessarily pick up on the immediate cues because it
was so new and I wasn't immediately sick. But I

(42:58):
went home, I told my family. Everyone was tested, and
we found out not just myself but my significant other
he was sick as well, and my mother and both
of our children. So it became this frightening sensation of
how do we self contain in our home, how do

(43:19):
we take care of ourselves and get better? What's to
come of us? It was a whole field of emotions.
I sadly and my partner sadly did get extremely sick,
difficulty breathing. We had respiratory functions that were much below standards.
It was a true blessing to have the Seattle Indian

(43:41):
Healthboard in my corner. Tradial medicine was brought to my home.
Tobacco was brought with a oxygen monitor. Traditional teas were
brought that promote better respiratory functions. Savs and other medicines
were brought to apply to our bodies to allow us
to be cleansed and blessed in a traditional way on

(44:03):
top of the care that the providers were giving us.
But the people that came into our home to check
the bottle statistics on my significant other, he had lost
consciousness twice. He was barely breathing, and they took a
few vitals. Only one medic came in the rest state
outside of the home because they didn't want to be

(44:23):
in a house with known exposure, and they chose to
leave him there, and he lost consciousness two more times.
And everyone in my household, my mother, my children, everyone
was so confused as to why Dad wasn't taken to
the hospital by nine one one. It was hard to say,

(44:44):
you know what, no, you're going because this is serious.
It's hard to be in the health care field and
to see that that really indeed happened. And I looked
at it as my mission, my goal to not provide
the care that was given in the hardest of times

(45:08):
for my family, but only focus on the things that
worked for us, that cared for us, that felt right,
that really built us up. And this care that we
provide is something that is so energizing and is so
real and it is so valuable. I just wanted to
get back out there and do it. But it's true.

(45:29):
For me, it's what kept me healthy. It's what kept
my mind, my soul, my body, my spirit healthy. And
it's what I wanted to reciprocate and what I wanted
to give back and what I wanted to share with
everyone that walks through the doors American Indian, Alaska, Native, White, Black, Asian, homeless, housed,

(45:51):
and everything in between. It's something, it's something else completely.
So resiliency. Yeah, I think it's and everything that we do.
I think of my family, I think of being a
third generation urban Indian. There have been hits to our
people for hundreds and hundreds of years, and yet those

(46:15):
teachings are in us the deeply rooted and being able
to understand that we've all been in a place where
we have seen inequity, where we've felt disparity, where we
see darkness, we turn it into light. We start in

(46:35):
a good way, we end in a good way. We
speak in a good way. We listen to our owners.
We watch strong indigenous people who are leading in our communities,
and we mirror that. And that is birth to death.
You're always growing, you're always fighting, and you're always lifting
one another up in a good way. And it's a

(46:58):
beautiful thing to be a part of and to be
blessed with. It's deeper rooted, and it's very hard for
me to articulate. I mean, I feel like resilience kind
of leads everything that I do always, and if it
ever doesn't, I'm having a really bad day. So all

(47:22):
of that is very important to me every single day.
As painful as it is to admit our country was
built upon slavery and pillaging indigenous people who still suffer,
paving the way to the inequities and health disparities that

(47:43):
we see today, it doesn't have to be this way anymore.
On one hand, our system now deliberately eliminates the collection
of real demographic data in healthcare, what Abigail echo Hawk
aptly refers to as data genocide. Then politicians cite a
lack of data as if that proves that no disparities exist.

(48:05):
I applaud Abigail for pursuing justice for her people. It's
the reasons some people call her a troublemaker. As the
late great John Lewis said, sometimes we need to get
in good trouble, necessary trouble. We need to do more
for American Indians and Alaska Natives, and politicians need to
stop insulting our intelligence about why certain data doesn't exist.

(48:28):
It's time to start fixing this system and facing reality.
Let's improve health equity in this country and create sustainable
data systems that shed light on what's happening and to
whom we already know why. I'm justin Beck. This is
Contact World Truth and Health. Thanks for joining us, and
we'll see you next time. Listen to Contact World the

(48:53):
podcast on the I Heart radio app or wherever you
get your podcasts.