Some years ago, I had the opportunity to visit with Stanley Crooks, former chairman of the Shakopee Mdewakanton Sioux Community, and he reminded me that the purpose of tribal gaming and other tribal enterprises are to “help the people.” There is no doubt many share this sentiment. However, despite the fact that many tribes have progressed economically through various development efforts, we continue to see epidemic rates of preventable diseases across Indian Country. While the reasons for such trends are many, I am convinced that any sustainable solutions to improving the health of Native people will require at least two primary actions: 1.) an overhaul of how Indian Country approaches community and economic development in building healthy communities and 2.) increased individual, family and community ownership and responsibility over their own health journey.


In this article, I will only touch on action item number one — an overhaul of how Indian Country approaches community and economic development in relation to health strategies. Any lasting transformation to improve health outcomes for Native people will require joint, multi-sector approaches and co-investments. Of course, this is easier said than done. Today, the systems, institutions and programs that are meant to “help the people” are structured to work in silos and often with limited resources. Moreover, they are designed to react to needs, often resulting in short term results but rarely transformational or sustainable outcomes. (Let us also remember that today’s norms or practices of sector disconnection is not an Indigenous form of practice or thought.)


Allow me to use one example, the need for tribal housing. There is no secret that many reservations have significant housing needs, thus a major public health issue. The “fix” is often left primarily to one area – the tribal housing department or authority. Its focus is to stretch every limited dollar and build as many affordable units as possible per its budget allocation (mainly federal). Meanwhile, who’s working to ensure there is access to affordable healthy foods and places to shop for those residents, who’s ensuring walkable and safe places to play or safe routes to school for the children in those homes, who’s ensuring access to nearby living wage jobs to pay the rent, who’s creating access to financial institutions and capital for homeownership and local business development, and who’s developing the health and wellness facilities for residences to access?  Are these efforts coordinated in a systemic way and are resources being leveraged to maximize efficiency and produce measurable results?


Clearly, this is beyond tribal housing development. But it is not beyond the ability nor affordability of multiple sectors working and investing together. Implementing comprehensive cross-sector strategies to improving the quality of life and health of Native peoples is not only smart practice with positive results, it’s good business and good public health.


It is time that we transform how we think about, plan and implement community and economic development and do it in manner that truly “helps the people.”


I welcome all comments and of course, please share any stories of Native Nation’s that you know who have been successful at this and improving the health of their community, especially their children.