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Hunger in a land of plenty

New study outlines poverty's role in causing reservation malnutrition

WASHINGTON - The current state of American Indian health continues to lag behind all other U.S. population groups and poverty clusters in the nation, according to a new study that indicates malnutrition on some reservations is comparable to levels seen in vastly underdeveloped countries.

''American Indian/Alaska Native populations are facing a number of serious challenges, including poverty and health-related issues,'' according to the report, which was commissioned by International Relief and Development, a food and welfare advocacy organization. ''Many of these problems have, at their root cause, a lack of sufficient and consistent access to nutritious foods.''

In many cases, researches say, Indians living on reservations don't have enough money to buy nutritious foods, and food subsidy programs often don't provide incentives to help people purchase healthy foods, which tend to be more expensive than, say, junk food.

''It's no secret that our nation's First Peoples are still struggling with poverty,'' said Thoric Cederstrom, director of IRD's sustainable food and agriculture program. ''In some cases, poverty conditions on reservations are at all-time highs.''

Most health advocates agree that poverty's role in malnutrition should not be underestimated.

While IRD has seen successes fighting malnutrition in such faraway places as Cambodia and Indonesia, leaders say that much work is overdue on the home front - especially on the American Indian home front. Leaders with the group believe that policymakers need to make more concerted efforts to helping reservation Indians combat the negative effects of poverty.

''It's ironic that Native Americans are the people who gave the world so many important crops that they domesticated in antiquity, like maize, and yet they're suffering this pandemic of malnutrition,'' Cederstrom said.

The report notes that the per capita income of families living on reservations still falls far below the national average, while a much higher percentage of Indians compared to non-Indians identify as ''food insecure.'' People who identify as food insecure are uncertain that they will be able to acquire enough food for all household or family members due to insufficient money or other resources.

Recent studies indicate that 23 percent of American Indian households report being food insecure, compared to 11 percent of all U.S. households. And for certain tribal populations, food insecurity is sometimes much worse. A 2002 study of high-needs groups of Northern Cheyenne tribal members found that up to 70 percent of the population experienced food insecurity and 35 percent experienced persistent hunger.

Obesity, too, is a focus in the report, which notes that overeating and sedentary lifestyles are all too common among low-income populations.

Cederstrom, who is of Choctaw descent, says that both malnutrition and obesity are physical manifestations of poverty.

''Some Indian people are not getting enough of the right kinds of food,'' he said. ''And too many Indian people are over consuming the wrong sort of nutrients, like refined carbohydrates and fats.''

According to Michele Companion, a researcher with the University of Colorado who wrote the report, unhealthy food choices have become a part of the collective taste buds of many Indian cultures. She believes the historical process of colonization, assimilation and acculturation all played into this contemporary effect.

While research indicates that the overall health of Indians has improved somewhat in recent years, experts say there is still a pressing need to do more.

''It is getting better, which is good,'' Cederstrom said. ''But it's not getting better fast enough.''

Companion added that she's cautious about numbers that show an overall improvement, since she isn't sure that the U.S. Census currently collects and identifies American Indians in ways that are completely accurate.

She said that because health data collection in Indian country has traditionally been spotty at best, she believes more tribes and tribal colleges should begin doing their own research on malnutrition and other health-related issues.

''There have been some good studies that are really tribally specific,'' Companion said, ''but I would love to see that happening on a larger scale, so that people can really look at their own population.''

She said it is very difficult to generalize findings on poverty and malnutrition to cover the more than 560 federally recognized tribes.

One project Companion highlighted in her report that promotes healthy eating originates in a partnership between Tohono O'odham Community College and the Tohono O'odham Community Action grass-roots organization. A goal of the collaboration is to rekindle traditional food production systems and reincorporate elements of traditional diet to address nutrition-related illnesses.

''TOCA and TOCC acknowledge that the realities of modern wage labor strain a family and individual's ability to devote the time needed to gather sufficient quantities of traditional foods to have a marked impact on health,'' Companion noted in her report.

''To make these foods more easily and readily available, they established a traditional agriculture project in 2002 as a learning laboratory and training area for traditional practices.''

As a result of the partnership, the groups have established community gardens in locations across the Tohono O'odham reservation that serve as learning and teaching centers for youth and elders. They also organize numerous trips to collect wild foods, which not only provide exercise, but also encourage healthier diets and provide opportunities for cultural revitalization and knowledge transfer.

Companion noted that the model wouldn't work for all tribes, but she is excited to see Indian-rooted programs focused on diet and nutrition, and she hopes more tribes are able to develop their own models.

''There are so many phenomenal opportunities for intervention,'' she said. ''It's just a matter of getting people to think about how they can do it in a creative, culturally appropriate way.''

As for solutions from IRD, leaders there support working to improve Indian access to healthy foods, reintroducing traditional diets and developing community-based agriculture options on reservations.