Urban Indian Health Institute

Date: July 10, 2019
Interviewer: Sarah Ballew, Headwater People
Interviewee: Abigail Echo-Hawk (Pawnee), Director, Urban Indian Health Institute

Quick Stats about the Urban Indian Health Institute
Urban Indian Health Institute works with the urban Indian populations across the United States, recognizing that we are tribal people regardless of where we live. UIHI primarily works in data collection, the research aspect, including evaluation and interpretation.

UIHI is a division of the Seattle Indian Health Board and located Seattle, WA.

There are very few scientific organizations that are grounded in traditional Indian medicine, and lack spiritual and cultural concepts. It is crucial for UIHI to think about how to come in a good way, a way of being, that is applied to science.

Additionally, UIHI works with tribal nations who are part of a CDC project, and the regional organizations that support them in a project called Good Health and Wellness in Indian Country.

Decolonizing data, for indigenous people, by indigenous people.

Key Considerations:
UIHI supports food sovereignty and food security by recognizing that colonial systems of injustice and colonization interrupted traditional food sources and they are working to reestablish those to support urban Indian organizations and tribal nations and tribal communities and reestablishing these cultural ties to our food system. And by recognizing that colonial forces interruption of traditional food systems, health disparities and chronic disease conditions directly resulted from unable to access our traditional food systems.

The elimination of Native people in the data where it says American Indians/Alaskan Natives are statistically insignificant is the continuation of genocidal practices for American Indian/Alaskan Native people, and it’s a direct attack on sovereignty.

UIHI recognizes when Native people are not represented appropriately and accurately in health data, it is a direct attack on tribal sovereignty and they see it as an imperative to make sure there is data representation.

Strengths, Keys for Success:
UIHI does their work centered in traditional knowledge systems, supplemented with western science, with a culturally rigorous approach that recognizes knowledge systems already in place in indigenous communities. Those communities are inherently full of strength and resilience that allows indigenous people to survive and thrive.

Representing what’s going on in the community is more than just gathering data. It’s about using evaluation, research, and data for the good and the wellbeing of the community and recognizing all of those things as indigenous value systems.

UIHI recognizes that health equity requires more than just giving more resources from outside allies. It really is about understanding that the knowledge systems to solve all of the health disparities in our community, all of that knowledge lies within our community. They want to attract partners who believe that indigenous people have the answers, and not just the problems.

Understanding how to have a respectful relationship that’s appropriate for a sovereign government has been key to address health disparities. Respecting and supporting tribal sovereignty are at the basis of everything UIHI does.

UIHI practices identifying opportunities rather than threats and finding the right questions that will lead to improving lives instead of focusing on developing innovations for the sake of being new. Those questions that are purposed for positively impacting lives within the community are where UIHI has found to create their best innovations.

Barriers and Challenges:
Because of the systems of colonization, because of the systems of prejudice and stereotypes and institutional and structural racism, indigenous people deal with very serious inaccurate perceptions. Outside communities don’t understand that there are thriving urban Native communities in every city in every state. The perception is that everyone is on the reservation or in villages, or that we don’t live normalized lives.

And so those prejudice stereotypes, the institutional, the built structural systems that have an inhibited American Indian/Alaskan Natives’ agency for change. When you look at federal governments and the way that they invest in improving the health and wellbeing of communities, they want you to do it their way. There is very little true community practice that is used.

Very little evidenced-based practices are vetted with Native people and Native communities. And AI/AN communities are expected to adapt to those practices without an understanding of those communities.

Primary Funding:
Primarily funded through federal funding sources, mainly through agencies, CDC, IHS, and we do have some philanthropic dollars

Insights for others:
Funders need to examine how their own structures and practices may be influenced by colonization and institutional racism.

Health equity needs to be based in community solutions to meet community needs and funding models must be flexible to do so.

Organizations that have built trust in the community and understand the culturally based support systems are the best investments to get data and results.