Be a Good Relative

Be a good relative. This is more than a short statement or concept, it’s a foundational value and a way of life. As Indigenous community members, leaders, advocates, professionals, and many other roles, these four words, “Be a good relative,” have a deeper meaning and are engrained in so much of who we are, how we engage with each other, and the work we do on a daily basis. The American Indian Cancer Foundation (AICAF) embraces this value in our work to address the tremendous cancer burdens impacting our American Indian/Alaska Native (AI/AN) relatives as well as the impacts COVID-19 is currently having on our communities. Our traditional ways of knowing and living have always been part of our thinking, our teachings, and most importantly our wellness. Despite the persistent inequities AI/ANs face, the historical trauma, and the loss of our traditional lands, we remain resilient through the deep connection to our rich culture. Mnisota Makoce, known to many as Minnesota, is home to the ancestral lands of the Dakota and the Anishinabe. There are 11 federally recognized Tribal Nations across Minnesota that make up just under 60,000 AI/AN according to the U.S. Census Bureau in 2019. A large proportion of the population reside in urban areas, such as Minneapolis and St. Paul, due to various Federal policies, such as the Indian Relocation Act of 1956. The act was the government’s mission to assimilate AI/AN into the general population, with a goal to weaken their community

By Melissa Buffalo and Wyatt Pickner

and tribal ties. Relocation, compounded by settler colonialism, legislation, policies, and violence have attempted to remove AI/AN from their culture, tradition, and land. As a result, many individuals and families move between urban areas and their traditional land bases as a means to stay connected, considering both home. Little Earth, HUD-subsidized housing in Minneapolis’ East Phillips neighborhood, has been a place for urban AI/AN health care with concepts of community wellness, healing, and culturally competent care. Many AI/AN community members also access large healthcare systems across the Twin Cities metro as their primary source of care, sometimes through referral and often times via emergency care. In a perfect world, trust among these large healthcare systems and AI/AN patients would exist and culturally competent care, grounded in Indigenous ways

to create community, access resources, and build resiliency through belonging. This neighborhood, according to Culture Connections, has the third largest urban AI/ AN population in the United States. Additionally, the federal government has a trust responsibility to provide healthcare services to AI/ANs. However, the funding for these healthcare services for AI/ANs is inadequate. AI/AN community leaders and members are often at the forefront of addressing this issue by identifying supplemental funding and resources to support efforts to integrate our knowledge systems and culture into health care. Twin Cities urban AI/AN residents have access to the Indian Health Board (IHB) of Minneapolis and the Native American Community Clinic (NACC) for their of knowing and being, would be at the center of all visits. Existing health inequities would not only be addressed by providers of western medicine but with input and guidance from the AI/AN community members and traditional healers. This concept is at the heart of our work at the AICAF and how we heal with culture and reclaim Indigenous health. AICAF, a national nonprofit organization based in Minnesota was established in 2011 to address the tremendous cancer burdens across Indian Country. AICAF works to eliminate the cancer burdens of Indigenous people through improved access to early detection, treatment, and survivor support. We do this in partnership with Native communities because we know as Indigenous people, our communities have

the wisdom to find the solutions to cancer inequities, but oftentimes are seeking the organizational capacity, expert input, and the resources to do so. AICAF supports innovative, community-based interventions that engage Indigenous communities in the discovery of their own cancer best practices. Through these efforts, trusted partners, community leaders, and relatives truly imagine a world where cancer is no longer the leading cause of death among AI/ANs. AI/ANs in the United States experience some of the worst cancer outcomes worldwide. As cancer mortality rates among most races have been decreasing in the last two decades, AI/ANs are not experiencing decreased rates (CDC, 2010). In addition to this, due to the COVID-19 pandemic, there has been a reduction in lifesaving preventative vaccinations and early detection cancer screenings. Early reports suggest that HPV vaccinations dropped by >70% in March 2020, and HPV vaccinations remained 25–50% below baseline levels in June, with a cumulative deficit of over one million doses (Hart, 2020). As highlighted by the Centers for Disease Control and Prevention (CDC) in June 2021, the total number of cancer screening tests received by women through the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) declined by 87% for breast cancer and 84% for cervical cancer during April 2020 as compared with the previous 5-year averages for that month. Breast cancer screenings also declined for AI/AN women by 98% from January to June 2020 through NBCCEDP funded programs (DeGroff et. al 2021). The American Cancer Society recently released their Cancer Facts & Figures 2022 report that estimates 1.9 million cancer diagnoses this year with just over 600,000 cancer deaths, about 1,670 deaths per day. Organizations like AICAF work in partnership with tribal leaders, clinics partners, and providers to ensure AI/AN community members have access to reliable information and are advocating for their health. To truly make this a reality for our Indigenous relatives, our history, culture, values, and experiences need to be seen, heard, understood, and valued in all the health care we receive. As we continue to heal with culture and reclaim Indigenous health, we encourage you as a healthcare professional to carry that foundational value that Indigenous people strive to live by, be a good relative.

Melissa Buffalo, MS, Chief Executive Officer, is an enrolled member of the Meskwaki Nation in Iowa, and Dakota from the Crow Creek and Lower Brule Sioux Tribes. She received her undergraduate degree in child psychology from the University of Minnesota–Twin Cities and earned an MS in Human Development from South Dakota State University. Melissa has over 15 years of experience working in the public health sector in a variety of different roles. She brings a wealth of knowledge to AICAF. As the CEO, Melissa is committed to working with and for tribal communities, both urban and rural, supporting our Indigenous people with opportunities to heal; emotionally, historically, spiritually, and physically from the burdens of cancer.

Wyatt Pickner, MPH (Hunkpati Dakota) is the Research Manager at the American Indian Cancer Foundation. In this role, he supports Indigenous communities in the collection and use of population-specific data, aiming to find culturally-relevant health solutions that are both effective and resonate with our relatives. Originally from Crow Creek, SD, Wyatt now lives and works in Minneapolis. A graduate of the University of Washington School of Public Health, Wyatt is dedicated to improving the well-being of Native communities across the United States. He has 10 years of experience in working with tribes, tribal organizations, and Native-serving organizations at local, regional, and national levels on research projects, capacity building, training, and community engagement.

Website: https://americanindiancancer.org; phone: 612-314-4848

Do your patients have trouble using the phone due to a hearing loss, speech or physical disability?

The Telephone Equipment Distribution Program offers easier ways to use the phone. Phone: 800-657-3663 Email: dhs.dhhsd@state.mn.us Web: mn.gov/deaf-hard-of-hearing

The Telephone Equipment Distribution Program is funded through the Department of Commerce – Telecommunications Access Minnesota (TAM) and administered by the Minnesota Department of Human Services.

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