Aisles filled with vibrant vegetables and fresh fruits define the stereotypical outer layer of American grocery stores that occupy nearly every street corner in affluent, suburban areas. While this quick access to healthy produce may be expected by many Americans, a large majority of low income and rural areas lack such luxury. Food deserts, areas without grocery stores, negatively impact vulnerable populations and escalate the hardships faced by the residents of these areas. With a lack of access to natural, unprocessed food, populations that are already at risk of poorer health outcomes are at a higher risk of contracting diseases that are preventable. Native Americans, who have been historically and systematically oppressed by the American government, lack access to fresh produce and are at a greater risk for morbidity and mortality.
To understand the vulnerabilities that Native Americans face requires exploring the history behind the formation of reservations, as the original intentions and goals of the US government continue to impact its current relationship with Native Americans. Beginning with the Indian Removal Act of 1830, tribes across North America were forced to leave their land and move to undesirable areas that the US government assigned to them. “For most of the nineteenth century the policy of the U.S. government was to isolate and concentrate Indians in places with few natural resources, far from contact with developing U.S. economy and society,” states Gary Sandefur, a social worker and sociology professor at University of Wisconsin-Madison. This intentional forced isolation from other upcoming economies led to worse qualities of life on reservations. Then, the Dawes Act of 1887 allocated small plots of land to individuals within tribes rather than to tribes themselves, and reservations were broken up and fractionated, leaving many tribes to share or have no reservation at all. This act was merely the beginning of decades of acts, treaties, and crimes committed with the intentions of isolating Native Americans. The blatant separation of tribes from the rest of society has directly led to the poor living conditions on reservations that exist today.
The mistreatment of Native Americans went beyond geographical colonization and expanded into the white washing of traditional cultural and culinary practices. Prior to the arrival of Europeans, Native Americans lived off the local flora and fauna, thriving on the culinary staples known as the three sisters—corn, beans, and squash. Their growing potential was maximized by farming the three together in harmony. Food waste was minimized by utilizing every part of the animal that had been hunted. These dietary customs were uprooted with the aforementioned forced migration; the land Native Americans settled on was devoid of the local agriculture to which tribes were accustomed. The inability to farm the plants they were used to led to the reliance on rations provided to reservations by the US government. Introducing sugar, lard, and other processed foods, the diets of tribes unnaturally shifted from seasonal and sustainable consumption to dependence on unhealthy, packaged foods.
The lasting effects of where Native Americans were forced to settle and the numerous other atrocities committed against them are evident today in the living conditions of the 1.14 million Native Americans that currently live on tribal lands. With 28.4% of Native Americans living in poverty, the median income of Native American households is $35,062 compared to the median income of the United States, $50,046, according to the 2008 U.S. Census. Housing is another large issue on reservations, as 30% of housing is overcrowded, and about 90,000 families are homeless. While striving to assimilate and isolate the various Native American tribes with the formation of reservations, the negative issues that riddle reservations, including the lack of access to grocery stores, are not shocking.
Food deserts disproportionally affect Native Americans but are also present throughout the United States. Food deserts are “geographic areas where residents’ access to affordable healthy food options is restricted due to the absence of grocery stores within convenient traveling distance,” as described by the Food Empowerment Project. Around 2.3 million people do not have access to a vehicle and live more than a mile from a supermarket, which typically sells less expensive produce than smaller convenience stores. Convenience stores and gas stations are present in areas without supermarkets, but these stores do not sell fresh produce. Individuals living in such restricted areas lack healthy and affordable options and are forced to purchase processed foods.
Native Americans are subjected to particularly high levels of food insecurity. With a low median income and geographic isolation of reservations from major cities, at least 60 out of the 326 reservations in the United States are food deserts. Furthermore, Native American families are 400 percent more likely to not have enough to eat at all.
The Navajo Nation, which spans 27,000 square miles and houses 300,000 people, has 13 grocery stores. For context, the Navajo Nation would cover all of Massachusetts, Vermont, and New Hampshire if it were in New England. With a quick Google search of grocery stores in Boston, a map with over 20 grocery stores spanning the Charles River alone pops up. While these may not all be in walking distance, public transportation makes many grocery stores that are a few miles apart much more accessible. The Navajo Nation, however, lacks public transportation, lacks the multitude of options for fresh produce, and lacks the accessibility to supermarkets that students of Boston College have. Meanwhile, the average resident of the Navajo Nation must drive three hours to even come in contact with a supermarket filled with fresh foods.
While geographic distance limits those who are able to go to grocery stores, the poverty and low average income of residents makes it extremely difficult to then afford the expensive fruits, vegetables, and unprocessed foods available at said stores. An updated report completed by the First Nations Development Institute found that Native American shoppers pay $7.51 more for a standard “basket of groceries,” which contains bread, ground beef, eggs, milk, tomatoes, and coffee. This reality in which Native Americans struggle to buy affordable fresh food prevents many from obtaining quality ingredients.
The impact of inaccessibility to fresh produce is evident in many of the health outcomes in Native American populations. Native Americans are disproportionately affected by non-infectious diseases, known as non-communicable diseases. Many of these diseases are preventable based on lifestyle factors, specifically diet and weight, but the disparities that Native Americans face leave them more vulnerable to the same non-communicable diseases.
With the forced loss of traditional food sources and the deficiency of affordable fresh foods, their diets now are filled with high quantities of foods with high added sugar content and sodium, which is reflected in the high percentage of diabetes in the population.
Compared to the 8.7% of non-hispanic white individuals, more than 16% of Native Americans have been diagnosed with diabetes. While this alarming rate of diabetes appears within a small population, this rate has been attributed to dietary rather than genetic factors. “Several studies have shown that unhealthy, nontraditional foods like canned meats and fast-food, are a large part of the problem,” notes Dr. Amanda Fretts, an epidemiologist who has studied the dietary habits of Native Americans. With scientific evidence attributing poor health outcomes to diet, the impact of the lack of access to fresh food is apparent.
With numerous resources attributing the poor health outcomes and high prevalence of disease in Native American populations to poor dietary habits, it is time that the American government is held accountable for the history of systemic oppression. To begin to improve health on reservations, federal funding for Native American programs needs to increase. In 2019, the GOP recommended that for the 2020 fiscal year, the Supplemental Nutrition Assistance Program (SNAP) would decrease by $17.2 billion, and families with an income of at least $90 per month would have to receive half of their SNAP benefits as canned or shelved items. Potential decreases in funding to programs aimed at mitigating the absence of fresh produce is only perpetuating the harm to Native American communities, and these programs need to receive better federal funding to enable those who rely on their benefits to adequately feed their families and to begin repairing the damages done by colonialist actions.
Furthermore, the federal government needs to utilize its power to provide incentives for supermarkets, who sell affordable produce, to open stores in areas that may traditionally be seen as unprofitable. When opening these grocery stores, incentives and programs that educate and encourage shoppers need to be an integral aspect of the shopping experience. Simply introducing accessible produce will help address the issue of food insecurity but may not immediately eradicate dietary habits.
In tandem with increasing federal funding for nutritional aid programs, additional non-profit organizations have been created to fight food insecurities rampant on reservations. The Fruits and Vegetables Prescription Program, which was started in the Four Corners region in partner with Partners In Health, provides patients with a “prescription” that is worth a month’s worth or free fruits and vegetables at their local store, and Partners In Health then reimburses the local stores. This has made produce more accessible and has demonstrated direct impacts on individual’s health, as one-third of children who were overweight at the initiation of the program are now at a healthy weight. Even though it is an example of a small scale intervention, the program demonstrates that change can be made and the health of a population can be improved with more affordable and accessible options.
While innovative programs are popping up on reservations and amongst other vulnerable groups to address food inequality, the federal government ultimately needs to take greater responsibility to solve the unequal access to healthy food. The 2020 elections offer an opportunity to vote for politicians that are dedicated to advocating for health equity for all populations and equitable health care options. Make sure that you are registered to vote and have signed up for your mail in ballot, if you need. We as voters need to ensure that our voices are heard and that all populations have equal opportunities to live healthy lives.