In 1851, the US government passed the Indian Appropriations Act, creating reservation lands for Native Americans. For decades prior, the US government had forcefully moved and abused Native American tribes, most notably through the Indian Removal Act and subsequent Trail of Tears under President Andrew Johnson.
In placing them on reservations, the US government often forced Native Americans to live on subpar lands under harsh conditions. Reservation rules were also oppressive and unfamiliar. By 1887, the government took further action with the Dawes Act. President Grover Cleveland signed the act, which aimed to assimilate Native Americans into white culture and improve their lives. It did the opposite. By taking more land away from Native Americans, splitting up land they already held, depriving them of productive and profitable farmland, and sending them into abject poverty, the US government only made matters worse.
During the 20th century, Native American life was directly tied to the reservation system. Until the 1950s, most Native Americans lived on reservations. Today, the majority of Native Americans live in cities, but life on a reservation is still difficult for those who remain. Poverty, inadequate health care, crime, and alcohol abuse characterize reservation life - but so do cultural strength and pride in tradition.
The median income for Native Americans and Alaska Natives was $37,227 in 2014, but some indigenous people living on reservations reportedly earn less than $10,000 a year. For example, Oglala Lakota County, SD, home to the Pine Ridge Reservation, has a per capita income of $8,768 - the lowest in the nation.
Income levels may be rising: In 1989, the per capita income on reservations was $4,478 and "ranged from about $3,100 on the Papago and Pine Ridge Reservations to over $4,500 on the Blackfeet ($4,718) and Hopi ($4,566) Reservations."
But Native Americans not living on reservations earn almost twice as much - something that has caused tension within reservations. According to one story in Native News:
Native Americans face a constant conflict: A push to move into a city, go to school, find a job, perhaps start a family and a pull to stay on the reservation, where there's family and generations of support. The conflict is reasonable, tribal reservations are often impoverished and have unemployment rates well into the double digits. Urban areas are increasingly becoming rife with promise and opportunity... Tribal government has a high turnaround rate, which can lead to economic uncertainty because the majority of jobs are tied to tribal government.
Dustin Monroe, a member of the Blackfeet Nation, corroborated this, saying, "People are drawn off reservations because of instability."
The life expectancy for Native Americans is reportedly up to 20 years shorter than the national average. Racism in the health care system and a general lack of access to health care may contribute heavily to this statistic.
Between 2009 and 2011, Native American life expectancy was more than five years below that of other racial groups in the United States. Native Americans and Alaska Natives live an average of 73 years, while the rest of the population lives roughly 78. This is an improvement from 1970, when the life expectancy for Native Americans was only 44 years, a third less than that of average Americans.
The life expectancy for Native Americans varies by state and by reservation. At the Pine Ridge Reservation in South Dakota, life expectancy hovers in the upper 40s for men, and the mid-50s for women - far below the state's already low average.
White colonizers first introduced Native Americans to alcohol. Native Americans modeled their drinking behavior on what they saw from Europeans during their expansion across North America. Alcohol took on economic and political roles in the relationship between Native Americans and white settlers on the frontier, from positive social aspects to more negative outcomes, including excess drinking.
Today, both drug abuse and alcoholism remain problematic. Olowan Martinez, a member of the Lakota Tribe, described the reservation she grew up on as "a hole," adding, "It's been based on liquid genocide for generations." Technically, two-thirds of reservations in the US are mandated "dry" by the tribal governments to combat high alcoholism rates, but there are countless bars and liquor stores just outside reservation boundaries.
Drugs like methamphetamine are a bigger problem for younger Native populations. Between 2006 and 2014, drug cases on reservations reportedly increased drastically. Studies show teenagers on reservations are much more likely to use drugs. Calls for prevention programs, especially in the face of high fetal alcohol syndrome numbers and incidents of babies born addicted to meth, emphasize the importance of local support systems.
Given Native Americans' underfunding and the long history of identity struggles, breaking the cycle of alcohol and drug abuse remains complicated. Nick Estes, an assistant professor at the University of New Mexico and a citizen of the Lower Brulé Sioux Tribe, wrote, "Misunderstanding the ways in which Native bodies are made poor and criminalized makes it impossible to understand the structure of settler colonialism as a precondition for that poverty."
Native Americans living on reservations rely on Indian Health Services (IHS) for medical care. The IHS, organized by the federal government, is underfunded and has been since its creation in the 1970s. The IHS receives a lump sum of money each year to treat and care for all Native Americans living on reservations, regardless of need or number. While more than half of Native Americans now live off-reservation, the health care gap between Native populations and other Americans demonstrates the continued lack of access, opportunity, and information among Native groups.
Clinics on reservations often have limited hours, do not let patients make appointments, and lack equipment like MRI machines. According to Donna Keeler, the director of South Dakota Urban Indian Health, even federal prisoners receive more care than people living on reservations. In 2013, the IHS spent "$2,849 a person, compared with $7,717 for health care spending nationally."
With a lack of access to adequate health care and substance abuse treatment facilities, Native Americans are more than four times more likely to die of liver disease, three times more likely to die of diabetes, and almost twice as likely to die of pneumonia or influenza.