Transcript of "Rooted in Story"
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Hello, everyone. Welcome. Thank you so much for being here today. I am so pleased to be introducing you all to our guest speaker, Dr. Janelle Palacios. Dr. Palacios is a practicing nurse, midwife, a researcher, a policy advisor, lecturer and storyteller who grew up just a few hours west of here on the Flathead Indian Reservation. Dr. Palacios has served as the co-president of the Native Research Network, which is the nation's largest organization of health research focused Native American researchers and allies that was created by Native people. Janelle has engaged in qualitative research, working with tribal communities, using story work to understand motherhood formation among their mothers. Dr. Palacios currently collaborates with several researchers here at MSU, myself included, examining rural and racial disparities in access to maternal health services. Biden has earned national recognition for expertise in indigenous maternal health, serving on the Federal Advisory Committee on Infinite Maternal Mortality under the Health Resources and Services Administration. In her role as the co-chair of the Health Equity Workgroup on this committee, Janelle has is helping to bring national attention to the enduring maternal and infant health disparities that face American Indian and Alaska Native populations. And she's working to help develop clinical and policy strategies to address these disparities. Dr. Palacios served as a content expert on the CDC's hear her campaign and is a project design consultant for a national nationwide campaign through the National Center for Fatality Review and Prevention, which is working to enhance our understanding of fetal, infant and maternal mortality review by employing storytelling as a method she serves as the American Indian Alaska Native Content population expert, consultants for the Association of Maternal and Child Health Programs, and is working to design an anti-racist health equity research curriculum for them. More recently, Dr. Palacios is integrating storytelling into the Storywalk project, which is an innovative health equity tool that integrates history and storytelling to spark action for change, for better maternal child and infant health outcomes among bipoc populations. So we are just so pleased to have Dr. Palacios here with us today to share her nationally recognized work on storytelling to help better understand maternal and health, maternal and child health, and to help address health equity and health in politics. Thank you. That's not so. Good afternoon. Thank you, Dr. Carson, for that introduction. And I was wondering where the clicker with everything. Thank you. So I just tried texting the person in Montana. Right, just to test this out. And normally it works. But I think so much that their service is down right now. And so it's telling people to go to an online web page. But basically, you can find Alex anywhere on the globe where indigenous people historically have been. And so it's a really great tool. And this is a map created by an Indian indigenous person, Victor Temporada, who is really trying to help people understand what the world looked like before colonization started happening, before dispersion was happening. So you can see when I look at this map, I actually see a few things that really challenged my internalized view of the world. One was that there are really overlapping borders, right? People weren't seeing similar spaces. There wasn't a clearly defined border, typically of a group that there were a lot of overlapping areas. And so what this told, to my mind, is that I grew up on the Flathead Reservation and solution could be and I grew up on the reservation viewing people from south of the border as not my cousins, but people to the north of me, my cousins, my relations. And what I understood later in college is that the border crossed to us like this. These are political borders that crossed us as a people, as people in community. So I like to bring this map and show that no matter where you are in the world, you can kind of find out where the indigenous people lived and where their historical territories were. I have this now question for all of you. Whose lands are you standing on right now? Pop quiz, everyone. You know we're in academia. Pop quiz. All right. So we are in Bozeman, Montana. Who were the people that were originally here? Shout it out. Just Shani. Yeah. Well. What? Solution could be? Yes. There are more people. Okay. More people or more people? Who else? Here. I hear. I like that. Lusaka. Is that. Yeah. I only know that meeting. That road. Right. Yes. Caves while the wilder Umatilla. Shan. Sue. We have people that are sue nations in here. So we're basically on lands that indigenous people have inhabited for millennia. And we now understand that there's new understanding of archeology that has shown us that native people have been here for much longer period of time than we actually thought of like 20 years ago. So that is that's it for that little piece of history. You guys kinda did. Okay, but I really challenge you to do a better job next time, okay? So it's really important to understand where you are because land and people have connection. How many people are here? Because their people have been here for a few generations? Whether you're often from families, from homesteading, my father's family were homesteaders. Yeah. Or whether you're here because of transplants from California. Also, count if you've been here for two years that you felt that. I came over here on the big airplane. All right. All right. But lands and people have connection. So I'm here to just share with you how strategic storytelling can impact clinical practice, research and health policy. And I'm going to share with you maternal child health outcomes. This is. Oh, sorry. 310. Can you hear me now? Thank you. All right. What you see here are three generations of my family members. I was trained. I'm a nurse midwife. I practiced in Oakland, California. And as people were trying to understand what health equity meant and put it in practice because it people were it was difficult for people to see their own biases, their own lenses that were clouding their vision of someone's experience. So I try to make it really concrete. And what I did is I took my family as an example. So what you see here before you, three generations of my family, when you see my grandmother on the far right, you see my great auntie, her sister, Rhonda. You see my mother in the middle with me. And then I'm on the side and I'm representing other women in my family of my generation. But I want you to know that of these generations here, these three generations, my grandmother, aunties generation, my mother's generation, and then we've had three generations that of the women represented here. They're they these women, these Native women who lived on the Salish and Kootenay Flathead Reservation experienced more than 12 miscarriages, two stillbirths, four pre-term deliveries, three low birth weight babies, six hemorrhages. Multiple accounts of interpersonal violence. One homicide attempt. And a number of suicide attempts as well. So that is just represented in three generations here on this slide right here. When we try to understand what does health equity look like or try to understand like where, how do you connect history to outcomes? I created a short presentation which all help will hopefully help you understand how history is important to understand outcomes and how storytelling can be a method for overcoming these. The historical experiences people have had as intervention, as understanding as well. So how many people are familiar with maternal infant health? How many people are in that world? A few people. All right. So for the few people, this is going to be information they already know. But let me just say, our great nation, the United States, has the worst outcomes among developed nations in terms of how we take care of women and infants. We have women in our country that die the highest rates, the developing world. So especially among black and indigenous women, our women die at a higher rate. Our babies die at a higher rate. So on the far left, you see that four out of every 100,000 live births. There are 13 white women that die and that's really high. Should not be that high. Among Native women, it's about 30 women. And this is national. This is not state region data. This is national nationwide data, which has its problems. And then if you look at black women, about 41 out of 1000 women will die while they're pregnant. So. This is really bad. This is really bad. A lot of the developing countries, the developed countries look at our data. And, Wolf, you don't treat your women well. All right. If you were to think of the canary in the coal mine, it's the babies on the. So let me first also share with you that if you look at the top right hand side, sorry, depending on age, if you look at white women in the blue, they tend to have worse health outcomes when they're pregnant, when they're younger. So when they're 14, 15, 16, 17, 18, 18, 20, 20, 22, 33, 24, their outcomes are a little worse. They have higher rates of hemorrhage, higher rates of infection, higher rates of C-sections than when they're 25 and older. It's exact opposite for black and indigenous women. We tend to be healthier when we're younger because when we're older, our bodies have had so much stress on it that it is difficult to carry a healthy pregnancy. And when he looks far down at the very bottom, they didn't have enough data for Native women, very untypical cases. But if you look at education, we expect that if you have a higher rate of education, the more if you finish high school, you went on to college and you have a graduate level degree. You should have really good birth outcomes, right? Because you're educated, you're healthy. You probably have resources for white women. That's true. For black women, they actually have the worst health outcomes. So education and resources are not protective for black and indigenous women. When you look at sudden unexpected infant death or sudden infant death syndrome. So it's and SIDS. So infants dying by foreign native babies die at a higher rate. And most babies we take we swap places depending on where you put your timeframe for which time period you're looking at. But we swap places with black infants, but consistently native infants die at a much higher rate. Here is an example of our country, right? Depending on where you put the reference point 2014 data to 2018 versus 2015 to 2019. Montana was a hotspot of infant deaths 2014 to 2018. But if you move it by a year, it looks like we're a little bit on the lower end. I want you to see that there is a pattern to infant deaths and it usually follows where Indian Health Service is that the hotspots where Indian Health Service services are, those states that have higher native population have a higher rate of infant death. So we know that Native people have risk factors for preterm birth. There are sociodemographic risk factors like poverty, medical risk factors, disparities in access to care, like being really in Montana, being really far from a clinic. How many people know where Glasgow is? Mm hmm. Okay. And how far do you have to drive to get to a hospital? Like. Like a hospital with, like, three doctors? Kind of far. Right. All right. So we know in Montana, like Alaska. Services. Access to services is difficult and there's a differential and resources. How many people have been on a reservation? Drug driven through it? I people. How many people have actually driven through a reservation and been to the HUD housing and seen the HUD housing that people are living in? Where I grew up in. It's very different. How many people remember the movie Lilo Stitch? All right. And Lilo Stitch. And if you're a millennial woman, I've seen it. But it Lilo and Stitch, there's a great scene where in Hawaii they're showing the actual like native people, indigenous people live in Hawaii and they live in hot housing like native people do here. And you see cars out front, you see all sorts of things out front, reach houses out in the lawn. You see all sorts of things out front. So when you go through the reservation, there's the reservation and then there's the reservation. So if you've ever seen Hutt housing, then inside the reservation, there's a big difference. All right. Why do people why do you need a women day? There's not a lot of data. Let me just say this. It's really difficult to even find data on Native women. But when they looked at native data on Native women, they said, oh, native women die from home. They die from problems with their heart. They die from hypertension like pre-eclampsia. But what they were not able to find in this review, they were not able to look at homicide or suicide. And I'm not sure if I have the slide in here, but I will just say, meeting with federal partners and Mary Wallace, who is an investigator from the East Coast, she has found that actually when you look at all women in our country and you look at the reasons for deaths while they're pregnant or 42 days after they've delivered their baby, it's not hemorrhaging. It's not hard heart problems. It's not blood pressure issues that are killing them. Guess what it is? It's homicide. It's violence. You don't have to raise your hand. But I want you to think to your own personal experience of someone you meet know. Who you suspected or knew for sure was experiencing violence while they were pregnant or the early parts of parenting. It's very common and it cuts across all groups of people. All right. So when I was trying to when I earlier in my career, I was trying to help people understand why Native women in particular are at risk for poorer outcomes. And in early 2000, there were not a lot of great theories out there. So in PhD programs, they're like, Go find it yourself, make it yourself. You can do it. Here are the tools. Learn about theory, test it. And so I was like, Oh, great. This is going to be like a roller coaster ride, like white knuckle. Let's see what's out there. And at the time, there were not a lot of things. I had a mishmash, a few things. One of the things I had, mish mash was something called Life Course. And this means that from birth to death, people have varied experiences. People have varied experiences in terms of access to economics, access to money, access to reliable transportation, access to a good road. How many people know what it's like? Yeah, some really big potholes here in Ferguson. But how many people know what it's like in the dead of winter, which is not too far away, that you have an emergency and you need to take a back road or you need take that paved road. But the road is not good. Like you're worried about having black ice or maybe not having like the best car with the best tires. I have ball tires. And I mean, I could not drive yesterday, but people had to come rescue me. But those are real consequences, and we don't think of that. All right. So people have differential access to resources. People have differential experiences to racism. And from birth to death, you either have factors that support your life or knock you down or try to knock you down. Okay, so that's from birth to life. Life course. Life course with it being developed. But what I used was a theory called weathering and basically the same thing just it was something that was identified by a Harvard professor of early drama. Ms. And she noticed that black urban women tend to have different life experiences than white women. And she called her theory leathery. Now, some people take objection because I'm not bothered. But really, it's all about stress. How many people are engineers? Or know about Ali's thesis. Our static load. That's all about the stress on the load of stress on something. So if you think of life, someone's life, the stress load on someone's life affecting their health and opportunities. So, okay. So I was like, okay, I got something here, but this is not necessarily it. Now we have a thing called Aces Adverse Childhood Experiences. How many people are aware of Aces? All right, this is great. Okay, so I'm not gonna spend too much time. So, you know, from birth to death, there are experiences that we can experience that impact our health and our behaviors. Right. And they have found that these things like neglect, like abuse, like having someone close in your family that you love incarcerated. These have effects on you as a kid. And it can be related to STDs. It can be related to depression, mental health issues, attempts at suicide, cancer, stroke. Does this make sense? Great. Great, because you're my favorite people now, because it's going to make it easier when we go forward. All right. And that from birth onward. The more cases, the more assaults you have in your early childhood, the more problems you have at risk of developing it. So I'm like, okay, we have birth to death. But what about like, what happened before birth? What about, like, that mom's life? And then really what about all of the women's lives were. Right. Talking about ancestors. So I was then looking. How do I help people understand that this is weathering? This is just a theoretical. Take your photo of this theoretical construct of weathering. But how many people are aware of historical trauma theory? Right. So historical trauma theory says. There are traumatic events, not just one of event, but events that consistently happened onto a community of people, population of people. And as these events happened onto a community of people, it had destructive ramifications intergenerationally. So back in 2000, three, Microsoft Word had this program. So this paper was my first paper I published where you could only use squares, circles, rectangles and straight lines. This was my masterpiece. Behold, right? So for everyone who gets has an attempt or is pushed into writing their first manuscript, it's not going to look like this. And there is this little nervous anxiety about sharing it. But this was trying to help people understand that at the first generation since contact, what year did that happen? Or to get be to think so since contact there have been generational effects that have happened on Native people that have large impacts today. So I'm going to talk a little bit about those impacts. We now know, thankfully, that the CDC Center for Disease Control recognizes intergenerational trauma, historical trauma, as a construct that has real meaning and real significance on people's health. I love that. Social determinants of health. How many people are aware of? SDH? All right, great. So understanding history helps you understand why we have the current social economic determinants of health today. All right. How many people have seen a photo like this, an image like this, that try to help, tries to help people understand outcomes related to social determinants of health. Maggie is cheating. I've shared this with her before, but if you look at this tree, this tree has no fruit, no leaves. And that's to represent outcomes on the women and infants. Okay. We have the maternal outcomes. We have obesity, diabetes, hypertension, suicide, homicide, mental health, unintentional injuries. We have a lot of things, a lot of issues. On the left, we see on infants high rates of sewage incidents, pre-term deliveries, low birth weight, suicide sepsis, unintentional injuries. I'm starting to hear stereotypes. How many people can connect like stereotype with some of these outcomes? Maybe, maybe a moment later. If you look down at the roots, we have things like homelessness, health care, access, environmental toxins, poverty, employment, racism. But what's in the soil? What's feeding those roots? How many people want to know what a Starlight tour is? What is the structure? Starlight tours is when men of color usually needed. Men are picked up by law enforcement. And they are driven far away. Usually in the winter. And left. And that person usually dies. It's called the Starlight Tour. That's something that actually happens both in Canada and the United States. That's an experience that Native people experience and face. And that's not been talked about. And you've got. How many people know what blood quantum is? Right. Some people. That's right. Good. That is a federal government policy telling Native people you have to decide who is a part of the tribe. You have to separate people, your family, and decide who gets things and who doesn't. How many people know when religion was outlawed for Native people? How many people know in religious freedom was found here in this country? Like everyone should know that that was like a middle school. Great thing, right? What year? When did that happen? 1620. Right about there's amendment. Which amendment? Guarantees like the right to freedom. In the first few. I heard first. Someone whispered first. Yes. But did you know that Native people were banned from practicing their religious beliefs and culture until 1978, a year before I was born? It was banned. It was illegal. You could be arrested and imprisoned. So what's in the soil? A lot of things are in the soil. So we have to amend the soil. All right. So I really want to understand, what are the generational implications that affected health? This is my grandmother, my great grandmother and my great grandfather, both Salish and we both attended boarding schools. I have a whole presentation ten minute long for those millennials who is about using means to talk about native history. This is one of those slides. How many people know what the doctrine of? Destiny. Is. So there's manifest destiny and there's a doctrine of discovery. Sorry, doctor of doctrine of discovery. All right, great. Yes. Yes. Yes. So when Columbus accidentally founded or arrived and was found by indigenous people that I know The Tonight Show people. And then came back to Rome and reported. And the pope found out, oh, my gosh, there are these lands out there. The pope instantly created a palpable and palpable said, if you are a Christian nation and you go out and you find lands that are uninhabited by Christian folk, you can claim those lands, plant your flag and demand and say that this is Christian land and you can enslave all the people and take all the resources without any sin. You have the power to bring forth Christianity and there's no fault to you. You can do this. That is the doctrine of destiny or doctrine of discovery. Sorry. So it is because of that orientation, that view of the world that you have a lot of people from European countries, that there was no sin connected to the havoc they were created with native peoples. So this is a winter camp and I really encourage you to look at winter counts because as a record keeping tool, it shows you throughout history when things like measles appeared in communities and decimated populations. All right. In 1491, what was the census for Native people? 100% Native people everywhere. We don't know because we didn't keep really great records at the time. But we don't know how many native people, indigenous people there were in North and Central and South America. There is a debate 100 million, few hundred million. We don't know. But we do know that in a very short timeline, about 90% estimated of Native people were annihilated largely by disease. Diseases moved really quickly, very fast, and not just one time, but like a few times. So diseases reached Native people long before Europeans did in many parts of the United States. Right. So the victor always gets to decide what the story is. Right. Where was this? Do it when they were writing the history books? Because I read those history books and this dude was not there. We don't talk about this, but our nation's constitution is largely based on the five civilized nations that women were largely involved in deciding what happened in government. Right. So they don't get that recognition of the five civilized nations or the native women. So we have enshrined. In our nation's history, even though we don't know that. But it's an act every day of the doctrine of death and discovery. And then we have a John Gast, beautiful portrait. It's beautiful. It's lovely painting. But this is the Western view of civilization. So this is a lady Columbian moving from the East Coast where contact had happened and was moving west. And what do you see in this allegory, this painting? For all my art students out there, what's this showing you as she's moving from the east to the west? What's happening in the east? You see light. You see cities. You see economic. Right? You see civilization. What do you see happening as she's moving westward? It's not just. She made us. You see, like, it's thundering, it's like ominous. It's terror, it's like savage territory. It's wild. You see, the farmers are some of the first people coming out, right? And behind the farmers are like, is the economics like the train system? So this is Manifest Destiny. Yes. History has effects on Native people that it has prohibited Native people from living their fullest potential in health. So that are quite confederacy of nations. The five civilized nations. The US Constitution. Right. How many people know about the Trail of Tears? Okay, great. So you know that in the 18 late 1800s that that Native people were being forced from the southeast into Oklahoma. Did you know that there was a case, a Supreme Court case, that Cherokee Nation, one that said they could not be reached, that no one could move them from their territory and they won it. And that the landmark piece that guarantees tribal sovereignty today. But what happened? No one no one, no one was able to enforce that ruling, that Supreme Court ruling. No one did. No one went against president. The president at the time. And so native people were forced about 5000. It's estimated they didn't keep great records back then. It's not to their advantage to, but about 5000 men, women, infants and children died on these marches to Oklahoma territory. The people who stayed behind and there were few there were few people who stayed behind. They hid in plain sight so that they would not have to be moved to Oklahoma territory. So in the 1860s, as the U.S. government was exploring, Manifest Destiny was taking all the Western territories and making them into states. The policies changed over time how the government interacted with people. So most of the treaties were made before the 18 before 1870. It was like around 1870 was like the last of the treaties were being done as a side note. What the state of California before it became a state as a territory, they were told, clean up your Indian problem. And so it was open season on Native Californians. And the government was estimated at the time in the 1880s to have financially sponsored almost $1,000,000 worth of money for scalps that were turned in on women. Infants. Children. Women. And that's not something that we are taught in our histories. And a lot of nations were wiped out. And to this day there are very few reservations in California and the tribes are very small. And they don't have access to Indian Health Service. In Alaska as a state. When it became a state, Alaska was treated more like a business. So they're called corporations, Alaska native villages, Alaska corporations. And so the way that the U.S. government treated them was also slightly different. And then we get to Hawaii. And native Hawaiians don't have the same access to resources or it's not enshrined in any sovereignty or any laws about protecting the indigenous people of Hawaii. So the government kind of like wised up a little bit on how they were going to treat Indigenous people because it was becoming costly for them. All right. This is just to show you that if you look at in the Dakotas, right. If you look at the traditional territories of different Sioux nations in light green and then in the dark green are the lands that were originally supposed to be held for reservations for Sioux people. And then the orange is actually what the government gave them. So it went from in in the trees are the dark green. That's all the land Sioux nations were supposed to have. And that happened for pretty much every single reservation. But the government takes these bakkies and gave them just the orange stuff. How many people know what Black Hills Gold is? All right. How many people have been on Mt. Rushmore? So those are Black Hills like hills have some gold, they have some resources. When the government found out that there was gold and then there hills it takes these that it's ours again. And just so you don't forget it, we're going to carve the faces of some residents in these sacred mountains of yours so you don't forget. So we can see a timeline. The dark representing indigenous homelands from 1492 to today. Little bit different view of that. I want to just point out that the largest land holdings typically are lands that people don't want. How you believe in the Four Corners area? And so at the time when reservations were formed, government was like, Oh, no one wants to apply and there's nothing there. What's there is? Anyone know what's in the Four Corners area, the a resource. Uranium. Yeah. So largely the lands that have the largest land holds are lands that the government and states thought were low resource land. Garbage land don't need it. You can have it. How many people knew that there were two kinds of buffalo. In our in our world, in the Northern Hemisphere, I had no idea we had two different types of buffalo. There were the woodland buffalo and then the plains bison buffalo. We all know today the woodland buffalo were wiped out. It was a government policy to take away the food supply from Native people so they couldn't organize. They couldn't be together in large groups. You can see from the timeline that there were over 5 million Buffalo in 1870. Ten years later, there are less than 400,000. And the nine years later, 540. And then just a short time later, 300. All the buffalo we have today are from the remaining 300 buffalo that were not wiped out. Every buffalo dead. Is an Indian gone? Again. It was to take away a food source, to make native people starve, to make them dependent on the government, and to take away their ability to organize. And then we had the Dawes Act. So basically reservations were formed, people were on reservations, and then the land was then divided up and heads of household were given tracts of land on my reservation. There was so much land that I didn't that the head of household, there were far too few of head of household that the land was opened up. And this is an actual replica of a newspaper advertisement to homesteaders inviting people to come. Cheap land, Indian land. So my reservation. Has people who have been home studying for a while, you know, seven or eight generations of people. But it is because the government said, even though we gave you this land, we're going to take it back and we're going to sell it. So my reservation right here in the state is a patchwork quilt of land held by my tribe. And lands held by non-native people. And you'll find that basically all the towns are held by non-native people. They own that land. It's not Trump land anymore. The purple now is no longer there because my auntie won a case that got all that land back. But the green is tribal held land and that's largely forested land. All right. You already answered this question. Kind of. Let's see. Pop quiz again. Witness Religious freedom found in this country. 16/21 Amendment. Okay. And when were Native people allowed to practice their religion? 1978. All right. All right. Let's briefly take a to Wounded Knee. So on Pine Ridge Reservation, a few days after Christmas, some Native people were trying to practice religion. They were organized. The government saw them as organizing, saw them as being violent, potentially being violent, and wanted to disrupt that. So they sent in the seventh Calvary. It's estimated over 300 people died. Largely men, native men, just a few Calvary people were lost. This is a mass grave, a pit that was dug. That's frozen land. Pine Ridge Reservation. Where people were just thrown to. Oscar Howe is a native who years later in the 1960s created this beautiful painting. And President Dwight Eisenhower, his family bought this painting, is now in his library. But this painting is from his grandmother's account of what she experienced as a child. She was a child when this happened and she was shot in the hand. It's not us per season, people. Chief Joseph Yeah. So, Chief Joseph as the, as the U.S. Calvary was trying to round up needy people and get them on the reservations, Chief Joseph was like, not taking that, taking my family leave and trying to get to Canada. They were just a few miles from Canada escaping, and they were caught and imprisoned in New Mexico for a few years. And then Chief Joseph tried to right everyone in the Northwest asking, can I can we come and live on your land? Can you share your land? And I believe it is only Colville. The Colville people answered his calling so you can share land with us. And then a short while later, the Nez Perce people were granted land in Idaho, but their original plans are not in Idaho. It's part of Idaho, but largely Oregon and California. That's where the people originally were and that's where they wanted to be. A lot of this is about land and resources taking that away. How many people know about boarding schools? Great. Must be really fast. Carlisle. I mean, boarding school, first Indian boarding school. And it was modeled after the military because the military has a great model of breaking people down and building them up. And that's exactly what they tried to do with children. There's a federal Indian boarding school report that Deb Haaland, interior secretary, had done that investigated federal run Indian boarding schools, and they found that it was intentionally done. Boarding schools were intentionally created to break down the Native American family system because it was a strong system. And if you could break that family, you could break the people. So children as young as age four were forcibly taken from their communities and put into these prisons for 1818 years. And. Colonel Henry Pratt, the founder of Carlisle Indian Boarding School, had before and after photos taken. Because you know what, propaganda is really important. So this is a before and after of Apache children. This is a very famous one. Tom Paulino, the name young man, about three years after he was taken. This is my great grandfather, Ernie Ernest, who attended Haskell Indian boarding school. And again, it's a military like these. Boarding schools were very militarized. The young men were shaped into becoming in a very militaristic role. He's wearing this uniform. They were taught skills and traits. And when they went back to their communities, they were often people. Survivors of that time talk about not having the skills equipped or their community to be to partake in their community. They didn't have the language anymore and they carried with them abuses. Physical abuse. Psychological abuse. Verbal abuse. Mental abuse. Right. Sexual abuse. Not just one time, multiple times, not just by adults, but by children as well. In the federal Indian Boarding School report, they found that boarding schools encouraged older children to punish younger children. And intentionally, children from the same tribe were torn apart, taken apart. Brothers and sisters were put in different boarding schools. They did not want children to have an identity. And because of this experience, we have what's called the Pan Indian, the Pan American Indian experience, the shared common history. Some more propaganda. Look at that front row. Like when I see those bees and the very front and know that they were held captive for years. It just is astounding. And it helps me understand and contextualize why we have mental health issues in our communities. When you take away religion, when you take away cultural practices, you outlaw them. There's no way. But what makes it very difficult to get through that trauma? So what do people do? You can't. Like you practice your religion, you can't access a way that's going to help you through that trauma. What might someone do? To. Get rid of it. Do not think of it to escape it. Yeah. Drugs, alcohol. Exactly. They might enact the same harms on other people. Right. We know from the Carlisle Indian boarding school that there were a number of children that died. This is a graveyard of 186 children that were that are buried with head markers. We know that a lot of native children died on outings like field trips. Well, what we also know, too, that there are accounts that lots of children try to run away and lots of children were murdered. We don't know how many. And Canada and the United States. Canada has more. There have been they've embraced more of a truth and reconciliation policy, where machines go through historical boarding school grounds and find bombs. They find mass unmarked graves. Happened in Canada. It happened here, too. And children's bodies and infants bodies were found in these mass unmarked graves, oftentimes run by the church, but sponsored by the federal mean the Indian boarding school. This is in downtown Albuquerque. When Albuquerque was undergoing, they were doing a public works project in a public park. They came across all these bones and then they realized, oh, my gosh, this is where the Indian boarding school was. They found all these bones of these children's bones in Albuquerque, downtown, in a park unmarked grave. September 30th is the National Day of Remembrance. We are still finding bombs. We don't know how many people have died or past. And now we have people coming forward, sharing their own accounts of witnessing traumas, witnessing murders that they have suppressed. All right. So as the boarding schools fell out of favor, residential ones far away fell out of favor. Then residential ones on reservations were created as those fell out of favor because of a lot of abuses were happening. Even on my home reservation, we had a boarding school on the reservation run by the Ursuline nuns. In 2011, about 40 adults stepped forward, sharing their history, their stories of trauma and abuse at the hands of nuns and Jesuit priests. And they sued their silence. So these traumas are not that far away. Like, they didn't happen, like, a long time ago. This is still in living memory as the boarding school era kind of fell out. Needy children were then hustled into foster care. Today need of children are disproportionately. In foster care more than any other group of children. So even though Native people are a small population, there are many more native people represented in children in foster care than any other group. In the 1950s the Indian then a federal policy Western saying, you know what? Let's get a result. Let's get rid of the reservation. It's not working. You guys need economic independence. Why don't you get out there, join the workforce. Hey, we'll get you a one way ticket for you and your family, and you can go to L.A. or Chicago. New York even was in Francisco, you can go to Minneapolis. So some people did do this because they were promised that they would have jobs, they would have a house, they would have a community, they would have a better life. And that didn't pan out. That didn't actually work. It was it was a way to terminate tribes. And some tribes were terminated, like lost all recognition, no longer time, not recognize, and people left in droves. And that's how we have a lot. That's how we have now the urban Indian population, native people who could not find their way back to their communities. So Luana Bros. She is the ocean put me as well. She did her work looking at the construction deviants, incarcerated Native American women. She shared that the federal government has embraced conflicting policies regarding Native people, shifting from genocide to expulsion, exclusion and confinement, and later to supposed assimilation. The rhetoric was integration. The reality was confinement and domination. Some U.S. policy was like, Let's first just kill everyone. And then if that's not working out, let's just kind of move to the side. We'll just push them westward. We'll just take this land and that's theirs. And then it was like, But that's really good land and we need more resources. Let's just make sure they have smaller areas. Let's make sure that we make sure their children, the next generation, are assimilated. So we'll do assimilation and acculturation will make sure that they become like us. And then when that didn't work out, they're like, okay, well, let's see. Let's, let's, let's just give them a little bit of power. So that is, in a nutshell, how the U.S. policies have affected Native people. All right. I'd share with you a little bit about how Twitter. All right. I'm an Eminem fan, so this is a common issue for many people. So I asked people, how many people know what blood quantum is? Right. So in the United States, it's not widely known. It's the secret. But that American using Alaska Native people is actually a political designation. It's not a race, it's not a ethnicity. But we use it as a race or ethnicity. But legally, American, any Alaskan Native people, it's a political designation because they are sovereign. They have sovereignty, they have different rights, they have different relation to the U.S. government. But the U.S. said you have to decide who is a member of your tribe. And so they really pressured story. They really pressured native communities to decide who was going to be Indian. And oftentimes they encouraged them to take a stance of one quarter of that particular Native American tribe. So you can have multiple different Native American identities in you. But if you did not make one quarter of any one tribe, you're not a tribal member. Other tribes have decided different criteria, but that is just it in a nutshell. If you have American Indian, Alaska Native identity or you are ruled in a tribe, you have access to some resources like HUD housing, like commodity foods. Like Indian Health Service. All right. This is the highlights of being a tribal member. All right. You also had a one way ticket as a native woman to be sterilized. And in the 1970s, between 1973 and 1976, over 3000 American women were sterilized when they only reviewed three of the 12 sorry, four of the 12 Indian Health Service things in a three year period. And they decided not to look any further, not to look at any other years, not to look at the rest of the night in the health services when they found that over 3000 women had been sterilized in the three year period and the youngest was 11. But that doesn't happen just in history, still happens today, and it happens disproportionately among women of color, women of culture. This just happened. This is happening. How many people are aware of this? You're in the news. You're paying attention, right? All the border issues and ice. So Latino women, Hispanic women were kept at the border and sterilized against their will. Missing, murdered indigenous women and girls and people. That's something that a lot of people are not very familiar with as well, but that impacts our community. Incarceration. So by far. Native American people are overrepresented in incarceration. And I would just say that this data is it's old, but it hasn't changed much. So here's the state of Montana. If you look at the portion of population, like if you have 80 or 80% of Montana identify as white, but they only make up 69% of the people who are incarcerated. But look at Native people. They make up 6% of this population, but over 22% of people who are incarcerated, I think three times. Death from police brutality. Native people die three times the rate of white people in the air. People die two and a half times the rate of black people. And that's actually here in this graph. The highest spike is green. It's the Native American death by police brutality. So what do we know about new American health? Right. We know that there are a lot of risk factors for it. More recently working with Montana State University's Thorsen power couple. At the very front role here, we know that Native American women drive significantly farther than white women to access care. And they're 20 times more likely to give birth at a hospital without OB services, even though they have more complex obstetric pictures. And it's really more pronounced among reservation dwelling women. I mean, let's get through this. But that was just to show you that homicide kills more women than hemorrhage, in fact, in retention. Okay. We are an asterisk nation. For the most part, our numbers are so small where the asterisk growth is something else. And so we have to consistently tell the states and hold the federal government accountable that you have to count us. You have to know our outcomes. Because if you don't know our outcomes, you don't know how bad it is or how good it is or how good it could be. So where do we go from here? I'm going to share with you a very brief storm. This is just to demonstrate how. Story is really important. Newly married at age 24. I'm pregnant for the first time, working for social services for the medical community. My husband also worked long hours. We had a rocky start to our relationship filled with the violence of alcoholism. But when I became pregnant, we grew with a couple and the balance ending, though his drinking continued. I was doing all my pregnancy, scheduling all the prenatal appointments I was told I needed, and rarely came sleeping all the time to isolate dangerous. When I was about six months pregnant, the clinic told me I had completed my year. She notified the doctor the Senate was fine not to worry and to go that weekend every time I was sick. I had the worst month in my life. I was nervous and the something was wrong and I felt awful. It was winter and the roads were icy. But I went to the local hospital. I was transferred to another hospital 65 miles away, bleeding and feeling worse, with no details from the medical personnel of what was happening to me and what I thought of them. When I found out my dog had died and I was told they needed to do something of Christianity adoption and took the request to look like a baby girl. I've stayed in three days in the hospital. No family or friends at my side. Generally covering the one adjective you have just faced, no one at the hospital asked me how I was going. Have I just lost the baby? I was told to take medication to prevent seizures. Educated me on how to care for myself this term or after the loss of a baby and how long I should wait before trying to get. Wanting to move on. We became public because I was considered high risk by clinic appointments for anything offered to them to attend 115 minute appointment. I had to drive 120 miles roundtrip. At the time we had just one car we shared again. I was pregnant, Jonathan Button, so was my dad and I had to cancel appointments simply because it was too dangerous to drive. One day at work while six months pregnant. Something felt off. I did not realize my mind had broken. I thought I was having my discharge, but then started spotting. I called the doctor's office and was told to come in. When I arrived at the hospital, I was a creature of labor and born of a local small hospital. The doctor told me that throughout the day I was not allowed to play my son. There was no way to answer that along with the nursery. But you see myself, Kelly, as a survivor. He lived despite the doctors pregnancies. I was immediately transported 500 miles away to the center. I think all the entitlements then, not just fashion. A week later, while visiting him. Kelly was born weighing £1.12 ounces and he lost weight his first week of life with six ounces because he was 20. A lot of the camp, he received six some. And I sent a great team of people and I did not completely understand the in the hospital. A hospital social worker told me that my son died and she encouraged me not to change my routine platform to continue working and live my life. I started getting the emphasis that I witnessed when I was on the short time I could visit, but I was not able to be with my son the entire time he stayed in the hospital for. And he was about three months of age. He was transferred closer to home to neonatal center that had just opened with staff positions. And a number of mistakes were made in my son's care. I was taught CPR in case I needed to resuscitate my baby. And when he was discharged five months of age. I had to give CPR a few times and he stopped breathing. Why then return to the clinic doctor without any understanding as to why I had a stillborn baby. I wanted to prove something with the second. I remember the doctor encouraging me to continue trying for children, he said. So why is story? When we look at data. There are different levels of data. On a community level that was long, 23 years old. Finch could be 3% less to buy birds 29 weeks or about seven months richer later, with no risk factors like violence, smoking in the household delivered. A preacher son encouraged me to pounce or actually let someone come and stay healthy with a stable career and access to one of our guns in hospitals. That's like community level data like program the. When we look at county level data, we see less of the story. This is what looks like. When you see stable data, we see that her identity as an American woman is sometimes dropped out altogether and labeled as another. We see federal data. It's usually other asterisk. The work of story. Story the importance of story in storytelling is that. We are blurring the story where humans become can the story. The shortest distance between two people is a story. Usually we think in story we learn the story. It is part of our connectedness. As humans, story can improve memory, it can provide instruction, it can help people identify problems and it can provide motivation. There is a story and this that. If you can change the head. And the heart and affect the heart, and you can change the hands for the action. So if you can change how someone thinks and believes and you can change how their heart feels or empathize, you can then change their actions. The story challenges us. Have you ever felt that feeling of getting the shivers when you're talking to someone, when you're connecting to someone or you're having listening to music or watching something, that's storytelling. That is connectedness. There's a science behind storytelling when they hook up to people, to MRI's, and they look at the brains of the person telling the story, and they look at the brain, the person who's listening to the story, they light up and the brain wavelengths become the same when there's a connection about what their identity is that they found. So if you really can change someone's perception of something, you can change someone's view, a stereotype. You can change how they empathize or think about something. It changes the way they think. It changes the way they act. And. We need history and we need story. They synergistically work well together because without history we don't understand that context. Context is really important to understanding why something is happening the way it is now. The story I shared with you. Does that sound like something that happened that could happen today in any of the communities that happened today? Right. I think that's. It happened 44 years ago on my resignation. My auntie, she's talking about her birth experience with her two children. 44 years ago. And that hasn't changed. It hasn't changed for me. Hasn't changed for rural. But it certainly hasn't changed for Native women because that's still today. So how can storing be used in the policy level area? You can use stories intervention for helping people change the way they think and believe. You can use story as a way to gather that data because when you take away that story and we strip it to the variables we lose, all that context doesn't mean much. But if you use story in policy making, which is something that we did I did recently in September on a national advisory committee where we invited people with lived experience to come share their stories of what it was like being native, being a woman, being on reservations, being in urban settings and accessing health care. You can see that people were moved. The big wigs with the federal suits were like, How can we help? What can we do? Their stories were so powerful that it really changed how federal policies are trying to change, but they need more people to buy into that. It takes more than just a few stories. It takes people as a community and community to make sure these changes happen. I am a staunch Montanan. I will live in Washington State. I will always be tenant, and I always introduced myself as an intended first. And that pride is that I have community and I no longer have anger for all the injustices that have happened to our people. But I have a shared belief that we can compete with each other. So the more people who buy in will have the similar view that we are one nation, that we are in community with each other, that we can be better all together and still have differences. But it takes all of us respecting one another, seeing each other as humans. Can we have a better future and all? By gosh, we are the laughing stock as a nation to many nations because we don't have a community. We say we do, but we don't. So how can we move that same connection with people through all bobcats? Right. There's a connection, right? You all have rivalries with like the Grizz or the Huskies, right? Bring that to the table and share that connectedness and then slowly introduce new ideas to people. Because we need all of us to make these changes, not just for Native women, but all women in our country. Thank you very much. I just have one question or one box. So you have sticky notes. I'm going to skip the beans because I feel like we have a lot of okay. But sometimes the fastest way of building rapport is to build some method. So I feel like I got some laughs. I mean, that guy over there is a little hard to get, but I think both of you will be. All right. So I want you to think for a moment and think about because this day I think of a ridiculous family moment or an embarrassing moment in six words or less. Write it down on your sticky note. So a headline might be What's an embarrassing moment? For Me? That's about six words. So money might be something like. A. Deadly SBT in and out of the airplane sometimes right like if something so embarrassing but that makes you go at once I want to know more, right? I want to know what was going on in that elevator. Who was in that place? Maybe another one might be. Oh. Sitting in his seat that actually happened to be sitting in Pee Daddy seat. It was no more about that story. Right. All right. Okay. What's another one? I'll think of another. You too. It's your assignment as well, because I'd like you to, if you're brave enough to share your six word story. All right. So while you're thinking of that, let me give you one. Think of a moment that led you to seek higher education. What is a six word headline? What's the moment you can think of that led you to where you are today? But the intention of this exercise is really to give you a taste of these headlines you create to generate someone wanting to know more about that story. Sitting next to PD or sitting in PD DC. I was hoping that no one was going to catch that red eye and I was going to sit in that book Six Feet and it was going to be mine the entire row and the last person to arrive with Peter and his handler. And Peter, he was like, Excuse me, my seat. And I was like, Oh, I'm so sorry. You let me move, right? Like thinking, oh, my gosh, I get this three seats to do this in the row. And I didn't recognize this. P because the handler though kept making a big deal commission his son Jamie get your bag from his son. And I'm like, what is up with this guy? Like six in the morning he's come a lot of ruckus. Like everyone just kind of go back to sleep. And I looked at the guy next to me and he's wearing sunglasses. Look, this airplane, six in the morning in Seattle. And then it was, oh, my gosh, he's smaller than I thought he'd be in real life. All right. Does anyone have a story? If there's one story that they want to share from higher ed or from a ridiculous, embarrassing moment. Yes, please do. It's family vomit. That was mother and son. Order to enjoy. I have something happening. I really want to know what happened. What did enjoy do right? Yeah. Oh, now I'm really intrigued. Now I'm like, did you embarrass him? Like, okay, this is great. Anyone else want to follow that up? It's hard to beat, but it makes you want to go find out what was going on in that story. Right. So open invitation going once. Going twice. I'm going to invite you to stick your sticky up on the wall that let's see. Just over here, as you're leaving up on the wall, no one will know that you wrote it. But it'll be wonderful if you feel like it. I'm not going to remember who had a pink pen, who had a red pen, who had that sticky. But the fact that you're doing this just shows that you're trusting and is also like a short, informal way of measurement of how many people have it. But I'm here to answer any questions and we can also move. So the next space to. And. Thank you so much for this. I'm Sally Wiseman in the College of Nursing students were learning about. And this week we were talking about that and wondering about your perspective and breaking this story into the sky. Yeah. So you have to know the question that you want. You have to know what are you really trying to understand? Because that's going to frame then the method of qualitative inquiry you're going to use. Because in qualitative research there are different beliefs and ways of looking at data. So if you want to know a process that's more like grounded theory, if you want to know lived experience, that can be narrative inquiry or that could be phenomenology, if you want to know, let's see. So a lot of oftentimes it's like the experience of an illness or the experience of something is as very popular, you see. And you want to know how do people make decisions that's grounded theory, that's more grounded theory. The big thing to know is that one trying to take qualitative data and try to like make it quantitative because qualitative research history is that it wasn't really well-respected. So quantitative people were like, We're going to make this respectable, we're going to make numbers assigned to language. And so it was a very rocky entry. But I just want to also say that a lot of native communities, indigenous peoples around the world story has a way of collecting data as a way of sharing information. So how do you take it? How do you take qualitative data into the science? Just like how I showed you when we look at data. If you strip away. A person's experience by age, race or ethnicity and outcome of their pregnancy. It takes away a lot of that contextualization. You really needed to know she lived in a rural area. There are bad roads in the winter and that's not well communicated in the data that was presented. So there is a space for data that or qualitative data or story in every place in science. And stronger sciences tend to have both methods together, integrated. Except those damn science people, you know, that are in the traditional scenario, they have no understanding typically of like qualitative work. Any other questions? Since. Split like. So loaded with that. This is a really great question, and that would be like a response to a dissertation committee, like how you describe that. But there are different ways of looking either, you know, is it that you're a scientist and you grab other scientists and you guys read the transcripts and you all agree that this is the way it is, this is true? Or do you invite the people who actually share their story and you get them to also be involved? And you ask them, does this mean something? Does this resonate with you and your experience? So there's a variation of what that analysis looks like. And I tend to be of the variation where you invite the people who participate, you invite the community into the analysis. So if you can repeat the question over something, that's. Any other questions? Are you all good? Yes. So when you are reporting on stories like this. How do you scale your findings? Like how did you get it out? The message breadth and the policymakers. What are the strategies that you use to take something like a video and make it into a format where people are going to soak that story? So the question was how to disseminate your research findings, right? How do you make it go to market? Basically, we then researchers, really successful researchers are really good at marketing to okay because they have to showcase their work. So the more that you can have publicity on the work that was done and have like a news station or have an article written about it, the more that you're able to share the results of the research in the community and the wider community and the nationally like conferences. The more people will be like, Oh, that's really interesting, and you make connections. So I would say people are using Instagram, they're using like a social media to get out their findings, they're using PR campaigns, are the contacting news places. They're sometimes writing their own article from like the local but on like the where we've both been like I don't know what the Bozeman periodical is the art, the newspaper. But okay, I was going to say the Chronicle or Gazette. But then, you know, you can write it for a writer there because they're inundated with lots of stuff. But when you're at conferences, it's another vehicle. Really successful partnerships, and especially when you're doing work with communities, is to invite community members or have it built into your design so that they're also participating in disseminating that research into something that work. Because it's their work, it's their stories, it's what's affecting their lives. You were the person that had skills and expertise that if you're able to share that light with them, share those resources, it leads to lasting impact, too. And the government loves those kinds of relationships and they love any PR you get. … Any other questions? I'm sure we can chat afterwards, but thank you so much again.