Aiding John Hopkins with COVID map
From my facebook post on Indigenous Peoples Day: https://www.facebook.com/nancy.marie.spears.0402/posts/426674012210273
As some may know, I have a heavy background in investigative and indigenous affairs coverage, but I'm also a huge enthusiast for data journalism. Over a year ago in June 2020, I was selected to be on a team that canvassed tribes directly for COVID-19 infection rate and death rate data in Indigenous communities in a partnership project with other volunteers from Indian Country Today, John Hopkins University and the University of Oklahoma. Today, the final product of that effort is available for public viewing. The data map is LIVE!
I quickly became the only consistent data contributor on the OU side of this project, something I threw myself into wholeheartedly once I was stuck at home during lockdown this past year. At my busiest, I was monitoring data in over 100 tribes in about ten states. I was later connected with a lovely group of data visualizers from John Hopkins' Center for American Indian Health, who implemented data collection methodology I had pioneered into their own data efforts. That said, it was truly an honor to advise and work alongside all the JHU and OU volunteers that I met along the way. This data map is a culmination of the tireless work by folks around the US who care deeply for Indian Country and its people.
This map is a small way I can honor the folks that lost the fight against this pandemic illness. This is for the families of my sources who died of COVID-19, the deaths that occurred after the interviews were scheduled. This is for the Elders, the speakers, the children, all the human beings who were taken before their time. This is for the folks I've written obituaries for, and all the ones I couldn't. This is for the health professionals that I had to get these numbers from, even with both of us knowing that it was so much more than a number loss. This map is for all of them.
Direct link to map: https://civicimpactjhu.maps.arcgis.com/.../index.html...
John Hopkins press release: https://hub.jhu.edu/.../map-covid-19-impact-american.../
As some may know, I have a heavy background in investigative and indigenous affairs coverage, but I'm also a huge enthusiast for data journalism. Over a year ago in June 2020, I was selected to be on a team that canvassed tribes directly for COVID-19 infection rate and death rate data in Indigenous communities in a partnership project with other volunteers from Indian Country Today, John Hopkins University and the University of Oklahoma. Today, the final product of that effort is available for public viewing. The data map is LIVE!
I quickly became the only consistent data contributor on the OU side of this project, something I threw myself into wholeheartedly once I was stuck at home during lockdown this past year. At my busiest, I was monitoring data in over 100 tribes in about ten states. I was later connected with a lovely group of data visualizers from John Hopkins' Center for American Indian Health, who implemented data collection methodology I had pioneered into their own data efforts. That said, it was truly an honor to advise and work alongside all the JHU and OU volunteers that I met along the way. This data map is a culmination of the tireless work by folks around the US who care deeply for Indian Country and its people.
This map is a small way I can honor the folks that lost the fight against this pandemic illness. This is for the families of my sources who died of COVID-19, the deaths that occurred after the interviews were scheduled. This is for the Elders, the speakers, the children, all the human beings who were taken before their time. This is for the folks I've written obituaries for, and all the ones I couldn't. This is for the health professionals that I had to get these numbers from, even with both of us knowing that it was so much more than a number loss. This map is for all of them.
Direct link to map: https://civicimpactjhu.maps.arcgis.com/.../index.html...
John Hopkins press release: https://hub.jhu.edu/.../map-covid-19-impact-american.../
DINI Final Project -- Tribal Colleges and State Colleges
When the COVID-19 pandemic moved K-12 and college -level classes online in schools nationwide, the shift to online learning negatively impacted some tribal colleges.
The digital divide plays a major role in the success of tribal colleges. With some tribal colleges being located on or near reservations, internet access became a priority as many tribal nations spent CARES Act allotments on expenses relating to establishing Wi-Fi in their communities.
InsideHigherEd.com said American Indian Higher Education Consortium data showed that 21 tribal colleges reported decreases -- among those, the average decline was 19%. There were 13 schools reporting enrollment increases, with the average increase among these being 28%. Of concern was an 11% drop across the tribal colleges in Native American freshmen enrollment. Enrollment declines have big implications for funding at tribal colleges, which receive a federal allocation per Native American student based on prior year enrollment data.
Despite all this, some tribal colleges are actually thriving amid the pandemic. In the eight schools that saw an uptick in enrollment, first-time student enrollment rose by an average of 45%. Tribal leaders at these schools attribute the rise in enrollment to extensive tuition discounts and waivers and the added flexibility from the transition to online instruction.
Oglala Lakota College president Thomas Shortbull said that the pandemic has actually made them stronger as a tribal college. Through the CARES Act allocations, Shortbull said the college was able to provide over 400 laptops and computers for students as well as hotspots to increase internet access on the Oglala Lakota reservation. The college has also been able to provide a multitude of financial aid and scholarships to faculty and students at Oglala Lakota College, which Shortbull said improved the overall cost-efficiency of operations, tuition costs and other expenses at the college.
“Our students come from the second and third poorest counties in the United States,” Shortbull said. “We really can't charge them that much because they don't have the resources to pay for those costs, and so we've learned to be cost conscious and cost effective in how we deliver our services to our students.”
Generally, tribal colleges are overall much more affordable to attend compared to state colleges. The chart below shows how the costs of tribal college tuition measure up compared to tuition rates at other types of schools. In 2019, the yearly tuition costs for tribal colleges was $3,426, while four-year baccalaureate colleges cost $26,500.
Tuition is only one piece of the cost of college, as any college student knows there are also “other expenses” like books, supplies, and room and board. This chart shows a comparison of other expense costs at tribal colleges versus other kinds of colleges. Room and board costs an average of $21,015 per year at tribal colleges in 2019, meaning they have cheapest housing out of all other types of colleges. However, tribal college students had the highest amount of “other expenses” at $12,345. This could be attributed to unique household and cultural factors that have an impact on unexpectedly incurred expenses, like a trip home for a special cultural ceremony, for example.
Oglala Lakota College is the second largest tribal college in the country, with the Dine College being the largest. In 2018, Oglala Lakota College had the lowest net price of any tribal college. In the below data story, the school with the highest tuition cost in the US was a state (Catholic) college, and the one with the lowest tuition was a tribal college; this same pattern was observed in the net prices comparison, where a state college had the highest net price and, again, a tribal college had the lowest net price.
Keeping tribal college students in school has always been a challenge, even in pre-pandemic times. The data for full- and part-time students’ retention rate was examined across different school types in 2019. Retention rate measures the number of first-time students who began their studies the previous fall and returned to school the following fall. Tribal colleges had a part-time student retention rate of 40% and a full-time retention rate of only 50% -- which is as high as the part-time retention rate of masters colleges. This means part time masters students are graduating at the same rates as full-time tribal college students. Comparatively, baccalaureate, masters and doctoral colleges had full-time retention rates of 63%, 74% and 83% respectively.
Carrie Whitlow is the director of education for the Cheyenne-Arapaho Tribe, a graduate of Haskell Indian Nations University and a current PhD student at Kansas State University. When she attended a tribal school, the school’s housing could hold about 90 students, but only about 50 were left by the end of the semester. She graduated with only about a handful of her peers. Retention rates and the time taken to complete a degree at tribal colleges can be influenced by many factors, most of them cultural or familial-related but also can be attributed to the systemic and generational, historical trauma endured by these students. If retention numbers were dwindling, in some cases, pre-pandemic, it can only be assumed that the exacerbating factors of internet access, inadequate funding, healthcare factors and other problems from the pandemic have negatively affected retention at tribal colleges moving forward. Whitlow said in her observations and experiences, she felt that the lack of an indigenous support system in state colleges definitely plays a role in whether that indigenous student stays in school.
Carrie Whitlow is the director of education for the Cheyenne-Arapaho Tribe, a graduate of Haskell Indian Nations University and a current PhD student at Kansas State University. When she attended a tribal school, the school’s housing could hold about 90 students, but only about 50 were left by the end of the semester. She graduated with only about a handful of her peers. Retention rates and the time taken to complete a degree at tribal colleges can be influenced by many factors, most of them cultural or familial-related but also can be attributed to the systemic and generational, historical trauma endured by these students. If retention numbers were dwindling, in some cases, pre-pandemic, it can only be assumed that the exacerbating factors of internet access, inadequate funding, healthcare factors and other problems from the pandemic have negatively affected retention at tribal colleges moving forward. Whitlow said in her observations and experiences, she felt that the lack of an indigenous support system in state colleges definitely plays a role in whether that indigenous student stays in school.
Regarding tribal college graduates, 8.5% of students completed their program within 100% "normal time" (i.e. 4 years for a 4-year degree) in 2019. Comparatively, 13.5% completed their degrees within 150% of the normal time, and 18% within 200%. The graduation rate is the percentage of first-time, full-time students who received a degree within a specific period of time that is considered normal for completion of their program.
Graduation time is a definite factor in the lives of indigenous peoples, as their cultures are grounded in their communities. Some Native American students experience identity conflicts, like Whitlow did, she said. Culture shock can be a real thing for an indigenous student leaving the reservation for the first time, or for an indigenous student whose only experience with education has been in predominantly white settings. Others just feel they don’t have a support system at non-tribal colleges.
“My grandpa was the chief, so we grew up very much connected to our tribal identity,” Whitlow said. “But what I experienced in public schools was that, it was more acceptable to be white, to look white and, you know, all my friends were white, and I wanted to be like them. So, going to a tribal college also helped me confront my identity crisis that I was going through.”
John Sanchez teaches at the College of Communications at Penn State University and has been a journalist and educator for many years. In his experience as someone who did recruitment for universities, he thinks the lacking support system at non-tribal colleges definitely plays a role in educational attainment and success for indigenous folks. In addition to the excessive costs and culture-shock of non-tribal colleges, Sanchez said his son, who went to Arizona State University, had a very hard time attending the school due to cultural stereotypes.
“He still had to deal with not only the cost of coming here -- even with scholarships you know there's still a lot of things that the scholarships don't pay for -- but also with how people thought he lived in a teepee,” Sanchez said. “He tried hard to explain that, but nobody really listens, you know, because whatever they consume in the media, they believe to be Indian.”
Further, at a tribal college there is more likely a chance that the school’s faculty will be someone that indigenous folks can connect with and trust. For example, out of some 4,000 faculty members at Penn State, Sanchez said there are less than three indigenous faculty members. Sanchez said that there is “big value” in attending a tribal college as opposed to a non-tribal college. In a tribal college, there is more acceptance and more opportunity to learn who you are as a tribal person, about the language, culture, and historical stories that apply to your identity.
“Education is sovereignty” said Julia White Bull, a graduate from Haskell Indian Nations University. Tribal college education can lead to increased tribal sovereignty because Native American people can become more educated about themselves and their histories. At tribal schools, they can learn their histories the way it actually happened, not the way modern education curriculum teaches (or rather, the way it ignores and smooths over details of decimation and destruction of indigenous culture and indigenous life).
“Sovereignty is getting your education, that’s being sovereign,” White Bull said. “Anything you feel you’re passionate about, go for it, and that’s being sovereign. It’s okay to have your own voice, even if you’re just sitting in a classroom. It’s important to how we tell our story.”
This sovereignty in education has further implications in the occupational outcomes of the degrees obtained at tribal colleges. The fields indigenous folks go into is usually intrinsically tied to the needs of their tribe, and often the job outcome trends of indigenous students can be telling to the priorities of the indigenous society that student affiliates themselves with. This is a complex angle that gets into the cultural implications of higher education in Indian Country and moreover how tribal colleges have an impact on the well-being of the tribe overall.
Graduation time is a definite factor in the lives of indigenous peoples, as their cultures are grounded in their communities. Some Native American students experience identity conflicts, like Whitlow did, she said. Culture shock can be a real thing for an indigenous student leaving the reservation for the first time, or for an indigenous student whose only experience with education has been in predominantly white settings. Others just feel they don’t have a support system at non-tribal colleges.
“My grandpa was the chief, so we grew up very much connected to our tribal identity,” Whitlow said. “But what I experienced in public schools was that, it was more acceptable to be white, to look white and, you know, all my friends were white, and I wanted to be like them. So, going to a tribal college also helped me confront my identity crisis that I was going through.”
John Sanchez teaches at the College of Communications at Penn State University and has been a journalist and educator for many years. In his experience as someone who did recruitment for universities, he thinks the lacking support system at non-tribal colleges definitely plays a role in educational attainment and success for indigenous folks. In addition to the excessive costs and culture-shock of non-tribal colleges, Sanchez said his son, who went to Arizona State University, had a very hard time attending the school due to cultural stereotypes.
“He still had to deal with not only the cost of coming here -- even with scholarships you know there's still a lot of things that the scholarships don't pay for -- but also with how people thought he lived in a teepee,” Sanchez said. “He tried hard to explain that, but nobody really listens, you know, because whatever they consume in the media, they believe to be Indian.”
Further, at a tribal college there is more likely a chance that the school’s faculty will be someone that indigenous folks can connect with and trust. For example, out of some 4,000 faculty members at Penn State, Sanchez said there are less than three indigenous faculty members. Sanchez said that there is “big value” in attending a tribal college as opposed to a non-tribal college. In a tribal college, there is more acceptance and more opportunity to learn who you are as a tribal person, about the language, culture, and historical stories that apply to your identity.
“Education is sovereignty” said Julia White Bull, a graduate from Haskell Indian Nations University. Tribal college education can lead to increased tribal sovereignty because Native American people can become more educated about themselves and their histories. At tribal schools, they can learn their histories the way it actually happened, not the way modern education curriculum teaches (or rather, the way it ignores and smooths over details of decimation and destruction of indigenous culture and indigenous life).
“Sovereignty is getting your education, that’s being sovereign,” White Bull said. “Anything you feel you’re passionate about, go for it, and that’s being sovereign. It’s okay to have your own voice, even if you’re just sitting in a classroom. It’s important to how we tell our story.”
This sovereignty in education has further implications in the occupational outcomes of the degrees obtained at tribal colleges. The fields indigenous folks go into is usually intrinsically tied to the needs of their tribe, and often the job outcome trends of indigenous students can be telling to the priorities of the indigenous society that student affiliates themselves with. This is a complex angle that gets into the cultural implications of higher education in Indian Country and moreover how tribal colleges have an impact on the well-being of the tribe overall.
The majors or degrees awarded at tribal colleges are insightful to the priorities of indigenous students and how education can impact their job outcomes. Education takes up the most significant portion of the degrees awarded in tribal colleges with 81 degrees awarded. The second most awarded major program was natural resources and conservation (42), then visual and performing arts (37), interdisciplinary studies(31), business (27) and health (26). This is telling to the way education is tied to the way of life of indigenous communities and the cultural implications of higher education in Indian Country.
“The biggest thing is that sovereignty, the tribal government's ability to operate effectively, is enhanced by us," Shortbull at Oglala Lakota College said. "For one, we employ over 300 employees in this reservation, which is a huge benefit to the tribe because you don't have these people being unemployed. The other thing is we provide graduates that go to tribal programs who can go on to our hospitals and be a major asset there. So I think that we play a huge role in the well being of our tribal government by having a tribal college like ours in this reservation.”
“The biggest thing is that sovereignty, the tribal government's ability to operate effectively, is enhanced by us," Shortbull at Oglala Lakota College said. "For one, we employ over 300 employees in this reservation, which is a huge benefit to the tribe because you don't have these people being unemployed. The other thing is we provide graduates that go to tribal programs who can go on to our hospitals and be a major asset there. So I think that we play a huge role in the well being of our tribal government by having a tribal college like ours in this reservation.”
Healthcare access in Native Americans in 2015 (DINI Story 2)
The Biden Administration's "American Rescue Plan" has appropriated a total of $6.1B to Indian Health Services (IHS) and tribal and urban Indian health programs. Indigenous medical professionals and tribal members alike are hopeful that this money, long overdue and still not an adequate provision for their actual need, will provide at least some relief to the indigenous population: a population that has died at up to 3.5 times the rate of other populations and minorities, according to the CDC. Native Americans and American Indians throughout the United States have shared chronic inadequacies in the healthcare systems available to them. As sovereign Nations and separate governmental entities from the US Government and its healthcare system, Native Americans are caught in a cycle of relying primarily on either private health insurance or Indian Health Service, the federal agency put in place specifically to provide and oversee healthcare resources to indigenous populations in the US. The National Council for Urban Indian Health said: "Before COVID-19, the IHS was already so underfunded that expenditures per patient were just one-fourth of the amount spent in the veteran’s health care system and one-sixth of what is spent for Medicare. IHS facilities are, on average, understaffed by 25 percent Now, the IHS is scrambling to provide crisis services to a vulnerable and hard-hit constituency with its stretched-thin staff, inadequate facilities, and severe lack of funds. While the CARES Act provided $1 billion to the IHS, unmet needs are estimated at $32 billion. Federal assistance during the pandemic has not been forthcoming; the Sault Ste. Marie Tribe of Chippewa Indians, for example, received only two test kits for a tribe of 44,000 people.The Oyate Health Center, a major health provider in Rapid City, South Dakota, which transitioned into tribal management in 2019, received almost no tests, PPE, or cleaning supplies.The Seattle Indian Health Board was sent body bags when it asked for more medical supplies to fight COVID-19.Urban Indian organizations are some of the worst hit, with 83 percent forced to reduce services and almost half unable to deliver medicine."
Despite numerous, repeated attempts by Tribal Leaders to get lawmakers to prioritize allocating funding to IHS, the agency remains severely underfunded at 59% of total need. This systemic underfunding is leading to real-time problems in tribes, who now find themselves without the resources, the financial capacity and the manpower to handle their own day-to-day operations, let alone a global pandemic that no one was expecting. A major factor in the underfunding of IHS is not accounting for inflation when allocating monies. For example, between 1993 and 1998, IHS allocations increased by 8% but medical inflation increased by 20.6%. Therefore when both the rate of medical inflation and increases in the AI/AN population were considered, there was, in reality, a decrease of 18% in the per capita IHS funding during this period.
Fast forward to 2015 -- IHS access and funding are still coming up short. Between 2010 and 2018, we don't really see funding allocations increasing or decreasing in any substantial way. Below is a map showing the number of indigenous folks in each state that had access to IHS in 2015. (States shown in gray had no data available).
Despite numerous, repeated attempts by Tribal Leaders to get lawmakers to prioritize allocating funding to IHS, the agency remains severely underfunded at 59% of total need. This systemic underfunding is leading to real-time problems in tribes, who now find themselves without the resources, the financial capacity and the manpower to handle their own day-to-day operations, let alone a global pandemic that no one was expecting. A major factor in the underfunding of IHS is not accounting for inflation when allocating monies. For example, between 1993 and 1998, IHS allocations increased by 8% but medical inflation increased by 20.6%. Therefore when both the rate of medical inflation and increases in the AI/AN population were considered, there was, in reality, a decrease of 18% in the per capita IHS funding during this period.
Fast forward to 2015 -- IHS access and funding are still coming up short. Between 2010 and 2018, we don't really see funding allocations increasing or decreasing in any substantial way. Below is a map showing the number of indigenous folks in each state that had access to IHS in 2015. (States shown in gray had no data available).
There are some things to consider here and it's important to note the regional trends of the data visualized below. One is that, obviously, Oklahoma has the highest concentration of indigenous folks with access to IHS resources. This state is also in the middle of probably one of IHS' most populous service areas, the Oklahoma City Service Area, which serves tribal nations in the states of Oklahoma, Kansas, and portions of Texas. Something else of interest is that the farther east you go, the less IHS access there seems to be. As you can see, data is not available for much of the eastern side of the US, save New York and Mississippi. A stunning number I found in the data shows that New York, during 2015, showed a percent change of -48% in IHS access, and that only 4.7% of the indigenous population in New York had access to IHS resources. But as you can see in the map below, funding varies by region and by need (i.e. concentration of indigenous populations).
The IHS service population serves approximately 60% of all indigenous tribal members residing in the US, according to the IHS site. Like mentioned earlier, this is the one and only federal agency put forth to provide and oversee healthcare for indigenous populations in the US. The consistent lack of funding given to a massive agency that is responsible for the well-being of this many tribal members is a true detriment to overall indigenous health and healthcare access in this country. Interestingly, there is a disproportionate gender divide when it comes to access to IHS and other healthcare. Beyond IHS access, we can also see where shortfalls may be in traditional health insurance enrollment for indigenous populations. In the next two visualizations below let's examine first insurance access by state and then IHS Access by sex.
The IHS service population serves approximately 60% of all indigenous tribal members residing in the US, according to the IHS site. Like mentioned earlier, this is the one and only federal agency put forth to provide and oversee healthcare for indigenous populations in the US. The consistent lack of funding given to a massive agency that is responsible for the well-being of this many tribal members is a true detriment to overall indigenous health and healthcare access in this country. Interestingly, there is a disproportionate gender divide when it comes to access to IHS and other healthcare. Beyond IHS access, we can also see where shortfalls may be in traditional health insurance enrollment for indigenous populations. In the next two visualizations below let's examine first insurance access by state and then IHS Access by sex.
The first chart is showing by-state trends of four things: the percent of indigenous people uninsured, percent change of uninsured, percent change of insured and the percent change from 2012 to 2015. Here, you can see the rises and falls of indigenous insurance rates, and where the four trends intersect. The second chart is essentially a simple Yes or No answer to whether a male or female indigenous person does (yes) or does not (no) have access to healthcare. The answers are organized by a total sum of females who said "yes or no" and males who said "yes or no" in the US generally. What is obvious by the graphic is the 2015 data found that there were significantly more people who did not have access to IHS -- more than 3/4 of all the indigenous people recorded for this dataset. This, coupled with the comparisons of indigenous folks who are insured or uninsured, compound the issues of healthcare access for indigenous populations and more broadly, could fuel the systemic racism towards indigenous folks in the medical system.
Finally, one indigenous community in the US that constantly goes underreported (and underrepresented in most easily available datasets) is the Alaska Native tribes, located in the remote state of Alaska. There are lots of reasons one could speculate why it can be hard to obtain and track data coming from Alaskan tribes, based on regional issues alone and coupled with all sorts of accessibility issues that go along with their extreme living conditions. There are probably more factors not mentioned here that I haven't done the research to confidently speak on, but the point is that we all know these tribes are chronically underrepresented in the media due to their location and accessibility. Below is a bar chart illustrating Alaska Natives' access to health insurance, and the data is organized by age group, with each bar listing the percentage of that age group that was enrolled in health insurance in 2015. This data alone, and the scarcity of it, is a testament to how far removed our understanding of health and healthcare access is in Alaska.
Finally, one indigenous community in the US that constantly goes underreported (and underrepresented in most easily available datasets) is the Alaska Native tribes, located in the remote state of Alaska. There are lots of reasons one could speculate why it can be hard to obtain and track data coming from Alaskan tribes, based on regional issues alone and coupled with all sorts of accessibility issues that go along with their extreme living conditions. There are probably more factors not mentioned here that I haven't done the research to confidently speak on, but the point is that we all know these tribes are chronically underrepresented in the media due to their location and accessibility. Below is a bar chart illustrating Alaska Natives' access to health insurance, and the data is organized by age group, with each bar listing the percentage of that age group that was enrolled in health insurance in 2015. This data alone, and the scarcity of it, is a testament to how far removed our understanding of health and healthcare access is in Alaska.
In conclusion, the data on indigenous populations in general is usually incomplete in some way, from healthcare data like the charts, graphs and maps above, to even recording their tribal populations; like how the 2010 Census arbitrarily "zeroed out" or scandalously misreported many tribes' populations. While admittedly it is quite a task to track the historical access, spending and other infrastructural needs across 574 federally-recognized tribes, there have been intentional legislative and historical efforts to mislead and otherwise disenfranchise the indigenous communities at large since the colonial days of forced removal and forced assimilation. Because of these data transparency issues in Indian Country, it's difficult to get a complete look at any given picture without lots of sources and data to help piece the puzzle together. Hopefully, these visualizations will provide some insight for future reporting on these issues. By looking at multiple factors at once, like these visualizations have done, theoretically will piece together a better idea of the shortcomings within the indigenous healthcare system and will help address overall indigenous health.