The Lumbee Tribe of North Carolina, the 575th tribe to secure federal recognition as a sovereign nation, is seeking better healthcare for its citizens. For Angie Lowery, a 44-year-old mother of four, this means taking her health into her own hands. She has lost 120 pounds in two years and weaned herself off daily insulin pills by cutting fatty foods and sugary drinks out of her diet and starting to move more.
Lowery’s backyard garden, filled with collard greens, bell peppers, onions, tomatoes, and kale, showcases her goals for a long, healthy life with her kids. However, the tribe’s leaders and citizens know that individual efforts won’t be enough to address the systemic health disparities they face. The Indian Health Service, which provides federal funding for healthcare services, has been chronically underfunded, with a budget shortfall of nearly $55 billion.
The nearest Indian Health Service facility is more than a two-hour drive from Robeson County, where most of the 55,000 Lumbee citizens live. The county is one of the poorest in the U.S. and has some of the worst health outcomes. Lumbee researchers and healthcare providers say that the tribe will have to rely on other revenue sources to reverse the health disparities their people have faced for decades.
Donald Warne, a physician and researcher at the Johns Hopkins Center for Indigenous Health, said, “None of us can depend on the Indian Health Service alone, because we just don’t have the resources within that system. But it’s a great starting point.” The Congressional Budget Office estimated that the tribe could increase Indian Health Service spending by $247 million over four years.
The Lumbee Tribe’s effort to establish a casino as a revenue source collapsed in June, with more than 60% of voters rejecting a constitutional amendment that would have allowed tribal leaders to create infrastructure needed for a gaming business. John Lowery, the tribe’s chairman, said that other funding sources, such as gas stations or hotels, could be used to provide health services for the tribe.
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Researchers believe that a twofold system, using Indian Health Service money and additional revenue, is necessary to address the tribe’s health disparities. Funds from gaming could compensate for what the Indian Health Service can’t support. However, the impact of casinos on tribal health has been debated, with studies showing that while gaming money helps tribes build more facilities and hire more doctors, it also increases unhealthy substance use and smoking.
Brittany Locklear, a social work professor at the University of North Carolina and citizen of the Lumbee Tribe, said, “There’s going to be negative impacts.” Ronny Bell, a Lumbee citizen and researcher, added that the community has felt ripple effects from systemic racism and economic downturn, which play a part in the health statistics in Robeson County today.
Despite the challenges, the Lumbee Tribe is moving forward with its efforts to improve healthcare. Jada Brooks, a Lumbee citizen and UNC researcher, is conducting a study on heart health among Lumbee women. The initiative includes classes where Lumbee women discuss their health and lifestyle changes. Brooks said, “I think what really matters is people feeling like they can trust the healthcare system.”
Angie Lowery believes in her people’s power to help themselves, regardless of whether the government steps in to help. “Just because we’re federally recognized don’t mean that the doors are going to open up and money’s going to fall through the door like dirt,” she said. The Lumbee Tribe’s journey to better healthcare is just beginning, and it will require a combination of individual efforts, community support, and creative funding solutions.
The tribe is relying on the Indian Health Service to provide some level of care, but they know that more needs to be done to address the systemic health disparities they face. The Lumbee Tribe’s story is one of resilience and determination, and their efforts to improve healthcare will be closely watched in the years to come as they consider new revenue sources, such as governor race outcomes.
