GLOBAL HEALTH | Addressing the world’s health challenges
11 April 2008
American Indians and Disability: Montana's AIDTAC Program
Julie Clay is the director and Gail Greymorning is the executive assistant of the American Indian Disability Technical Assistance Center (AIDTAC) at the University of Montana's Rural Institute. With principal funding from the Department of Education, for the last five years, AIDTAC has supported American Indians and Alaska Natives in their efforts to improve employment opportunities and vocational rehabilitation outcomes wherever they live in the United States.
The U.S. Census Bureau estimates that 4.4 million American Indians and Alaska Natives live in the United States. (This number includes those who are mixed with other races.) The largest populations live in California, Oklahoma, Arizona, and Alaska. Native Americans speak more than 250 languages, and there are 561 federally recognized tribal governments in the United States. Some live on rural or remote reservations, in villages and pueblos, or on rancherias and tribal trust lands.
The National Council on Disability reports that the types of disabilities found in the general population also are found in the American Indian and Alaska Native population. Some disabilities, such as those related to diabetes and drug and alcohol abuse, are more prevalent among Native American groups, and, therefore, the overall rate of disability is higher. Among Native Americans of working age (16-64), the disability rate is 27 percent, as opposed to 18 percent for the general population; among those age 65 and older, the disability rate is 57.6 percent, as opposed to 41 percent. (1)
Disability in Native American Culture
The concept of disability takes on new meaning when one considers that most tribal languages do not even have a word for handicap or disability. Disability is an idea familiar to Western culture but with no direct parallel in American Indian culture. The closest American Indian concept does not look at physical characteristics but views disability as disharmony of spirit. (In addition, the cultures and traditional beliefs of the many tribes vary significantly, each with a unique set of creation stories, religious doctrines, and sacred taboos.)
Julie Clay, a member of the Omaha tribe, has a disability and is director of the American Indian Disability Technical Assistance Center (AIDTAC) at the University of Montana's Rural Institute. She explains, "The concept of unwellness is described as disharmony in body, mind, and spirit. If one of these areas is in disharmony then the whole being is affected. Just because a person may have a physical or mental disability, however, does not mean one is in disharmony or in a state of unwellness. But if there is disharmony in one's environment or reactions to certain events, then a state of unwellness is present." Indeed, while many American Indian people have assimilated into the dominant culture, many Indians still hold to their old ways and traditions. This "living in two worlds" is problematic enough; coping with disability adds a "third world" of difficulties.
Understanding Tribal Communities
The National Council on Disability recognizes that meeting the needs of people with disabilities living on tribal lands requires an understanding of the various American Indian and Alaska Native cultures and history and an appreciation for the unique legal and socioeconomic environment of tribal communities. Consultation with tribal leaders and tribal members with disabilities is critical in understanding the depth and complexities of these cultures and the concept of disability in Native American communities.
Julie Clay observes that economic, legislative, political, social, historical, and cultural constraints forced on the people living within the reservation boundaries make life tumultuous. Resources and opportunities are scarce for the majority of people living on tribal lands. Because of the poor living conditions and barriers found on some reservations, there are few opportunities to fulfill personal life goals.
For the past five years, AIDTAC has served as a national technical assistance center. Groups that have benefited from their services include American Indians and Alaska Natives with disabilities and their families, tribal governments, tribal and state vocational rehabilitation agencies, employers and employer representatives, urban Indian centers, and others. In conjunction with other programs at the Rural Institute, AIDTAC addresses issues of employment, transportation, health, independent living, and education. With funding from the Social Security Administration and the Department of Education's Rehabilitative Services Administration, AIDTAC provides training and technical assistance to improve employment opportunities and vocational rehabilitation outcomes for Native Americans with disabilities.
(1) General population figures from the Department of Health and Human Services 2005 fact sheet "What is Disability? Who is Affected by Disability?" found at http://www.surgeongeneral.gov/library/disabilities/calltoaction/factsheetwhatwho.html
The opinions expressed in this article do not necessarily reflect the views or policies of the U.S. government.
