The Trump administration unleashed a flood of outrage earlier this month after unveiling a proposal to overhaul the Supplemental Nutrition Assistance Program, formerly called food stamps. The plan would replace half the benefits people receive with boxed, nonperishable — i.e. not fresh — foods chosen by the government and not by the people eating them.
Among those horrified at the thought: American Indians who recognized this as the same type of federal food assistance that tribes have historically received, with devastating implications for health.
Since 1977, the U.S. Department of Agriculture has bought nonperishable foods to distribute on Indian reservations and nearby rural areas as part of the Food Distribution Program on Indian Reservations. The program was designed as an alternative to SNAP for low-income Native Americans living in remote areas without easy access to grocery stores. The food boxes delivered were filled with canned, shelf-stable foods like peanut butter, canned meats and vegetables, powdered eggs and milk.
"If you talk to people like me who grew up solely on this stuff, you hear stories of 'I never even tasted a pineapple or real spinach' — you didn't taste these foods until you were older," says Valarie Blue Bird Jernigan, a citizen of the Choctaw Nation in Oklahoma.
"We would scrape together whatever commodities we had available to us," Jernigan recalls.
Both of her parents worked full time, but "it just wasn't enough to support a family," she says. They relied on government provisions for meals. Breakfast was often a grain like farina served with powdered milk with water added to it. "A lot of times we had mashed potato flakes — you add water, too – and maybe canned peaches, and if you had any vegetables, it was canned. And that was pretty much it."
The effects of this kind of government commodities-based diet can be seen all around Indian country, says Jernigan, now a University of Oklahoma researcher who studies the impacts of food environments on Native American health. "There's even a name for it – it's called 'commod bod.' That's what we call it because it makes you look a certain way when you eat these foods."
The name, she says, is a joke, but the health implications of this kind of diet are anything but funny. American Indians and Alaska Natives are at least twice as likely as whites to have Type 2 diabetes, and they have 1 1/2 times the rate of obesity as non-Hispanic whites, according to the government statistics.
Scientists think one explanation for these health differences may lie in what is called the "thrifty gene" theory, which suggests Native Americans have a genetic predisposition to obesity and diabetes. But these diseases didn't become prevalent until tribes adopted a more processed Western diet, notes Elizabeth Hoover, who is of Mohawk and Mi'kmaq ancestry and teaches about indigenous food movements at Brown University.
"A good part of this is not because indigenous bodies are somehow inherently susceptible to diabetes. It's because of these really insufficient diets that are not nutrient-dense, but they're very calorie-dense," says Hoover, who is writing a book about Native American efforts to reclaim their traditional food culture.
Like SNAP, the Indian food distribution program is meant to supplement a family's food budget. But Jernigan says recent studies have found that 60 percent of Native Americans who receive food assistance through the program rely on the government program as their primary source of food. (By comparison, 37 percent of people enrolled in SNAP rely on it as their main source of money for food, according to a new report from the Urban Institute.) So the quality of that food can really affect health.
"If you want to know what eating primarily shelf-stable and packaged foods does to a household or family or community, I think you could look closely at the Native American experience," she says.
While program began in the 1970s, the federal government had been providing American Indians with government commodities for far longer. In the late 1940s, the U.S. government began distributing to tribes surplus foods that it was buying up as a way to support prices for struggling farmers.
Before the 1950s, Jernigan says, "there were few accounts of these lifestyle diseases [like Type 2 diabetes] — they couldn't really be found in Native American communities. The major problem was malnutrition." By the 1960s, researchers were seeing higher rates of Type 2 diabetes among this population.
After the program began in the 1970s, Jernigan says, "you started to see high consumption of these packaged and shelf-stable canned foods – nothing fresh, no fresh vegetables, foods high in sodium, fat and sugar. And you see the rates of these preventable diseases skyrocket."
Those government-provided food boxes also contained something else: stigma, says Joe Van Alstine, a citizen of the Little Traverse Bay Bands of Odawa Indians in Michigan.
"I grew up on it, a bunch of my friends did. It was always the stigma of the can ... you opened it up, and it was gross and nasty-looking," Van Alstine says.
For many in Indian country, says Hoover, the Trump administration's "Harvest Box" proposal brought back childhood memories of foods at which they now "shudder when they look back on and started to avoid when they could afford groceries."
Hoover says the quality and healthfulness of the food aid to tribes has improved a lot over the years, and she credits the efforts of people like Van Alstine. He is the food distribution program director for his tribe and oversees the reservation food distribution program in the Midwest. He is also the vice president of the National Association of Food Distribution Programs on Indian Reservations, which is made up of tribal representatives who administer federal food aid at the local level.
Over the years, he says, they've pushed for changes to the program — like the inclusion of more culturally relevant, and healthful, foods like hand-harvested wild rice, grass-fed bison, wild-caught Pacific salmon and blue cornmeal. Another welcome innovation: a grocery-store like model where aid recipients can shop the aisles and select their own foods, including fresh fruits and vegetables and frozen (not just canned) meats. The stores are roughly the size of a 7-Eleven, and about a third of the 103 tribal organizations now have them, Van Alstine says.
"So when they come in here they do have a choice," says Van Alstine. "Because I do feel that's what makes them happy."
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LULU GARCIA-NAVARRO, HOST:
This past wildfire season, there were unprecedented amounts of wildfire smoke in communities across western Montana. Instead of just issuing warnings, public health agencies tried something new - actually making the air cleaner in the homes of vulnerable residents. Nora Saks from Montana Public Radio reports.
NORA SAKS, BYLINE: Wildfire smoke is bad for everybody but especially older folks and those with chronic heart and lung diseases. The Dunagans, who live in Seeley Lake, Mont., check both boxes.
JOY DUNAGAN: We put towels around the doors, the windows, everything. Grime from the smoke came in through the whole house.
SAKS: Joy and her husband Don are 69 years old and are on oxygen. She's a stroke survivor. He recently developed asbestosis after almost 40 years working in an aluminum factory.
DON DUNAGAN: I've got less than 50 percent breathing capacity right now.
SAKS: Then a wildfire blew up half a mile from their cozy log home.
D. DUNAGAN: That smoke on top of it - it was killing me.
SAKS: But with no family in state and limited mobility, they had to stay in their house all summer. An appliance called a HEPA air filter made that possible. It removes the fine particulates in woodsmoke that are so hazardous. It resembles a space heater. Amy Cilimburg is busy installing a new one in a corner of their living room.
AMY CILIMBURG: There's a prefilter - takes out the large stuff. And then that's the HEPA filter.
SAKS: She's the director of a nonprofit called Climate Smart Missoula. When wildfire smoke swamped Seeley Lake, Missoula County's health department worked with Climate Smart to distribute HEPA filters to at-risk residents. Don says he slept next to it in his recliner every single night.
D. DUNAGAN: I believe that that machine saved my life. I really do.
SAKS: Kids are also extra vulnerable to the pollutants in smoke. So when the wildfires dragged on into September, Missoula County and Climate Smart scrambled to put filters in the worst-hit schools. The county health department's Ellen Leahy says that strategy of finding a solution and taking action was a big shift.
ELLEN LEAHY: Messaging that the air isn't good isn't enough. There has to be a more concerted effort to provide clean indoor air. We have to plan to be able to do that and deploy those systems much more quickly.
SAKS: The challenge is figuring out who pays for it. Portable HEPA air filters that can clean a big room cost under $200 each. It costs about $30,000 to put them in just three schools last fire season. And the money the county pitched in to buy filters last minute came from emergency funds, which quickly dried up. Leahy says they tried their best to respond to the need.
LEAHY: But it was very, I would say, makeshift.
SAKS: The county health department wasn't equipped to launch a large-scale emergency response because they're set up to regulate easily controlled, manmade sources of air pollution, like factories or woodstoves. But scientists predict wildfires are only going to get worse. So public health departments see a need for a more proactive approach. That's going to require some creativity, Leahy says, because right now...
LEAHY: There's not a new source of funding that we're aware - there's not a pathway for us to do that.
SAKS: The state also lacks resources for wildfire smoke, says Jim Murphy with Montana's health department. And given Montana's budget shortfall...
JIM MURPHY: I don't anticipate that there's going to be a lot of new monies coming or anything like that. I think it's maybe making the best of what we already have.
SAKS: For now, the state will keep supporting local health agencies. And the county health department will continue to work with Climate Smart. They're also encouraging larger public institutions, like school districts, to improve their air filtration systems and pay for them from their own budgets. For NPR News, I'm Nora Saks in Missoula, Mont.
(SOUNDBITE OF STAN FOREBEE'S "SWITCH")
GARCIA-NAVARRO: This story is part of a reporting partnership with NPR, Montana Public Radio and Kaiser Health News.
(SOUNDBITE OF STAN FOREBEE'S "SWITCH") Transcript provided by NPR, Copyright NPR.
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