Success Stories

Success Stories

UIHI Success Story: Missing and Murdered Indigenous Women and Girls Report

Success Stories, TEC News
Report provides snapshot of crisis in urban Native communities

Analysis of data in 71 U.S. cities points to much larger problem, inaccurate data

In November 2018, Urban Indian Health Institute (UIHI), a division of Seattle Indian Health Board, released the Missing and Murdered Indigenous Women and Girls (MMIWG) report. This snapshot of data from 71 U.S. cities identified 506 cases of MMIWG and detailed significant challenges in collecting data on the total number of missing or murdered American Indians and Alaska Natives residing in off-reservation areas and outside rural villages. UIHI intends to provide the report as a resource for urban Indian organizations, tribal governments, and legislators.


“This report provides a necessary snapshot of the epidemic and is a call-to-action to protect Native women and girls.”


– Abigail Echo-Hawk, Director of UIHI and co-author of the report.


Annita Lucchesi (Southern Cheyenne descendant), doctoral student and creator of an extensive MMIWG database, co-authored the report with Echo-Hawk. In the course of her research, Lucchesi found some significant issues: a lack of available data on urban Indians, the need for non-tribal law enforcement agencies to coordinate with tribal nations regarding their members and to share data on MMIWG, the racial misclassification of these cases, and inadequate funding for research on violence against urban American Indian and Alaska Native women and girls.

The report has been circulated by major local, national, and international media outlets including The New York Times, The Washington Post, NPR (National), CBC News, The Seattle Times, KUOW, and King 5 News. The communications team shared the report and related information on social media which increased engagement exponentially—it reached over 400,000 people and helped UIHI’s follower base grow by over 2,000 across all social media channels. This report has also been shared by U.S. Senator Lisa Murkowski (R-AK), U.S. Senator Heidi Heitkamp (D-ND), and Juana Majel-Dixon (Pauma Band of Mission Indians), Executive Board Member and Recording Secretary of the National Congress of American Indians (NCAI) in a press event in Washington, D.C.

The researchers also note that Urban Indian organizations need this information to better inform programming and to advocate for change. They also note that this issue is more than just data. For more information and to view the report, visit the UIHI website.



USET TEC Success Story: NIHB Annual Heroes in Health Awards Gala

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2018 Area Impact Award Winner

The United South and Eastern Tribes (USET) Tribal Epidemiology Center received a National Indian Health Board “Area Impact Award” for the support and technical assistance that it provides to USET Member Tribal Nations.


“Honors an individual or organization whose work has contributed to improving American Indian/Alaska Native health care or affected change on an area or regional basis.”




2018 Area Impact Award Winner
2018 Area Impact Award Winner

ANEC Success Story: Alaska Native Tumor Registry

Success Stories, TEC News
ANTR Awarded First-Place by SEER Program

Cancer is the leading cause of death among Alaska Native people. Many cancers can be prevented. To understand the unique pattern of cancer among Alaska Native people, Dr. Anne Lanier and colleagues established the Alaska Native Tumor Registry (ANTR). The ANTR has been collecting cancer data for Alaska Native people since 1969. Since this time, these data have been used to help Alaska Native tribal health organizations understand the burden of cancer in their communities. The data have also been used in over 100 scientific publications, and 9 five-yearly reports. Our most recent five-year picture of cancer among Alaska Native people was published in 2015. Our Executive Summary of this report has been very useful to tribal health leaders in understanding this public health issue.

The ANTR is a population-based central cancer registry. This means we collect information from all over Alaska, not just from one hospital. We are funded by, and a member of, the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program. This program, which includes 17 other registries nationwide, is known for its high-quality cancer data collection. Each year, the SEER program assesses the quality of data submitted by each of its registries. This year, we were pleased to be awarded a First-Place Award by the SEER Program for data quality. This means that we achieved all 14 of the data quality metrics established by SEER as benchmarks for having high quality data. This is the first time in ANTR’s history that we have been awarded a first-place award!

Members of the Alaska Native Tumor Registry display their SEER Program first-place award.



CTEC Success Story: August 2018

Success Stories, TEC News
Good Health and Wellness in Indian Country

Tiffany Ta, MPH

Within the project year, the California Tribal Epidemiology Center (CTEC) conducted key informant interviews with the CDC Good Health and Wellness in Indian Country (GHWIC) Advancing California Opportunities to Renew Native health Systems (ACORNS) subcontractors. These subcontractors were Tribes, Tribal Health Programs, or Tribal Organizations. The purpose of these interviews were to gather information on how information has been shared with Tribes in their respective area and across other areas.


CTEC conducted a total of nine key informant interviews from ACORNS subcontractor program leads.


Findings from the key informant interviews indicated that sharing information helped the program leads and community members gather information. Such information included implementation of new programs, sharing of ideas on successes and challenges, and sharing of resources and tools. This sharing of information helped ACORNS subcontractors avoid “reinventing the wheel.” Several recommendations were made by program leads on how improvements could be further made on methods to sharing information to Tribes and across Tribes. The current primary method of communication in sharing information to their community are at meetings, workshops, and conferences. In other words, opportunities for program leads, staff, and/or Tribal community members to gather were considered a success in sharing information within and across other areas. A notable example mentioned from program leads was the 1st Annual 2018 Data, Evaluation, and Grant Writing Training hosted by CTEC last March. Unfortunately, this method of communication did not demonstrate as the most efficient method because meetings, workshops and conferences are held only once or twice a year. In other words, these opportunities to gather and share information are too infrequent.

Key informant interviews revealed concerns that there is a need for more frequent meetings, workshops, or conferences within the program year. More frequent gatherings would further enable them to share information. After conducting these interviews, ACORNS subcontractor program leads and GHWIC staff came to understand the pressing need to gather together in one location more often to share information as well as build relationships with one another. Typically, meetings, workshops, and conferences are held to simply provide health education and training to Tribal communities and staff, but many Tribal Epidemiology Centers (TECs) have yet to realize these meetings are too often the only occasion for them to gather together in one space to connect, build relationships, and share information. Hence, creating opportunities to gather more frequently will foster these connections, further enable the sharing of information, and strengthen relationships with Tribal communities. This is critical for us, as TECs, to truly understand what their needs are, improve overall health, and improve relationships with Tribes in their respective area and across other areas.

As a result of the key informant interviews, GHWIC staff are now aware of the need for more frequent gatherings and will work with program leads to help us develop additional meetings, workshops, and conferences that are efficient and will help Tribes overall. In addition, having these interviews in-person provided GHWIC staff an opportunity to build/strengthen relationships with their program leads. This will help guide future GHWIC work. The significance of this is that program leads are typically members within the Tribal community, having far more knowledge about community needs and can provide invaluable guidance to improvements needed to achieve overall community health and wellness. Lastly, building and strengthening relationships between TECs and Tribal communities will subsequently build trusting relationships that will, in turn, further support them in sharing information within and across other Tribal areas.


GPTEC Success Story: July 2018

Success Stories, TEC News
Criminalizing Pregnancy in South Dakota

Prepared By: Dr. Jennifer Giroux and Sara Albertson

In South Dakota (SD), maternal substance use disorders during pregnancy are a tribal public health crises. Maternal Child Health (MCH) providers on reservations in SD suggested that 50-75% of pregnant women use a non-prescribed drug. This rate range was confirmed by reports with two tribes that participated in a 2016 CDC EPI AID maternal substance use during pregnancy investigation.

Women who sought help for opioid addiction, learned there were no Medication Assisted Treatment (MAT) options available among Indian Health Service (IHS) facilities in the Great Plains region. There are limited substance use treatment resources in general, and even fewer for pregnant women.

Maternal Child Health providers anecdotally reported that women who tested positive or who were at risk of testing positive tended to avoid prenatal care out of fear of losing their children or legal prosecution. Women seeking assistance with Substance Use Disorders (SUD) face additional barriers in SD. Health care providers are required to report her to authorities or risk being charged with a misdemeanor. 1

South Dakota Codified Law 26-8A-2, states that physicians are mandatory reporters of child abuse and neglect, and in South Dakota, prenatal exposure to controlled substances or alcohol is considered child abuse. South Dakota child-welfare statues consider substance use during pregnancy to be child abuse and grounds for civil commitment (SDCL 34-20A-63). South Dakota Codified Law 22-42-5.1 classifies ingestion of a non-prescribed controlled substance as a felony. A positive urine drug screen is used as evidence for prosecution of 22-42-5.1. South Dakota law enforcement has used forced catheterization and entering treatment facilities to take a photo of patient’s positive drug urine screen as evidence for prosecution, enforcement officials are protected from being prosecuted for these acts under SDCL 22-42-5.1. 2, 3, 4

State laws shuttle pregnant women needing or wanting help for their SUD into the criminal system. Data supports that these laws are disproportionately applied to American Indian women. Evidence from the South Dakota Women’s Prison (SDWP) from July 2018, demonstrates that out of the 564 women in custody, 52% (295) of them were American Indian. 5, 6 Nearly 64% (361) of the women were incarcerated due to drug related offenses. 7 Of the 64% of women in prison on drug charges, 132 of them, or 37% were prosecuted under South Dakota Codified Law (SDCL) 22-42-5.1. 8

In Pennington County, South Dakota, American Indians Comprise 10% of the population, but 52% of inmates. 9

Pennington County ranks top three in the nation for both incarcerating women, predominantly AI mothers, and for recidivism rates. 10 To address this high rate of incarceration and recidivism the criminal justice system has received numerous grants for diversion, interventions, and reentry programs. These grants did not initially network with Tribes and Tribal organizations to integrate Lakota Culture into the programs, or deliver critical education and training on the perpetuation of historical trauma and the impacts of institutionalized racism.

From a public health perspective, upstream substance use education and prevention interventions are critical to reduce the costly and limited downstream treatment services and law enforcement repercussions. Currently there are no substance use education requirements for an individual to graduate from high school in SD. Teachers are not required to have training or knowledge of SUD. Evidence based substance use prevention programs exist with interventions targeting critical development years, but State funds are not allocated towards these prevention services.


GPTEC is taking a multi-prong approach to the Tribal Maternal Substance Use Disorder During Pregnancy crisis:


Policy Work

  • Address need to adapt SD mandatory reporting laws of pregnant women with substance use disorders



  • Participate in American Indian Youth Substance Abuse Prevention Coalition.
  • Host Subject Matter Expert, Dr. Annette Bosworth, to speak on Brains of Addiction
  • Develop and conduct survey of substance abuse disorder education and prevention and Harm Reduction education in reservation schools.
  • Host Subject Matter Expert, Dr. Annette Bosworth to speak on Brains of Addiction
  • Mental Health First Aid Instructors – 8 hours
  • Presentations on Resiliency, Toxic Stress, ACEs and Historical Trauma- 2 hours

At the falls

  • Survey of tribal treatment program services
  • Collaborated with NWPIHB to complete a People Who Inject Drugs qualitative research project on local needs
  • Provide GPTEC leadership in the 2016 CDC EPI AID on maternal substance use during pregnancy investigation

Downstream – Breaking the cycle of Intergenerational Trauma

We recognized a need for Tribal involvement in the emerging criminal justice system’s new programs, and the need for support from the criminal justice system to adapt SD state laws that are serving as barriers to women who have SUDs and are pregnant. Shifting resources to cost effective upstream prevention and education programs requires community and elected official’s buy-in. Tribal and Criminal Justice System collaborations were unlikely relationships that first needed to be forged. It was out of this need for relationships and partnerships that the idea of our symposium was born. On July 10th, 2018, we held our symposium titled “Exploring the Intersection of Criminal Justice, Lakota Culture and Behavioral Health”.

1 South Dakota Legislative Research Council. (2017). South Dakota Codified Law. Accessed at:

2 Ibid.

3 South Dakota Cops Indulged ‘Sadistic Desires’ Forcing Catheters into Men, ACLU Lawsuit Says. (2017). Accessed at:

4 Rapid City Journal. (2016). Woman sues Pennington County authorities for alleged violation of her civil rights. Accessed at:

5 South Dakota Department of Corrections. (2018). Adult Population. Accessed at:

6 South Dakota Department of Corrections. (2018). Adult Inmates by Race/Ethnicity. Accessed at:

7 South Dakota Department of Corrections. (2018). Adult Crimes Breakdown. Accessed at:

8 Ibid.

9 Pennington County Sheriff’s Office. (2017). Pennington County Sheriff’s Office 2017 Report. Accessed at:

10 The Pew Charitable Trusts. (2013). South Dakota’s 2013 Criminal Justice Initiative. Public Safety Performance Project. Accessed at: