Nearly 100,000 Native Americans live in Ohio, 28% of them in Greater Cleveland. The community includes people from many tribes who arrived here generations ago after the Indian Relocation Act of 1956 encouraged Native Americans to move from reservations to urban areas.
That law brought Native Americans to Cleveland with the promise of jobs and housing. But it left many isolated from their tribes, stuck in poverty, and lacking access to healthcare. It’s this type of stress, along with hundreds of years of generational trauma, that many say is at the root of health disparities among Native Americans today.
"Since the day that we’ve come here on relocation, that whole trip was toxic stress," said Cynthia Connolly, a member of the Little Traverse Bay Bands of Odawa Indians from northern Michigan. She currently lives in Northeast Ohio.
"Then you add on the layers of poverty, you add on our chronic health issues, it just sort of compounds itself." Connolly added. "Then you add on the generational trauma of us having survived the last 500 years of colonial encroachment. It’s really a challenge to find the support that we need, especially being such a small community, not often heard, not often sought after for our opinions or our input."
Stroke and heart disease are among the most notable health disparities. Marlys Rambeau is the leader of Lake Erie Native American Council and is considered a community elder.
"Everyone in my family goes out, heart attack," Rambeau said. "Our hearts just explode at some point. I’ve actually been very lucky, but I’ve been in and out of the hospital because I have lupus. Lupus attacks my heart and my lungs now."
Rambeau and many Native Americans she knows also have diabetes or pre-diabetes, which are linked to an increased risk of heart problems. Nationally, Native Americans experience diabetes at triple the rate of other populations, according to the Indian Health Service.
A January 2019 study conducted by a Cleveland Clinic doctor found that stroke risk factors among Native Americans, including high blood pressure and diabetes, were rising compared to other population groups.
Connelly says these health disparities are catastrophic to the culture and community.
"The biggest thing that’s happening is we’re losing a lot of our elders way too soon," Connolly said. "Our culture, traditionally, we learn and take guidance from our elders. When we don’t have our elders around, we’re a little bit lost as to where to go."
Research has shown that trauma accumulated over generations, or the toxic stress of racism, poverty, and other social determinants of health, can lead to worse health outcomes, said Bruce Kafer, Minority Program Manager at the VA Northeast Ohio Healthcare System.
"Our Native community has challenges to accessing health resources," Kafer said. "Because of the phenomenon of historical trauma, simply defined as an accumulative wounding over their lifespan and across generations. Those factors complicate the health profile of American Indians we see here in the greater Cleveland area."
Kafer says better access to healthcare can help Ohio’s Native American communities address the effects of this trauma.
Another way to buffer against the health effects of trauma: Building relationships and a sense of identity.
"Bringing our community back together is making sure that our youth learns their culture, learns their history, and has a firm sense of their identity and their roots," Connolly said.
During the weeklong celebrations marking the 50th anniversary of the 1969 Cuyahoga River fire, a small group of young Native American dancers performed as part of a water blessing ceremony at Headwaters Park in Geauga County.
Rambeau hopes to help members of the community return to their Native American identity by organizing events and dance performances like this.
She also hopes to remind the rest of Northeast Ohio that Native Americans are still here.
"And that’s another thing I’m trying to do is give our people a voice, so we can be noticed more, and invited to the table, and have our voices heard," Rambeau said. "Because we haven’t for a very long time, and that needs to change. Because we are members of the community at large."