Between 2020 and 2021, Native Americans and Alaskan Natives saw a two-year decrease in their life expectancy - the biggest drop among demographic groups, according to the Centers for Disease Control and Prevention. One Arizona group is working to reverse the trend.

COVID-19 took a big toll on this population, and a more recent CDC report said Native Americans are also more likely to be hospitalized if they get the flu.

In Flagstaff, Shay Brown, a COVID-19 resource nurse with Native Americans for Community Action, said she isn't surprised by the findings.

"A lot of these families are living in multigenerational housing, and many of them do not have running water, don't have electricity," she said. "It's like compounding effects that cause a lot of these infection rates to rise."

While NACA provides medical attention to limit the spread of disease, the group said this issue goes beyond access to health care for the more than 311,000 Arizonans who are Native American. Poverty and lack of basic services on reservations also are factors.

In northern Arizona, NACA is in close proximity to several tribal nations, but the Navajo Reservation is one of the largest in terms of size and population. NACA's interim director, registered nurse Verity Quiroz, said the reservation struggles with insufficient housing and ready access to health-care facilities, which affects the overall health of the community. She said they're still seeing COVID cases.

"Most of the people that are significantly sick are being evaluated and treated in the hospital," she said. "At NACA we do our best to prevent, first of all - and then, for those milder cases, we refer to our COVID resource nurse."

The CDC said about 41% of Native American and Alaskan Native adults are immunized. Public health officials say if health-care providers work to build trust in the communities they serve, it will be easier to teach disease-prevention strategies and fight misinformation.

A Nevada grassroots organization has launched its inaugural endorsement process for the 2024 elections in an effort to champion indigenous voices in the Silver State.

Taylor Patterson, executive director of the Native Voters Alliance Nevada, said the state is getting better about tribal and indigenous representation but contended there is still a long way to go. Nevada is home to 21 federally recognized tribes and 28 reservations, but only one Native legislator.

Patterson explained they saw the need to be more engaged with issues from the top to the bottom of the ticket.

"I think very easily we can forget that Native people are everyday people," Patterson observed. "I think it has been painted in a very specific way of 'still is very much a person of the past,' but there are people who are in all different spaces that are engaging with the government in a multitude of ways that need to be represented."

Patterson acknowledged the state does have elected officials who understand the needs of the Native community but hopes the new initiative will give those who are not familiar with the Native space an opportunity to learn more.

Last summer, Republican Gov. Joe Lombardo expanded Nevada's Effective Absentee System for Elections program program, which requires election clerks to meet with all tribes located in their respective jurisdictions to coordinate voting locations prior to elections.

Patterson noted they have had a good response from candidates and she is pleased to know officials are starting to realize the meaning and value of an endorsement from Native Voters Alliance Nevada. She said her organization can help provide politicians with access to Indigenous communities.

"In recent years there has been so much made of sort of this 'BIPOC' label," Patterson emphasized. "I very often have to remind all sorts of people, whether those are federal agencies or elected officials, you're not truly working with the BIPOC vote share or BIPOC people if you're not working with the 'I.'"

Patterson added the endorsement process will be instrumental to shaping policy and governance in the Silver State.

Next week, Native American leaders from the Midwest will go before a United Nations panel with their concerns over a controversial oil pipeline they say is trespassing on tribal lands.

Enbridge's Line 5 operation in the Great Lakes region is expected to be a topic when the Permanent Forum on Indigenous Issues convenes Monday in New York.

In the Midwest, the law firm Earthjustice represents some Tribes contesting the rerouting of Line 5 in Wisconsin. There, managing attorney Debbie Chizewer said climate change is affecting the region and tribal nations' ability to exercise their treaty rights.

"The perpetuation of this fossil-fuel infrastructure will only worsen that," she said, "and will affect their special tribal resources, like sugar maple and loons, and whitefish and other species that are an integral part of Bay Mills and other tribal nations."

The pipeline runs through Wisconsin and Michigan, traversing the treaty-reserved territory of tribal nations, including the Bay Mills Indian Community and Bad River Band of Lake Superior Chippewa. Enbridge rejects those claims and has said it isn't trespassing on tribal lands.

Similar cases have been filed in other parts of the Midwest. In Michigan, opponents have said they're worried about Enbridge's plan to construct an oil tunnel beneath the Great Lakes. The company has claimed it would be safer than the existing pipeline, but Native American Rights Fund senior staff attorney Wes Furlong said he sees it as a disaster waiting to happen.

"There is a likelihood that if a leak happened within that tunnel, it would cause a catastrophic failure," he said. "Essentially, the tunnel could explode underneath the Straits of Mackinac, pumping crude oil into the strait and into the Great Lakes."

Furlong said pushing back against Line 5 aligns with calls to reduce the use of fossil fuels, citing its connection to climate change and the impact on treaty-reserved resources in the Midwest, on which Tribes rely.

"There's pending litigation over the State of Michigan's order to shut down the pipeline, and ordering Enbridge to vacate the state-owned bottomlands of the Strait of Mackinac," he added. "So, that would spell, I think, the end of Line 5 as we know it."

The Nebraska Winnebago Tribe's Ho-Chunk Community Development Corporation, or HCCDC, has been awarded $2 million through MacKenzie Scott's Yield Giving company.

Some 6,300 nonprofits applied to Yield Giving's open call for grants. The HCCDC was among 279 to receive a top tier rating. In the next-highest tier, 82 organizations each received $1 million.

Kristine Earth, executive director of the corporation, said the Tribe has a lot to be proud of but a lot of work left to do.

"We're so excited and are so thankful for this generous gift for our community," Earth stated. "We do have a lot of issues; we have a lot of health disparities. And so, a donation like this really is going to make an impact for our entire Tribe as a whole."

HCCDC marks its 20th anniversary this year, working to improve economic, educational and social opportunities for tribal members. Earth pointed out they have five key initiatives: housing development, commercial development, financial services, quality of life and food sovereignty.

The Winnebago Tribe has experienced huge growth in its middle class in the past few decades but roughly 30% of its members still live in poverty. HCCDC created a farmer's market, which Earth says is helping them address both health disparities and food sovereignty.

"Through our farmers market, now we're able to touch on not only agriculture and tribal farming, but also our health care system," Earth outlined. "Offering the fresh fruits and vegetables and the Indian corn; things that will restore the health of our people."

Earth added Winnebago is in a "food desert," making food security a major focus for the Tribe.

"It's hard for people to access fresh fruits and vegetables, and we have such a growing community," Earth stressed. "We are all coming together to grow our own food and to feed ourselves, so we can be sustainable in the future."

On the website, MacKenzie Scott called all the open call grant winners "vital agents of change." Scott's Yield Giving organization has donated more than $17 billion to 2,300 nonprofit organizations since 2019.