Report of the Social/Cultural Task Force


Introduction 55
A Time of Transition 55
Overarching Recommendations 56
The Search for Social and Cultural Equity 57
Subsistence: The Cultural Imperative 57

Key Findings
Recommendations: Alaska Native Subsistence

Native Empowerment: Self-Governance 59

Key Findings
Recommendations: Empowerment through Self-Governance

Native Empowerment: Self-Reliance vs. Dependency 61

Key Findings
Recommendations: Dependency on "Anti-Poverty" Programs

Native Empowerment: Reestablishing a Functional Social Order 63

Key Findings
Recommendations: Reestablishing a Functional Social Order

Social Aspects of Physical Health 64

Key Findings
Recommendations: Social/Cultural Aspects of Physical Health

Alaska Native Education: The Key to Future Survival 66
Key Findings
Recommendations: Alaska Native Education
Alcohol and Alaska Natives 69
Summary 69

The Situation: The Facts Tell the Story
Solutions Must be Found

Alcohol's Carnage in the Native Community 70

Native Deaths as a Direct Result of Alcohol Abuse
Native Suicides: The Alcohol Connection
Alcohol as a Contributing Factor in Other Deaths

Alcohol and Social Pathologies 73

A Partner in Crime
A Lifetime of Damage
Family/Community Life: A Breakdown of Values and Roles

Findings and Recommendations 75




I. Introduction

A Time of Transition

Alaska Natives are in a period of social, cultural, economic, and political transition. By its very nature, transition means change. Native people have been undergoing this change since contact with Europeans in the mid-1700s, but the most dramatic changes have occurred in quick succession during the past century. As discussed in other sections of the Commission s three-volume report, many of the changes have been sudden and traumatic, resulting in social, cultural, political, and spiritual upheaval. The changes have generally not been voluntary, and the Native people have not, by and large, been able to control either the scope or the pace of change. Consequently, Alaska Native societies have been under tremendous and ever-increasing stress. This stress permeates all aspects of their lives from the physical to the spiritual and has caused severe damage to Native cultures and societies. The end results of this constant and massive stress — the social and psychological breakdown and upheaval among Alaska's Native people — are the very issues that brought the Congress to empanel the Alaska Natives Commission. Alaska Natives, most of whom were economically, socially, and culturally independent one hundred years ago, are now struggling to get by on the fringes of a society and an economy imposed on them by others; trying to survive in the land of their forebears on the leavings of a dominant society and culture.

To see a reversal of today's self-destructive tendencies within Alaska Native society, there needs to be a comprehensive approach by the federal and state governments and the Alaska Native people themselves. With all — and not just some — aspects of Alaska Native society, seemingly at or near the breaking point, any piecemeal attempts at reform will fail. Reforms must address all of the problems and issues facing Alaska Natives and they must be concurrent. The success or failure of one initiative hinges on the success or failure of others. Such a comprehensive, multi-faceted approach in and of itself would be a positive and long-needed departure from present governmental policymaking which is issue-specific in nature and political in approach.

This section creates a broad policy agenda that weaves together the many and varied aspects of today's Alaska Native society and the interrelated issues that bear on Natives' future well-being. Many of the recommendations made are meant to complement and add fuller substance to recommendations made elsewhere by the Commission. Also highlighted here are key areas not covered in-depth in other sections — especially those related specifically to social, behavioral, health, and cultural issues — and specifies overarching strategies.

The Commission recognizes that Alaska Natives' problems cannot be solved effectively nor policy issues resolved to the maximum benefit of Natives unless the Native community, itself, takes "ownership" of the many problems that face it and assumes responsibility for the solutions. Though many, if not most, of the social and cultural problems that Natives face today are not of their making, the consequences of those problems certainly belong to them. Without this clear recognition and acceptance of the facts, no amount of public policy intervention by the state and federal governments will ever effectively improve the social, economic, or physical well-being of Alaska Natives.

B. Overarching Recommendations

The Alaska Natives Commission chose a broad approach to its study of the social and economic well-being, or lack of same, of the Alaska Native population. While focusing on issues and problems of social functioning and cultural integrity, the Commission recognized the broader aspects of the total environment in which Alaska Natives live and their effects on social and cultural concerns. As such, the Commission, in addition to the more issue-specific recommendations found in other sections of the report, makes the following recommendations:

Repeal the following language from Sec. 4(b) of P.L. 92-203: "and including any aboriginal hunting or fishing rights that may exist."

Repeal the following language from Sec. 2(b) of P.L. 92-203: "without establishing any permanent racially defined institutions, rights, privileges, or obligations, without creating a reservation system or lengthy wardship or trusteeship, and without adding to the categories of property and institutions enjoying special tax privileges."

The Congress should appropriate and specifically direct a minimum of $10 million annually ($5 million redirected from current sources and $5 million new funding) for five years for use by Alaska Native tribes to solve Alaska Native social problems in culturally relevant ways.

The Congress and the State of Alaska must allow Alaska Native tribes to design their own family support (welfare) programs in lieu of programs that provide Food Stamps, Aid to Families with Dependent Children, and other income maintenance payments to Alaska Natives; the programs to be of a "workfare" nature where family members are paid to work on needed projects and services within the village.

The Congress should create a $10 million Alaska Native Heritage Trust to be administered by the Alaska Inter-Tribal Council; the funds to be granted to Alaska Native tribes for use in schools and in the community for enhancing Native languages and cultures.

An Alaska Native Economic Development Trust should be created by and funded by the Congress; the principal of the trust to be used in the development of feasible, locally-initiated economic projects in predominantly Native areas of the state that create real local employment and training opportunities for rural residents.

IHS, through contract with the Alaska Native Health Board and in conjunction with the Alaska Department of Health and Social Services, should develop a comprehensive infectious disease prevention education strategy to address Alaska Native tribes, families, and children with materials developed by and for Alaska Natives and in Native languages.

The Department of Housing and Urban Development should fund an Alaska Native Housing Authority that (a) designs, manufactures, and constructs houses for villages with the participation of village residents and (b) has the long-term goal of substantially increasing rural local hire and other economic benefits to localities and regions in which major HLTD construction activities are taking place.

II. The Search for Social and Cultural Equity

By most measures, many Alaska Natives, their families, and even virtually entire villages are lacking in mental and emotional well-being. Disharmony disrupts Native lives and village life with increasing and widespread frequency. The evidence is found in the "numbers" that compelled the Congress to empanel the Alaska Natives Commission. These include the well-documented cases of alcohol abuse, domestic violence (including child abuse and neglect and child sexual abuse), and homicide and suicide among Alaska Natives.

Other indicators of this lack of well-being include the continuing poor physical and mental health of many Native people. And, most tragic of all, is the fact that Native children are not learning in school and that they, themselves, are abusing alcohol and other chemicals at ever-increasing rates.

If one theme can be identified as having emerged during the course of the Commission's work, it is Alaska Natives' loss of control of, and responsibility for, their economies, their governing institutions and, in many cases, their families and themselves. The result is that entire generations of village residents have lived in a relationship of control by others and of dependency on public services and subsidy.

The Commission has determined that many of the causes for today's upheaval in Alaska Native communities and within families can be found in their often-tragic experiences since contact with Europeans, and in the cultural, social, political, and economic climate created for them by both federal and state governments. At the core of the problems are unhealed psychological and spiritual wounds and unresolved grief brought on by a centuries-long history of deaths by epidemics, and cultural and political deprivation at others' hands. Some of the more tragic consequences include the erosion of Native languages — in which are couched the full cultural and spiritual understanding — and the shattering of cultural value systems.

Many Alaska Native villages at this time might be looked at as families that have fallen apart; families so unhealthy that others have had to step in and run them where the parents are no longer parenting and where children are listening to someone else. Alaska Natives, with mounting frequency, are losing hold of their communities, their cultural identities and, perhaps most importantly, their children's lives.

The following subsections contain many recommendations addressing a variety of Native issues. While some are targeted specifically at social and cultural imperatives, the interwoven nature of all aspects of Native life cannot be ignored. It is for this reason that a holistic approach to the multitude of Native problems is outlined which envisions concurrent action on a number of different fronts.

A. Subsistence: The Cultural Imperative

The most fundamental reason why subsistence is such a difficult issue in contemporary Alaskan politics is that it is really about Alaska Natives and their cultures. Many non-Native Alaskans, particularly those residing in rural areas, harvest and use fish and game resources. But the numbers are unambiguous: those who most seriously practice subsistence as a way of life are Alaska Natives.

In recognition of this basic fact, Congress gave rural Alaskans a subsistence preference (i.e. Title VIII of P.L. 96-487, the Alaska National Interest Lands Conservation Act). Though Congress chose to couch the preference in terms of "rural" residents, there can be no doubt that the primary Congressional motive behind enactment of Title VIII was the protection of Alaska Native subsistence rights.

Subsistence, from the Alaska Native perspective, is — as many non-Natives clearly understand — an economic necessity. It is an honorable and ageless way in which Native people have, and can, provide for the nutritional needs of their families. But it is also a way of life, an Alaska Native way of life. This fact transcends any economic arguments in support of subsistence.

Alaska Native cultures, like most aboriginal cultures, are ancient; cultures tied directly to nature and the bounty it provides. The practices of hunting, fishing, and gathering constitute a direct link between the old and the new. With its spiritual and religious underpinnings, that are difficult to explain and even more difficult for non-aboriginal peoples to understand, subsistence is — quite clearly — an Alaska Native cultural imperative.

Most Native villages now have what researchers describe as "mixed" economies, in which small to moderate amounts of earned cash are available on, most frequently, a seasonal basis. In fact, many non-Native observers, including policy-makers, perceive modern subsistence as nothing more than a cultural antique, an increasingly ineffective holdover from previous times that will inevitably disappear as market economics take over.

In fact, research clearly demonstrates that the vast majority of village residents choose to practice subsistence, even if they have access to good wage incomes. The same research fails to establish any cash cutoff point at which Alaska Native individuals or households stop harvesting fish and game. And the testimony given repeatedly to the Commission is also quite clear: To take away subsistence from Alaska Native people is to deal the final and fatal blow to their survival as a distinct people.

Like other tribes that fought for survival, Alaska's Native people do not want to disappear. They will, the record shows, continue to fight for their subsistence way of life. Having lost most of their aboriginal landholdings and other inherited rights, they seem most willing to go to great lengths and face drastic measures — including arrest and imprisonment — rather than bend to the will of those who seek to curtail or otherwise limit Natives' subsistence rights.

1. Key Findings

The key social/cultural findings regarding Alaska Native subsistence practices and rights include:

The subsistence issue in Alaska, regardless of the terminologies and concepts in which the issue has been couched for political reasons, is an Alaska Native issue affecting, principally, Alaska Natives and is the foundation of Alaska Native cultures — a foundation without which these ancient cultures would cease to exist;

Subsistence is an economic necessity in the absence of which many Native families would become totally dependent on government handouts for survival;

The vast majority of village residents choose to practice subsistence, regardless of the accessibility of cash incomes; and,

Subsistence hunting and fishing remain under concerted political assault by powerful, organized interests which compete with villages for the limited public resources that governments must allocate to the extent that state and federal laws and policies at times serve to criminalize the very art of feeding one's family and one's spirit.

To Alaska Native people, subsistence is not just a nutritional or economic necessity; it is cultural and spiritual sustenance on which survival of their cultures depends. The record clearly shows that Alaska Natives know this inherently, and they appear willing to go to any lengths to protect their subsistence rights. This is significant for a people who gave up almost everything without a fight; a people who have suffered through indignities that would have driven other people to physical retaliation.

At present, the issue of Alaska Native subsistence remains unsettled. And so long as it remains unsettled, Native people will continue to live precariously in a legal no-man's land, stuck between federal vacillation and State of Alaska hostility to their subsistence way of life.

2. Recommendations: Alaska Native Subsistence

a. Congress should repeal the following language from Sec. 4(b) of P.L. 92-203 (the Alaska Native Claims Settlement Act) — language that serves only to confuse and distract from Alaska Natives' attempts to secure real subsistence rights.

b. The Alaska State Legislature should adopt and pass on to Alaska's voters a proposed amendment to the Alaska State Constitution allowing for a rural subsistence preference consistent with federal statute.

c. To the extent that the State of Alaska does not develop subsistence laws and policies consistent with Title VIII of the Alaska National Interest Lands Conservation Act (P.L. 96-487), the Congress should enact legislation preempting the Alaska Constitution under the Supremacy Clause of the U.S. Constitution to allow for — at a minimum — a rural subsistence preference consistent with Title VIII of ANILCA.

d. The Congress should amend the ANILCA Title VIII subsistence preference to include all Alaska Natives regardless of place of residence within the state.

B. Native Empowerment: Self-Governance

Alaska Natives are tribes indigenous to the United States, and full tribal recognition by the United States government would not only fully legitimize the special relationship Alaska Natives have with the federal government, but would also help define the social and political status of Alaska Natives and their communities throughout the state. The lack of this recognition is a central concern of the Commission.

At present, rather than recognizing and working with Alaska Native tribal governments, the State of Alaska and, to a degree, the federal government, have attempted to suppress and replace them with Western institutions and values.

In a throwback to periods when termination and assimilation were government policy, the State of Alaska refuses to recognize the existence of Alaska Native tribes and opposes the empowerment of their traditional and Indian Reorganization Act governments. To the State, Alaska Natives area terminated people and, therefore, do not exist on the legal landscape. For its part, the federal government has attempted to walk a non-existent fine line between by bowing to the State's position of non-recognition while concurrently trying to treat Alaska Natives as it does other Native Americans.

Alaska Natives have seen the benefits of tribal governments and tribal judicial systems. They have recognized and attempted to live by such laws as the Indian Self-Determination and Education Assistance Act, the Indian Child Welfare Act, and other Congressional initiatives intended to benefit Alaska Natives and their tribal governments. But their efforts are continually frustrated by the State of Alaska and its agencies.

After several centuries of painful experience, the federal government has determined that Native Americans are best able to govern their own lives as evidenced by the prevailing federal policies emerging over the past quarter-century. But Alaska Natives have been singled out as not falling fully under the opportunities and protections found in many of these laws.

The Alaska Natives Commission has determined that termination and assimilation — tragic and failed policies that, for the most part, were long ago discarded for dealings with Native Americans in other states — are still the de facto policies of government with respect to relations with Alaska Native people.

1. Key Findings

The key social/cultural findings regarding Alaska Native empowerment and self-government include:

Federal and state policies regarding or affecting Alaska Natives have served to aggravate the basic psychological and spiritual "dysfunction" of Native people by acts which have tended to dispossess them of their social, cultural, and political resources;

Federal policies and initiatives regarding Alaska Natives have shifted, as elsewhere in the United States, to emphasize self-determination over true self-governance;

The State of Alaska claims that tribes do not exist as a matter of law and that Alaska Natives enjoy no powers of self-governance beyond those available under state law; thus, relations between the State of Alaska and Natives are devoid of mutual respect and parity in political rights; and,

Natives have always maintained self-government as a component of self-determination, though Native views on tribal governments and Native self-governance are not uniform. However, Natives generally agree that the state and federal governments should leave more room for Natives to live their lives and govern their communities as they see fit while understanding the political interests that will need to be balanced.

Alaska Natives are mature and capable residents of the nation and of the state, but they also occupy their own cultural and political communities. Native villages and their tribal governments — as distinct partners with the state and federal governments — must be entrusted with the social and political decisions critical to Alaska Natives' future well-being and survival. The validity of Alaska Native cultural perspectives, inasmuch as they impact on social organization and governing institutions, must be recognized and afforded due respect.

2. Recommendations: Empowerment through Self-Governance

a. Congress should repeal the following language from Sec. 2(b) of P.L. 92-203 (The Alaska Native Claims Settlement Act): "without establishing any permanent racially defined institutions, rights, privileges, or obligations, without creating a reservation system or lengthy wardship or trusteeship, and without adding to the categories of property and institutions enjoying special tax privileges."

b. A bona fide list of Alaska Native governments should be published in the Federal Register; further, the previous administration's opinion regarding Native tribal government jurisdiction and powers should be withdrawn and the federal government's position on the jurisdictional status of Native lands in Alaska clarified.

c. The State of Alaska should, through Executive Order or legislative enactment, recognize the existence of Native tribes in Alaska to clear obstructions to successful implementation of policies and programs affecting predominantly Native areas of the state.

d. The state and federal governments should create and utilize all possible opportunities for Native tribes to demonstrate their respective capacities to regulate tribal members.

e. The federal and state governments must implement policies and enact necessary statutes that give maximum local powers and jurisdiction to tribes and tribal courts in the areas of alcohol importation. and control, community and domestic matters, and law enforcement, among others.

C. Native Empowerment: Self-Reliance vs. Dependency

Due mainly to the lack of widespread or sustained economic opportunities, an ever-increasing number of Native villages and families have become, in many ways, virtual economic wards of the federal and state governments. What is generally viewed as a social "safety net" in contemporary American life has become more of a solid platform that, for many Alaska Natives, acts as the base from which they now live their lives.

While financial assistance is necessary until the rural areas of Alaska become economically viable, the form in which the aid is given has proven to be very destructive to Native families and Native communities. Income maintenance programs — or what are commonly referred to as "welfare" programs — have completed the breakdown of healthy village and familial interdependence; a breakdown that began, in some instances among Alaska Natives, with the arrival of the Russians over two centuries ago. In the place of that social dependence today on government to meet the basic interdependence is an unhealthy survival needs of tribal and family members.

There is no pride attached to this way of living. In fact, their way of life intensifies the sense of helplessness and lack of self-esteem for affected individuals and families. In some cases, it appears as if welfare programs have become an added addiction and that they are symptomatic of all that is wrong with life in today's Alaska Native villages.

Native families were traditionally close knit, depending on one another for food and shelter, and for caring when they needed it. Family and community members took care of each other; they looked after each other. The health of one family was of paramount importance to the others. Families hunted together, camped together, celebrated together, were full together, and went hungry together. So, while they may have been "poor" materially, they at least had each other. All too often, this is not the case anymore. Government anti-poverty programs have created a new poverty — the poverty of the broken village family.

The Commission finds that "welfare" programs must be restructured to meet a broader spectrum of needs of Alaska Natives in areas beyond the general scope of income maintenance. Instead of (1) direct payments under the Aid to Families with Dependent Children program; (2) Food Stamps; (3) General Assistance under both state and federal programs; and, (4) other unearned income substitutes to families where there are members able to work; a "workfare" program should be instituted. The benefits to the working head of household and his/her family are incalculable. Not only would it help restore pride and self-esteem to individuals and families, workfare programs could be fashioned to benefit communities by providing needed labor for, as examples, building and maintenance projects, and village planning and management.

There are any number of village projects toward which workfare funds can be directed, many of them related to improving the overall cleanliness and orderliness of communities. Others relate to increasing the ability of the community to manage and maintain village infrastructure and to improve local government administration. By offering a viable and honorable interim solution to the need for meaningful employment in village Alaska, such a move by government would compliment various prevention and education efforts and village healing efforts proposed in other sections of this report.

1. Key Findings

The key social/cultural findings with regard to Alaska Natives' growing dependency on government income maintenance programs include:

Historically, Alaska Natives were a people fully capable of meeting their own and each other's needs through close familial and communal sharing and support systems;

The chronic unemployment situation in much of village Alaska together with the virtual loss of control of local resources and local decision-making processes have created widespread dependence on government aid and a sense of helplessness and hopelessness for many Alaska Natives; and,

There exists a critical need to restore pride and self-esteem to individuals and communities with the Alaska Native population as a prerequisite for improving overall economic and social well-being among Alaska Natives.

Alaska Natives are at risk of becoming permanently imprisoned in America’s underclass, mired in both the physical and spiritual poverty that accompany such social standing. Unless serious — and what some might consider drastic — changes are made to the current system of income maintenance and support in Native communities, the overall well-being of Alaska Natives will continue to deteriorate. In the absence of near-term prospects for radically increased employment opportunities in Alaska Native villages, "welfare" programs must be redesigned to take into account (1) the need for individuals to attain improved mental health status through the building of self-esteem and pride in productive undertakings and (2) the basic human resource (i.e, manpower) needs of villages.

2. Recommendations: Dependency on "Anti-Poverty" Programs

a. Federal and state regulations must be changed to allow for tribal design and management of government income support and maintenance programs, most notably Aid to Families with Dependent Children, Food Stamps, State General Assistance, and the federal General Assistance program funded under the Bureau of Indian Affairs.

b. Tribal governments should be permitted to implement local "workfare" programs utilizing government transfer payment receipts that require productive, community development-related employment where aid-eligible households have at least one able-bodied, employable member.

c. Adequate provisions for training, child care, and other support services for workfare participants should be integral to tribal programs instituted under this subsection.

d. Village workfare programs should be designed to complement local community development initiatives including, but not limited to, public health imperatives (i.e., maintenance of solid waste and sewage disposal systems); local government administration; and in-school health education and substance abuse prevention programs.

D. Native Empowerment: Reestablishing a Functional Social Order

Understanding the present condition of many Alaska Native families and communities requires that Native people be viewed as the children and grandchildren of those who survived mass death at the hands of famine and disease and attempts at cultural annihilation at the hands of governments and their agents. It has been hypothesized that many Alaska Natives alive today still carry the symptoms of what is now termed Post Traumatic Stress Disorder; symptoms they inherited and learned from their parents and grandparents . . . the "survivors."

One of the most dangerous and destructive inherited symptoms is the way of coping — or not coping — with life's problems on a personal, familial, and communal level. Most of the survivors were orphans of one kind or another. Many were physically orphaned and thus reared in institutions, situations that compounded the mounting social and cultural discontinuities. The remainder suffered in varying degrees from the loss of not just loved ones and other tribal members but also the loss of the rich spirituality and cultural traditions at the center of their forebears' world view. It appears that the way in which survivors learned to cope was to look away from the devastation and the problems and to remain silent about their feelings, as if by not having to face the situation, the problems might go away.

This trait is seen today in many Alaska Native families and communities. And it cripples them. It stands in the way of healing and growth. And, just like untreated wounds, the problems fester and ultimately become disabling to individuals, families, and entire communities.

In discussing Native families and villages, it has to be remembered that it was not only the Native cultures that were fatally wounded by the assault of diseases and the invasion of Western life. Also wounded — and in some cases nearly destroyed — were the family and kinship systems that governed everyday life. These systems included a clear delineation of relationships, responsibilities, and rights of all the members of a village: grandparents, parents, brothers, sisters, uncles, and aunts. Today, what is seen in village Alaska is the tattered remains of the traditional social and cultural complex overlaid with a jumble of confusing, marginally accepted Western social, governmental, educational, and legal structures.

1. Key Findings

The key social/cultural findings regarding Alaska Native empowerment through the reestablishment of a functional social order include:

Unless the social, cultural, psychological, and spiritual ailments — borne out of the history of Native people themselves — are addressed, the disorders from which they have arisen will continue; and, the continuing lack of control over their own lives and their governing and social institutions, while not leading directly to social disorders, aggravates the feelings of powerlessness, hopelessness, and low self-esteem among Alaska Natives.

Though many, if not most, of the social and cultural problems that Natives face today are not of their making, the consequences of those problems certainly belong to Alaska Natives.

If significant improvements are to be made with respect to overall Alaska Native well-being, the Native community must take "ownership" of the problems and assume responsibility for the solutions. A large body of testimony has been offered to the Alaska Natives Commission, clearly indicating the readiness on the part of Alaska Natives to take ownership and responsibility for their problems. It is incumbent upon the federal and state governments to assist Alaska Natives as they strive to affect change from within.

2. Recommendations: Reestablishing a Functional Social Order

a. The Congress should give back to Alaska Native tribes responsibility and control over the lives of Alaska Natives living in villages by granting them full tribal status as defined by federal Indian law and as presently enjoyed by other Native American tribes, thereby creating the framework within which Native solutions to Native problems can be developed and carried forward.

b. The Congress should appropriate and specifically direct a minimum of $10 million annually ($5 million redirected from current sources and $5 million new funding) for five years for use by Alaska Native tribes to develop the capacity for reassuming responsibility for the total health and welfare of their people.

c. With financial backing (as proposed in recommendation "b" above) and technical assistance, Alaska Native villages and organizations must be encouraged — through appropriate governmental policy at both the federal and state levels — to design community and family healing and strengthening projects to address unresolved grief and to bring families and villages together as well-functioning social and cultural units.

d. The federal and state governments should target financial resources toward maximizing the effectiveness of funding for tribal government/village leadership development as well as development of functional tribal court and law enforcement systems in Alaska Native villages.

e. The Bureau of Indian Affairs should reinstate funding for the Indian Child Welfare Act grants to tribes to its FY 1993 level and offer even greater assistance to tribes and tribal organizations in their efforts to eliminate child abuse and its consequences, rather than considering the termination of funding for these important programs.

E. Social Aspects of Physical Health

Many of the physical ailments of Native families are preventable, as they stem from living in less than sanitary conditions. The infections and disease still very prevalent in Alaska Native villages arise when people don't wash their hands and when houses are left uncleaned. They arise when people are not eating well-balanced meals and are not getting enough rest and when there is an over-consumption of alcohol and tobacco and other chemicals.

When the health condition of Alaska Natives is compared, as it often has been, to that of Third World countries, the comparison applies only to the types of infections and diseases from which people suffer. The level of government expenditures on Alaska Native health (see Alaska Natives Commission Report of the Health Task Force) outstrips what most people in the world receive, and yet Alaska Natives continue to experience physical health ailments in categories that could be prevented — even by such simple means as appropriate use of soap and water.

The question is "Why are Native families not taking better physical care of themselves?" Certainly, simple lack of knowledge is part of the answer. But a fact that cannot be ignored is the psychological and spiritual condition of these families. Simply stated, many Alaska Natives are depressed; people psychologically, mentally, and spiritually preoccupied with troubling or unfulfilling lives. The "anomic depression" — characterized by a perceived loss of control, loneliness due to social disintegration, and a feeling of frustrated expectations — is further aggravated by poverty and by lack of economic opportunities aside from government anti-poverty assistance.

Safe water supplies and appropriate means for sewage and solid waste disposal for Alaska Native villages are imperatives that cannot be overlooked. Greater efficiencies in overall health delivery must be realized, and a focus must be put on preventative health and health education. However, for governments to expend additional money on health services — including massive sewer and water public works expenditures — without also addressing the cultural, social, and economic needs of Native families, will only add another layer of bandages presently wrapped around the body of Alaska Natives.

1. Key Findings

Key social/cultural findings regarding Alaska Native physical health issues include:

Many of the types of infections and diseases frequently experienced by Alaska Natives are altogether preventable; thus, even under the present conditions in villages, Alaska Native health could improve;

For the government to redirect funds toward meaningful prevention and health education efforts now would almost certainly serve to save literally hundreds of millions of dollars in future government public health expenditures for Alaska Natives;

Efforts to improve the overall physical well-being of Alaska Natives, if they are to be successful, must recognize and account for the deeper and oft-times overlooked explanations for why Alaska Natives are not taking care of themselves; i.e., the psychological and spiritual impairment experienced by so many Alaska Natives and the feelings of hopelessness and apathy that such impairment spawns; and,

Efforts to improve the overall physical well-being of Alaska Natives will not see marked positive changes unless, at that same time, the cultural, social, and economic needs of Alaska Natives are adequately and appropriately addressed.

Alaska Natives have demonstrated a keen ability to address various public health threats on a case-by-case basis when proper prevention and health education initiatives are made available. For instance, near eradication of the Hepatitis B virus in southwest Alaska during the 1980s is a notable example of this capability. However, it appears that the most successful efforts occur only when there is a clear and present danger.

In order for prevention and health education to produce long-lasting, positive health outcomes for Native people, the underlying causes of why many Alaska Natives do not — or cannot — make wise lifestyle choices must be understood and addressed. A depressed soul does not take care of its body or home; due to the suffering inside, it does not care.

2. Recommendations: Social & Cultural Aspects of Physical Health

a. The Indian Health Service should contract with the Alaska Native Health Board to develop an infectious disease prevention education strategy geared directly for Alaska Native tribes, families, and children, with materials developed and delivered by and for Alaska Natives in locally understood Native languages.

b. Health education strategies for Alaska Native people should not only address how to keep healthy but also why physical well-being is so important and should provide linkages between physical health, cultural and spiritual health, and mental health — especially with respect to children and their primary care givers.

c. The federal and state governments should appropriate funds for village and family healing projects (see similar recommendations under separate subsections), developed by Natives themselves, to address cultural, spiritual, and psychological depression in Alaska Native families and communities.

F. Alaska Native Education: The Key to Future Survival

A multitude of theories have been put forth over the past several decades as to why Alaska Native children are not learning in school. Attempting to understand why Native children are at or near the bottom of academic achievement charts continues as a topic of great concern and debate. Certainly, some of the arguments have merit, and some of the remedies that have been tried have improved various aspects of the educational system for Alaska Native children. There have been many changes in curricula. Multi-million dollar schools have been built in virtually every village in the state. Rural school districts with Native board members have been created. But the fact remains: Native children are still not learning.

Having given the responsibility of their childrens' education to missionaries and territorial school teachers during the early part of this century, most Native families and villages have never reassumed that responsibility. Consequently, education is now perceived as being someone else's job. Native villages and their governments remain, if not disinterested, then certainly disengaged with respect to schools and the school systems in which their children are immersed.

In order to fully understand the current situation, it must be understood that, in spite of the long history of ;attempted acculturation of Alaska Native peoples and tribes, Alaska Natives remain culturally different from the rest of Alaska and the United States. In other words, the ideas, methods, and languages used to teach Native children are still alien and, therefore, still difficult for students to grasp. And while the cultural gap between Native children and their teachers has narrowed, there remains a chasm that must be bridged. Teachers, by and large, still come from places foreign to students and their families; the language of information transfer remains English; the pictures painted as the backdrop for learning are still from another world.

Exacerbating the complexities of transferring information and ideas from one culture to another are the social and economic conditions of the families and villages themselves. Many children come from homes where there is chronic abuse of alcohol and a frightening prevalence of domestic violence. They come from homes that have a near total dependence on government for their economic survival; homes steeped in spiritual and economic poverty, where the parents and other family members are too preoccupied with their own problems to pay adequate attention to the child and how he or she is doing in school.

All too often the school is a place of rest for a child who does not sleep well and does not get the nurturing she needs at home. The school, then, is a place not for learning but, instead, a place to temporarily escape the less-than-fortunate realities of home. Needless to say, such children — distracted by problems in the home — will not learn. This, without doubt, is on the short list of reasons why Alaska Native children are not learning in school — the problems of village and home are robbing them of their most receptive and inquisitive years . . . their childhoods.

While government must bear some of the blame and responsibility for the inadequacy of the formal education being delivered — or not delivered — to Alaska Native children, Native villages and families are equally responsible. While many Native parents and other community members might themselves lack the formal Western educational grounding to teach the children algebra, chemistry, grammar, and the like, they can certainly give active and positive support to their children and the teachers. In many instances, they also have the tools and the knowledge to teach their children the Native language, history, and traditions — they can help the children understand who they are. But in this they appear to be failing.

1. Key Findings

The key social/cultural findings regarding the current state of Alaska Native education:

Notwithstanding the relatively recent construction of modern school facilities in most Alaska Native communities throughout the state, these educational institutions as yet do not provide adequate cultural linkages to the communities nor social linkages to the families;

In most schools in predominantly Native communities, there remains a wholly inadequate representation of Alaska Native school teachers and administrators;

Native families and villages appear not to understand or fully appreciate the critical importance of education to Alaska Natives' collective survival as healthy peoples with strong cultural foundations, and, because their villages and parents do not seem to consider education important, the children are not pressed to perform at a level consistent with their inherent capabilities; and,

The sometimes desperate social and economic conditions of many Native families and communities compound the above-identified problems and, if not improved, will continue to stand as barriers to Native children reaching their full academic achievement potentials.

For countless centuries Alaska Native people proved themselves abundantly capable of passing on to their young ones the knowledge and skills required not only for survival but also for the advancement of their societies and cultures. In times past, nature was the subject and principal teacher; her aides, all members of the family and tribe. Everyone — parents, aunts, uncles, cousins, elders, and medicine people — had his and/or her place in teaching the children what they needed to know in order to be productive members of society and in order to survive harmoniously in their world.

Though Native societies and cultures have gone through transformations from the ancient ones of their forebears, Alaska Native people must continue as the primary conduits through which education of young Natives is successfully realized. There can be no other way.

2. Recommendations: Alaska Native Education

a. The Congress should create a $10 million Alaska Native Heritage Trust to be administered by the Alaska Inter-Tribal Council; the funds to be granted to Alaska Native tribes for use in schools and in the community for enhancing Native languages and cultures.

b. The Congress and the State of Alaska should direct resources towards implementation of a three-year, statewide campaign demonstrating to all segments of the Alaska Native population the importance of education and educational achievement to the survival and advancement of Alaska Native societies and cultures.

c. The State of Alaska should, over a five-year period, dismantle the Regional Educational Attendance Area system and give the responsibility for schools to village tribal governments and their school boards in partnership with the State Department of Education; it is further recommended that tribal governments — to the extent of their capabilities — together with the Bureau of Indian Affairs be required to participate in the funding of these schools at a per capita level equaling the minimum support given schools currently operated by Alaskan municipalities.

d. The State of Alaska, in partnership with the Bureau of Indian Affairs, should increase funding for the University of Alaska's X-CED program (the village teacher training and certification program) to at least four times its current level.


III. Alcohol and Alaska Natives

In the Alaska Federation of Natives' 1989 report entitled A Call for Action, the incidence of alcohol abuse among Alaska Natives was characterized as both a "plague" and an "epidemic" every bit as threatening as other diseases that have ravaged the Alaska Native population since first contact with Westerners. Nothing in the Commission's inquiry has provided evidence disputing those characterizations.

Though alcohol abuse is essentially a symptom of a much more complex set of problems within the Native community, it is, in itself, a distinct problem area that breeds an abundance of negative outcomes.

There is a tremendous need to look at short- and medium-term solutions to alcohol abuse, violence, deaths, and the various associated effects to individuals, families, and communities. Native lives, quite literally, depend on these solutions being found. To ensure that future generations of Alaska Native people are not similarly affected, however, massive attention must be paid to the underlying economic, social, cultural, and spiritual factors that cause Alaska Natives to seek refuge in alcohol and other chemicals. The creation of real economic opportunities, reestablishment of Natives' cultural integrity, and the true empowerment of individuals and Native communities are among the long-term solutions that must be forthcoming.

A. Summary

1. The Situation: The Facts Tell the Story

In the Alaska Federation of Natives' original report that provided the seeds for the Alaska Natives Commission work, several pronounced problem areas were identified that, together, help to demonstrate clearly the tragic consequences of a people in social and cultural peril. Among these are the widespread abuse of alcohol, the resultant violence — both physical and sexual — against and between family and community members, and violence towards self in the form of suicides and accidental deaths.

As evidenced by both the statistics and the volumes of first-person testimonials given to the Commission by Natives, alcohol abuse among Alaska Natives is a culprit that, if unchecked, holds the very real potential for permanently destroying the social, cultural, physical, and emotional well-being of Natives as a people. Some of the facts that help tell the story include:

In fiscal year 1993, the state and federal governments spent approximately $13 million (not counting Medicaid, Medicare, or other third-party reimbursements) providing substance abuse programs for Alaska Natives;

Between 1980 and 1989, once every 12 days an Alaska Native died from alcohol (i.e., alcohol being the primary cause of death), for a total of 305 Alaska Natives deaths attributable directly to alcohol;

A majority of Native crimes for which Natives are serving jail time are alcohol related, and a majority of those crimes fall into categories deemed among the most violent: assault, sexual assault, sexual abuse of a minor, and murder/manslaughter;

Initial findings of a special IHS/Alaska Native Health Board project which began in 1989 indicate at-risk prenatal alcohol/drug exposure among Alaska Natives ranging from 14% to 78% by region in 1991;

The suicide rate among Alaska Natives continues its decades-long climb, reaching nearly 69 per 100,000 population in 1989. The most profound consequence of this continuing increase during the 1980s is the death from suicide of an Alaska Native once every 10 days, on average, during the 1980s;

Alaska Natives are over-represented in cases of child abuse by a factor of two-to-one with the percentage of substantiated cases of abused children being over twice what would be expected based on the overall percentage of Alaska Natives in the population.

2. Solutions Must be Found

There is no way to measure the true emotional, psychological, and economic toll being taken by rampant alcohol abuse and the resultant "culture of violence" within the Alaska Native community. But Alaska Natives have made it clear to the Commission that if the tide is not halted and then turned, behavioral health problems and social pathologies will continue to consume — and eventually obliterate — any hope of Alaska Natives' survival as a healthy, productive people.

B. Alcohol's Carnage in the Native Community

Facts do not lie: alcohol abuse among Alaska Natives equals tragedy for family and village. It is proven that alcohol abuse equals violence, imprisonment, and death. It is proven that alcohol abuse in the Native family results in frightened, psychologically disordered children. Alcohol abuse leaves Fetal Alcohol Syndrome, Fetal Alcohol Effect, and a myriad of other physical and psychological symptoms in its destructive wake.

The story of alcohol and Alaska Natives is a difficult and tragic one to tell. But it is one that must be told and its message clearly understood if long-term solutions to the social and economic crisis of Alaska Natives are to be found.

1. Native Deaths as a Direct Result of Alcohol Abuse

Of all the data available regarding the effects of alcohol on the very lives of Alaska Natives, the least ambiguous is that which deals with deaths due directly to alcohol.

In the decade of the 1980s, 305 Alaska Natives (173 males, 132 females) were killed by alcohol and drugs. Put another way, between 1980 and 1989, once every 12 days an Alaska Native died directly from alcohol intake. In contrast, during that same time period, alcohol killed 478 non-Native Alaskans (341 males, 137 females). Considering that Alaska Natives made up roughly 16 percent of the state's population throughout the 1980s, the alcohol mortality rate of Natives was three-and-one-half times that of non-Natives (4.1/10,000 Natives, 1.2/10,000 non-Natives).

A more telling, and certainly more striking, statistic regarding alcohol as a killer of Natives is the years of potential life lost (YPLL: the number of years that a person died prior to his or her 65th birthday) as a direct result of alcohol abuse. For the period 1980-1989, officials estimate that the cumulative YPLL attributable to alcohol was 6,607 among Alaska's non-Native population. An almost equal number of years (6,323) of potential life was lost in the Native community as a direct result of alcohol during that same time period, despite the fact that there are five non-Natives in Alaska for every Native.

2. Native Suicides: The Alcohol Connection

The 2(c) Report, submitted to Congress in the mid-1970s, chronicled the rise in suicide deaths within the Alaska Native community. In that report, the authors concluded that "(t)he underlying causes for . . . increases in suicide undoubtedly lie in the varying cultural heritages of Native societies and the stresses of rapid social change. Suicides provide one important indicator of social stress." If such is indeed the case, then the findings of the Alaska Natives Commission suggest very strongly that social stresses for Alaska Natives, using suicide as one important variable, have increased considerably.

In sheer numbers, more Alaska Natives are taking their own lives today than at any other time in history, and the rate at which suicides occur among Alaska Natives continues to rise. The problem continues to be most prevalent within the Native male population, particular those in their late teens and twenties. In one age group within the Native male population, the rate of suicide in the late 1980s had risen to some 30 times the national average. Alcohol abuse is a factor in a large majority of Alaska Native suicides: among Native suicide victims, 79% have detectable levels of blood alcohol.

a. The Epidemic Grows. In a recent update to its report A Call For Action, the Alaska Federation of Natives found that suicide mortality rates for Alaska Natives increased from 42 per 100,000 population in 1981 to 58 per 100,000 population in 1986. The Alaska Natives Commission has found that the Native suicide rate continues an upward climb, reaching nearly 69 per 100,000 population in 1989. The most profound consequence of this continuing increase during the 1980s is the death from suicide of an Alaska Native once every 10 days, on average, during the decade.

The steep, steady rise in the Native suicide rate during the 1980s continues an upward trend that dates back to the mid-1950s. In the quarter century between 1964 and 1989, the rate of Alaska Native suicides increased 500%. And even with the large explosion in the Alaska Native birth rate during the 1980s, the non-age-adjusted crude death rate from suicide (i.e., which includes tens of thousands of Native children not at-risk for suicide), the upward trend in the Native suicide rate continued at a pace of six percent annually.

b. An Affliction of the Young. In all populations, suicide is generally concentrated in the younger populations, usually from mid-adolescence through the young adult years. Among Alaska Natives, the numbers in this age range that choose to take their own lives are even more pronounced.

While about one-in-four (26%) of non-Native suicides in Alaska are committed by 15-24 year olds, in the Native community virtually half (49%) are committed by 15-24 year olds. Correspondingly, while 30% of Native suicides occur among the population 30 years and older, 56% of non-Native suicides are by those 30 years and older.

Because Alaska Natives are prone to commit suicide at younger ages, the total number of years of potential life lost (YPLL: the number of years that a person died prior to his or her 65th birthday) goes up accordingly in the Native community. During the decade of the 1980s, 13,094 years of potential life were lost within the Alaska Native community as a result of suicide deaths. In terms of potential life lost, suicide ranks number one among injury deaths for Natives.

c. The Gender Gap. Though the occurrence of suicide by anyone — Native or non-Native, male or female, young or old — is always tragic, it is necessary to point out that suicide's huge death toll within Alaska's Native population continues to be concentrated among males. During the decade of the 1980s (1980-89), males accounted for 86% of Native suicide victims. In the last two years of that period, 1988-89, males represented 87% of the victims.

In the 1988-89 period, the suicide rate for Alaska Native females was only slightly greater than the national average (14 deaths/100,000 population versus 13/100,000). In that same time period, however, Native males died from suicide at a rate seven times the national average (91/100,000).

As is the case with Alaska Native males (see following discussion), Alaska Native females in the 20-24 year-old age group are most at risk for suicide. Measurements taken throughout the 1980s show that within this highest risk category, suicide rates remained fairly stable (43/100,000 in 1982-1984; and 44/100,000 in 1988-89).

d. Those Most At Risk. As pointed out in previous sections, suicide within the Native community is most likely to occur among males and among those in young adulthood. In fact, and as has been pointed out in several recent studies, Native males age 20 to 24 are the most at risk for committing suicide.

The Alaska Federation of Natives determined that for the period 1982-84, the suicide mortality rate in this highest risk group was 228 per 100,000 population. The Alaska Natives Commission has found that by the latter part of the decade the rate had increased by some 77%, approaching and then exceeding 400 per 100,000 population (1988: 374/100,000; 1989: 403/100,000). These rates are in excess of 30 times the national rate for the entire U.S. population.

Also disturbing is the fact that during the whole of the 1980s there were more Native male suicide victims (118) aged 20 to 24 than there were non-Native male suicide victims (114) aged 20 to 24. These numbers are astounding if for no other reason than the fact that Native males comprise only 14% of this age category statewide.

e. Where Native Suicides Occur. The 2(c) Report cited a 1974 study which indicated "that Natives in urban environments tend to have a greater incidence of suicide than those in rural areas." Nearly two decades later, statistics point quite clearly to a reversal of that trend with suicide now largely a "rural" problem.

Nearly one-third of Alaska Natives currently live within four distinct urban areas (Anchorage/Mat-Su Valley, Fairbanks, Juneau, and Ketchikan). Alaska Native suicide deaths within these urban areas, however, accounted for just 21% of the total during the 1988-1989 period. In contrast, whereas 54% of Alaska Natives live in village Alaska, two-thirds of Native suicide deaths occurred in village Alaska during that same 1988-1989 period.

There is another notable reversal of demographic/geographic trends since the time the 2(c) Report was issued. As of 1974, it was established that Athabascans in interior Alaska had the highest rates of suicide, and Southern Eskimos (Yup'iks) the lowest. Of the census districts with the 10 highest rates of suicide deaths for Alaska Natives during the period 1988-1989, the three principal Yup'ik census districts (Dillingham, Wade-Hampton, and Bethel) today have some of the highest rates.

3. Alcohol as a Contributing Factor in Other Deaths

Empirical data relating to alcohol as a contributing, as distinct from primary, factor in Alaskan deaths can be sketchy and inconsistent, and thus not entirely reliable. This is due mainly to the fact that the State of Alaska has no clear or comprehensive procedure for recording secondary causes of death. The data that does exist, however, supports the generally held belief that alcohol is a contributor in many Native deaths, especially deaths caused by both intentional and unintentional injury (e.g., suicides, homicides and drownings).

Though it is impossible using current numbers to clearly define the overall role alcohol plays in injury deaths, it can be established that, all other factors being equal, the rate at which alcohol is an underlying or a contributing cause of injury death among Alaska Natives is nearly triple that among non-Natives.

In a few specific categories, the State of Alaska in recent years has begun to accumulate more reliable data with respect to alcohol as a factor in Alaskan deaths. Overall, it is currently estimated that for Alaska, as a whole, one of every five deaths is alcohol related. About one-half of fire deaths, which occur roughly twice as often per capita in the Native community than the non-Native community, were attributable to alcohol in 1987.

C. Alcohol and Social Pathologies

1. A Partner in Crime

In other sections of this report the Commission explores in greater detail the issues of Alaska Native violence, crime, and incarceration. As is shown in those discussions, alcohol is a significant factor in domestic and other interpersonal violence and in the commission of crimes in nearly all categories for which Natives are sentenced and incarcerated.

At this time, limited data is available on the connection between alcohol and Alaskan crime rates in general. This data serves, however, as indication of the extent of the relationship between alcohol abuse and Native criminality. In the area of sexual assault, for instance, 79% of those charged and sentenced were under the influence of drugs or alcohol at the time of the offense. About three-fourths of all murders, and at least 65% of all other crimes in Alaska, were alcohol or drug related. And in rural Alaska, it is estimated that 80% of all crimes are alcohol or drug related.

The Alaska Sentencing Commission, which has been studying crime and incarceration for several years on an on-going basis, said the following in its annual report issued in December 1992:

"The commission finds a clear connection between the abuse of alcohol and the commission of criminal offenses in Alaska. This alcohol connection is particularly strong in rural areas and among Alaska Natives wherever situated. It is estimated that at least 75% of offenders have problems with substance abuse, and this figure is probably even higher for Native offenders."

This assessment was bolstered in hearings held by the Alaska Natives Commission in March of 1993 where 55 Native inmates from correctional institutions throughout the state testified. Nearly all inmates who were asked whether alcohol was involved in the commission of his or her crime answered in the affirmative.

2. A Lifetime of Damage

Because its victims cannot speak for themselves, and because it is a damaging childhood health condition that is completely preventable but, once acquired, a permanent condition for life, Fetal Alcohol Syndrome (and the related Fetal Alcohol Effect) is among the most disturbing of health concerns for any population. For Alaska Natives, with an FAS rate more than double the national average, the problem is compounded and magnified.

Accurate statistics are not easy to come by because diagnosis of FAS is generally difficult. An FAE condition is even harder to accurately diagnose. Additionally, it was not until the mid-1980s that the Indian Health Service began a comprehensive approach to measuring the true extent of FAS and FAE in Alaska.

Somewhat reliable data are only now beginning to emerge, and though it is still too early to make sound assumptions regarding trends, current figures point to the possibility that the FAS rate among Alaska Natives slowly declined during the decade of the 1980s. Figures through 1988 suggest an Alaska Native FAS rate (5.1 per 1,000 live births cumulative 1981-1988) of roughly two and one-half times the overall FAS rate in North America (2.2 per 1,000). This means that from 1981 to 1988, one Alaska Native child with medically diagnosed FAS was born each month.

Fetal Alcohol Effect, sometimes called the "hidden problem" because diagnosis is extremely difficult, should be of major concern. Though victims are not characterized by the physical attributes of those afflicted with FAS, the neurological problems and complications generally associated with FAS are also found in FAE victims.

Though preliminary evidence suggests that rates of FAS might be slowly declining in the Alaska Native population, there is every reason to believe that it will remain a crucial problem for years to come. Initial findings of a special IHS/Alaska Native Health Board project which began in 1989 indicate at-risk prenatal alcohol/drug exposure among Alaska Natives ranging from 14% to 78% by region in 1991.

There is no way to measure the true emotional and psychological costs paid by individuals and by society for alcohol's prenatal damage. In purely economic terms, however, it is estimated that it will cost society over $1 million per FAS child to pay for a lifetime of needed medical, special education, and welfare services.

3. Family/Community Life: A Breakdown of Values and Roles

Violence within Native homes and Native communities has escalated hand-in-hand with the rise in alcohol abuse. Violence towards self (suicide, alcohol-assisted accidents), violence against family members including children, and violence towards other members of society are among the hallmarks of Alaska Natives' experience with alcohol.

a. Alcohol and Native Sex Offenses. Alaska Native adults make up roughly 13.5% of Alaska's prison-age population but represent about one-third of the state's inmate population. Of particular note within the Alaska Native prison population is the high percentage of sex offenders. While less than 16% of Alaska's non-Native inmate population fell into the sex offender category (sexual assault/sexual abuse of a minor) in April of 1993, over 27% of the Alaska Native inmate population was made up of those who had sexually abused either another adult or a child. Strikingly, virtually half of the Native sex crimes for which prison time is currently being served were committed against children.

Well over half (53%) of Alaska Native inmates are incarcerated for crimes falling into categories deemed among the most "violent": Assault (14% of total Native inmates); Sexual Assault (14%); Sexual Abuse of a Minor (13%); and Murder/Manslaughter (12%). From testimony received at village and regional hearings of the Commission and at hearings held within prison institutions and with state and federal officials, a pattern is clear: the types of crimes depicted above are crimes that, without the effects of alcohol overconsumption, an Alaska Native individual would likely not even contemplate, let alone commit.

b. A Breakdown in the Parenting Role. Alcohol's significant negative impacts on Native families and communities has come out quite clearly and loudly at all levels of the Commission's inquiry. The terms "dysfunctional families" and "dysfunctional communities" have been mentioned so often that they are standard for anyone — from professionals to Native elders — who seek to adequately describe how alcohol affects Native society and culture.

Native parents' inability to adequately provide for the care, protection, and guidance of their children is one measure of the growing affects of alcohol abuse. The Alaska Federation of Natives found that between 1984 and 1988 the number of Native children receiving protection services from the State of Alaska increased from 2,035 to 3,109. This means that in 1988, at least one in every eleven Native children was in need of and receiving child protection services.

In 1992, the State Department of Health and Social Services received 11,509 CPS (Child Protection Services) reports of harm (i.e. physical abuse, neglect, sexual abuse, and mental injury). Of these, 30% (or about 3,500) involved Alaska Native children. That number translates into a rate of alleged victims of 94 per 1,000 Native children, as compared to 55 per 1,000 children in Alaska's non-Native community and 39 per 1,000 children nationwide.

Alaska Native youths are likewise overrepresented. in the state's juvenile detention system. In 1992, some 41% of youths held in detention during the year and a matching 41% held in long-term, secure treatment were Alaska Natives. Native juveniles, for comparison, make up only about 16% of Alaska's overall juvenile population. Based on juvenile offender characteristics such as sex, race, and age as reported by the State of Alaska, it can be ascertained that in 1992 nearly one in every eight Native males between the ages of 14 and 17 had been in, or was currently in, juvenile detention during the year.

The above figures, as troubling as they are, reflect only those juvenile offenders who, after intake, are detained in state facilities. There are actually about eight to ten times as many juveniles who are referred for intake as there are detainees. With respect to the overall category of juveniles referred to intake, the following can be stated: about 27% of all Native males between the ages of 14 and 17 were referred to the state's juvenile intake system in 1992.

D. Findings and Recommendations: The Alcohol Crisis

Since its introduction into their world, alcohol has been a constant source of destruction and sorrow for Alaska Natives. Experts have put forth any number of reasons as to why Alaska Natives become abusers of alcohol virtually at the same time that they become users. One theory suggests that because the chemical is new to the Alaska Native body, Natives lack the chemical and genetic capability to break alcohol down the way other races of people — with long exposure to it — can. Others believe that the answer is purely genetic: that is, many Alaska Natives are genetically predisposed to becoming addicted to alcohol whereas, in other races, those genetically predisposed have long since died out through alcohol-related deaths. Still others feel that the type of alcoholism prevalent among Alaska Natives, the so-called "binge drinking," is behavior learned from the trappers and miners and traders with whom Natives had initial contact.

Regardless of its physiological and psychological origins, alcoholism among Alaska Natives must be arrested and brought to remission if there is to be a livable future for this and following generations of Alaska Natives. The statistics outlined in Section II of this report, as startling as they are, paint only part of the picture. They are statistics having to do with the most serious and deadly outcomes of alcohol abuse in the Native community and don't even begin to reflect other, more subtle effects being visited upon Alaska Native communities, families, and individuals.

1. Findings

a. Alcohol as Self-Medication. Alcohol is, at its most elemental level, a form of self-medication for people suffering from depression. The Commission finds that the widespread depression for which alcohol becomes a medication in the Alaska Native context is attributable to many factors, including, but certainly not limited to, communal and personal trauma, loss of culture, and persistent rates of high unemployment. From this has grown unresolved grief, hopelessness, loneliness, and a widespread sense of poor self-esteem.

Left unchecked, alcohol abuse leads ultimately to alcoholism, a disease where the body develops a dependency for the chemical. Left untreated, this disease destroys a persons' spiritual and family life, and all too often ends in maiming — both physical and psychological — and death. Many Alaska Natives, in both the villages and cities alike, are now alcoholics. Tragically, many of them are fathers, mothers, siblings, grandparents, and community leaders whose alcohol-induced behaviors harm the physical and emotional development of Native children. This is of utmost concern, as all evidence points to the fact that children born to alcoholics and reared in alcoholic environments tend to become alcoholics themselves.

b. Alcohol's Effects on Natives' Mental and Spiritual Well-Being. Alcohol abuse and alcoholism pose the greatest threats to the mental and spiritual well-being of many Alaska Native families, especially the women and children who all too often live in fear and uncertainty and who become scarred for life from repeated exposure to domestic violence. While the statistics for domestic violence, sexual abuse, and mental abuse are unacceptably high, the figures do not reflect the full extent of these alcohol-driven abuses. Based on first person accounts and testimonials taken by the Commission and its Task Forces in a multitude of forums, the evidence suggests strongly that many cases of abuse go unreported and remain hidden. It is only when the abuses escalate to the point where they can no longer be hidden from social service and law enforcement agencies that reports of harm are tallied. It is, therefore, difficult to accurately gauge the extent of the suffering being inflicted on women, children, and the elderly. There is little doubt, however, that the suffering is substantial.

c. Alcohol's Effects on Natives' Physical Well-Being. Alcohol abuse poses the single greatest threat to the physical health and well-being of Alaska Native families and communities. Not only does the misuse of alcohol result in accidents that maim and kill, it is also the triggering factor in most Native homicides and suicides. Alcohol misuse among pregnant Alaska Native women, as pointed out earlier in this report, results in much higher than average rates of Fetal Alcohol Syndrome and Fetal Alcohol Effect. The physical — not to mention mental — development of the affected Native children is compromised for life.

Alcoholism results in poor personal hygiene practices and unclean homes, compounding existing unsanitary conditions caused by the lack of adequate sewer and water facilities in many Native communities. It also results in. the contracting and spreading of infectious diseases, a situation made even more serious in this age of HIV and AIDS.

d. Alcohol's Effects on the Functioning of Communities. Though the abuse of alcohol — which in some instances involves an inordinate percentage of a village's population — is not necessarily the principal cause of the social and political breakdown currently being experienced by many Native villages, it is without doubt a major contributing factor. In many Native communities there exists a general apathy with respect to involvement in local government, the law enforcement system, the schools, and the social complex that keeps a community healthy and functioning. Alcohol exacerbates this general indifference.

e. Lack of Adequate and Appropriate Treatment. Attempts to treat Alaska Native alcoholism has been, at best, marginally successful. As with most alcoholism treatment approaches, those designed for Alaska Natives generally seek to treat the individual. But, even in the cases that can be pointed to as successful (i.e., where individuals have changed lifestyles and no longer use alcohol), the underlying problems have not been treated. These underlying problems, which frequently become evident only after the mask of alcoholism has been removed, generally go unacknowledged and untreated.

When an individual has undergone treatment, family members usually are not offered appropriate assistance. Family members and others close to the abuser will have experienced the newly treated person only as alcoholic and will have developed patterns of life to handle the dysfunctional situation. Most often they have many serious problems of their own to deal with, especially if the alcoholism and related abusive situations have existed for extended periods of time. These family members are oft-times as much in need of help as is the alcoholic.

f. Failure of Current Regulatory and Judicial Regimes. The constant rise in alcohol-related criminality in the Native community, together with steady increases in other key indicators of social pathology directly related to alcohol abuse, is clear proof that current methods of controlling alcohol's destruction are simply not working. For over a century governments (federal, territorial and, later, the State of Alaska) have attempted policies and regulatory schemes for controlling alcohol use and abuse by Alaska Natives. Everything from outright prohibition of alcohol sales to Natives, to present-day attempts at curbing alcohol importation and use under the State's so-called "local option laws," have been tried. (Conn and Moras 1986). No alternative, or combination of alternatives, has proven even nominally effective. The situation continues to spiral out of control.

The very fact that answers have been impossible to formulate has resulted in piecemeal policy approaches, with the ultimate outcome being a series of jurisdictional disputes among governments and governmental agencies that have otherwise proven themselves incapable of effective action.

Any future attempts to regulate alcohol importation and use in Alaska Native villages — as well as the enforcement, prosecutorial, and sentencing powers and resources without which such regulation is meaningless — must be premised on the fundamental belief that Alaska Natives can and should have ultimate and unquestioned control. Based on the ever-increasing numbers of Alaska Native deaths, maimings, and social and psychological disorders caused by alcohol, a continuation of historic and present approaches to the issue should be deemed unacceptable by those who genuinely care about the future well-being of Alaska Natives.

2. Recommendations

Note: The following recommendations are supplemental to those made in the "Health" and other sections of this volume.

a. Alaska Native Jurisdiction. The federal and state governments should implement policies — in the form of appropriate legislation, if needed; regulations; and operating procedures — that give maximum local powers and jurisdiction to tribes and tribal courts in the areas of alcohol importation and control, community and domestic relations, and law enforcement. If this cannot be achieved under current federal and state statutes or because of political intransigence on the part of the State of Alaska, Congress should amend Public Law 83-280 to specify all tribes in Alaska have concurrent criminal jurisdiction with the State of Alaska, similar to the jurisdiction now exercised by the Metlakatla Community Council.

b. Substance Abuse Treatment for Alaska Natives. Approaches to substance abuse treatment for Alaska Natives must be reconstructed to emphasize community-based, family-oriented, and culturally relevant strategies developed at the village level. Maximum discretion with respect to governmental regulation of program designs and outcomes should be fundamental to new treatment strategies. To this end, federal and state appropriations for alcohol programs in predominantly Native areas of the state, where feasible and appropriate, should bypass governmental agencies and instead be redirected as grants to Alaska Native organizations and village councils that have developed, or are developing, projects aimed at lessening alcohol abuse and its resultant Native criminality and social pathologies.

c. Alternative Corrections Programs. Regional and village alternative corrections programs should be established by the State of Alaska for all but the most violent Alaska Native offenders. These locally based corrections programs should be administered and/or overseen by local Native organizations and should contain adequate and culturally relevant alcohol treatment components.

d. Early Risk Detection. Programs for early risk detection, for example, the "Healthy Start" program that has proven to produce drastic reductions in child abuse, should be implemented for Alaska Natives with initial contact beginning prior to the birth of the child to also help prevent Fetal Alcohol Syndrome and Fetal Alcohol Effect.

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