South Dakota Urban Indian Health
Today, more Native Americans live in urban settings than on reservations in the United States. The South Dakota Urban Indian Health (SDUIH) supports people in Sioux Falls through the implementation of culturally appropriate programming alongside the modern medical services promised in the treaties of the nineteenth century.
According to the 2020 Census, 87 percent of Native Americans in the United States live off reservations. The move from reservations to urban settings began with Congress’ termination period of the 1950s that tried to "terminate" treaty obligations to Native Americans. In response to dismantling reservation lands, the Bureau of Indian Affairs (BIA) started their urban relocation program which helped Native Americans who chose to move into cities find housing and employment.
As more Native Americans continued their move into cities like Sioux Falls, healthcare became a concern because of lack of social support. Healthcare was guaranteed to Indigenous nations on ther northern plains in the Treaty of 1868 which states, “The United States hereby agrees to furnish annually to the Indians the physician.” Advocacy by Indigenous community leaders for urban healthcare increased in the late 1960s. After nearly a decade of advocacy, Congress finally established the Indian Health Care Improvement Act (IHCIA) which created the Office of Urban Indian Health Programs (OUIHP).
The OUIHP was housed under Indian Health Service (IHS) of the Department of Health and Human Services, which provided health services for American Indians and Alaska Natives in the United States. Both IHS and OUIHP aim to improve “the physical, mental, social, and spiritual health” of their clients. OUIHP is important because Native Americans living in urban settings face different mental and physical health risks than those living on reservations. These heightened risks come because of the lack of cultural and family environments available to Native Americans living in urban settings.
In 1977, the first Urban Indian Health referral center opened in Pierre, South Dakota. At one point, there were five clinic locations in South Dakota, including Aberdeen, Rapid City, and Yankton, but those clinics were no longer functioning because of “local politics, low census and trouble finding providers.” Today, South Dakota Urban Indian Health (SDUIH) operates as a non-profit organization with two full-time clinics – one in Pierre and one in Sioux Falls. The Sioux Falls clinic – located near the Denny Sanford Center as of 2009 – opened just shortly after the Pierre clinic. In addition to the clinic, Sioux Falls also has a Cultural Healing Center downtown, which opened in 2022. According to Chief Cultural Officer Thomas De Couteau Jr., the Cultural Healing Center in Sioux Falls provides a place for the “Native community just to come and learn.” Having the Center downtown also makes it much easier for people to access than the clinic.
SDUIH clinics provide primary care, behavioral health, and cultural health services at all locations. They also support patients with accessing affordable health insurance as well as medication-assisted treatment. Primary care services include physicals, immunizations, HIV and STD testing, and family planning services, among others. In terms of behavioral health, SDUIH offers various counseling services and substance use programs. Cultural health services including cultural groups and activities are also offered at SDUIH locations in South Dakota.
SDUIH allows people living in Sioux Falls to access affordable healthcare that implements cultural health in its services. This cultural aspect that does not exist in the mainstream healthcare system plays a huge role in making sure that Indigenous populations – who are already at a higher risk of many health issues – get the care that they need in a way that feels comfortable and is effective.
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