Tribal veterans have played a significant role in the U.S. Armed Forces throughout history, yet this community often faces unique challenges in accessing the care and support they need after their time in service.

There are an estimated 160,000 Indigenous veterans across the country, and as we look toward recognizing Native Americans on Indigenous Peoples Day and throughout Native American Heritage Month, it is important to acknowledge the hurdles our tribal veterans experience on a daily basis.

At Mission Roll Call, we use the term “tribal,” though we recognize there are several terms used to describe Indigenous people, including Native American, American Indian, or the names of the many communities within this ethnic group. We have incorporated a few of these with respect to the information referenced and in hopes of highlighting the diversity among Indigenous veterans.

Connected by their deep roots in this land and a complicated history, tribal veterans have bravely served in every major conflict since the founding of our nation. Unfortunately, they often have lower incomes, lower education levels, and higher unemployment than veterans of other ethnicities. They are also more likely to lack health insurance and have a disability – service-related or otherwise – according to the Department of Veterans Affairs (VA).

Tribal veterans have played a crucial part in serving in the U.S. Armed Forces over time. Like so many of our brave service men and women, their transition to civilian life can be hard. This is not only because of gaps in our veteran care but also due to historical factors that have created social barriers for this group. In this article, we will discuss:

• How many tribal veterans are there in the U.S.?
• What are the unique challenges of Indigenous veterans?
• Is there a high suicide rate among Native American veterans?
• How can we support Native American veterans?

How many tribal veterans are there in the U.S.?

Indigenous people have long been part of the rich fabric of our nation. There are 9.7 million American Indians and Alaska Natives, accounting for approximately 2.9% of the U.S. population.

Historical factors of dislocation, discrimination, and violence have caused grave disparities among Indigenous communities, and even with the majority living outside of reservations today, Indigenous communities are often isolated from the mainstream public. Yet their tremendous resilience and service to our nation can not be understated, having served with distinction in every major conflict, from the Revolutionary War to our most recent conflicts in the Middle East.

There are approximately 160,000 Indigenous American Indian, Native Hawaiian, and Alaska Native veterans across the country. While racial identification can be complex, as of July 2021, there are 14,246 – 1.1% of the total force – who claim to be of Native American ancestry in the active duty force, according to the Defense Manpower Data Center.

American Indians and Alaska Natives serve in the military at higher rates than any other group — five times the national average – and have the highest per-capita service rate of any population.

Exact figures were not recorded, but it is estimated that up to a quarter of all Native American men served in World War I. In World War II, 44,000 of them served (along with 800 Native women in a variety of roles); 10,000 served in Korea, and around 42,000 in Vietnam.

And many Indigenous service members have made the ultimate sacrifice.

Some 30 Native Americans and Alaska Natives were killed in Operation Enduring Freedom (Afghanistan, 2001–2014), with 188 wounded. In Operation Iraqi Freedom (2003–2010), 43 American Indians died while 344 were wounded.

To date, 29 Native Americans have been awarded the Medal of Honor, our nation’s highest military honor. In November 2020, the Smithsonian’s National Museum of the American Indian opened the National Native American Veterans Memorial, which pays tribute to Native heroes in every branch of the U.S. military.

What are the unique challenges of Indigenous veterans?

Whether returning from service to live on reservations, in rural communities, or in urban environments, many Native American service members are experiencing gaps in veteran care that are exacerbated by unique socioeconomic factors.

There are currently 574 federally recognized Native American tribes in the U.S. Today, 325 American Indian reservations are home to about 22% of American Indians and Alaska Natives. Residents of these areas continue to deal with a poor quality of life, such as a lack of adequate cooking equipment, plumbing, and air conditioning. And though the majority of Native Americans currently live outside of reservations, serious disparities exist among Indigenous communities in general, including:

• Native Americans have the highest risk for health complications.
• Native Americans are the most impoverished ethnic group in the U.S.
• Native Americans are frequently victims of violence, especially Native American women.

Native American health is disproportionately worse than other racial groups in the U.S., with extremely high rates of heart disease, diabetes, and cancer. According to the Centers for Disease Control (CDC), 22.4% of American Indian and Alaska Native adults are considered to be in fair to poor health and close to one-third (27.3%) of adults in this demographic are uninsured. And although almost three-quarters (74.3%) of American Indian and Alaska Native service members are enrolled in VA health, Indigenous veterans living in rural areas often have trouble accessing care because VA facilities are backlogged or far away. Coupled with combat-related wounds or illness, this can lead to further health disparities among Indigenous veterans.

Religious stigmas can impact the well-being of Indigenous veterans as well.

Native American service members have often described military experiences as “spiritually isolating” due to judgments or ignorance around their unique customs. In fact, they were not legally allowed to practice their religion until 1978 with the passage of the American Indian Religious Freedom Act (AIRFA), and gaps in faith services for Indigenous service members have persisted.

In recognizing the impact of these socioeconomic and environmental factors, the VA is seeking to incorporate more “culturally tailored health initiatives” to foster better health outcomes in the Native American veteran community, such as providing alternatives to clinical exam rooms, acknowledging stress related to racial stereotypes, and consulting with tribe leaders for outreach — yet there is much to be done in this regard.

Coming from a community that is facing serious health disparities, high poverty rates, social isolation, and a history of systemic discrimination, Native American service members can often be disproportionately affected by issues in veteran care. As we look to improve support, ensure equity, and provide easier access to benefits for all of our courageous service members, the unique challenges of Indigenous veterans should be taken into consideration.

Is there a high suicide rate among Indigenous veterans?

Suicide and mental health are sensitive issues for anyone to discuss. In the Indigenous community, it’s particularly delicate. While there is still a lack of analysis on the subject, research shows that Native Americans are dying by suicide at a high rate.

Indigenous people in the general population have the highest suicide rates of all ethnic groups in the U.S. Factors such as cultural stigmas, substance use, social isolation, poverty, limited access to health care, and high unemployment rates play a role, along with experiences unique to Indigenous people around historical trauma and discrimination.

For Indigenous service members returning home from their time in service, the numbers are particularly concerning. In 2020, the suicide rate was 30.2 per 100,000 among Asian, Native Hawaiian, or Pacific Islander veterans; 29.8 per 100,000 among American Indians or Alaska Native veterans, compared with 34.2 per 100,000 among white veterans and 14.2 per 100,000 among black or African American veterans.

A study published in Medical Care reveals suicide rates among Indigenous veterans receiving services provided by Veterans Health Administration (VHA) rose substantially from 2005 to 2018. Based on the retrospective analysis, for American Indian and Alaska Native veterans who received VHA care between October 1, 2002, and September 30, 2014, the age-adjusted suicide rates more than doubled, rising from 19.1 to 47 out of 100,000 over the 15-year observation period. In the most recent observation period (2014–2018), the age-adjusted suicide rate was 47 per 100,000, with the youngest age group (18–39) exhibiting the highest suicide rate (66 per 100,000).

How can we support Native American veterans?

The well-being of Native Americans is largely shaped by language, culture, and traditions. Because healthcare is closely connected to socioeconomic realities, culturally tailored health initiatives can help improve health outcomes in tribal communities.

Last July, the American Indian and Alaska Native Veterans Mental Health Act (H.R. 912) was introduced to Congress, directing the VA to regularly provide mental health and suicide prevention outreach to American Indian and Alaska Native veterans. The bill would mandate that “every VA medical facility have a minority veteran coordinator and that every minority veteran coordinator is trained in the delivery of culturally competent mental health care for Native veterans.”

Further, the suicide prevention coordinator and minority veteran coordinator of each VA medical center would have to develop a plan for conducting mental health and suicide prevention outreach to all tribes and urban Indian health organizations within proximity to the medical center.

There are numerous benefits geared toward Native American veterans, but there’s much work to be done to ensure their awareness and access to these benefits.

The VA has made an effort to recognize the unique circumstances of tribes related to cultural, geographical, or language barriers that may prevent or deter Native American veterans from seeking out representation on their benefit claims. Yet, realizing there is still more that can be done to advance equity for Native American veterans, the VA released a notice for its Tribal Representation Expansion Project in February 2022. The initiative seeks to establish greater collaboration with tribal governments to expand opportunities for claims representation where needed.

As individuals looking to support this community, our first step is educating ourselves on the unique challenges tribal veterans face. Becoming aware of the incredible contributions Native American veterans have made to our nation’s history and national security should inspire us all to look for ways to show our support to these brave former service members. This includes partnering with local organizations that serve Native American veterans, helping to point these veterans to much-deserved federal resources and benefits, or volunteering as a mentor to assist in their transition to civilian life.