If you look at a map of South Dakota, you’ll see that the southwestern corner shows the outline of a border within the state. That border demarcates the boundaries of the Pine Ridge Indian Reservation, more than 2.8 million acres of rolling hills, prairie, scattered pine trees, and creeks, brimming with an abundance of wildlife including buffalo, elk, deer, antelope, and turkey.

Innovations in Health Equity

This special supplement examines the organizations and programs that are addressing social inequalities in housing, transportation, work, and other parts of society that create disparate health outcomes.

The reservation, a sovereign nation, is home to the Oglala Lakota people—approximately 40,000 residents living in more than 50 small communities and governed by the Oglala Sioux Tribe. The vibrant culture of the Lakota people is apparent there. Our culture is centered on a strong spiritual connection to the land, and our many traditional ceremonies focus on healing the human spirit and honoring all living things.

Although Pine Ridge is a place of breathtaking natural beauty and rich culture, it is also ground zero for poverty in America. Oglala Lakota County, which is entirely within the boundaries of the reservation, is often labeled the poorest county in the United States. Unemployment rates hover between 60 and 80 percent, and 48 percent of the population lives below the federal poverty line. The county is also burdened by overcrowded and poor-quality housing, coupled with a severe lack of opportunities for economic growth and progress.

Pine Ridge is also ground zero for health disparities in America. The life expectancy on the reservation is age 48 for men and 52 for women, the lowest in the Western Hemisphere with the exception of Haiti. More than 50 percent of the population is under the age of 18, and young people on Pine Ridge are 10 times more likely to commit suicide than in any other community in America. Chronic diseases such as diabetes and heart disease are also at epidemic levels.

But there are signs of improvement. The percentage of young people on the reservation clearly reflects the area’s low life expectancy, but it also represents an opportunity to transform the region by empowering young people to become leaders who can change the future of their community. That shift is already beginning to happen. Over the past decade, Native American youths there have begun reconnecting to their culture, spirituality, and identity, spurring the emergence of a movement toward regional equity that will change Pine Ridge forever.

A Community Development Corporation Approach

The current youth movement on Pine Ridge began in late 2006 and early 2007, when a group of us came together to see how we could improve our situation. We were all from the reservation, and we all felt a deep conviction and responsibility to create a better future on Pine Ridge.

We wanted to run youth programs, build housing, create jobs, improve health, and do anything else needed to strengthen our communities. But we also wanted to make progress that would stick. So we began to search for the root of the systemic barriers facing our communities. As we did that, we realized that all the issues our people were confronting were interconnected. The policies, statutory decisions, and bureaucratic processes that exist today have created silos, separated people from resources, and most important, discouraged people from feeling empowered to create their destiny.

To tackle these interconnected problems we chose a community development corporation (CDC) model and created the Thunder Valley Community Development Corporation—we didn’t want to be confined to a narrow focus. That’s also why we adopted a framework focused on equity and empowerment through the lens of our Lakota cultural identity.

In Lakota we say “Mitákuye Oyás’iŋ”—we are all related. All living things—people, plants, animals, organisms, and systems—are collectively part of a living, breathing entity that encompasses all creation. Through time, conflicts, wars, and the oppression of our people and culture, this connection between us all has broken down. As Oglala Lakota people working through these issues on Pine Ridge, we recognize that we need to return to our ways and live in harmony with one another.

Culturally Based Collective Problem Solving

We have also adopted a philosophy of regeneration that is both about healing the human spirit and about fixing the unsustainable systems that perpetuate poverty, create health disparities, and fuel the injustice and inequality that affect us every day. It is a culturally based approach to collective problem solving.

So far, our regeneration work has led to the creation of two major initiatives that are catalyzing Pine Ridge to build more equitable communities. The first, our Regional Equity Initiative, started with a HUD Sustainable Communities Planning Grant in 2011. Through this process, Thunder Valley CDC partnered with the Oglala Sioux Tribe and a 22-member consortium of local organizations to create the first sustainable development plan for this region—the Oyate Ominiciyé Oglala Lakota Plan.

This plan, which includes 12 initiatives, was published in both Lakota and English. Since it passed the Oglala Sioux Tribal council in 2012, it has brought more than $12 million into the region in the form of grants, loans, and investments to improve roads, build homes, and create more livable communities. In addition, the plan was instrumental in the selection of Pine Ridge as a Promise Zone. In a Promise Zone, the federal government works collaboratively with multiple agencies—in this case, the Oglala Sioux Tribe, Thunder Valley CDC, and other local partners—to make targeted investments that will reduce crime, expand job opportunities, improve education, and take other steps toward building healthy communities on the reservation.

The Extended Family Neighborhood

Our approach to creating regional equity is to build an actual physical community and to create the associated models for development that will sustain that community. We are doing this so that we can have a physical location as a base for generating ecosystems of opportunity. We are now building a 34-acre affordable, eco-friendly, place-based community in the Porcupine district on Pine Ridge. The mixed-use and mixed-income development is the largest creative placemaking project in the history of the region. It will emphasize home ownership and include healthy, livable neighborhoods with walking paths, a community wellness center, outdoor youth spaces, artist live-and-work spaces, an organic garden and farm, a workforce development training center, and spaces to incubate local businesses. The new homes are being located in circle patterns to create positive interactions among the families, reflecting the historical way we organized our tipis. We are calling this the thiyóšpaye (extended family) pocket neighborhood design.

Thunder Valley CDC is carrying out this work through an intensive community engagement process. It pairs the physical and cultural ideas and needs of the community with a design team of award-winning architects and planners that include BNIM of Kansas City, Mo.; Pyatt Studio of Boulder, Colo.; and KLJ of Rapid City, S.D. Ultimately, we have a net-zero energy goal, with 100 percent water reclamation, passive solar homes, and 30 percent cost savings on construction.

The development has brought together federal agencies, foundations, and banks to collaborate in a place where the majority of them had never invested. In June 2015, we marked the beginning of Phase 1 with an emotional groundbreaking ceremony. More than 300 people from the reservation and around the country came to Pine Ridge to participate. We shared stories, poetry, songs, and prayers for the future. And rather than have a few people pose with shovels to commemorate the event, hundreds of people picked up shovels and turned the ground over together to put our energy into this place and to symbolize the unity and collectivity that guides our vision of regeneration.

The Importance of Community-Based Organizations

Our holistic approach to problem solving offers systems-based solutions for cultivating healthy, sustainable communities. Crosssector collaboration and community leadership are absolutely essential to creating regional equity. Community-based organizations are just as important to change making as multi-million-dollar philanthropic institutions and federal agencies. And so our message to philanthropy is this: If the goal is fostering sustainable social and economic change on a national scale, then funding grassroots community organizations working to create holistic pathways to healthy and prosperous communities is crucial—especially if the change you seek is in the poorest and most challenged communities.

We are working with and actively engaging our community, and we are challenging foundations and other private partners to help us disrupt the status quo and build a long-lasting commitment to the principles of equity, regeneration, and social justice. We have a long way to go to create a lasting ecosystem of opportunity so that our people, and others who experience the effects of generations of oppression and failed development, can become their own agents of change. We have a long way to go, but there is hope. Fierce, electric, contagious hope.

We have the ability to end poverty in Native American communities in our lifetime if the philanthropic community is ready to partner with us, take risks, and invest in long-term, community-led capacity-building programs. Today, less than 1 percent of all philanthropy in America goes to rural Native American communities. We need to change this now, and we need to change it together. There is a growing nonprofit sector in Native America, the community development finance institution movement is in full swing, and we have powerful, resilient cultures to rely on. Cross-sector collaboration will be the next step in the pathway forward as we all start working toward a vibrant, just, and sustainable world. The movement is here and the time is now.

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Read more stories by Nick Tilsen.