In August, the Centers for Disease Control and Prevention reported that the COVID-19 pandemic is disproportionately affecting Native Americans. They are 3.5 times more likely to be diagnosed with the virus than white people, in large part because of inadequate health care services and poor public health infrastructure.

“We’re sitting at 41 deaths within the tribe,” shared Lukaya Williams, housing management manager at the White Mountain Apache Housing Authority (WMAHA). “Many of our elders lost their lives to COVID, and it was one too many.”

On the latest episode of the Urban Institute’s podcast, Critical Value, Institute fellow Nancy Pindus and Joe Cushman and Justine Capra from the Nisqually Indian Tribe’s planning and economic development department discussed how Native communities like the White Mountain Apache and Nisqually Indian Tribe are weathering the pandemic, and they identified a few critical ways to address the ongoing challenges they face.

1. The availability of safe and affordable housing is key to preventing COVID-19—especially for multigenerational households

“There was a family of 12 living in a house, and they all got infected. If everybody lived in their own homes, then we would have had a better hold on [the virus],” said Williams.

In December, Urban research found Native American households have a heightened risk of exposure to and transmission of COVID-19 because they are more likely to live in multigenerational homes, have members who work in close proximity to others, and have children requiring care or supervision.

Williams has answered many calls from people who live in such households and fear infecting their elders. “I can’t go back to Grandma’s house. I don’t want to infect Grandma. I don’t want to infect Grandpa,” they told Williams. “Please take me somewhere. Give me a house where I can stay for a couple of weeks until I’m clear because I can’t afford to lose Grandma. I can’t afford to lose Grandpa.”

But Williams’ hands are tied. She’s had to turn families away because the authority cannot relocate them—highlighting the unique housing deficiencies Native communities face and the barriers to accessing additional, much-needed tribal housing.

As Pindus wrote, “tribes’ housing circumstances today were determined by the reservations the government placed them on years ago. They were given limited funding and training to develop housing in remote or geographically challenging areas. To this day, this prevents many tribes from maintaining existing housing and developing sufficient new housing.”

2. Additional funding will help keep tribal communities healthy

“If there’s something I can stress, it’s more funding. It’s more funding for the Native American community. It’s more funding for the Native housing program and getting our Native people into houses, homes and infrastructure,” said Williams.

Though the housing authority offers emergency shelters for families who lack sufficient housing, all are full. But long before the pandemic, the White Mountain Apache Tribe had been dealing with severe housing shortages. Out of the 17,000 tribal members, 1,500 families are wait-listed, explained Williams.

According to Williams, families are living in inhospitable and overcrowded conditions. Many lack running water and heat.

“Here, you have a situation where they’re saying, ‘Wash your hands and socially distance,’ but you have communities who don’t even have access to clean running water. The Indian Health Service has been underfunded for a very long time, so you’ve got limited health facilities, aging facilities, lack of equipment and a pandemic,” said Pindus.

A report from the Center for American Progress describes how decades of poor infrastructure and underfunded health systems have created huge disparities for some tribal nations, and they are a direct reflection of previous public policies “informed by manifest destiny that stripped Native communities of land, wealth, and opportunity.”

3. Flexibility in funding will help tribes adapt to pandemic conditions and quickly put resources to use

More funding can provide access to basic needs to help stabilize Native communities. Through the Coronavirus Aid, Relief, and Economic Security (CARES) Act, WMAHA received $3 million to build two fourplexes in the McNary and Cibecue communities, which lack emergency shelter and rental units for infected people. But progress has stalled.

“The tribe is in phase three and unable to open anything. Construction is at a standstill, and all supplies are backordered. So because of that, we haven’t really been able to actually start construction.” Williams said.

The Nisqually Indian Tribe also secured funding through the CARES Act and is using funds to build emergency operations and victim assistance units. Although Congress provided $47 million for domestic violence prevention and services, Capra—a grant writer for the Nisqually Tribe—says, “There’s a pandemic within the pandemic of victims that are isolated that can’t get out.”

Stay-at-home orders, rising unemployment, and limited access to social supports are likely contributing to domestic abuse. “When people are locked down in their house and they can’t go anywhere, things start to happen. We had an increase in domestic violence cases, and it became really evident we have to have that program response there,” said Cushman, who has worked with the Nisqually Tribe for 46 years.

“Having a centrally located domestic violence program where people that are in domestic violence situations can go and access is imperative—not only for them to access, but also to be a visible deterrent, that there are people in the community that care about this issue so that it doesn’t continue,” explained Capra.

Although COVID-19 has hit Native communities hard, Williams says they have quickly come together to identify and prioritize what’s important. “We’re all working together to fight COVID. We’re a tight-knit community, and we’ll always be here for one another. We’ll always support each other.”