Feb 4, 2025
Strength in Partnership: Montana Consortium for Urban Indian Health
More than 70% of Native Americans live in urban areas, yet healthcare systems often overlook their unique needs. Urban Indian Organizations (UIOs) are changing that—providing essential healthcare and cultural programs that honor Native traditions while ensuring access to quality care in cities across the country.
In Montana, five UIOs serve Native people in Butte, Missoula, Great Falls, Billings, and Helena. Despite their vital role, UIOs receive only about 1.2% of the Indian Health Service (IHS) budget nationwide – far below what is needed to fully meet urban Native health needs. This makes collaboration among UIOs even more essential.
In 2021, the Montana Consortium for Urban Indian Health (MCUIH) was established to connect and support the work of Urban Indian Organizations. MCUIH helps them share resources, strengthen advocacy efforts, and build capacity to better serve Native communities. Today, the leaders of Montana’s five UIOs serve as directors for the consortium, guiding its initiatives.
To learn more about this important work, we spoke with MCUIH’s Executive Director, Jason Smith, and their Development Director, Lisa James, who shared insights into their approach, and how funders and community members can support urban Indian health.
Challenges Facing Urban Native Communities
Like Native people on reservations, urban Native communities are keeping traditions strong, advocating for better healthcare, and working to ensure they have the services they need. Native people overall experience higher rates of chronic diseases like diabetes and heart disease, as well as mental health and substance use concerns. But living in a city can add extra barriers than make accessing care more challenging. These include:
- Navigating healthcare outside of IHS. Unlike on reservations, where IHS clinics are more prevalent, urban Native people often turn to mainstream healthcare providers, many of whom are unfamiliar with Native health traditions and experiences, creating challenges in accessing culturally competent care.
- Limited visibility in data and policy. “Urban Native populations are often a ‘lost bucket’ in data collection, and we want to change that,” Lisa told us. Because health data often focuses on reservation-based communities, urban Native needs are frequently overlooked in funding decisions and policy discussions.
- Lack of awareness about UIOs. Many people—both Native and non-Native—aren’t familiar with UIOs or the services they provide. “We want Native Americans and non-Natives to understand what UIOs are, what their purpose is, and how communities can support them,” Lisa said.
MCUIH’s Approach: Collaboration, Data, and Advocacy
MCUIH has launched an array of impactful initiatives to take on these challenges, but a few stand out:
- Reclaiming Data to Strengthen Services
Data drives funding, policy, and healthcare programs. But when urban Native communities are left out of the numbers, their needs aren’t fully addressed. MCUIH is working to take control of urban Native health data so that it reflects the realities of these communities and informs stronger programs and policies.
“Rather than relying on external entities to dictate healthcare priorities, we are collecting and managing health data in a way that prioritizes community needs,” Lisa shared. This work helps ensure that urban Native populations are counted—and that services and funding align with their needs.
- Expanding Workforce Development
MCUIH is expanding opportunities for Native professionals in healthcare—both in cities and on reservations.
“We’re connecting UIOs with high schools, tribal colleges, and certification programs to ensure Native youth and adults have access to training and career opportunities,” Lisa said. MCUIH is also building relationships with existing healthcare professionals to encourage long-term careers within UIOs and ensure sustainable leadership for the future.
- Strengthening Advocacy for Urban Native Health
By engaging with policymakers and educating them on urban Native health realities, the consortium helps ensure that UIOs have the resources they need to serve their communities.
“We’re strengthening our efforts to educate legislators on the realities of urban Native health,” Jason said. “Anything our directors bring to us as a priority, we make sure we’re talking to our delegation, speaking with legislators, and pushing for better funding and support.”
Advice for Funders Partnering in Indian Country
One of the biggest lessons MCUIH has learned is that relationships and trust must come first.
“In Indian Country, it takes time to build relationships, and trust is critical for moving policy and capacity forward,” Jason said. He also stressed that policy changes don’t happen overnight. “Sometimes, funders and partners want to see immediate results, but real change takes time. Building relationships, engaging communities, and creating long-term solutions requires patience, flexibility and trust.”
How You Can Support Urban Indian Health
There are several ways to support MCUIH and Montana’s Urban Indian Organizations:
- Visit www.mcuih.org to learn more.
- Follow MCUIH on LinkedIn and Facebook.
- Support your local UIO— in Missoula, Butte, Great Falls, Billings, or Helena.
- Advocate for policies that support urban Native health.
- Donate to Native-led organizations working to improve health outcomes.
Thank you to Jason and Lisa for sharing their insights and the incredible work MCUIH is doing to strengthen urban Native health. We are grateful for all that MCUIH and Montana’s Urban Indian Organizations do to ensure that Native people in cities receive the care and support they need. We encourage our community to learn more, get involved, and support this important work!