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UND in The Conversation: Why American Indians forced to attend boarding schools are more likely to have poor health

UND public health researcher unearths the connection between forced boarding school attendance and poor health

children in a classroom
Children in the Albuquerque Indian School in 1910. Photo from National Archives Catalog

Editor’s note: UND Communications would like to introduce regional news outlets to The Conversation, a media resource that publishes “explanatory journalism” columns by university faculty members, and makes those columns available for free and immediate republication.

Faculty members at UND are among those whose columns now are routinely being published by The Conversation. One such column is below; it is by Ursula Running Bear, assistant professor of public health, and was published by The Conversation on Wednesday, June 14.

As noted above, media outlets that would like to republish Dr. Running Bear’s column are welcome to do so. For more information and to review The Conversation’s republishing guidelines, click here.

The Conversation is a not-for-profit organization that works with academics to “Inform public debate with knowledge-based journalism that is responsible, ethical and supported by evidence.” In a little over a year, 13 UND scholars have contributed articles to The Conversation. In total, these articles have been republished by media outlets around the world and have generated hundreds of thousands of views.

A complete list of all articles authored by UND scholars can be found on The Conversation’s website here. Questions? Please contact Tom Dennis, UND associate director of communications, at, or Adam Kurtz, UND strategic communication writer, at


By Ursula Running Bear

Ursula Running Bear
Ursula Running Bear

Many American Indians attended compulsory boarding schools in the 1900s or have relatives who did. My family is no different. Three generations of Running Bears – my grandparents, parents and those from my own generation – attended these residential schools over a period stretching from approximately 1907 to the mid-1970s.

American Indians are very resilient, given the harsh history we have endured. Drawing upon the strengths of our spirituality, cultural practices and family and community interconnections, we continue to persevere.

Even so, as a young adult I recognized that – compared with the broader society – my community experienced higher rates of mental and physical health problems: depression, anxiety, suicide, diabetes and cancer, to name just a few. I wondered whether attending compulsory boarding school – an experience that sets American Indians apart from other minority groups – contributed to these health disparities.

I’m a scholar who studies public health, so this question – and the fact that little quantitative scientific inquiry into it had been undertaken – was at the forefront of my thoughts when I had the opportunity to investigate the health effects of boarding schools on American Indians.

Truth in the data

When I embarked on this research in 2014, I began by analyzing a portion of the data collected from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project. That project focused on the prevalence of mental health disorders and service utilization among Northern Plains and Southwest tribes and collected some data on boarding school attendance and experiences.

For my study, I used the Northern Plains sample that included more than 1,600 randomly selected tribal-enrolled members from the Northern Plains and assessed quality of life – specifically overall physical functioning and well-being. I found that those who attended boarding school had on average statistically significantly lower scores than those who did not attend.

As a researcher, I felt vindicated to find a statistically significant relationship between boarding school attendance and poor physical health – quantitative evidence of what I and many other American Indians already knew instinctively. Yet this finding was also deeply painful. Throughout my life I have sensed the unspoken pain and emotion of my family’s boarding school experiences.

These results made their devastation undeniable and much more tangible.

Forced assimilation takes a physical toll

American Indian boarding schools used brutal methods to assimilate their students into the dominant culture and inculcate Christian beliefs and practices. Although those practices are well documented, quantitative research into whether they had an effect on the long-term physical health of American Indian people who were subjected to them was hard to come by.

Using a subset of the Northern Plains sample, which included more than 700 American Indians who had attended boarding school, I examined the effects of five well-established aspects of boarding school experience. They included an age of first attendance of 7 or younger, rare or nonexistent visits with family, forced church attendance, punishment for use of their native language and a prohibition on the practice of American Indian cultural traditions.

I found that those who endured these experiences during boarding school had worse physical health status than those who did not.

However, the poorest physical health status occurred among people who had been older than 7 when they entered boarding school and had also experienced punishment for speaking their tribal language. I am not sure why this is the case, but one possibility is that older children were more proficient in their first, tribal, language, making it more difficult to transition to English, which led, in turn, to more punishment for failure to speak the colonizing language.

Again, although the findings hit me deeply, I was not surprised. Fortunately, today there are efforts to revitalize and restore American Indian languages and culture, such as the Wakanyeja Tokeyahci Lakota Immersion School.

Chronic health issues

Recognizing the seriousness of all of this, and its potential effect on my immediate family, I examined whether 15 chronic health conditions were statistically associated with having attended boarding school. These conditions include diabetes, hypertension, arthritis and kidney disease, among others. I found that former boarding school attendees were 44% more likely to have chronic physical health conditions, with seven out of the 15 chronic conditions statistically related to boarding school attendance.

For example, those who had attended boarding schools were more than twice as likely to report tuberculosis. This, too, was not surprising, since historical accounts and health reports have documented the overcrowded conditions. In addition, windows were often boarded to prevent students from running away, which led to inadequate ventilation.

Boarding school attendees likewise had nearly four times the risk of any type of cancer as those who were not subjected to boarding school. One reason for this could be exposure to the pesticide DDT, which was banned in the U.S. in 1972. Upon arriving for the school year, students were often coated in DDT powder to target disease-bearing insects like mosquitoes.

I also found higher rates of diabetes, high cholesterol, anemia and gallbladder issues – diseases that can be associated with changing from a whole food diet to one higher in sugars, starches and fats. Given that this shift has been widely reported throughout the American Indian population in recent decades, it is worth noting that these effects appear to be even more pronounced in former boarding school students than in their peers who did not attend.

Generational effects

Finally, I examined whether a participant’s mother’s and father’s attendance was related to the number of chronic physical health conditions the person experienced.

I found that someone whose father attended boarding school had, on average, 36% more chronic physical health conditions than someone whose father did not attend. Notably, I did not find this effect from a mother’s boarding school attendance, although the reasons for that aren’t yet clear.

Although this study did not specifically look at epigenetics – shifts in gene expression that are heritable – it points to the possibility of epigenetic effects that can produce biological changes that span generations.

All of this is to say that compulsory residential boarding school education has had profound consequences for several generations of American Indians. As troubling as that is, I have faith that, as evidence mounts on the impacts of boarding school attendance on American Indians, our communities and their allies will develop solutions that improve health and healing for all of our people.