With the country’s labor shortage only projected to worsen, employers are being forced to reconcile with the fact that some populations have long been overlooked in the workforce. High on that list: Native Americans.

More than nine million people in the United States identify solely as American Indian or Native Alaskan, or in combination with other races, according to the U.S. Census Bureau. 

While Native Americans make up just 2.9% of the population, their unemployment rates are traditionally higher than national averages. In October, the unemployment rate for Native Americans was 7.% compared to 4.1% for the overall population. Additionally, labor force participation among Native Americans also has historically lagged the national average.  

Education-to-career programs in several states are working to change that trajectory, providing new pathways to quality jobs in in-demand fields for Native Americans.

For single mother and skilled trades apprentice Katie Bugg – a member of Red River Nation in Minnesota – and medical resident Ashton Gatewood, MD – a member of the Choctaw Nation and a descendent of the Chickasaw and Cherokee Nations in Oklahoma – these programs have been life-changing.

First Tribally-Affiliated Medical School       

Oklahoma has the second highest population of Native Americans in the country behind California. For the first time in 30 years, the state’s labor participation rate has surpassed the national average, largely driven by Native Americans, according to the Federal Reserve Bank of Kansas City. The bank notes that the gains were led by jobs in government, schools, and hospitals.

A first-of-its-kind medical school in Tahlequah, Oklahoma is one example of partnerships that are leading to new ways of addressing labor shortages and improving outcomes for Native Americans in the workforce. 

Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation (OSU-COM) is the nation’s only medical school affiliated with a tribe. The Cherokee Nation spent $40 million to build the medical school facility that opened in 2020. The inaugural class graduated in May. With an enrollment of 202 medical students, 22% are Native American. 

Addressing a Community Need

The partnership between OSU-COM and the Cherokee Nation was formed to address the shortage of physicians in Native American and rural communities in Oklahoma and serve its residents.

“We really were trying to think about creative ways that we could get a sustainable workforce to meet the needs,” says Natasha Bray, DO, MS Ed, dean of the medical school. “The question becomes, then how do we change that? We change that through opportunities and pathways.” 

Bray explains that having an understanding of the cultural needs, the local environments, and mentoring youth to consider a career in medicine or other health care fields becomes an important part of the story. 

To create opportunities, the school provides a range of support for students that include an advocacy office, educational assistance for different learning styles to ensure academic success, and financial aid. 

Along with scholarships from the school and different tribes, there are scholarships and aid available from the Indian Health Service and National Health Service Corps.

Medical Students as Messengers

Building pathways starts in elementary school and continues through college to reach students about opportunities in health care. 

“We use the medical students to go out and be the messengers. There’s nothing more powerful than seeing someone who’s from my community who looks like me, who’s had similar experiences to me, coming into the community,” explains Bray. 

She stresses the goal is not only to encourage more students to seek out health care careers, but to make sure they stay in the communities that need them. 

To that end, there are residencies in tribal communities. Bray says of the 46 students who graduated this year, 48% are doing rural or tribal-based residency programs. Roughly two-thirds stayed in Oklahoma and 65% are practicing primary care medicine. 

‘Mentorship and support are critical’

One of those graduates is Ashton Gatewood, MD, an OB/GYN resident physician at the University of Oklahoma in Tulsa School of Community Medicine. 

Gatewood first went to medical school at the age of 22 in Missouri. But after a year-and-a-half, she left explaining she felt isolated with few Native American students at the university. 

She returned to Oklahoma, became a nurse, earned a masters degree in public health and worked at Indian Health Services. When she learned about OSU COM, she decided to give medical school another try.

“The main thing for me was to be able to continue working with tribal members on tribal land. The fact is we had faculty, staff, students, patients – everyone is part of that community – all working together to improve our health and wellness. That’s something that’s really unique about being a student at that school,” explains Gatewood. “Mentorship and support are critical.”

Inspiring and Helping Others in Her Community

Only 0.4% of active physicians in the United States identify as Indian American or Alaska Native. Gatewood hopes she can help to change that. 

She plans on remaining in Oklahoma with her husband and two children and intends to encourage others to pursue medical careers in Native American and rural communities.  

The annual mean wage for family medicine physicians is $258,900 in Oklahoma, the kind of career that can bring generational change. Gatewood is determined to help build pathways for others like her. 

“I think support from the community is really important because so few of us have parents or grandparents who are physicians. We don’t have that kind of built in networking that people who do have that background  or who are raised in that environment have,” she adds.

Reducing Internalized Barriers

Mentorship and support are a key part for a very different workforce training program for Native Americans in the Midwest. It’s primarily geared toward construction work. 

Nicholas Kedrowski, a member of the Oneida Nation, and his wife Nyree co-founded Five Skies Training and Consulting, in Black River, Wisconsin in 2018.

While the goal is landing construction-related jobs, much of the focus is centered on developing soft skills. It was a need he noticed wasn’t being addressed in other training programs Kedrowski worked on in tribal communities. 

“I was able then to identify that there are some internalized barriers that exist that kind of reduce successes off of the reservation. Whether it’s the fear of leaving your community, or some of the challenges of interacting in a workforce that’s not as familiar with Native culture and tradition, those create more barriers,” explains Kedrowski, who is also a managing partner and senior instructor. 

Some of the soft skills taught, explains Kedrowski, are critical thinking and research that can help with everyday life no matter what the job along with financial literacy. Participants also obtain OSHA 30 certificates, along with ones for First Aid CPR.  

250 participants have gone through the program which is free and comes with a $300 stipend.

Why Trauma Healing is Part of the Course

Kedrowski describes the four-week training as intensive. That’s because the course starts with a modified version of a White Bison program called Mending Broken Hearts. It addresses generational trauma. 

Kedrowski explains it is a way to teach healthier outcomes. While he admits most people, including his wife, didn’t understand at first why it was part of the class, many came to realize the connection. 

“Somebody says something at work, and then that triggers you. And now you’re going off on it, and – quote unquote – ‘dealing with it.’ But that may cost you your position.

“We try to get them to start addressing those things, or at least identifying that they’ve had different traumas that are impacting their everyday life, even if they don’t realize it,” stresses Kedrowki. 

Free Training, No Obligation

Much of the program’s funding initially came from Enbridge, the Canadian energy company building oil pipelines through the U.S..  

Kedrowski says one key provision he made before accepting the funding was that participants who go through the program weren’t obligated to work for Enbridge once the program was completed. 

Kedrowski is now diversifying his revenue sources as contractors need more workers and he has built up a database of people who’ve gone through training and are eligible to work. 

Most graduates, he says, are in construction, with the goal of becoming a union apprentice. 

“They don’t need to have advanced degrees. There’s no student loans, which is great. They can go to a four-year apprenticeship and then come out of that making $30, $40, $50 an hour.”

Finding a Second Chance Through a Career

One such apprentice is 41-year-old Katie Bugg, a single mother of two sons and soon-to-be grandmother who is a member of Red River Nation.  She is a journey worker at a labor union in Duluth, Minnesota.  

Bugg says she first learned about Five Skies when she was emerging from a difficult period in her life that included jail time and a recovery program. 

“I have never thought about my future. I never thought I would have a career. I’ve had jobs. And when I say jobs, I didn’t see myself going anywhere with it,” says Buggs who explains her job history mostly consisted of casino work.

She admits she was initially drawn to the Five Skies training program because of its weekly stipend. But in the first week, she came to appreciate the class about healing trauma, something that had the most impact on her. 

“A lot of people can’t hold a job and they don’t know why, you know what I mean?” questions Bugg. “That week was probably the best week because you got to find out what’s going on. You have to find out what’s going on. Identify some stuff and be able to release it,” she explains. 

Now, she is on her way to becoming a journeyman and her career has brought stability. She is looking forward to being eligible for a pension. 

“My life has changed. It’s so much better now. I’m able to provide for my family by myself,” says Buggs. 

She hopes that her new pathway will set an example for her sons.

“They see me getting up and working all these hours and working all these days. I hope that they’re able to take that work ethic with them.”