NC Lumbee are closer to federal recognition. Our health depends on it. | Opinion
The recent presidential action directing the Department of Interior to pursue full federal recognition for the Lumbee Tribe of North Carolina represents a crucial step toward righting a historical wrong that has persisted for more than a century. As the largest tribe east of the Mississippi River and the ninth largest in the nation, the Lumbee’s limbo status in federal Indian law demands resolution.
Since receiving state recognition in 1885, the Lumbee have existed in a peculiar halfway state — acknowledged by North Carolina and partially recognized by the federal government through the 1956 Lumbee Act, yet denied the full benefits afforded to other federally recognized tribes. There was a 2024 bill before Congress to amend the Lumbee Act to align with full federal recognition — the Lumbee Fairness Act. However, this bill was not considered before the end of the congressional session. Partial recognition has had profound consequences, limiting access to federal programs for healthcare, education and housing.
The health implications are stark. American Indians, including the Lumbee, suffer from some of the worst health outcomes of any racial or ethnic group in the United States. Diabetes, the fourth leading cause of death among American Indians, affects one in seven American Indians in North Carolina. Compared to the Eastern Band of Cherokee Indians, who access care at the Cherokee Indian Hospital partially funded through federal recognition, the Lumbee have fewer healthcare opportunities. Importantly, Robeson County in North Carolina, the home of the Lumbee Tribe, is last among the state’s counties in health outcomes. The federal Indian Health Service could substantially improve these outcomes by providing screenings, preventive care and referrals while supplementing other insurance.
Cultural and historical factors further hinder healthcare access for the Lumbee Tribe. The legacy of colonization, cultural trauma,and assimilation efforts has fostered a mistrust of medical professionals and government systems. Geographic and socioeconomic challenges exacerbate these disparities. To address these challenges, several key steps must be taken, including a comprehensive federal evaluation, health resource allocations, economic development and cultural revitalization.
As the executive order indicates, the Department of Interior should evaluate all available legal pathways for the Lumbee Tribe to be recognized, balancing historical verification with an understanding that traditional documentation may not fully capture Southeast tribal histories.
Any recognition plan must ensure that IHS services are adequately funded and accessible.
Federal recognition will open doors to grants and funding opportunities supporting public health infrastructure, economic growth, housing and transportation.
Recognition must support cultural preservation efforts to rebuild trust and promote holistic health approaches.
The political dimensions cannot be ignored. North Carolina — home to the Lumbee — has become significant in national elections, and support for recognition often aligns with electoral considerations. While political attention has advanced the recognition cause, the final determination must be based on historical and legal merit.
The Lumbee case can demonstrate that federal Indian law can evolve to address historical inequities while maintaining rigorous standards. Full recognition will provide vital resources to one of North Carolina’s most marginalized communities and affirm that Native American identity and survival take many forms. Several factors support the success of a new federal designation. The Lumbee community’s existing healthcare infrastructure — including multiple Lumbee providers and UNC Pembroke’s indigenous-tailored healthcare services — positions it to develop a federal recognition healthcare strategy. The tribe’s Health and Human Services Committee provides additional organizational capacity for managing federal healthcare funds.
The People of the Dark Water, as the Lumbee are known, have waited long enough for their rightful place in the federal tribal family. Addressing healthcare disparities through recognition and resource allocation is a necessary step toward justice and equity for the Lumbee. With strategic planning and cultural sensitivity, full recognition can pave the way for healthier, more vibrant Lumbee communities.