The tribe’s approach to life, fed by its rich and deep history, reflects the core values of the RWJF Culture of Health Prize. “Our elders and our ancestors taught us that health is a holistic thing,” explains Earl Davis, a former Marine and a master woodcarver. “It’s not just whether you get up and exercise and eat right. It’s taking care of your mind, taking care of your body, taking care of your spirit and taking care of everything around you.”
Formed 150 years ago, the 1-square-mile reservation is located in a crook of coastline where tribes from the Pacific Northwest used to gather to trade. Much of the area is wetland or tidal plains with little room for the tribe to grow. Flooding and extreme erosion are constant threats. A neighborhood just north of the reservation on Highway 105 has seen houses and beachfront swallowed by the sea. In 2013, the U.S. Army Corps of Engineers rebuilt a mile-long dune barrier to protect the reservation. But everyone knows that even that would be insufficient to withstand “The Big One”—an anticipated offshore earthquake that could trigger a catastrophic wave within minutes. Up and down the coast of Washington, other communities have taken steps to relocate to higher ground in response to stepped-up tsunami planning in the Pacific Northwest. The Shoalwater tribe has purchased land on Eagle Hill, using funds from tribal businesses, including a small casino, a restaurant, a motel, a gas station and a convenience store. It also has constructed a multi-purpose building, 55 feet above sea level, that doubles as an evacuation center in case of a tsunami, earthquake or flood.
All the members of the tribe take emergency preparedness very seriously. On a recent summer morning, hundreds of neighbors took part in a “tsunami and health walk,” which started at the reservation’s gym next to marshes and wound its way along a path to Eagle Hill Road and the new evacuation center. Along the way, participants, from toddlers to seniors, learned what to do and where to go in the event of an earthquake-triggered wave as high as 50 feet.
The tribe’s sharpened focus on community health began in the early 1990s after tribal women experienced a perplexing increase in the frequency of miscarriages and infant deaths. Epidemiologists from state and federal agencies conducted investigations but came up with nothing conclusive.
With the very future of the tribe in jeopardy, the experience proved to be a turning point. At the time, the closest tribal clinic was 70 miles away at another reservation. Motivated to improve the health of its community, the tribe started a small clinic in four rooms at the tribal center. The clinic’s success led to the opening in 2005 of the larger, stand-alone Shoalwater Bay Wellness Center, which provides medical, dental, behavioral health and substance abuse services not only for tribe members, but for all neighbors. “It’s a great step forward,” Nelson says.
Evidence of the tribe’s improving well-being is measured in the number of young people: 40 percent of residents on the reservation are under 18. Nelson recalls being “thrilled” with the first few births. “It was wonderful,” she says, “because we hadn’t had babies and suddenly we had babies. Lots of them.”