Healthy Diné Nation Act: Challenges Before Success

Denisa Livingston at Shiprock

Denisa Livingston at Shiprock

First Nations Development Institute (First Nations) proudly supported the Diné Community Advocacy Alliance (DCAA) on the Navajo Nation in its efforts to begin to address serious health and nutrition issues. DCAA worked over the past few years to enact an increased sales tax on junk food sold on the reservation as well as the elimination of sales taxes on healthy foods. Both initiatives were successful. These legislative bills were enacted by the Navajo Nation Council and placed into effect. In doing so, the Navajo Nation became the first in the country on two fronts: 1) the first to eliminate a tax on local fruits, vegetables and water aiming to increase access to fresh and healthy foods and, 2) passed a tax on junk food including sugary beverages sold on the reservation with revenue aimed at supporting health and wellness programs across the Navajo reservation.

DCAA LogoDCAA had championed the legislative package as a way to begin to improve the health and nutrition of citizens on the Navajo Nation, who suffer high rates of diabetes, heart disease and other diet-related illnesses. Denisa Livingston of the DCAA presented a speech about the effort to the “Fertile Ground II: Growing the Seeds of Native American Health, Policy Convening and Conference” in May 2016 in Minneapolis, Minnesota, during the opening plenary, which was titled “Exemplary Examples of Health Advocacy & Policy Change in Indian Country.” Her speech follows (and it has been updated to reflect recent activities):

Yá’át’ééh. Greetings.

We have been called: #SodaTaxWarriors, #FoodRangers, the #FBI or frybread investigators.

Food is not only a material pleasure; healthy food is our tradition — our identity.

A leader once said, the “Best way to predict the future is to create it.”

Our mission at Diné Community Advocacy Alliance is “Let’s Live a Long Life” or in Navajo, “Shánah Daniidlįįgo As’ah Neildeehdoo.” As difficult as it may sound, it is just as difficult to implement. It is the first time in history people are dying from #diabesity, diabetes and obesity, and not starvation. Every Navajo family has been affected. One of three of us is diabetic. This is our reality.

Our tribe has been hijacked by the processed-food industry, creating a 99% food desert. We are hungry for change. We are addressing unhealthy food or “junk food” or in Navajo, “ch’iyáán bizhool,” meaning the leftovers, the scraps and the non-nutritious pieces. Jonas Astrup Pedersen from Nordic Food Lab shared, “If we get food right, we get sustainability right.”

Our goal is to move from a #FoodDesert to a #FoodOasis and health is very political. Our work has been referred to as the “first community-led referendum in the country.” In 2013, we introduced one bill known as the “Junk Food Tax,” a 5 percent tax increasing every year on “junk food,” including an “Elimination of 5% Tax on Healthy Food” on our Navajo Nation. It failed, so we split it into two bills, reintroduced the tax-free healthy food bill and the “Junk Food Tax” as the “Healthy Diné Nation Act of 2014,” a 2 percent friendly awareness tax on unhealthy food.

Denisa with Navajo Preparatory School teacher and students

Denisa with Navajo Preparatory School teacher and students

Some things to consider: we removed the two words “junk food” from the entire bill since we could not find a scientific definition of “junk food” that also determined which foods were exactly “junk food.” Health promotion specialists reminded us consistently that there is “no such thing as junk food, there is junk and there is food.” So, after much research and debate, we settled on “minimal-to-no nutritional value food items.” Previously, we had included definitions of “junk food” containing certain milligrams of sodium, sugar and fat, but we removed them as well, as we were aware that food items are continuously being created to not “qualify” as “junk food” but rather labeled “healthy” when they are in fact unhealthy.

So after many improvements to the bills, they both passed. In the beginning of 2014, our former Navajo Nation President Shelly vetoed the bills. Immediately, we introduce legislation to override the vetoes. The tax-free healthy food bill passed, and the unhealthy foods tax failed by three votes.

As this point, we received much criticism about the impact of a 2 percent tax. We knew that a 15 to 25 percent tax would impact behavior but our Navajo Nation Council did not support that idea since the ceiling was 7 percent, except in the townships of Kayenta and Tuba City, it is higher, with the highest taxes in the country according to Forbes.

Finally, on November 21, 2014, after much consultation with former President Shelly, he signed the “Healthy Diné Nation Act of 2014” into law. On April 1, 2015, the news echoed, “It is no April Fool’s joke; the junk food tax is in effect today.” Simultaneously, our “Community Wellness Development Projects Fund Management Plan” passed in April – a special revenue account to ensure 100 percent of the unhealthy foods tax would only fund Community Wellness Projects on the Navajo Nation.

Although there was minimal confidence in the 2 percent unhealthy foods tax from the outside, we believed in our cause, the estimated revenue according to the Office of the Navajo Tax Commission, at 80 percent inventory of “junk food,” the sales would be $2.7 million, but we knew the inventory and sales were higher, so at 90 percent it would be $3.1 million, and with many stores at 99 percent, we are estimating about $4 million to $5 million a year or even more.

So far, we raised about $300,000 from the first quarter of the unhealthy foods tax. It has now been over one year into the tax and we are strongly advocating for the official numbers to be reported. Also, now going on 13 months, we are advocating for a distribution policy to be finalized so our 110 Navajo chapters can receive the funds to pursue their Community Wellness Projects. Our communities have been waiting with blueprints and wellness plans ready to utilize this opportunity.

Also beyond the wellness projects, we have an opportunity to create healthy entrepreneurship opportunities — healthy grocery stores, C-stores, and produce markets providing more access to fresh and healthful foods.

In Michael Pollan’s Cooked, he states, “We can’t afford the food we are eating,” referring to the unhealthy highly-processed food, junk food, cheap food, oppressive food, fast-casual food, or “Ch’iyáán Bizhool.” We cannot afford the heavy price that comes after eating from the value menu. We cannot afford the health care costs, dialysis centers, stomach stapling, and the consequences of eating unhealthily.

Recent budget and finance meeting on the Navajo Nation

Recent budget and finance meeting on the Navajo Nation

We face many challenges as we move forward in our work. It has been five years since the inception of these initiatives. We need support. For a successful implementation, we need more support. Our tribal government is very complex. Through our sweat and tears, we did not intend to uncover issues, it happened organically. We can now say we need support for our tax commission. Our taxes are not regulated and there is loss of revenue of all taxes. Enforcement of taxes needs to be addressed to improve the health of our government. We need interdepartmental synergy to fully implement these laws. We have faced silos — departments and programs minding their own. Since these were taxation bills, the programs we needed most for technical support were told to disengage, we lost support in all areas, programs withdrew, and we were abandoned to complete the work alone. Now, we are trying to mend those relationships and gain trust to implement these laws.

Further on, at the beginning of our work, we lacked Navajo-specific data to support the bills. Fortunately over the years, there have been several Community Health Needs Assessments completed but we still need more data to be shared about the health challenges to meet the needs of our Navajo people. Also, we need to help our children apply their healthy living and eating lessons outside of school. Children are learning in school about health and wellness but they cannot apply their lessons to their social and physical environment. They cannot find healthy food in excess at their local convenience store or in their home. These are only a few obstacles of many.

Parallel to the obstacles, there is still opposition to the “Healthy Diné Nation Act of 2014,” arguing that it is regressive yet the benefits are progressive. We need to put health as a priority on the agenda of our tribal council. In our work it took over three years to educate the previous council on our health, food desert, lack of healthy food access, epidemics, and unhealthy food inventory. We should not have to educate our leaders for years about health and about our epidemics when the suffering is evident — we all know someone who is personally suffering or have a family member suffering from #diabesity. We are an endangered species. When there is a population at risk, threats are targeted to protect the population, what are we doing? The focus should be the health of our people. Taxation is nothing new to our tribe, places like Kayenta have utilized their township tax to fund their community park, playground, climbing wall and skate park. Historically, our elders tax themselves in times of hardship by limiting their offspring, protecting their families, and sacrificing what was necessary to survive. History is repeating itself with taxation to save our tribe – to ultimately allow future generations to live a healthy life. This taxation has been a platform to address suffering, disease, sickness, and unhealthy lifestyles all related to food – a tool to start a health revolution in our communities.

Community advocacy is a relevant focus of public health emphasized throughout higher education but we struggle to actualize it entirely. From experience, on our Navajo Nation, it is a viewed as a “worthy cause” yet there is minimal to no support and even encouragement of it. It takes a community to raise a child and also to raise a community advocate. We are constituents championing a healthy cause and yet we are only viewed as “volunteers who do not represent a formal program or department.” Our message is to help our leaders understand that we, community members, need to be seen as an asset rather than a liability, and to be supported to create healthy change.

We all have a civic responsibility to create healthy change. Being a woman leading in these efforts, we need to raise a culture of #PrincessWarriors. Our Navajo culture is both a matrilineal and matriarchal society and it is urgent that female leadership roles need to be encouraged at all ages and in all areas – for we were born to lead. It is time to rebuild #IndigenousPower and regain our identity through healthy food. We need more education that will create a healthy culture with an educated public. It is a ripe time to create intergenerational and intertribal synergy and collaboration. We need to connect to our elders and tap into their healthy food knowledge. Wanjiku Mwangi from Kenya once said, “Elders are our knowledge keepers, they are our wi-fi hotspots.” Here is our chance to impact the world. Don’t wait for someone to inspire you, inspire yourself. Be a leader without a title — a dealer of hope.

Lastly, I charge you to pursue a Ph.D. – a Personal Health Decision.

We would like to thank First Nations Development Institute for their guidance and support.

Ahéhee’. Thank you.

Note: As of June 21, 2016, the Navajo Nation Chapter Project Guideline and Distribution Policy received a final approval from the Budget and Finance Committee of the Navajo Nation Council and the date of the first distribution of the Unhealthy Foods Tax is pending.

Denisa Livingston is a tribal member of the Navajo Nation. Her mission is improving the lives of others and her purpose – to empower others. She is committed to addressing the diabetes epidemic, the dominant culture of unhealthy foods, and the lack of healthy food access on the Navajo Nation. Denisa is a volunteer leader, legislative speaker, and community health advocate for the Diné Community Advocacy Alliance (DCAA). When she is not working from her mobile office, she enjoys the outdoors with her Japanese Akita, cooking and exploring new healthy recipes, or creating inspiring photo collages for social media. Denisa is passionate about servant leadership and public health. She can be contacted at, on Facebook, or on Twitter at @PrincesseDenisa.

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