This conversation has been lightly edited for clarity.

I was born and raised in Alaska. And then came to Seattle when I was 18, and have been here ever since. My sisters were here — I have a large family, and I followed them. Being from Alaska, I wanted different educational opportunities that I didn't have there.

When I came here to Seattle, it took me a little bit to find the urban Indian community. We're not as present and as visible in this city, and you've got to know where to look. But once I was able to find the Seattle urban Indian community, it really has become a way of not only sustaining my way of life, but also consistently giving me hope, knowing that we're building a stronger future for our people.

The Seattle Indian Health Board was the first urban Indian program that I went into, when I was 19 years old, and now I work there. Thanks to the services that they provided me, I now have a place to call home, in regards to serving the people who served me.

I was pregnant, and I had been really mistreated in a hospital system here in Seattle. I was definitely stereotyped and received prejudice as a result of me being a young Native woman who was pregnant. My sister knew about the Seattle Indian Health Board. I hadn't been here very long, and she told me that that's where I could go and get medical care that would meet me, and understand, and not mistreat me as a result of being Native.

When I walked through the doors, all of a sudden, not only was I surrounded by incredibly culturally attuned services, but all these Native people that I hadn't been seeing on the streets of Seattle. And from there, I was able to connect with the community at a larger scale.

I'm the chief research officer at Seattle Indian Health Board. [As part of that,] I direct the Urban Indian Health Institute. I help oversee and understand what's going on with our clinical population, and work with our chief medical officer and our CEO to make sure that we're serving patients really well. We're also building up brand-new data systems for us to be able to access our information, and to be able to use that for programming, and policies, and looking for where we need to make further investments.

The words “public health” are a Western concept, but my parents were the first public health practitioners I knew. They always took care of people, they took them to doctor's appointments, they fed them, they got a roof over their head. All of those things are public health. I'm really fortunate that now we have these systems that are providing support to our people in a multitude of different ways.

[Public health] touches on so many different fields that I could go and work in a lab. I could work in a clinic with patients. I could just look at data and building out systems. But one of the things we do the best is decolonizing data. And that is really what my organization and I have really focused us on the last couple of years, gathering data for indigenous people, by indigenous people.

Abigail Echo-Hawk at the Westin in Seattle on May 29, 2019. Echo-Hawk is the chief research officer of the Seattle Indian Health Board and the director of the Urban Indian Health Institute. (Photo by Dorothy Edwards/Crosscut)

The Urban Indian Health Institute is one of 12 tribal epidemiology centers across the United States. Eleven of them serve regional areas that are federally recognized tribes across the U.S. We're the only one that is national. And we are the only one that specifically serves the urban American Indian/Alaska Native population. Right now, 71% of American Indians/Alaska Natives live in large, urban settings across the United States.

The Urban Indian Health Institute was born out of this time when the urban Indian community was saying, "Hey, we're living in these cities.” We're always being shown as statistically insignificant. Our health data needs to be represented. We need to be doing more research. We need to be gathering our own information.

Our responsibility as a tribal epidemiology system is to make sure that they're represented in the data. It’s to make sure that they're present in the research, that they get good data data analyses, that we work with them to provide evaluation services and really looking at building public health capacity across their programmings.

When we think about data, and how it's been gathered, is that, from marginalized communities, it was never gathered to help or serve us. It was primarily done to show the deficits in our communities, to show where there are gaps. And it's always done from a deficit-based framework. They talk about how our communities have the highest rates of obesity, have the highest rates of diabetes, highest rates of infant mortality. How our people may be experiencing high rates of opiate misuse.

What they don't talk about is the strengths of our community. What we know, particularly for indigenous people, is that there was a genocide and assimilation policies and termination policies that were perpetuated against us. If they had worked, we wouldn't be here. And so we were always strength-based people, who passed on and continued knowledge systems regardless of people who tried to destroy us.

As indigenous peoples, we have always been gatherers of data, of information. We've always been creators of original technology. And so I was brought up with knowing that that was the ancestral knowledge from which I came.

When I went to the University of Washington [and studied policy], I was able to take some of the Western knowledge systems and understand how that related to the indigenous. I recognized that the systems that were currently working towards evaluation, data collection, technology, science, and the way that we looked at the health of Native people weren't serving my people, because they didn't have the indigenous framework.

Decolonizing data means that the community itself is the one determining what is the information they want us to gather. Why are we gathering it? Who's interpreting it? And are we interpreting it in a way that truly serves our communities? Decolonizing data is about controlling our own story, and making decisions based on what is best for our people. That hasn't been done in data before, and that's what's shifting and changing.

I always think about the data as story, and each person who contributed to that data as storytellers. What is our responsibility to the story and our responsibility to the storyteller? Those are all indigenous concepts, that we always care for our storytellers, and we always have a responsibility to our stories.

I wasn't looking for a new job. I had been working with the University of Washington, where I worked at a very large research center, then moved to Washington State University, again, directing a large research center. But the CEO of the Seattle Indian Health Board approached me and said that they had this opening.



I went back to my family and asked them if it was the right thing for me to do, because that's how we work in my family. That's how tribal communities work, because you don't make these kinds of huge decisions by yourself. You make them together as a community, as a collaborative.