Missouri Breaks Industries Research presents

Research about Indian Country should be run by Indian Country.

Eagle Butte, South Dakota. Serving the Cheyenne River Sioux Tribe, Oglala Sioux Tribe, and Spirit Lake Nation. Since 1988.

So what is Missouri Breaks? We are the Northern Plains field center for the Strong Heart Study — the longest-running and most comprehensive study of cardiovascular health in American Indian communities ever conducted.

We are not a university. We are not a federal agency. We are community members — from Cheyenne River, Pine Ridge, and Spirit Lake — doing this work because nobody from the outside was going to do it right.

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Years
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Publications
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Field Centers
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Tribal Nations

We hire locally. We train locally. When someone joins our team, we build researchers — not temporary data collectors. We listen to our community first — always have.

We've been here for forty years helping our community — and we'll be here for what comes next.

2 — What We Built

What came out of this — and why it matters.

When the Strong Heart Study started in 1988, nobody in federal health agencies was asking why American Indians were dying from heart disease at rates that didn't make sense. Missouri Breaks helped change that.

1985
Heckler Report
The Gap That Didn't Exist Before
The federal government identified a critical gap in American Indian cardiovascular data. Strong Heart was the direct response. Today, SHS is cited alongside Framingham in national cardiovascular literature — filling the evidence gap that federal health planning frameworks need to set equitable goals for all populations.
2,100+
Citations
Risk Assessment — Fixed
The Framingham risk calculator — the tool doctors across America use to predict heart disease — was validated for American Indian patients using Strong Heart data. Before that, clinicians were using tools built on other populations and guessing.
SDPI
Evidence
Diabetes Burden — Quantified
Strong Heart documented the diabetes-cardiovascular link in American Indian communities for the first time — evidence that helped make the case for federal programs like the Special Diabetes Program for Indians. SDPI now uses SHS data as a benchmark to measure whether its interventions are working.
135
Since 2022
Accelerating
The last five years produced more than a quarter of everything the study has ever published. The questions our communities need answered aren't slowing down — and neither are we.

This is what happens when research stays in the community long enough to matter.

3 — Who This Serves

Research doesn't treat patients. It changes the systems that do.

No single doctor, clinic, or hospital can answer the question: Why does heart disease affect our communities differently? That takes data from thousands of people tracked over decades. And it takes trust.

We know trust is earned, not assumed. We know the history.

The federal health system sterilized 25,000 Native women without consent in the 1960s and 70s. Boarding schools took children and some never came home. When government agencies said "trust us, this is for your benefit," the result was harm. That's not ancient history. People in this room remember.

So when we say this research serves the community, we understand why that gets scrutinized. It should be scrutinized. That's what tribal oversight is for.

Here's what public health research does when it works right:

It changes clinical practice.
Before Strong Heart, risk assessments for heart disease were built on data from white populations. Our communities were invisible in the science that was supposed to protect them. That changed because this research exists.
It gives tribal leaders evidence that moves legislators.
When tribal leaders go to Washington to advocate for funding and resources, they need numbers. Not stories about suffering — evidence that shows what works, what's needed, and what the return on investment looks like.
It builds programs designed for us — not adapted from somewhere else.
Culturally based health interventions outperform generic ones. But you can't build them without the evidence base. Missouri Breaks provides that evidence base.

It took 40 years from the first evidence on smoking before rates meaningfully dropped. Change is slow. But without the evidence, there is nothing to change.

4 — How It Works

We didn't adopt these principles. We were here first.

Before "community-based participatory research" was a term in a textbook, before the CARE principles were published, before data sovereignty became a conference topic — Missouri Breaks was already operating on the understanding that research in Indian Country either serves the community or it doesn't belong here.

The community owns the data.
No publication leaves without tribal review and approval. No outside researcher accesses data without going through the tribal IRB. The data belongs to the nations that generated it.
Research has to help the people it studies.
Not careers. Not institutions. Not grant applications. If a study doesn't serve the community, it doesn't happen here.
Every participant knows exactly what they're part of.
Informed consent means informed. Not a form someone signs without reading. A conversation about what this is, why it matters, and what happens with the results.
Research dollars stay in the community.
Local hiring. Local training. Capacity building. When Missouri Breaks runs a study, the community benefits economically — not just scientifically.
Tribal IRBs have the final word.
Not the university. Not the funder. Not the coordinating center. The tribal IRB's authority is sovereign authority. If the answer is no, the answer is no.

This isn't theory — here's what it looked like

In 2009, the NIH told us that open data sharing was now required for all federally funded projects. The SHS investigators had been meeting with NIH about this policy — and refused to budge. The data, they believed, belonged to the Tribal partners. Not to NIH. Not to a public repository.

NIH finally said: if you can get a letter from one Tribal nation stating they oppose open data sharing, we'll honor it for all SHS data.

Because of the long-standing trust relationship between Missouri Breaks and the Cheyenne River Sioux Tribe, we were able to go directly to the CRST Health Committee and Tribal Council. They passed Resolution No. 1-2009-CR — unanimously. Fifteen yes, zero no. It declared that all DNA information collected on the Cheyenne River Sioux Reservation belongs to the Cheyenne River Sioux Tribe, and may not be released without specific Tribal authorization.

The resolution also said something the Tribe already knew: that the trust between the SHS and the Tribes had been built carefully over time, and could not automatically be transferred to investigators who had no such relationship with the community.

NIH honored that resolution for all SHS Tribes. That's what 20 years of trust looks like when it counts.

We know that IRB members change. New people come to the table who weren't here when this work started. That's a good thing — fresh eyes keep us accountable.

Your job is to protect this community. Our job is to make that easy.