Missouri Breaks Industries Research

Research about Indian Country should be run by Indian Country.

Missouri Breaks Industries Research is a tribally based research organization. We are not a university. We are not a federal agency. We are community members — from Cheyenne River, Pine Ridge, and Spirit Lake — and we have been doing this work since 1995 because outside researchers don't know us like we know ourselves.

Most people know us as the Northern Plains field center for the Strong Heart Study. That's where we started, and it's still a major part of what we do. The trust and infrastructure we built through the Strong Heart Study became the foundation for something larger: a research organization that works across every area of community health.

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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: we always have, and we always will.

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

2 — The Strong Heart Study

Where it started.

In 1989, nobody in federal health agencies knew why American Indians were dying from heart disease at rates that were higher than other populations. The problem was: there was no data.

The Strong Heart Study was the direct response. It was the first large-scale study of cardiovascular health in American Indian communities. The Aberdeen Area Tribal Chairmen's Health Board was the original grantee for the Northern Plains center. Missouri Breaks was founded in 1995 to take over the Dakota field center in Phase II — and has run it ever since, serving three Tribal nations for three decades.

Today, Strong Heart is the longest-running and most comprehensive study of cardiovascular health in American Indian communities ever conducted. Here's what came out of it:

1985
Heckler Report
The Gap That Started Everything
The federal government identified a critical gap in American Indian cardiovascular data. Strong Heart was built to fill it. Today, SHS data is part of the evidence base that federal health planning frameworks use 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. Today, the Strong Heart findings on this clinical tool have been cited over 2,100 times in research worldwide.
SDPI
Evidence
Diabetes Burden — Quantified
Strong Heart documented the diabetes-cardiovascular link in American Indian communities for the first time. This evidence helped make the case for the Special Diabetes Program for Indians. Even now, SDPI uses SHS data as a benchmark to measure whether its interventions are working.
VIII
Phase
Coming Soon
Strong Heart recently finished its seventh phase and is planning for Phase VIII. The study has expanded into other, related areas that are important to our Tribal communities: brain health, sleep, environmental health, genomics, and the gut microbiome. 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 — What Else We Do

Strong Heart is where we started. It's not all we do.

The relationships and infrastructure that Strong Heart built over decades opened the door for work that touches every part of community health. Missouri Breaks has run over a hundred projects across eleven research areas which expand beyond the original focus on heart disease.

We work with partners like Johns Hopkins, Columbia, Harvard, the CDC, NIH, and Tribal health boards. But the work happens here, run by people from here. That's the model.

Strong Heart Study
Cardiovascular health, diabetes, stroke and brain aging, sleep, environmental and metals exposures, gut microbiome, and more
Tobacco & Smoke-Free
Canli Coalition, retail audits, youth programs, smoke-free policy evaluation
Nutrition & Chronic Disease
Cooking for Health, diabetes prevention, kidney disease, Four Winds nutrition
Maternal & Child Health
ECHO, pediatric asthma, HPV, pre-eclampsia genetics, Supporting Families
Genomics & Precision Health
Ethical genome research, bio-banking talking circles, Stanford SPHERE partnership
Community & Cultural
Red Talks, community health assessments, respiratory therapy, DME services
Environmental Health
Arsenic in water, mercury exposure, indoor air quality, autoimmune study
Behavioral Health
Opioid response, suicide prevention, youth & family interventions
COVID-19 Response
Novavax clinical trial, CRST Wayakta-He pandemic response
Education & Workforce
WE RISE, environmental health literacy, gene-environment teaching

When COVID hit, we ran a vaccine clinical trial and collected information about infection rates and risk for long-COVID as part of a larger, unprecedented rapid public health response. When arsenic showed up in our community water, we partnered with Johns Hopkins to study ways to reduce these exposures. When families were noticing more asthma in kids, we brought education programs door to door. When opioids started harming our most vulnerable community members, we built research and response programs to improve pain and mental health.

None of that happens without the decades of trust that Missouri Breaks has built with our communities. This work is our own, driven by what our communities need most.

4 — Who This Serves

Research can't treat patients. But it can help to change the systems that do.

No single doctor, clinic, or hospital can answer questions like: 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 this research looks like when it is done right:

It changes clinical practice.
Before Strong Heart, risk assessments for heart disease were built on data from other populations. Our communities were invisible in the science that was supposed to protect them. That changed because we did the research. We changed it for ourselves.
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. That's what these 102 projects produce.
It turns data into action on the ground.
When Strong Heart data showed the diabetes-cardiovascular link, that evidence helped create SDPI. When our environmental studies found arsenic in water, that became an intervention program. When our asthma research identified risk factors, we went into homes with remediation. Research finds the problem. Public programs fix it.

It took 40 years from the first evidence on smoking before lung cancer rates meaningfully dropped. Change can be slow. But without the evidence, we don't know what to change.

5 — How It Works

We didn't adopt these principles. We built them.

Before "community-based participatory research" was a term in a textbook, before the CARE (Collective, Authority to Control, Responsibility, and Ethics) 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 the Strong Heart Study 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.

Missouri Breaks went directly to the Cheyenne River Sioux Tribe — to the Health Committee and Tribal Council. Not because we had to negotiate or convince anyone. Because the relationship was already there. It had been there for twenty years.

The Tribal Council passed Resolution No. 1-2009-CR — unanimously. Fifteen yes, zero no, zero abstaining. 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 to any individual, agency, or organization without specific Tribal authorization. It further declared that the DNA of the people and their ancestors belongs to the Tribe and their respective families.

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

NIH honored that resolution — not just for Cheyenne River, but for all SHS Tribes.

That's what decades of doing this right looks like when it counts.

We know that new people come to the table who weren't here when this work started. That's a good thing — fresh eyes keep us accountable, and moving forward. Our job is to make sure our communities are not just represented, but an active participant at all levels of the research process. But you are the voices of our community. We want to hear from you.