Thats the decline in life expectancy that the COVID-19 pandemic wrought upon American Indians and Alaska Natives, based on an August 2022 report from the National Center for Health Statistics.

This astounding figure translates to an overall drop in average living years from 71.8 years in 2019 to 65.2 by the end of 2021.

Although the pandemic is a major reason for this decline, its not the whole story. Even before COVID-19 emerged, life expectancy for Indigenous men was already five years lower than for non-Hispanic white men in the United States.

The grim reality

As a Native American physician and board-certified M.D., I am all too familiar with the health challenges that Indigenous Americans face.

Growing up in remote rural Alaska as a member of the Koyukon Athabascan tribe, I heard stories of how infectious diseases like flu, smallpox and tuberculosis threatened our survival. My cultural group descends from three families that survived the 1918 flu pandemic.

This history inspired me to become a traditional healer. Along with my training in Western medicine, I have also studied plant-based medicine and earth-based science, which was taught to me by my elders practitioners who passed down thousands of years of accumulated knowledge to me.

Through both my medical and traditional practices, I have learned there are many reasons for the decline in life expectancy and the divide between Indigenous and non-Indigenous health outcomes. But this gap if the government and the medical system will act can be narrowed.

Poverty, unemployment and lack of health care

American Indians and Alaska Natives die from diabetes at more than twice the rate of non-Indigenous populations. A report from the Centers for Disease Control and Prevention shows Native Americans have significantly higher rates of obesity, high blood pressure, cancers and general poor health status than other Americans. The suicide rate in Indigenous communities is about 43% higher than that of non-Indigenous communities. And Native American women experience sexual violence far more often than non-Hispanic white women.

There are many reasons for these disparities. For starters: Native Americans have the highest poverty rate among all minority groups, perhaps as high as 25%.

Unemployment among American Indians and Alaska Natives in November 2022 was 6.2%, compared to 3.7% in the general population. Many Indigenous people, working only seasonally, are also woefully underemployed.

American Indians and Alaska Natives are also underserved in the U.S. health care system. The Indian Health Service  the federal agency that provides medical care to Indigenous Americans is funded at about US$6 billion per year. That translated to only $4,078 per person in 2021.

The result is that there are fewer physicians, nurses and therapists seeing Indigenous patients, particularly those who live in rural areas. Those providing care have fewer technologies available to them, such as MRI and ultrasound machines, to help diagnose and treat disease earlier. Such shortages mean less access to either primary or emergency care, which contributes to lower life expectancy.

Historical trauma

A shaky health care system is only part of the problem. Adverse childhood experiences, social marginalization  and toxic, relentless stress also contribute to shorter lives.

Then there are the effects of unresolved historical trauma  the cumulative emotional and psychological trauma within a specific group that spans generations.

This kind of collective trauma cannot be overstated. A growing body of evidence is documenting its effects on Indigenous people. Historical trauma can produce physiological stress, striking not just individual people, but entire families. There is recent evidence to suggest that the bodys stress response has caused epigenetic changes meaning changes in gene expression caused by the environment  in Native Americans that can affect ones health even before birth.

To this day, the U.S. government has consistently created policies that sanctioned inequality actions that have likely contributed to the historical trauma and health disparities present today. American Indian and Alaska Native communities have suffered from disease, war, internment and starvation for centuries.

Not only were Indigenous people displaced from the lands that were once our home, the U.S. government even made it illegal for us to practice their traditions. Throughout most of the 20th century, the U.S. government placed Indigenous children into boarding schools that separated them from their families.

Breaking the cycle

Its clear that Indigenous communities need new or upgraded hospitals and clinics, more and better diagnostic technology, more specialty services in dental care, obstetrics, pediatrics and oncology, and more alcohol and substance abuse treatment programs.

There is some good news: The Biden administrations 2022 infrastructure bill makes $13 billion available to address some of these needs for Native American tribes. And an additional $20 billion appropriation for COVID-19 relief will also provide help for some of the most immediate challenges.

But even with this aid, there is still a funding gap. The National Indian Health Board, a nonprofit advocacy group representing federally recognized tribes, recommends a commitment of $48 billion for the 2024 fiscal year to fully fund the health needs of Indigenous people. The current budget, $9.3 billion, is less than one-fifth of that.

The recent increases in funding are certainly a step in the right direction. But the factors contributing to the shorter lives of Native Americans started generations ago, and they are still reverberating among the youngest of us today.

Both from a professional standpoint as well as one that is very personal to me and my ancestors more work in this area cannot come soon enough.

Allison Kelliher is a assistant professor with the Department of Family & Community Medicine at the University of North Dakota

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For months, the Fed has been warily watching the U.S. economys robust job gains out of concern that employers, desperate to hire, would keep boosting pay and, in turn, keep inflation high. But Januarys blowout job growth coincided with an actual slowdown in wage growth. And it followed an easing of numerous inflation measures in recent months.

The past years consistently robust hiring gains have defied the fastest increase in the Feds benchmark interest rate in four decades an aggressive effort by the central bank to cool hiring, economic growth and the spiking prices that have bedeviled American households for nearly two years.

Yet economists were astonished when the government reported Friday that employers added an explosive 517,000 jobs last month and that the unemployment rate sank to a new 53-year low of 3.4%.

Todays jobs report is almost too good to be true, said Julia Pollak, chief economist at ZipRecruiter. Like $20 bills on the sidewalk and free lunches, falling inflation paired with falling unemployment is the stuff of economics fiction.

In economic models used by the Fed and most mainstream economists, a job market with strong hiring and a low unemployment rate typically fuels higher inflation. Under this scenario, companies feel compelled to keep boosting wages to attract and keep workers. They often then pass those higher labor costs on to their customers by raising prices. Their higher-paid workers also have more money to spend. Both trends can feed inflation pressures.

Yet even as hiring has been solid in the past six months, year-over-year inflation has slowed from a peak of 9.1% in June to 6.5% in December. Much of that decline reflects cheaper gas. But even excluding volatile food and energy costs, the Feds preferred inflation gauge has risen at about a 3% annual rate over the past three months not so far above its 2% target.

Those trends have raised questions about a core aspect of the Feds higher rate policy. Chair Jerome Powell has said that conquering inflation would require some pain. And the Feds policymakers have forecast that the unemployment rate would rise to 4.6% by the end of this year. In the past, an increase that large in the jobless rate has occurred only during recessions.

Yet Fridays report suggests the possibility that the long-standing connection between a vigorous job market and high inflation has broken down. And that breakdown holds out a tantalizing possibility: That inflation could continue to decline even while employers keep adding jobs.

Their model is that this inflation is driven specifically by wage inflation, said Preston Mui, senior economist at Employ America, an advocacy group. In order to get that down, they think we have to bring some pain in the labor market in terms of higher unemployment. And what the past three months have shown us is that that model is just wrong.

That said, its possible that Fridays report could still nudge the Fed in the opposite direction: The consistently strong job growth might convince Powell and other officials that, despite signs that wage growth is slowing, a powerful job market will inevitably reignite inflation. If so, their benchmark rate would have to stay high to cool the pace of hiring.

With that outlook in mind, Wall Street traders are now pricing in an additional Fed rate hike this year: Investors foresee a 52% likelihood that the Fed will raise its benchmark rate by a quarter-point in both March and May, to a range of 5% to 5.25%. Thats the same level that Fed officials themselves had predicted in December.

Many economists say the pandemic so disrupted the job market that it is acting differently than it has in the past.

There are a lot of norms . that arent normal anymore, Labor Secretary Marty Walsh said Friday. Were seeing a lot of companies maybe not doing layoffs in January that they normally would have because they went through a pandemic where they lost people and they didnt come back.

At a news conference this week, Powell argued that much of the easing in inflation since fall has reflected falling prices for goods items like used cars, furniture and shoes as well as sharply lower gas prices. Those price declines reflect a clearing of formerly clogged supply chains, he suggested, and will likely prove temporary.

And Powell reiterated one of his central concerns: That inflation in the labor-intensive services sector is still rising at a steady 4% pace and shows no sign of slowing. Much of that increase is a consequence of strong wage growth at restaurants, hotels and transportation and warehousing companies, with fewer workers available to take such jobs.

My own view, the Fed chair said, would be that youre not going to have a sustainable return to 2% inflation in that sector without a better balance in the labor market.

Yet even with the vigorous job gains, several measures of wage growth show a steady easing: Average hourly pay grew 4.4% in January from a year earlier, down from a peak of 5.6% in March.

More focus should be placed on the earnings data, said Rob Clarry, investment strategist at Evelyn Partners, in a research note. The high headline (job) reading does not appear to be translating into further inflationary pressure an important finding for the Fed.

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The founder and CEO of ARK Investment Management said Thursday that she and her team misjudged the uptake of the cryptocurrencyor at least the timing of itby companies and governments. Her firm has invested heavily in Bitcoin and continues to bet on its eventual rise to meteoric heights.

We tempered a few assumptions, she told Bloomberg Radio on Thursday. We thought thatled by Tesla, Block (formerly Square), and MicroStrategymore corporations would put Bitcoin on their balance sheets. Weve dialed that one down considerably. And the same thing with nation states.

Bitcoin lost nearly 65% of its value over 2022, ending the year at about $16,500. It currently stands at just over $23,500. 

Companies holding Bitcoin, not surprisingly, took a beating last year. Tesla for example said in a regulatory filing this week that it registered a $204 million impairment loss on its Bitcoin holdings in 2022. As the cryptocurrency plunged, it sold 75% of its holdings last year.

Meanwhile few governments were eager to follow the lead of El Salvador, which in 2021 became the first country to adopt Bitcoin as legal tender. A Bloomberg article in November last year carried the headline, El Salvadors $300 Million Bitcoin Revolution Is Failing Miserably.

Other countries will probably not move as quickly as they might have if El Salvador had had a grand swoosh right off the bat, said Wood. We do think it will happen, its just weve pushed it out a bit.

As for why it will happen, she noted the inflation and fiscal crises people have suffered due to governments monetary responses to the pandemic. Well, where do these people go for an insurance policy against an implosion in their purchasing power and wealth? It is in something like Bitcoin. Bitcoin is an insurance policy, she said.

Wood acknowledged that 2022 was a terrible year for everything crypto. But she said it was the centralized, opaque players like crypto exchange FTX that went bankrupt. Bitcoin, by contrast, is a rules-based digital monetary system, and its global, and theres no human intervention, she said.

FTX founder Sam Bankman-Fried didnt like Bitcoin because its transparent and decentralized. He couldnt control it, Wood said in December. 

Wood is sticking to her prediction that Bitcoin will see a rapid rise in value in the coming years. In five years, she said, it will hit roughly $670,000, something like that, and then by 2030, as we see more use cases and more of these insurance policies taken out against fiscal and policy regimes that are not healthy, we think it could pass a $1 million.

Plenty of doubters have questioned her prediction. As Bloomberg host Carol Massar noted to Wood, People are saying to me, Really? Does she really stick to this?

Mark Mobius, the billionaire co-founder of Mobius Capital Partners, predicted in December that Bitcoin would fall to $10,000 at some point this year.

And this week, Warren Buffetts right-hand man Charlie Munger argued in a Wall Street Journal op-ed that a cryptocurrency is not a currency, not a commodity, and not a security. Instead, its a gambling contract with a nearly 100% edge for the house.

Munger, who once called Bitcoin rat poison, said the U.S. should follow Chinas lead and pass laws that prevent both crypto trading and the formation of new cryptocurrencies. 

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