Centering Indigenous Voices in Pursuit of Health Equity

Since initial European contact, significant physical and mental health disparities have persisted in Indigenous (American Indian/Alaska Native) communities in the United States. Although Indigenous people have the lowest life expectancy of any racial/ethnic group in the country, and they continue to experience disproportionately high rates of morbidity and mortality in many categories of preventable health outcomes, they are chronically under- and mis-represented in research. As an Indigenous (Mohegan) student here at Mailman and an aspiring researcher, I am dedicated to uplifting the voices of Indigenous people and centering Indigenous epistemologies in my work.

Last semester, I was the Research and Community Engagement Intern at United States of Care (USofCare). As a commitment to their mission to ensure that everyone has access to quality, affordable healthcare regardless of health status, social need, or income, USofCare and I interviewed five Indigenous women from various tribal backgrounds to help us understand how the U.S. healthcare system can better serve Indigenous people. Through our listening work, we identified that histories of violence and experiences of mistreatment in healthcare have had lasting impacts on the trust that Indigenous people might have in healthcare services, providers, and the system overall. When combined with other barriers to care including transportation and cost, the experiences of these women support existing and emerging research that tells us that the healthcare needs of Indigenous people are not being adequately met in the U.S. From our conversations with these Indigenous women, we derived three suggested solutions for how the U.S. healthcare system can better serve Indigenous people: 1) train culturally competent healthcare providers; 2) invest in pathways to medical careers for Indigenous youth; and 3) promote the acceptance and inclusion of traditional healing in Indigenous healthcare. It was such an honor to work alongside USofCare to develop these solutions and share the stories of these women.

Since publishing our findings on the USofCare website, I have been invited to my alma mater, Quinnipiac University, to give two presentations about my work. In October, I was invited by the Indigenous Student Union, of which I am the founder and former president, to draw upon my findings to discuss the pressing need to Indigenize healthcare, as well as how we can address the barriers created by a homogenous healthcare workforce. In November, I was welcomed back for the annual Indigeneity Initiative Teach-In to give an overview of my project and findings. Continuing to share these women’s stories and highlight critical issues facing Indigenous communities has been beyond rewarding, and I truly hope I am making my ancestors and community proud.

I continued engaging in research this summer as a Visiting Graduate Student at Harvard Medical School. For my APEx, I did a thematic analysis of an interview with an Indigenous traditional healer as a Pre-Doctoral Research Fellow/Visiting Trainee in the Department of Global Health and Social Medicine under the guidance of Dr. Joseph Gone and Dr. Rachel Wilbur. We are currently still working together to write a case study manuscript of this thematic analysis that will illustrate and contextualize Indigenous traditional healing philosophy and principles of healing within the framework of this particular healer’s lived experiences and cultural knowledge. The incorporation of Indigenous traditional healing practices has been suggested by researchers, providers, and community members as a potential way to ameliorate the burden of physical and mental health disparities in Indigenous communities (you will recall it was one of the suggested solutions derived from my USofCare research, as well). However, to understand how we can best integrate Indigenous and Euro-American (or “Western”) practices, we need to explore and understand Indigenous traditional healing more in-depth, which this paper will seek to do.

My education here at Mailman, specifically ReMA [Research Methods] in the Core, as well as Qualitative Research Methods and Social and Economic Determinants of Health in SMS, have given me a valuable set of research skills and a comprehensive introduction to social science theory that I applied during my experience as a research intern and pre-doctoral research fellow. I am eager to continue learning and complete my MPH this year, with hopes of pursuing a PhD in the near future and continuing this work. As I continue to share Indigenous narratives and address the issues that plague our communities, it is in a commitment to honoring my ancestors and my people.

Kiara Tanta-Quidgeon is a candidate for an MPH in the Department of Sociomedical Sciences with a certificate in the Social Determinants of Health.