Recognizing an Important Health Equity Milestone in Native American Heritage Month

Ed. note: This was originally published on the NPA blog.

Native American Heritage Month is a time to celebrate rich and diverse cultures, traditions, and histories, and to acknowledge the important contributions of Native Americans. It provides an opportunity to educate all Americans about American Indian and Alaska Native (AI/AN) Tribes, to raise awareness about the unique challenges Native communities have faced historically and continue to face today, and the ways in which Tribal leaders and members have worked to conquer these challenges.

To that end, as part of the National Partnership for Action to End Health Disparities (NPA), the Office of Minority Health at the U.S. Department of Health and Human Services Office of Minority Health (OMH) has partnered with the National Indian Health Board (NIHB) to raise the capacity of Tribes to utilize a health equity and social determinants of health framework in their strategic planning and public health accreditation activities.

The mission of the NIHB is to serve as, “one voice affirming and empowering American Indian and Alaska Native Peoples to protect and improve health and reduce health disparities.” Connected to that mission are the efforts of OMH and the NPA to increase the effectiveness of programs that target the elimination of health disparities. The NIHB represents tribal governments—both those that operate their own health care delivery systems through contracting and compacting, and those receiving health care directly from the Indian Health Service. This provides the NPA a platform to work collaboratively on activities that will foster and increase the adoption of practices integrating health equity considerations into policies and programs.

Despite 567 federally recognized Tribes and an estimated 5.2 million AI/ANs living in the United States, this population continues to experience some of the greatest health disparities in the nation.¹ The collective burden of historical and generational trauma, stress, and adverse childhood experiences impacts physical and mental health, as well as social determinants of health such as access to educational and job opportunities. For example, life expectancy for AI/ANs is lower than the average U.S. life expectancy by 4.4 years.²

To help address this, OMH provided funding to NIHB to support the integration of health equity in programs and policies at the Tribal level and help reduce health disparities through systems change. OMH and NIHB collaboratively developed a plan for implementing activities that are focused on ways to strategically increase health equity efforts and achieve public health accreditation—all with the aim of reducing the health disparities faced by these populations.

In recognition of Native American Heritage Month, I would like to highlight some of the achievements that Tribal health departments have made around strategic planning and public health accreditation as a result of the OMH-NIHB partnership:

• Enhanced learning opportunities: In April 2016, NIHB conducted training at the National Tribal Public Health Summit. Attendees received information on the elements of strategic planning for overall health and the application of using an equity lens framework in strategic planning.
• Webinars and information dissemination: NIHB hosted webinars, with Tribal communities in mind, which focused on the planning process for constructing a Tribal health and health equity strategic plan. The webinars and other dissemination efforts such as articles, reached more than 4,000 individuals.
• Strategic planning capacity-building assistance with Yellowhawk Tribal Health Center: NIHB provided direct, tailored, one-on-one capacity-building assistance to the Yellowhawk Tribal Health Center in Oregon to develop a comprehensive strategic plan that incorporates social determinants of health and health equity into its scope of services, a key requirement to obtain accreditation from the Public Health Accreditation Board.

The OMH-NIHB partnership efforts have reached hundreds of Tribal communities, Tribal health centers, and policymakers. Most importantly, the effort has brought health equity to the forefront of Tribal communities, according to the NIHB. The building of an infrastructure and inclusion of a health equity lens is an important and crucial milestone toward the ultimate goal of achieving health equity.

For more information on the NPA and OMH support for American Indian and Alaska Native communities, please visit: aian.npa-rhec.org/

J. Nadine Gracia, MD, MSCE, is the Former Deputy Assistant Secretary for Minority Health and the Director of the Office of Minority Health at the U.S. Department of Health and Human Services (HHS)