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National Indian Health Board

The National Indian Health Board’s (NIHB) Inter-Tribal World Café on Health Equity provided a forum for tribal, federal, and state governments, including representatives from the Indian Health Service (IHS), Centers for Disease Control and Prevention (CDC), and Centers for Medicare and Medicaid Services (CMS), to come together and discuss what health equity means from a tribal perspective. Stacy A. Bohlen, Sault Ste. Marie Chippewa, National Indian Health Board Chief Executive Officer, and Carrie Field, National Indian Health Board Policy Analyst cofacilitated the interactive virtual discussion.

Dr. Alicia Mousseau, Vice-President of the Oglala Sioux Tribe provided opening remarks on the importance of Indigenous knowledge in achieving health equity. Dr. Mousseau discussed her work culturally adapting, implementing, and evaluating prevention and intervention programs with American Indian/Alaska Native (AI/AN) youth and families. “Indigenous knowledge is what has made us still be here today and still in existence. If we lose that, we are losing key piece of who we are and our health and our futures,” she said.

National Indian Health Board's Inter-Tribal World Cafe virtual forum an opportunity for tribal, federal, state, and federal governments to discuss health equity from tribal perspective.

National Indian Health Board's Inter-Tribal World Cafe virtual forum an opportunity for tribal, federal, state, and federal governments to discuss health equity from tribal perspective.

Any conversation on health equity should include the concepts of social determinants of health (SDoH). The traditional social determinants of health such as housing, food, water, education, jobs, and transportation are “void of the Native voice and are not inclusive of or responsive to Indigenous determinants of health. Discussion of health equity in Indian Country must have a Native lens and include addressing the impact of culture, traditional healing practices, spiritual vitality, Indigenous knowledge, and historical trauma to improve health and well-being long-term”, said Bohlen. The World Café on Friday was the beginning of such a discussion. 

“There are always challenges in adapting the curriculum. We have to be open to facing those challenges, like the Buffalo head on, moving forward.” There is always barriers in our tribal communities, but we have to look at the big picture and not rush to simple solutions. Using traditional and historical knowledge to merge past, present and future knowledge is vital so we can continue to protect our communities. "The government has a trust responsibility to American Indian/Alaska Native people. Why do we have to wait for our people to be voted in or get appointed to have representation in the government. We should always have a seat for us. We should always be at the table." Mousseau reminded attendees.

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The World Café model provided an opportunity to dive further into five key themes: structural discrimination, income inequality and poverty, disparities in opportunity, disparities in political power, and governance that limits meaningful participation. For instance, American Indian/Alaska Natives must often leave their communities to receive the education needed to obtain desirable jobs. All too often those desirable jobs are also outside of their communities. Both the educational institutions and job opportunities are Western models that do not embrace or respect Native knowledge and practice. Therefore, American Indian/Alaska Natives face a double threat to their health and well-being: their training and vocation are not culturally informed, and they are disconnected and separated from the protective factors of their communities.

Next steps:

A virtual Health Equity Summit is planned for August 16, 2022, to identify next steps in nationally advancing health equity for American Indian/Alaska Natives.

For more information please contact Cariee Field, National Indian Health Board Policy Analyst at

About National Indian Health Board

Established by the tribes to advocate as the united voice of federally recognized American Indian and Alaska Native tribes, the National Indian Health Board seeks to reinforce tribal sovereignty, strengthen tribal health systems, secure resources, and build capacity to achieve the highest level of health and well-being for our people.

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