Throughout history, different tribes have different rituals for healing following what is called the bio-psycho-social-spiritual model. Tranditional healing practices involve the balance of the physical, mental, social, and spiritual factors in life. Ceremony is an important part of healing as it incorporates the Spirit, Creator, and the Universe. Alaskan Native, Hawaiian Native, and Native American healers utilize indigenous plants to heal conditions from muscle aches to diabetes. Healers of the Nation utilize their tribal Medicine Wheel that represents the four directions along with Father Sky, Mother Earth, and the Spirit Tree. The Medicine Wheel’s four directions connect the life stages (birth, youth, adulthood, and death), life aspects (physical, intellectual, emotional, and spiritual), the seasons (spring, summer, autumn, and winter), along with other factors connecting one to nature. Movement along the Medicine Wheel also is a reflection of one’s connection to nature, as one moves along withe Medicine Wheel in the same direction the Sun moves across the sky, East-West, in a clockwise direction (Native Voice: Healing Ways).
History of American Indigenous People and Healthcare
Native Americans healers would utilize the aforementioned healing practices, however once the western people arrived to the American shores, they also brought diseases that the Natives were not immune. As a result of the lack of immunity, an estimate of 90% of the population, prior to colonization, perished.
The Indian Health Service (IHS) was established on July 1, 1955 under the Public Health Service for the betterment of healthcare for Native Americans. The IHS was responsible for providing healthcare to Native Americans in accordance to the Synder Act of 1921 and the later Indian Healthcare Improvement Act (IHCIA) of 1976 (Baciu et al, 2017). However, the IHS mission was not always realized and had a documented unethical practice. In 1976 the General Accounting Office (GAO) found that in a span of three years, Native women ages 15-44 years old were subjected to involuntary forced sterilizations. This unethical practice and several other clinical misconducts along with genocide, ethnocide, and trauma has fostered mistrust in the American healthcare system (Pacheco, et al, 2013).
Native American Healthcare Today
Despite the advancement and access to healthcare, Native Americans continue to experience disparities. Their average lifespan is 73 years in comparison to the 78.5 years for the rest of Americans. Indigenous people in the US also have higher rates of impact from liver disease, chronic respiratory diseases, and the recent Covid-19 pandemic (Stanley, 2020).
However due to the mistrust in the American healthcare system, the improvement of these disparities are challenging to say the least. The Indian Self-Determination and Education Assistance Act (ISDEAA) of 1976 and the subsequent amendments place the power back to the Native Americans. They have the option to receive or decline healthcare services from the IHS. By placing the power with the people, the leaders of each tribe can determine their need or even desire to contract with IHS. However a factor that continues to impact the efficacy of the IHS is insufficient funds (Baciu et al, 2017).
Many tribes within the Nation have also reintroduced the traditional healing practices their ancestors utilized. In Hawaii, some communities have adopted the Waianae Diet, or the “Pre-Captain Cook Diet”, where the focus on the reduction of preservative, fatty, and high-caloric foods to promote a healthy living. Furthermore, several tribes have also opened up their Powwow to the public and invite non-natives to healing ceremonies to engage in the aforementioned traditional healing practices.
Koithan M, Farrell C. Indigenous Native American Healing Traditions. J Nurse Pract. 2010 Jun 1;6(6):477-478. doi: 10.1016/j.nurpra.2010.03.016. PMID: 20689671; PMCID: PMC2913884.
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Community-Based Solutions to Promote Health Equity in the United States; Baciu A, Negussie Y, Geller A, et al., editors. Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press (US); 2017 Jan 11. Appendix A, Native American Health: Historical and Legal Context. Available from: https://www.ncbi.nlm.nih.gov/books/NBK425854/
Native Voices: Healing Ways (Retrieved Nov. 2022).
Pacheco CM, Daley SM, Brown T, Filippi M, Greiner KA, Daley CM. Moving forward: breaking the cycle of mistrust between American Indians and researchers. Am J Public Health. 2013 Dec;103(12):2152-9. doi: 10.2105/AJPH.2013.301480. Epub 2013 Oct 17. PMID: 24134368; PMCID: PMC3828980.
Stanley, B. ‘Many Years To Overcome’: A Brief History of Native American Health Care Disparities. The Rotation. 2020 Aug.
This month’s blog post was written by our Chronic Illness specialist, Aarti S. Felder, MA, LCPC, BCN.