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Graduates of a new doctoral program in Indigenous health strive to address disparities in Native communities

By Nicquel Terry Ellis, CNN

(CNN) — Cole Allick remembers growing up on the Turtle Mountain Indian Reservation in northern North Dakota and watching his mother struggle to navigate the overburdened and under-resourced health care system.

Allick said his mom, who suffered from lupus and thyroid disease, would often struggle to get appointments with doctors. And her referrals for specialty physicians, he added, were sometimes denied because the Indian Health Service — a federal health agency that serves American Indians and Alaska Natives — didn’t have the funds to cover the appointments.

“There are times when our system runs out of funds to support everyone that may need that specialty care,” Allick said. “That’s where the increased resources for this system needs to happen.”

But, Allick said, those experiences shaped and inspired his career path and in August he graduated with his doctorate in Indigenous health from the University of North Dakota in the program’s inaugural class.

“That was the best decision I’ve made,” Allick said. “It has really refined my interest not only in health systems, but how to use health research as a tool for healthy equity and policy work.”

The Indigenous health doctoral program, which launched in 2020, is the first of its kind in the United States, according to the university’s website, and it was designed to offer students a deeper understanding of the unique health challenges faced by Indigenous communities.

Native Americans often face barriers to medical care, such as lower incomes, inadequate sewage disposal, cultural differences, and geographic isolation on reservations, according to the U.S. Department of Health of Human Services.

The life expectancy for Native Americans is also decreasing. A report from the National Center for Health Statistics found the average life expectancy among Native Americans was 67.9 years in 2022, a modest increase from the previous year’s average of 65.2 years, but down signifanctly from 71.8 years in 2019.

The decrease in life expectancy was exacerbated by the pandemic, the report found. The average life expectancy for all races in the US in 2022 was 77.5 years.

Melanie Nadeau, interim chair of the doctoral program, said the university’s goal is to develop graduates who will go out and connect with Indigenous communities.

“Our students are trained to be systems-level thinkers,” Nadeau said. “We focus a lot on getting to know the community that you’re working with, so that you can understand historically what happened with that community and how we can support and advance their health and wellness.”

Danya Carroll, who also graduated with her doctorate in Indigenous health in August, said she feels the knowledge she gained in the program is essential to providing more culturally competent health care on reservations.

Carroll, who grew up in Navajo Nation and is a member of the White Mountain Apache Tribe, said there is often high turnover and a language barrier with medical professionals who aren’t Native American. Her grandmother, who speaks the Navajo language, often struggled with doctor’s appointments, Carroll said.

“We need our own people in those spaces,” she said. “You just have that understanding when you are from that community.”

Carroll said after graduating from the program, she hopes to help build health care systems and promote policies that are more inclusive of Indigenous culture and values.

She is now completing a post-doctoral program at the University of Western Ontario.

Nadeau said graduates from the program are equipped to work in academia, conduct research, and partner with community health programs such as the Indian Health Service.

Lung cancer is the leading cause of cancer death among Native Americans, according to the National Library of Medicine. Allick, who is now a research coordinator and tribal liaison at Washington State University, said one of the disparities he hopes to address through his work is improving access to lung cancer screenings on Indian reservations.

Allick said there needs to be a system that not only makes screenings more accessible but helps identify people who are at higher risk and need to get screened.

“A lot of our communities are deeply rural,” Allick said. “So, if they aren’t being told to get lung cancer screenings, they are not going to go for it. And when they do need it, it’s often a really long drive or the resources aren’t available for them to access it.”

While there is no silver bullet to solving health challenges faced by Indigenous communities, Nadeau said she hopes the doctoral program, with its focus on engaging Native communities and understanding their needs, will be a step in the right direction.

“I am so hopeful,” Nadeau said. “Because our students, they are going to change the world.”

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