American Indians and Native Alaskans have a life expectancy of 67.9 years, compared to 77.5 years for white people in the U.S., according to a 2022 report from the Centers for Disease Control and Prevention. Many in the population have chronic health conditions, such as heart disease, obesity, type 2 diabetes, liver disease and cancer.

But broadening health services for this population has been challenging because of spotty funding, difficulty reaching remote tribal villages and lack of data to create a viable health service infrastructure. 

During a Monday session called “Approaching Indigenous Health with Community and Culture,” public health experts talked about gathering data and connecting with communities to build future health care services for this population. 

With over 8.5 million people in the U.S. identifying as American Indian/Alaska Native or a combination with other races, the topic is timely, presenters said. In Minnesota, the topic is important because the state has 11 American Indian tribes and over 100,00 people who identify as American Indian or a combination with other groups, according to the Minnesota Department of Health.

Imagine trying to serve 20,000 people spread across a roadless area as big as Washington state. Andrea Bersamin, an associate professor of biology at the University of Alaska in Fairbanks, is trying to do just that for indigenous people in a vast Yukon territory.

For thousands of years, American Indian/Native Alaskan people ate healthy foods and endured food shortages. This resulted in populations developing so-called “thrifty” genes that enable the body to efficiently store fat and nutrients. This is great if your diet is healthy and lean, but not so great if it is unhealthy and calorie-dense, as most modern diets are. 

The result of modern diets for many Alaska Native groups has been high rates of obesity and type 2 diabetes.  

To address this issue, Bersamin and her colleagues are collecting data through elder interviews on traditional food sources of the Yup’ik tribe. 

“The erosion of traditional foodways weakened cultural systems, increased stress and increased dependence on buying foods from a store,” Bersamin said. 

Revitalizing traditional foods, cultural systems and cultural identity may reverse obesity and its attendant health maladies, she said.

Achieving “food sovereignty, holistic health and health equity” are long-term goals for the Yup’ik people, Bersamin said.

CDC’s Healthy Tribes program is on a similar mission. The program partners with tribal communities to deliver strategies and programs that strengthen cultural connection to improve health and promote wellness.

Sarah Mueller, a research scientist with ICF International, talked about her work in developing Healthy Tribes programs and the importance of including tribal voices in plans and strategies.

“There is need for stories to be recognized as valid forms of evaluation,” Mueller said. “Partnering with American Indian/Alaska Native recipients in developing the evaluation has ensured that each step is infused with a health equity lens.”

Photo: A worker holds up produce grown at a farm in Hugo, Minnesota, run by American Indians. The farm is owned by Dream of Wild Health, an organization that works to restore health and well-being to the Native community through healthy practices. Photo courtesy Dream of Wild Health.