Culture as a Social Determinant of Health: Examples from Native Communities
AUTHOR: James Knibb-Lamouche. Paper presented at the Roundtable workshop on Leveraging Culture to Address Health Inequalities: Examples from Native Communities, Seattle, Washington (November 14, 2012)
INTRODUCTION: Native American populations in the United States are subject to the longstanding effects of historical subjugation. The consequences of colonization, forced migration from their land, and oppression include poor health conditions, high mortality rates when compared with the majority white population, and disproportionately high rates of diseases such as diabetes, alcoholism, and tuberculosis. The extreme levels of poverty among Native American populations mean lower education attainment, economic adversity, social dysfunction, and little or no access to high-quality health care. Additionally, because the standard biomedical approach focuses primarily on disease progression and treatment, traditional indigenous healing practices and other cultural complexities often have not been taken into account in the design of programs to change health behaviors and improve health outcomes in indigenous communities. The purpose of this project, then, is to describe the role of culture in health promotion and disease prevention for Native American communities.