Indigenous Health

Stan and Clarence chat with two incredible leaders in Indigenous health and public policy: Ravyn Gibbs and Kris Rhodes.

Ravyn Gibbs serves as the Tribal Liaison at the Minnesota Department of Health. Ravyn works to uplift Native communities, focusing on Indigenous rights and reducing health disparities. With a Bachelor’s degree in Criminology from the University of Minnesota Duluth and dual Master’s degrees in Social Work and Public Health from the University of Minnesota, Ravyn is also pursuing a Doctorate in Public Health at Johns Hopkins University. Drawing on previous work in federal Native and Tribal affairs policy, Ravyn is committed to addressing social injustices and advancing health equity.

Kris Rhodes was appointed Director of the Office of American Indian Health in 2024. With a deep commitment to public health, Kris leads initiatives to improve the well-being of Indigenous communities through policy and collaboration. Kris holds an MPH in Public Health Administration & Policy from the University of Minnesota School of Public Health and an undergraduate degree in Community Health Education from the University of Minnesota Duluth. Over a decades-long career, Kris has founded initiatives like the American Indian Cancer Foundation, playing a key role in culturally grounded, sustainable public health programs across tribal, academic, and nonprofit sectors.

Join us as Ravyn and Kris share their journeys, professional experiences, and visions for creating a healthier future for Native communities.

Join the conversation at healthchatterpodcast.com

Brought to you in support of Hue-MAN, who is Creating Healthy Communities through Innovative Partnerships.

More about their work can be found at http://huemanpartnership.org/

Research

• Overview

• Indigenous populations have a complicated history with US government related to health and healthcare 
• US government has a legal obligation to provide health care to indigenous populations 
• History of conflict, warfare, laws/policies, etc. between government and indigenous populations 
• AI/AN population made up of folks from North American, South America, and Central America
• 324 federally recognized American Indian reservations in the US (as of 2022)
• 574 federally recognized tribes
• 2010 US Census reported that almost 80% of AI/AN population lives outside tribal areas
• States with the largest indigenous populations include California, Oklahoma, Texas, Arizona, and New Mexico 
• Estimated almost 4 million people who identify as AI/AN live in the US (2022)
• Accounts for just over 1% of total US population (2022)

• Health disparities

• High prevalence/risk factors for several conditions including substance use, obesity, mental health challenges & suicide, diabetes, liver disease, etc. 
• 2018 CDC report stated that AI/AN community has the largest percentage of uninsured individuals amongst all races
• STIs/STDs
• 2018 HIV diagnosis rate in US was higher among AI/AN males (16%) compared to white males (10%)
• In 2019, tuberculosis rate was 7x higher for indigenous populations compared to white populations
• Indigenous populations also have lower life expectancy/higher mortality rates compared to white populations
• Impacted by lack of access to adequate education, disproportionate poverty rates, healthcare discrimination, and cultural differences

• Additional topics 

• AI/AN healthcare is chronically underfunded
  • Deficiency of resources for AI/AN populations 
  • Salaries for physicians working with tribal populations are historically lower than army/navy physicians 
• Federal government does not address disparities/needs 
• Mistrust in medical systems/government systems
• Histories of discrimination 
• Addiction & substance use 
• Overprescription of opioids
• Tobacco consumption
• Highly prevalent within AI/AN community
• AI/AN youths and adults have highest cigarette smoking rates among all other races and ethnicities within the US
• Prevention/education efforts targeting indigenous populations
• Violence
  • 56% sexual violence
  • 55% physical violence by intimate partner
  • 66% psychological aggression from intimate partner
  • 48% stalking
• 4 in 5 AI/AN women experience violence at some point in their lifetime
• Rural v. urban tribal communities 
• Shortage of physicians/health care options in rural areas compared to urban areas 
• Indigenous populations and homelessness 
• American Indian communities make up a disproportionate percentage of the homeless population in the US 
• Barriers to accessing care, transportation challenges, stigma, discrimination, etc. 
• COVID-19 impact on AI/AN community

• What is MN doing to support its American Indian communities?

• Office of American Indian Health, MDH
  • Supports AI communities through grants, trainings, reports/publications, tribal liaison(s), partnerships, etc. 
• Created in 2022 to improve health and well-being of MN American Indian communities and ensure tribal/urban Indian communities are represented in all state public health initiatives 
• MNsure
• Insurance to help cover costs for services received outside Indian Health Service (IHS) or Tribal/Urban Indian health care facility (ex. Hospital visit or specialty care)
• Expanded enrollment period for household members who are not tribal members 
• Cost-sharing benefits

Sources

• Office of Minority Health, US Dept. of Health & Human Services - https://minorityhealth.hhs.gov/american-indianalaska-native-health#:~:text=American%20Indians%2FAlaska%20Natives%20also,%2C%20liver%20disease%2C%20and%20hepatitis.
• Indian Health Service - https://www.ihs.gov/newsroom/factsheets/disparities/?mobileFormat=0;%20Indian%20Health%20Service,%20Indian%20Health%20Disparities
• Clinical Practice Issues in American Indians and Alaska Natives (Mangla and Agarwal, 2023) - https://www.ncbi.nlm.nih.gov/books/NBK570601/
• CDC - https://www.cdc.gov/health-disparities-hiv-std-tb-hepatitis/populations/american-indian-alaska-native.html
• Berkeley Public Health - https://publichealth.berkeley.edu/alumni/native-american-health-care-remains-vastly-underfunded
• American Indian Health Policy: Historical Trends and Contemporary Issues (Warne and Frizzell, 2014) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035886/
• Office of American Indian Health, MDH - https://www.health.state.mn.us/about/org/indianhealth/index.html
• About the Office of American Indian Health, MDH - https://www.health.state.mn.us/about/org/indianhealth/aboutus.html
• American Indians, MNsure - https://www.mnsure.org/new-customers/who-can-enroll/american-indians/index.jsp
• American Bar Association - https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/native-american-crisis-in-health-equity/
• Health Coverage Among American Indian and Alaska Native and Native Hawaiian and Other Pacific Islander People (Hill and Artiga, 2023) - https://www.kff.org/racial-equity-and-health-policy/issue-brief/health-coverage-among-american-indian-and-alaska-native-and-native-hawaiian-and-other-pacific-islander-people/
• Barriers to Healthcare for American Indians Experiencing Homelessness (Wille et al., 2017) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783318/