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Improving Care for Native Americans Through Community Health Partnerships

6 minute read
A Native American grandmother and granddaughter in front of a traditional house.

With a focus on improving access and equity for patients, Mass General Brigham’s community health efforts continue to expand to better address health disparities in underserved communities. An often-overlooked population faced with a staggering rate of chronic health conditions and access inequalities is the Native American community. With the help of national and regional partners, Mass General Brigham is taking great strides to improve the underlying conditions that contribute to poor health and unmet care needs for Native Americans across the United States and more locally in Massachusetts.

Ellen Bell, MBA, MPH, Director, Community Health Outreach and Training Programs, Mass General Brigham comments, “Inadequate infrastructure, limited specialty care, and woeful underfunding contribute to well-documented and astounding health disparities in our Native American communities — all of which were severely intensified during the COVID pandemic.”

As of the end of 2021, the average life expectancy of Native Americans is 65.2 years compared to 76.4 years for the general U.S. populations. One in six Native Americans has diagnosed diabetes (more than double the prevalence for the general U.S. population) and this community has the highest rates of death than all other Americans in a wide range of chronic conditions and unintentional and intentional injuries. In addition to the highest COVID-19 mortality rate of any ethnicity in the U.S., American Indian Non-Hispanic communities in Massachusetts have the highest rate of opioid related deaths compared to other minoritized populations according to a June 2023 report by the Massachusetts Department of Health.

The Shiprock rock formation at sunrise in Shiprock, New Mexico

In collaboration with Indian Health Service (IHS), a federal agency under the Department of Health and Human Services, since 2010 the Mass General Brigham Outreach Program with Native American Communities is filling critical gaps in clinical care and training though faculty volunteer services. Outreach efforts include Mass General Brigham providers working alongside IHS colleagues while supporting direct patient care and physician education and training. The program serves the Navajo Nation and the Navajo Area IHS health care facilities in Gallup and Shiprock, New Mexico, and in Chinle, Arizona. In 2023, faculty from across Mass General Brigham will have volunteered a total of 30 weeks at Navajo IHS hospitals, led 24 remote CME talks and mentored four providers from Cherokee Nation for focused learning in substance use disorder. 

Bell says, “Since 2010, over 400 specialists from all clinical services across multiple institutions have generously volunteered their time establishing long-lasting professional relationships, building sustainable clinical programs and leading much needed specialty care training to these native communities. We are so deeply grateful to these MGB providers and the significant impact of their work to improve the health status and well-being of these under-resourced communities.”

Closer to home, the Outreach Program partners with Boston’s Native American LifeLines to support their health-focused initiatives and to work together to break down barriers to care for Native Americans in Massachusetts. In addition, MGB sponsors Grand Rounds sessions led by leaders in the local Native American community to help educate and inform our providers about the unique health challenges in these communities.

The time is ‘now’ to change the health outcomes of Native peoples, and we can make this change if we work together, and combine resources and talent, to bring Native Americans back into visibility.

Nichol Brewer-Lowry, MSc
Site Director
Native American LifeLines Boston

Native American LifeLines Boston Site Director Nichol Brewer-Lowry, MSc (Lumbee Tribe of N.C.) comments, “We are excited to be part of a new partnership with Mass General Brigham. This alliance will allow us to better meet the needs of the Native American communities and tribal nations across Massachusetts. The time is ‘now’ to change the health outcomes of Native peoples, and we can make this change if we work together, and combine resources and talent, to bring Native Americans back into visibility. Native American people continue to be underrepresented within healthcare data collection. Even within the insufficient data, we have an increasingly clear picture that Native peoples are suffering various disease states at rates that outpace every other racial/ethnic population in the United States.”

Through well-coordinated events focused on Native American communities, resources like the Mass General Brigham Community Care Vans are providing mobile medical services, such as health screenings, vaccines and interventions for chronic health conditions. First implemented during the COVID-19 pandemic, these vans deliver expanded care to more than 25 communities in partnership with community-based organizations to improve access, equity and community health outcomes while continually reinforcing the United Against Racism initiative.

The Community Care Van at the 102nd Annual Mashpee Wampanoag Powwow

Recently, a Community Care Van attended the 102nd Annual Mashpee Wampanoag Powwow, held July 1-3, 2023. The well-attended event is a traditional celebration of Mashpee Wampanoag culture, featuring Native American dancing, drumming, games, food art, jewelry, wampum, gifts, crafts and clothing. Also in attendance was the MGH Home Base Program to share collaboration and support opportunities available for Native American veterans.

Priya Sarin Gupta, MD, MPH, Medical Director for Community-Based Clinical Programs, Mass General Brigham comments, “The Mass General Brigham Community Care Vans are moving the front door of the hospital into the community, notably into communities that have often been forgotten by the health care system. The opportunity to bring the van to this event allowed us to provide clinical care and health education focused on high blood pressure and diabetes. Our goal through these efforts, which are co-designed by our community partners, is to help close gaps and improve the health of all individuals in the communities we serve.”

The Community Care Vans also provide important resources for substance use disorder treatment and linkages to Mass General Brigham Bridge Clinics under the co-leadership of Priya Sarin Gupta, MD, MPH and Sarah Wakeman, MD, the Mass General Brigham senior medical director for substance use disorder. MGB is committed to listening and learning from community partners and to expanding substance use disorder support for Massachusetts Native American communities.

The Community Care Vans next plan to visit Native American community health sponsored events on October 9, October 14 and October 28 (with future dates being scheduled) to provide vaccination and health screening services. The van schedule has also been posted on the Native American Lifelines website to inform their clients of ongoing MGB mobile locations and services.