This resource collection was originally developed by the Global Health Education and Learning Incubator at Harvard University. It is used and distributed with permission by the Global Health Education and Learning Incubator at Harvard University. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University.

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Health and Native American Experiences Resource Collection 2017 Link: http://repository.gheli.harvard.edu/repository/collection/30

Overview This resource collection was curated by the Global Health Education and Learning Incubator to support the Forum on DISCRIMINATION IN AMERICA: Native American Experiences, hosted by the Harvard T.H. Chan School of Public Health, Robert Wood Johnson Foundation (RWJF), and NPR on December 12, 2017. The collection includes reports, articles, data portals, fact sheets, infographics, multimedia, related resource collections and teaching material. Educators can leverage The Forum video, searchable transcript, and materials from this resource collection to build lesson plans. Also see the related resource collection Discrimination in America: African American Experiences. The multidisciplinary materials may be suitable for students at the undergraduate college and public health graduate school levels. Learning objectives and supporting materials will vary depending on how the material is used in a course. Brief annotations provide a cursory summary. The Incubator maintains a digital repository of global health teaching and learning resources, curated from both within and outside of Harvard, which includes documents (e.g., reports, briefings, factsheets, country profiles), web portals (e.g., data, topic, news and policy), and multimedia (e.g., graphics, interactives, audio, video).

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Selected Resources – At a Glance REPORTS

Report. Tribal Infrastructure: Investing in Indian Country for a Stronger America. National Congress of American Indians 2017. http://www.ncai.org/resources/ncai_publications/ncai-infrastructure-in-indian-country-report.

Report. Tribal Nations and the United States: An Introduction. National Congress of American Indians 2015. http://www.ncai.org/resources/ncai_publications/tribal-nations-and-the-united-states-an-introduction.

Report. Supporting Wellness: Substance Abuse Services at Urban Indian Health Organizations. Urban Indian Health Institute 2014. http://www.uihi.org/wp-content/uploads/2017/08/Supporting-Wellness-Substance-Abuse-Services-at-UIHOs.pdf.

Report. Supporting Sobriety Among American Indians and Alaska Natives: A Literature Review. Urban Indian Health Institute 2014. http://www.uihi.org/wp-content/uploads/2017/08/Supporting-Sobriety_A-Literature-Review_WEB.pdf.

Report. Ending the Legacy of Racism in Sports and the Era of Harmful “Indian” Sports Mascots. National Congress of American Indians 2013. http://www.ncai.org/resources/ncai_publications/ending-the-legacy-of-racism-in-sports-the-era-of-harmful-indian-sports-mascots.

Report. Addressing Depression Among American Indians and Alaska Natives: A Literature Review. Urban Indian Health Institute 2012. http://www.uihi.org/wp-content/uploads/2017/08/Depression-Environmental-Scan_Complete_2012-08-22_ER.pdf.

Report. Progress Toward Health Equity: Efforts to Address Cardiovascular Disease Among American Indians and Alaska Natives. Urban Indian Health Institute 2011. http://www.uihi.org/wp-content/uploads/2017/08/Health-Equity_Progress-Toward-Health-Equity.pdf.

Report. Reproductive Health of Urban American Indian and Alaska Native Women: Examining Unintended Pregnancy, Contraception, Sexual History, and Non-Voluntary Sexual Intercourse. Urban Indian Health Institute 2010. http://www.uihi.org/wp-content/uploads/2017/08/nsfg-report_final_2010-09-22.pdf.

Report. Broken Promises: Evaluating the Native American Health Care System. US Commission on Civil Rights 2004. http://www.usccr.gov/pubs/nahealth/nabroken.pdf.

ARTICLES AND BRIEFS

Article. Burnette CE, Figley CR. Historical Oppression, Resilience, and Transcendence: Can a Holistic Framework Help Explain Violence Experienced by Indigenous People? Social Work 2017; 62(1): 37-44. https://doi.org/10.1093/sw/sww065.

Article. Raglan GB et al. Racial and Ethnic Disparities in Preterm Birth Among American Indian and Alaska Native Women. Maternal and Child Health Journal 2016; 20: 16-24. https://doi.org/10.1007/s10995-015-1803-1.

Article. Rutman S et al. Health Care Access and Use by Urban American Indians and Alaska Natives: Findings from the National Health Interview Survey (2006-09). Journal of Health Care for the Poor and Underserved 2016; 27(3): 1521-36. https://doi.org/10.1353/hpu.2016.0123.

Article. Warne D, Frizzell LB. American Indian Health Policy: Historical Trends and Contemporary Issues. American Journal of Public Health 2014. 104(S3): S263-67. https://doi.org/10.2105/AJPH.2013.301684.

Article. Kunitz SJ et al. Historical Trends and Regional Differences in All-Cause and Amenable Mortality Among American Indians and Alaska Natives Since 1950. American Journal of Public Health 2014. 104(S3): S268-77. https://doi.org/10.2105/AJPH.2013.301682.

Article. Rhoades ER, Rhoades DA. The Public Health Foundation of Health Services for American Indians and Alaska Natives. American Journal of Public Health 2014. 104(S3): S278-85. https://doi.org/10.2105/AJPH.2013.301767.

Article. Hutchinson RN, Shin S. Systematic Review of Health Disparities for Cardiovascular Diseases and Associated Factors among American Indian and Alaska Native Populations. PLOS One 2014; 9(1): e80973. https://doi.org/10.1371/journal.pone.0080973.

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Article. White MC et al. Disparities in Cancer Mortality and Incidence Among American Indians and Alaska Natives in the United States. American Journal of Public Health 2014; 104(S3): S377-87. https://doi.org/10.2105/AJPH.2013.301673.

Brief. Native American Youth 101: Information on the Historical Context and Current Status of Indian Country and Native American Youth. Center for Native American Youth at the Aspen Institute 2012. http://www.cnay.org/docs/Native-American-Youth-101.pdf.

Article. Sequist TD et al. Indian Health Service Innovations Have Helped Reduce Health Disparities Affecting American Indian and Alaska Native People. Health Affairs 2011; 30(10): 1965-73. https://doi.org/10.1377/hlthaff.2011.0630.

Article. Walters KL et al. Bodies Don’t Just Tell Stories, They Tell Histories: Embodiment of Historical Trauma Among American Indians and Alaska Natives. DuBois Review 2011; 8(1): 179-89. https://doi.org/10.1017/S1742058X1100018X.

Article. Holm JF et al. Assessing Health Status, Behavioral Risks, and Health Disparities in American Indians Living on the Northern Plains of the U.S. Public Health Reports 2010; 125: 68-78. https://doi.org/10.1177/003335491012500110.

Article. Sotero M. A Conceptual Model of Historical Trauma: Implications for Public Health Practice and Research. Journal of Health Disparities Research and Practice 2009; 1(1): 93-108. https://ssrn.com/abstract=1350062.

Article. Sarche M, Spicer P. Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects. Annals of the New York Academy of Sciences 2008; 1136: 126-36. https://doi.org/10.1196/annals.1425.017.

Article. Johansson P et al. Perceived Discrimination in Health Care Among American Indians/Alaska Natives. Ethnicity & Disease 2006; 16: 766-771. https://www.ethndis.org/priorarchives/ethn-16-04-766.pdf.

Article. Jones DS. The Persistence of American Indian Health Disparities. American Journal of Public Health 2006; 96(12): 2122-34. https://doi.org/10.2105/AJPH.2004.054262.

DATA PORTALS, TOPIC PORTALS, AND FACT SHEETS Data Interactive. My Tribal Area. United States Census Bureau. https://www.census.gov/tribal.

Data Portal. American Fact Finder. United States Census Bureau. https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml.

Fact Sheet. Facts for Features: American Indian and Alaska Native Heritage Month. United States Census Bureau 2017. https://www.census.gov/newsroom/facts-for-features/2017/aian-month.html.

Fact Sheet. Fast Facts: Native American Youth and Indian Country. Center for Native American Youth at the Aspen Institute 2016. http://www.cnay.org/Default.aspx?PageID=17232707.

Data Publication. Community Health Profile: National Aggregate of Urban Indian Health Program Service Areas. Urban Indian Health Institute 2016. http://www.uihi.org/wp-content/uploads/2017/08/UIHI_CHP_2016_Electronic_20170825.pdf.

Data Publication. Indian Health Focus: Injuries 2015 Edition. Indian Health Service 2015. https://www.ihs.gov/dps/includes/themes/responsive2017/display_objects/documents/Injuries2016Book508.pdf.

Data Publication. Indian Health Service Trends in Indian Health 2014 Edition. Indian Health Service 2014. https://www.ihs.gov/dps/index.cfm/publications/trends2014.

Fact Sheet. Statistics on Violence Against Native Women. National Congress of American Indians 2013. http://www.ncai.org/resources/ncai_publications/policy-insights-brief-statistics-on-violence-against-native-women.

Data Publication. Indian Health in Focus: Women 2012 Edition. The Indian Health Service 2012. https://www.ihs.gov/dps/includes/themes/responsive2017/display_objects/documents/IndianHealthFocusWomen2012Ed.pdf.

TOPIC PORTALS AND ORGANIZATIONS

Topic Portal. Native Voices: Native Peoples’ Concepts of Health and Illness. U.S. National Library of Medicine. https://www.nlm.nih.gov/nativevoices/index.html.

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Topic Portal. Native American Communities. Urban Institute. https://www.urban.org/features/native-american-communities.

Topic Portal. Indigenous Studies Portal Research Tool. University of Saskatchewan. http://iportal.usask.ca/index.php?sid=458415822&cat=0.

Organization. Indian Health Service. https://www.ihs.gov. Organization. National Congress of American Indians. http://www.ncai.org. Organization. Urban Indian Health Institute. http://www.uihi.org. MULTIMEDIA AND NEWS

Video. Discrimination in America: Native American Experiences. The Forum. Harvard T.H. Chan School of Public Health 2017; Dec 12. https://theforum.sph.harvard.edu/events/discrimination-in-america-2.

News. Labaree A. NoDAPL: Standing Rock and the ‘Deep North.’ Al Jazeera 2017; Jan 17. http://www.aljazeera.com/indepth/features/2017/01/nodapl-standing-rock-deep-north-170109063857178.html.

Online Gallery. Lowell T, Estrin J. Land, Loss, and Rebirth in Standing Rock. The New York Times 2016. https://lens.blogs.nytimes.com/2017/09/04/land-loss-and-rebirth-in-standing-rock.

News Feature. Fuller N. In the Shadow of Wounded Knee. National Geographic 2012; Aug. http://ngm.nationalgeographic.com/2012/08/pine-ridge/fuller-text.

Video. America’s Native Prisoners of War. TEDxDU 2010. https://www.ted.com/talks/aaron_huey.

Video. McDonald B. Gangs on Tribal Lands. The New York Times 2009. https://www.nytimes.com/video/us/1247465539709/gangs-on-tribal-lands.html.

Online Gallery. Matthews M. Urban Jungle on the Reservation. Time Magazine 2009. http://content.time.com/time/photogallery/0,29307,2048598,00.html.

Video. Indian Country Diaries. PBS 2006. http://www.pbs.org/indiancountry/index.html.

Online Gallery. American Indians of the Pacific Northwest Collection. University of Washington. http://content.lib.washington.edu/aipnw.

TEACHING MATERIAL

Lesson Plan. Harris K, Gonchar M. Battle Over an Oil Pipeline: Teaching About the Standing Rock Sioux Protests. The New York Times 2016; Nov 30. https://www.nytimes.com/2016/11/30/learning/lesson-plans/battle-over-an-oil-pipeline-teaching-about-the-standing-rock-sioux-protests.html.

Teaching Case. Smith BL. Whose Story Should be Told. The Evergreen State College Native Cases Initiative 2014. http://nativecases.evergreen.edu/collection/cases/whose-story-should-be-told.html.

Teaching Cases. Enduring Legacies Native Case Studies. The Evergreen State College Native Cases Initiative 2017. http://nativecases.evergreen.edu.

Lesson Plan. Native Voices Lesson Plans & Additional Resources. U.S. National Library of Medicine 2015. https://www.nlm.nih.gov/nativevoices/resources/lesson-plans-list.html.

Teaching Case. Who Owns Your Story? Global Health Education and Learning Incubator at Harvard University 2014. http://repository.gheli.harvard.edu/repository/10692.

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Annotated Bibliography REPORTS

Tribal Infrastructure: Investing in Indian Country for a Stronger America Report. Tribal Infrastructure: Investing in Indian Country for a Stronger America. National Congress of American Indians 2017. http://www.ncai.org/resources/ncai_publications/ncai-infrastructure-in-indian-country-report. GHELI repository link: http://repository.gheli.harvard.edu/repository/11955 The National Congress of American Indians produced this report using nation-wide data to communicate the infrastructural needs of Tribal Nations to the incoming U.S. Presidential Administration and Congress in 2017. The report describes the magnitude of unmet need, provides data on the extent to which federal dollars have been allocated to address these issues in Indian Country, provides examples of existing disparities between funding support received by Tribal Nations in comparison to the rest of the United States, and discusses the ways greater funding and action from the government can lead to substantial improvements. In-depth descriptions of infrastructural needs are provided in relation to physical needs (e.g. water, waste and sanitation, housing, healthcare, and education), as well as public safety, the justice system, communications, jobs, and data quality. Tribal Nations and the United States: An Introduction Report. Tribal Nations and the United States: An Introduction. National Congress of American Indians 2015. http://www.ncai.org/resources/ncai_publications/tribal-nations-and-the-united-states-an-introduction. GHELI repository link: http://repository.gheli.harvard.edu/repository/11956 This report was developed by the National Congress of American Indians to provide a general overview of Tribal Nations’ history, the principles underpinning governance in Indian Country, and the ways in which these systems operate among American Indian and Alaska Native populations today. Information is presented in simple, easy-to-read yet comprehensive infographics, timelines, and narrative descriptions, and serve as a useful starting point for learners with limited knowledge of American Indian history. Supporting Wellness: Substance Abuse Services at Urban Indian Health Organizations Report. Supporting Wellness: Substance Abuse Services at Urban Indian Health Organizations. Urban Indian Health Institute 2014. http://www.uihi.org/wp-content/uploads/2017/08/Supporting-Wellness-Substance-Abuse-Services-at-UIHOs.pdf. GHELI repository link: http://repository.gheli.harvard.edu/repository/11957 This report by the Urban Indian Health Institute details programs and services geared towards substance abuse prevention and recovery. Data was collected through surveys and key informant interviews conducted among executive directors and program staff at Urban Indian Health Organizations to assess the types of services offered, how native culture was incorporated into service provision efforts, and successes and challenges faced when offering care in this context. Supporting Sobriety Among American Indians and Alaska Natives: A Literature Review Report. Supporting Sobriety Among American Indians and Alaska Natives: A Literature Review. Urban Indian Health Institute 2014. http://www.uihi.org/wp-content/uploads/2017/08/Supporting-Sobriety_A-Literature-Review_WEB.pdf. GHELI repository link: http://repository.gheli.harvard.edu/repository/11958 American Indians and Alaska Natives experience the highest rates of alcohol dependence and abuse compared to all other racial and ethnic groups in the United States. This report provides an extensive review of scientific research on the impact of public health programs aimed at addressing alcohol abuse among native people focusing on five key areas: cultural care, client-centered care, skill building, community support, and healing traumas.

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Ending the Legacy of Racism in Sports and the Era of Harmful “Indian” Sports Mascots Report. Ending the Legacy of Racism in Sports and the Era of Harmful “Indian” Sports Mascots. National Congress of American Indians 2013. http://www.ncai.org/resources/ncai_publications/ending-the-legacy-of-racism-in-sports-the-era-of-harmful-indian-sports-mascots. In the midst of the legal action taken by members of the American Indian community to challenge the trademark protection granted to Washington’s football team, the National Congress of American Indians released this 2013 report to describe the negative impact of derogatory stereotypes on native youth, and the historical legacy of discriminatory sports mascots. In addition to describing rates of suicide experienced among American Indians and hate crimes, this report also details support from a wide range of society for ending the use of damaging mascots at the college and high school levels, which stands in stark contrast to limited change enacted among professional sports teams.

Addressing Depression Among American Indians and Alaska Natives: A Literature Review Report. Addressing Depression Among American Indians and Alaska Natives: A Literature Review. Urban Indian Health Institute 2012. http://www.uihi.org/wp-content/uploads/2017/08/Depression-Environmental-Scan_Complete_2012-08-22_ER.pdf. GHELI repository link: http://repository.gheli.harvard.edu/repository/11959 This report provides a comprehensive overview of programs designed to address depression and other major mental health issues among American Indian and Alaska Native communities. Key topics covered include family and community-level interventions, the use of traditional knowledge and practices, the development of positive coping skills, the integration of prevention and treatment systems, ways to make health care providers and systems more culturally competent, and the need to address structural factors impeding the health of native people (including policies and systems related to health and economic opportunity). Progress Toward Health Equity: Efforts to Address Cardiovascular Disease Among American Indians and Alaska Natives Report. Progress Toward Health Equity: Efforts to Address Cardiovascular Disease Among American Indians and Alaska Natives. Urban Indian Health Institute 2011. http://www.uihi.org/wp-content/uploads/2017/08/Health-Equity_Progress-Toward-Health-Equity.pdf. In light of recent research suggesting that cardiovascular disease is a growing public health concern among native people, this report summarizes key findings from 19 successful prevention and treatment programs targeted towards this population. Reproductive Health of Urban American Indian and Alaska Native Women: Examining Unintended Pregnancy, Contraception, Sexual History, and Non-Voluntary Sexual Intercourse Report. Reproductive Health of Urban American Indian and Alaska Native Women: Examining Unintended Pregnancy, Contraception, Sexual History, and Non-Voluntary Sexual Intercourse. Urban Indian Health Institute 2010. http://www.uihi.org/wp-content/uploads/2017/08/nsfg-report_final_2010-09-22.pdf. This report uses nationwide data from the sixth cycle of the National Survey of Family Growth from 2006 to describe the sexual and reproductive health of urban American Indian and Alaska Native women between the ages of 15 and 44, focusing particularly on pregnancy and childbearing, unintended pregnancies, sexual history and behaviors, contraceptive use, and experiences of non-voluntary sex. Results showed that native women residing in urban areas were more likely to have three or more pregnancies compared to urban white women, and were more likely to report having two or more abortions. Native women also were more likely to reach menarche before age 11, have a non-voluntary first sexual encounter, were less likely to use contraception, and experienced higher rates of female sterilization. Broken Promises: Evaluating the Native American Health Care System Report. Broken Promises: Evaluating the Native American Health Care System. U.S. Commission on Civil Rights 2004. http://www.usccr.gov/pubs/nahealth/nabroken.pdf.

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GHELI repository link: http://repository.gheli.harvard.edu/repository/11960 This publication produced by the U.S. Commission on Civil Rights provides a comprehensive account of the social, cultural, and structural factors contributing to health disparities experienced by American Indians and Alaska Native populations. Since the report was produced more than 10 years ago, the data presented is outdated, however the content and themes discussed continue to be relevant in 2017. In the first chapter of the report, health conditions afflicting native people are described in relation to diabetes, tuberculosis, mental health, unintentional injuries, heart disease, and cancer, and in the subsequent chapters, factors impacting access to health care are discussed in detail, including discrimination, cultural understanding and language barriers, poverty, quality of care, and issues relating to health care service delivery (e.g. quality of facilities and wait times). Lastly, the report also touches on financial barriers at the federal level impacting health care access, including poor funding and specific unmet needs.

ARTICLES AND BRIEFS

Historical Oppression, Resilience, and Transcendence: Can a Holistic Framework Help Explain Violence Experienced by Indigenous People? Article. Burnette CE, Figley CR. Historical Oppression, Resilience, and Transcendence: Can a Holistic Framework Help Explain Violence Experienced by Indigenous People? Social Work 2017; 62(1): 37-44. https://doi.org/10.1093/sw/sww065. GHELI repository link: http://repository.gheli.harvard.edu/repository/11961 This article provides a new framework informed by the concepts of historical oppression and resilience to explain disproportionately high rates of violence faced by American Indians and Alaska Native women and help develop solutions to mitigate disparities. Expanding upon the concept of historical trauma, historical oppression refers to, “the chronic, pervasive, and intergenerational experiences of oppression that, over time, may be normalized, imposed, and internalized into the daily lives of many indigenous people.” Resilience, on the other hand, refers to the ability to cope and positively adapt to adversity. In this article, the authors use ethnographic data to articulate risk and protective factors at the societal, cultural, community, partner, and individual levels that contribute to both historical oppression and resilience. Racial and Ethnic Disparities in Preterm Birth Among American Indian and Alaska Native Women Article. Raglan GB et al. Racial and Ethnic Disparities in Preterm Birth Among American Indian and Alaska Native Women. Maternal and Child Health Journal 2016; 20: 16-24. https://doi.org/10.1007/s10995-015-1803-1. This review article describes research published in the past 20 years on preterm birth among American Indian and Alaska Native and the factors contributing to the disproportionately high rates they experience. The impact of psychosocial stress resulting from prolonged persecution and marginalization is discussed, as well as high rates of violence, victimization, mental health disorders, and behavioral risk factors like tobacco use during pregnancy. Sociodemographic factors related to age, employment, and socioeconomic status are also discussed, as well as poor access to prenatal care due to geographic locations of facilities and distrust of the health care system due to historical trauma and discrimination by providers. Health Care Access and Use by Urban American Indians and Alaska Natives: Findings From the National Health Interview Survey (2006-09). Article. Rutman S et al. Health Care Access and Use by Urban American Indians and Alaska Natives: Findings From the National Health Interview Survey (2006-09). Journal of Health Care for the Poor and Underserved 2016; 27(3): 1521-36. https://doi.org/10.1353/hpu.2016.0123. This research study describes trends in health care access and utilization among American Indians and Alaska Natives living in urban areas in the United States using data from a nationally administered in-home health survey. More specifically, access to care was examined in relation to health insurance status while health care utilization was assessed as the time since individuals saw or talked to a health care provider in the past year. Barriers to care, including those related to cost, were also assessed, as well as sociodemographic factors like sex, age, education, and income. Results showed that native people have lower rates of health care utilization

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compared to non-Hispanic white populations, and also have greater barriers to access, including a lack of health insurance due to cost. American Indian Health Policy: Historical Trends and Contemporary Issues Article. Warne D, Frizzell LB. American Indian Health Policy: Historical Trends and Contemporary Issues. American Journal of Public Health 2014. 104(S3): S263-67. https://doi.org/10.2105/AJPH.2013.301684. GHELI repository link: http://repository.gheli.harvard.edu/repository/11962 As a part of a 2014 supplemental issue of the American Journal of Public Health focused on American Indians and Alaska Native health, this article describes challenges related to the historically poor funding of the Indian Health Service. Specifically, the authors provide a concise but thorough review of important policy milestones that have improved the provision of health services in light of funding limitations, including the Snyder Act, Transfer Act, Indian Self-Determination and Education Assistance Act, and Indian Health Care Improvement Act. Despite advances, the authors note that underfunding remains a substantial barrier to the improvement of population health outcomes. Historical Trends and Regional Differences in All-Cause and Amenable Mortality Among American Indians and Alaska Natives Since 1950 Article. Kunitz SJ et al. Historical Trends and Regional Differences in All-Cause and Amenable Mortality Among American Indians and Alaska Natives Since 1950. American Journal of Public Health 2014. 104(S3): S268-77. https://doi.org/10.2105/AJPH.2013.301682. GHELI repository link: http://repository.gheli.harvard.edu/repository/11963 This article describes how mortality rates among American Indians and Alaska Natives have declined since the 1950s, but have been relatively stagnant since the 1980s. Analyses showed that socioeconomic status measures were not associated with changes over time, however the authors conclude that “migration, changes in self-identification as a native person, interracial marriage, and variations in healthcare effectiveness all appear to be implicated.” The Public Health Foundation of Health Services for American Indians and Alaska Natives Article. Rhoades ER, Rhoades DA. The Public Health Foundation of Health Services for American Indians and Alaska Natives. American Journal of Public Health 2014. 104(S3): S278-85. https://doi.org/10.2105/AJPH.2013.301767. GHELI repository link: http://repository.gheli.harvard.edu/repository/11964 This article describes the integration of public health practice and the provision of federally-administered health care services among native people in the United States. An overview of the evolution of Indian health programs is provided tracing back to 1800 in order to provide historical context to current trends. The authors also explicitly discuss the ways tribal sovereignty, tribe-specific sociocultural factors, and the distinct nature of tribes residing in different geographical areas have shaped the health landscape. Systematic Review of Health Disparities for Cardiovascular Diseases and Associated Factors among American Indian and Alaska Native Populations Article. Hutchinson RN, Shin S. Systematic Review of Health Disparities for Cardiovascular Diseases and Associated Factors among American Indian and Alaska Native Populations. PLOS One 2014; 9(1): e80973. https://doi.org/10.1371/journal.pone.0080973. GHELI repository link: http://repository.gheli.harvard.edu/repository/11965 This article provides an overview of research from the past 15 years on cardiovascular diseases among native people, including heart disease, diabetes, metabolic syndrome, dyslipidemia, obesity, and hypertension. In addition to describing substantial disparities that exist, the authors also discuss factors that may be contributing to observed trends, such as socioeconomic factors including experiencing poverty, food insecurity, and living in inadequate housing, as well as poor access to high quality healthcare. Ultimately, the authors state that “structural changes must occur to address the root causes of disparities,” including the expansion of economic and educational opportunity, improving living conditions and access to healthy foods among native communities.

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Health and Native American Experiences: Resource

Disparities in Cancer Mortality and Incidence Among American Indians and Alaska Natives in the United States Article. White MC et al. Disparities in Cancer Mortality and Incidence Among American Indians and Alaska Natives in the United States. American Journal of Public Health 2014; 104(S3): S377-87. https://doi.org/10.2105/AJPH.2013.301673. This 2014 study from the American Journal of Public Health used data from the National Death Index, central cancer registry, and the Indian Health Service to provide a comprehensive, updated account of cancer mortality and incidence among American Indian and Alaska Native populations between 1990 and 2009. Findings showed that while progress was made in reducing cancer rates among white population over the prior 20 years, fewer improvements were experienced by native people. Comparisons between native populations and whites varied by region and by type of cancer, but in relation to malignant cancers, were higher for native men and women than white men and women living in the northern plains, Alaska, southern plains, and pacific coast. Native American Youth 101: Information on the Historical Context and Current Status of Indian Country and Native American Youth Brief. Native American Youth 101: Information on the Historical Context and Current Status of Indian Country and Native American Youth. Center for Native American Youth at the Aspen Institute 2012. http://www.cnay.org/docs/Native-American-Youth-101.pdf. This brief produced by the Center for Native American Youth at the Aspen Institute provides a short but substantive description American Indian history and current challenges impacting the lives of native youth today. In addition to providing an overview of historical factors, demographic trends, and current needs in Indian Country, the brief also includes descriptions of priority areas for youth, including health promotion, education, and safety and juvenile justice. Within the area of health promotion, particular attention is paid to issues of prevention as they relate to suicide, obesity/diabetes, and substance abuse. Indian Health Service Innovations Have Helped Reduce Health Disparities Affecting American Indian and Alaska Native People Article. Sequist TD et al. Indian Health Service Innovations Have Helped Reduce Health Disparities Affecting American Indian and Alaska Native People. Health Affairs 2011; 30(10): 1965-73. https://doi.org/10.1377/hlthaff.2011.0630. GHELI repository link: http://repository.gheli.harvard.edu/repository/11966 This article describes innovations made by the Indian Health Service to improve the health status of native people in the United States (including the use of new technologies and telemedicine to address health care access issues) and the impact they have had on reducing existing health disparities. The advances described by the authors are put into a broader historical and social context by the authors through descriptions of the Indian Health Service more broadly, health programming directed to native people, and persistent challenges to advancing health equity among American Indian and Alaska Natives. The authors ultimately conclude that, “continued innovation and increased funding are required to further improve health and achieve equity.” Bodies Don’t Just Tell Stories, They Tell Histories: Embodiment of Historical Trauma Among American Indians and Alaska Natives Article. Walters KL et al. Bodies Don’t Just Tell Stories, They Tell Histories: Embodiment of Historical Trauma Among American Indians and Alaska Natives. DuBois Review 2011; 8(1): 179-89. https://doi.org/10.1017/S1742058X1100018X. GHELI repository link: http://repository.gheli.harvard.edu/repository/11967 Considerable research has identified historical trauma (defined by the authors as “traumatic events targeting a community (e.g. forced relocation) that cause catastrophic upheaval”) as a major factor driving current disparities in health observed between American Indian and Alaska Natives and people of other racial and ethnic groups in the United States. This article provides an overview of research that has examined the ways in which historical trauma gets under the skin to impact population health outcomes, including through processes involving collective loss, psychological stress, and resultant epigenetic and neurobiological changes.

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Assessing Health Status, Behavioral Risks, and Health Disparities in American Indians Living on the Northern Plains of the U.S. Article. Holm JF et al. Assessing Health Status, Behavioral Risks, and Health Disparities in American Indians Living on the Northern Plains of the U.S. Public Health Reports 2010; 125: 68-78. https://doi.org/10.1177/003335491012500110. GHELI repository link: http://repository.gheli.harvard.edu/repository/11968 This study from Public Health Reports used data from interviews conducted through the Behavioral Risk Factor Surveillance System to examine the health status and behavioral risk factors experienced by American Indians living in rural, northern plains reservation communities. Health conditions, preventive assessments, and behavioral risk factors were examined among American Indians and compared to state-level data, as well as national data. Results showed that native people experienced a higher prevalence of diabetes, coronary heart disease, heart attacks, smoking, obesity, and heavy alcohol use in comparison to both state and national samples, and were also less likely to engage in physical activity or have undertaken preventive screenings. A Conceptual Model of Historical Trauma: Implications for Public Health Practice and Research Article. Sotero M. A Conceptual Model of Historical Trauma: Implications for Public Health Practice and Research. Journal of Health Disparities Research and Practice 2009; 1(1): 93-108. https://ssrn.com/abstract=1350062. GHELI repository link: http://repository.gheli.harvard.edu/repository/11969 This article provides a general overview of the concept of historical trauma and summarizes foundational research on its impact on American Indian and Alaska Native people. The authors propose a conceptual model to illustrate how experiences of historical trauma may shape health profiles of marginalized people and explain observed health disparities for subsequent generations. Implications of this theory for public health practice is also discussed, including the importance of developing interventions that emphasize community capacity and empowerment. Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects Article. Sarche M, Spicer P. Poverty and Health Disparities for American Indian and Alaska Native Children: Current Knowledge and Future Prospects. Annals of the New York Academy of Sciences 2008; 1136: 126-36. https://doi.org/10.1196/annals.1425.017. GHELI repository link: http://repository.gheli.harvard.edu/repository/11970 This article provides a general overview of the ways social and health inequities impact child development among American Indian and Alaska Native youth. In addition to describing demographic trends relating to poverty, education, and employment, the authors also discuss social issues including experiences of violence, trauma, and loss, disparities in physical and mental health, and cultural resources that can be leveraged to enhance child development. Perceived Discrimination in Health Care Among American Indians/Alaska Natives Article. Johansson P, Jacobsen C, Buchwald D. Perceived Discrimination in Health Care Among American Indians/Alaska Natives. Ethnicity & Disease 2006; 16: 766-771. https://www.ethndis.org/priorarchives/ethn-16-04-766.pdf. GHELI repository link: http://repository.gheli.harvard.edu/repository/11971 This study used data from 55,000 participants in the 2001 California Health Interview Survey to describe the extent of discrimination experienced in health care by American Indian and Alaska Natives. Findings showed that native people were more likely to report experiencing discrimination, with especially higher rates among those respondents who identified as both native and white. The Persistence of American Indian Health Disparities Article. Jones DS. The Persistence of American Indian Health Disparities. American Journal of Public Health 2006; 96(12): 2122-34. https://doi.org/10.2105/AJPH.2004.054262.

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GHELI repository link: http://repository.gheli.harvard.edu/repository/11972 This American Journal of Public Health article provides a comprehensive historical context for contemporary health disparities observed among American Indian and Alaska Native populations by describing the complex interplay between economic and political interests and the health of native people over the past 500 years. Although published over 10 years ago, this article provides a critical historical lens to effectively understand and analyze present day challenges.

DATA PUBLICATIONS, PORTALS, INTERACTIVES, AND FACT SHEETS

My Tribal Area Data Interactive. My Tribal Area. United States Census Bureau. https://www.census.gov/tribal. GHELI repository link: http://repository.gheli.harvard.edu/repository/11973 My Tribal Area is a data tool developed by the U.S. Census Bureau to provide easy access to demographic, social, economic, and housing statistics describing the experiences of American Indians and Alaska Natives at the tribal level. Data comes from the American Community Survey and is publicly available for download. American Fact Finder Data Portal. American Fact Finder. United States Census Bureau. https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml. GHELI repository link: http://repository.gheli.harvard.edu/repository/11974 American Fact Finder is a publicly available, searchable archive of data from the U.S. Census Bureau describing communities living within the United States, Puerto Rico and the Island Areas. While My Tribal Area allows for statistics to be examined at the local level, data from American Fact Finder allows for a more broad examination of statistics on American Indian and Alaska Natives across geographic regions in the United States. Facts for Features: American Indian and Alaska Native Heritage Month Fact Sheet. Facts for Features: American Indian and Alaska Native Heritage Month. United States Census Bureau 2017. https://www.census.gov/newsroom/facts-for-features/2017/aian-month.html. GHELI repository link: http://repository.gheli.harvard.edu/repository/11975 This fact sheet was developed by the U.S. Census Bureau to provide a general overview of the most recent estimates of key indicators within the American Indian and Alaska Native community, including those related to demographics, housing, education, jobs, income and poverty, and health insurance coverage. Fast Facts: Native American Youth and Indian Country Fact Sheet. Fast Facts: Native American Youth and Indian Country. Center for Native American Youth at the Aspen Institute 2016. http://www.cnay.org/Default.aspx?PageID=17232707. GHELI repository link: http://repository.gheli.harvard.edu/repository/11976 This fact sheet provides a quick statistical snapshot of the American Indian and Alaska Native community, focusing particularly on youth. Data is presented on major health issues impacting native youth (including suicide and victimization), incarceration rates, educational attainment, and foster care. Community Health Profile: National Aggregate of Urban Indian Health Program Service Areas Data Publication. Community Health Profile: National Aggregate of Urban Indian Health Program Service Areas. Urban Indian Health Institute 2016. http://www.uihi.org/wp-content/uploads/2017/08/UIHI_CHP_2016_Electronic_20170825.pdf. GHELI repository link: http://repository.gheli.harvard.edu/repository/11977 The Urban Indian Health Institute published this report in 2016 to describe the health status of American Indian and Alaska Native populations living in urban areas across the United States. In addition to demographic data, the report also includes statistics related to the social determinants of health, mortality, sexual and

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reproductive health, mental health, substance use, and maternal and child health. The data presented was aggregated from a wide array of sources, including the US Census Bureau, the US Center for Health Statistics, The National Notifiable Disease Surveillance System, and the National Survey of Drug Use and Health. Indian Health Focus: Injuries 2015 Edition Data Publication. Indian Health Focus: Injuries 2015 Edition. Indian Health Service 2015. https://www.ihs.gov/injuryprevention/injury_data_links.asp. GHELI repository link: http://repository.gheli.harvard.edu/repository/11978 This report was published by the Indian Health Service to describe the public health burden of injuries on American Indians using up-t0-date data, focusing particularly on sub-populations that are disproportionately impacted, including children, youth, males, and the elderly. Major categories of injuries explored include unintentional injuries, suicides, homicides, firearm injuries, falls, and injuries due to fires or smoke. Extensive data is provided to describe the magnitude of these issues by region, age, and sex. Indian Health Service Trends in Indian Health 2014 Edition Data Publication. Indian Health Service Trends in Indian Health 2014 Edition. Indian Health Service 2014. https://www.ihs.gov/dps/index.cfm/publications/trends2014. GHELI repository link: http://repository.gheli.harvard.edu/repository/11979 This report is the most recent publication from the Indian Health Service describing the health status of American Indians and Alaska Natives. In addition to describing a general overview of the Indian Health Service, the report provides data in table, chart, and narrative form describing demographic and health trends over time, and how the condition of native people compares to the larger United States population. More specifically, age and gender-specific data is provided in relation to a number of key indicators, including population statistics (e.g. population by age and sex, educational attainment, and income), birth rates, infant and maternal mortality rates, general mortality statistics (including age-specific causes of death and death rates by disease), causes for hospitalizations, and various other patient care and community health statistics.

Statistics on Violence Against Native Women Fact Sheet. Statistics on Violence Against Native Women. National Congress of American Indians 2013. http://www.ncai.org/resources/ncai_publications/policy-insights-brief-statistics-on-violence-against-native-women. GHELI repository link: http://repository.gheli.harvard.edu/repository/11980 This fact sheet describes key statistics relating to violence against native women, focusing particularly on overall prevalence statistics, data on perpetrators of violence and where violence is most likely to occur, and substantiated barriers to prosecution. Indian Health in Focus: Women 2012 Edition Data Publication. Indian Health in Focus: Women 2012 Edition. The Indian Health Service 2012. https://www.ihs.gov/dps/includes/themes/responsive2017/display_objects/documents/IndianHealthFocusWomen2012Ed.pdf. This report from the Indian Health Service describes the health conditions impacting American Indian and Alaska Native women’s health.

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TOPIC PORTALS AND ORGANIZATIONS

Native Voices: Native Peoples’ Concepts of Health and Illness Topic Portal. Native Voices: Native Peoples’ Concepts of Health and Illness. U.S. National Library of Medicine. https://www.nlm.nih.gov/nativevoices/index.html. GHELI repository link: http://repository.gheli.harvard.edu/repository/11981 Native Voices is an exhibition through the U.S. National Library of Medicine examining the ways in which health, disease, and cultural practices intersect for native people. The exhibits extensive website includes a wide array of resources on health and illness among American Indians and Alaska Natives, including interviews with health professionals, community leaders, traditional leaders, and others working to address community health needs, a timeline of events chronicling the history of native people, lesson plans for instructors interested in teaching K-12 students about health and illness in this population, and a supplementary reading list for young readers. Native American Communities Topic Portal. Native American Communities. Urban Institute. https://www.urban.org/features/native-american-communities. The Urban Institute’s topic portal on Native American communities includes reports on issues impacting native people living in urban communities, including housing needs and financing, social safety net programs, the justice system, health insurance coverage, and health care access. Indigenous Studies Portal Research Tool Education Portal. Indigenous Studies Portal Research Tool. University of Saskatchewan. http://iportal.usask.ca/index.php?sid=458415822&cat=0. GHELI repository link: http://repository.gheli.harvard.edu/repository/11983 This education portal was developed by researchers at the University of Saskatchewan to serve as a repository of resources including books, articles, academic papers, photographs and other historical documents focusing primarily on First Nations and aboriginal communities in Canada, with a secondary focus on North American tribes more broadly. Indian Health Service Organization. Indian Health Service. https://www.ihs.gov. GHELI repository link: http://repository.gheli.harvard.edu/repository/11982 The Indian Health Service (IHS) is an agency within the U.S. Department of Health and Human Services responsible for providing American Indian and Alaska Native populations with federally-based health services in order to “uphold the federal government’s obligation to promote healthy American Indian and Alaska Native people, communities, and cultures, and to honor and protect the inherent sovereign rights of Tribes.” The IHS’ main goal is to provide comprehensive, culturally appropriate services, and as such, their website includes many resources for patients on various health issues, as well as information for providers serving native people, and those working to enhance community health more broadly. National Congress of American Indians Organization. National Congress of American Indians. http://www.ncai.org. GHELI repository link: http://repository.gheli.harvard.edu/repository/11984 The National Congress of American Indians is a non-profit organization founded in 1944 to represent the interests of tribal governments and communities through a unified voice. According to the Congress’ Constitution, their purpose is to, “serve as a forum for unified policy development among tribal governments in order to protect and advance tribal governance and treaty rights, promote the economic development, health, and welfare of Indian and Alaska Native communities, and to educate the public toward a better understanding of Indian and Alaska Native tribes.” Their website houses a comprehensive collection of reports, policy papers, and testimonies, while their Policy Research Center has produced numerous data-based

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publications. Urban Indian Health Institute Organization. Urban Indian Health Institute. http://www.uihi.org. GHELI repository link: http://repository.gheli.harvard.edu/repository/11985 The Urban Indian Health Institute (UIHI) is a division of the Seattle Indian Health Board designed to, “support the health and well-being of urban Indian communities through information, scientific inquiry, and technology.” As one of 12 tribal epidemiology centers supported by the Indian Health Service, UIHI is responsible for both responding to major public health issues within the urban American Indian and Alaska Native community, as well as monitoring health issues, researching major challenges, and managing information systems. UIHI adopts a nationwide focus, and produces numerous informative resources for public consumption, including reports, fact sheets, and presentations.

MULTIMEDIA AND NEWS

The Forum – Discrimination in America: Native American Experiences Video. Discrimination in America: Native American Experiences. The Forum. Harvard T.H. Chan School of Public Health 2017; Dec 12. https://theforum.sph.harvard.edu/events/discrimination-in-america-2. GHELI repository link: http://repository.gheli.harvard.edu/repository/12084 This webcast seminar from The Forum at the T.H. Chan School of Public Health explores the ways in which Native Americans experience discrimination in daily life. It builds upon a poll by NPR, the Robert Wood Johnson Foundation (RWJF), and the Harvard Chan School, which was the first among a series of reports that surveyed numerous groups, including African Americans, Latinos, Asian Americans, Native Americans, men, women, and LGBTQ adults, on their experiences with discrimination.

NoDAPL: Standing Rock and the ‘Deep North’ News. Labaree A. NoDAPL: Standing Rock and the ‘Deep North.’ Al Jazeera 2017; Jan 17. http://www.aljazeera.com/indepth/features/2017/01/nodapl-standing-rock-deep-north-170109063857178.html. This news article discusses the historical and social context surrounding the protests of the Dakota Access Pipeline (DAPL) construction project in 2016, including the legacy of discrimination experienced by native people in the region tracing back to the 1800s. Related content includes a photo essay on the Standing Rock ‘water protectors,’ a produced video documenting the Standing Rock protests, and a live video recording of the standoff that occurred in Standing Rock on August 29, 2016. Land, Loss, and Rebirth in Standing Rock Online Gallery. Lowell T, Estrin J. Land, Loss, and Rebirth in Standing Rock. The New York Times 2016. https://lens.blogs.nytimes.com/2017/09/04/land-loss-and-rebirth-in-standing-rock. This photo essay depicts the protests of the Dakota Access Pipeline (DAPL) in Standing Rock, North Dakota, in 2016 and their aftermath. In the Shadow of Wounded Knee News Feature. Fuller N. In the Shadow of Wounded Knee. National Geographic 2012; Aug. http://ngm.nationalgeographic.com/2012/08/pine-ridge/fuller-text. Historically, Wounded Knee Creek has served as a persistent reminder of the struggle of American Indian people as it was the site of the Wounded Knee Massacre of 1890 in which the US military killed more than 150 disarmed Lakota men, women, and children, as well as the Wounded Knee Incident of 1973 in which 200 Oglala Lakota people had a prolonged stand-off with the United States Marshall Service in protest of the US government’s refusal to meet American Indian treaties. In 2012, National Geographic Magazine published a feature on the contemporary challenges facing the Oglala Lakota people living in the shadow of Wounded Knee in the Pine Ridge Reservation in South Dakota. The article documents the ways in which the community

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continues to foster their tribal customs, language and beliefs in the face of decades of hardship and broken promises, and is accompanied by numerous additional features, including audio interviews with residents, a community storytelling interactive, and a powerful photo essay by Aaron Huey. America’s Native Prisoners of War Video. America’s Native Prisoners of War. TEDxDU 2010. https://www.ted.com/talks/aaron_huey. GHELI repository link: http://repository.gheli.harvard.edu/repository/11988 Aaron Huey is a photojournalist whose work documents experiences of poverty in America. For seven years, he lived on the Pine Ridge reservation outside of Wounded Creek capturing the experiences and challenges impacting the native Lakota tribe, culminating in a photo essay published in a 2012 issue of National Geographic Magazine. In this TED Talk from 2010, he discusses both his time with the Lakota and provides a timeline of events chronicling the treaties that were established with tribes and subsequently broken by the U.S. government, as well as the long history of aggression and violence inflicted on native people.

Gangs on Tribal Lands Video. McDonald B. Gangs on Tribal Lands. The New York Times 2009. https://www.nytimes.com/video/us/1247465539709/gangs-on-tribal-lands.html. This video provides personal accounts and interviews about gang violence on the Pine Ridge reservation to accompany Matthew Williams’ photo essay, Urban Jungle on the Reservation, and the 2009 The New York Times article, Gang Violence Grows on an Indian Reservation. Urban Jungle on the Reservation Online Gallery. Williams M. Urban Jungle on the Reservation. Time Magazine 2009. http://content.time.com/time/photogallery/0,29307,2048598,00.html. This photo essay documents life among American Indians living in the Pine Ridge reservation in South Dakota where poverty, alcoholism and violence is rampant. Matthew Williams full photo essay, “A Beautiful Dream,” can be found on his photography website, and more detailed reporting on living conditions in Pine Ridge (focusing particularly on gang violence) can be found in the 2009 The New York Times article, Gang Violence Grows on an Indian Reservation.

Indian Country Diaries Video. Indian Country Diaries. PBS 2006. http://www.pbs.org/indiancountry/index.html. This two-part PBS documentary describes the present day issues impacting the American Indian community. Focusing on experiences both in urban areas and on reservations, the film provides comprehensive insights into contemporary experiences while also providing historical context for the challenges manifesting in the day-to-day lives of American Indians. American Indians of the Pacific Northwest Collection Online Gallery. American Indians of the Pacific Northwest Collection. University of Washington. http://content.lib.washington.edu/aipnw. GHELI repository link: http://repository.gheli.harvard.edu/repository/11989 This digital collection compiled by the University of Washington chronicles photography and historical writings by anthropologists, historians and teachers on the Northwest Coast and Plateau Indian cultures. According to the website, the archive contains “over 2,300 original photographs as well as over 1,500 pages from the Annual Reports of the Commissioner of Indian Affairs to the Secretary of the Interior from 1851 to 1908 and six Indian treaties negotiated in 1855.” In addition to photos and essays, the archives also include study questions designed for K-12 teachers to use as they develop classroom exercises related to American Indian history.

TEACHING MATERIAL

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Battle Over an Oil Pipeline: Teaching About the Standing Rock Sioux Protests Lesson Plan. Harris K, Gonchar M. Battle Over an Oil Pipeline: Teaching About the Standing Rock Sioux Protests. The New York Times 2016; Nov 30. https://www.nytimes.com/2016/11/30/learning/lesson-plans/battle-over-an-oil-pipeline-teaching-about-the-standing-rock-sioux-protests.html. GHELI repository link: http://repository.gheli.harvard.edu/repository/11990 This lesson plan focuses on advocacy efforts taken on by the Standing Rock Sioux tribe to protest the construction of the Dakota Access pipeline (DAPL) through tribal lands. The DAPL project was developed to streamline the transport oil from North Dakota and Montana to Illinois, and was mired in controversy when construction began in 2016 due to concerns from American Indian communities about the desecration of land and potential threats to the local water supply the pipeline could present. This lesson plan provides a structure to teach students about protests that considers the advantages and disadvantages of the pipeline project for all involved stakeholders, focusing particularly on the broader context of environmental advocacy and Native American history. Whose Story Should be Told Teaching Case. Smith BL. Whose Story Should be Told. The Evergreen State College Native Cases Initiative 2014. http://nativecases.evergreen.edu/collection/cases/whose-story-should-be-told.html. GHELI repository link: http://repository.gheli.harvard.edu/repository/10774 This case study describes the controversy over murals in a Washington, D.C. federal building that Native American employees say perpetuate inaccurate and demeaning stereotypes of Native Americans and create a hostile work environment. The conflict illustrates important issues of human rights and concerns about racial and cultural discrimination and prejudice. The case explores the connections between government and the arts, as well as leadership, public policy, stereotypes, historical integrity, civil rights, and cultural politics. This case is one of several developed by the Enduring Legacies Native Cases Initiative at The Evergreen State College in Washington State. A number of the Initiative’s cases address health-related issues for Native American communities in the United States; each includes both the case narrative itself and a short Teaching Note with identified learning outcomes and suggested discussion questions.

Enduring Legacies Native Case Studies Teaching Cases. Enduring Legacies Native Case Studies. The Evergreen State College Native Cases Initiative 2017. http://nativecases.evergreen.edu. GHELI repository link: http://repository.gheli.harvard.edu/repository/10770 These select cases address health-related issues for Native American communities in the United States. The selection is drawn from cases developed by the Enduring Legacies Native Cases Initiative at The Evergreen State College in Washington State. The mission of the Initiative is to develop culturally relevant curriculum and teaching resources in the form of case studies on key issues in self-governing Native American communities throughout the United States today. Each case includes both the case narrative itself and a short Teaching Note with identified learning outcomes and suggested discussion questions.

Native Voices Lesson Plans & Additional Resources Lesson Plans. Native Voices Lesson Plans & Additional Resources. U.S. National Library of Medicine 2015. https://www.nlm.nih.gov/nativevoices/resources/lesson-plans-list.html. GHELI repository link: http://repository.gheli.harvard.edu/repository/11991 As a part of the Native Voices: Native Peoples’ Concepts of Health and Illness exhibition, the US National Library of Medicine produced a series of K-12 lesson plans designed to teach students about the lived experiences of native people and how historical events have impacted their health over time. In addition to teaching plans collected from other sources, the website also has lessons developed for the exhibition, including the following:

• Native Voices Exhibition Scavenger Hunt • Understanding the Bond Between Human Beings and Our Environment: An Indigenous Perspective • Exploring the Impact of Western Expansion and Industrial Development on Native People’s

Environment, Culture, and Health

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• The Indigenous Perspective on Health and Healing

Who Owns Your Story? Teaching Case. Who Owns Your Story? Global Health Education and Learning Incubator at Harvard University 2014. http://repository.gheli.harvard.edu/repository/10692. GHELI repository link: http://repository.gheli.harvard.edu/repository/10692 This case uses a role play simulation to illustrate ethical implications when research practices violate cultural taboos and norms. In Who Owns Your Story?, the Trilanyi - a fictional Native American tribe based on a real community that is not identified or located in the case – is adversely affected by a high prevalence of diabetes. They ask a university professor with whom they have a close relationship to study their tribe, and they agree to give samples of their blood – which they consider sacred – for the study. Tribe members signed a consent form to participate but it was unclear whether they realized that the consent covered the university potentially using their blood for other possible research topics beyond diabetes. Ultimately, the study does not discover that the tribe has a genetic predisposition to diabetes. Years later, however, tribe members learn that their samples had also been used to study topics they considered objectionable. The case is based on true events between the Havasupai tribe and the University of Arizona which ultimately led to a legal suit that was settled out of court. In the case, students are asked to develop and simulate role play negotiations toward an acceptable resolution for all the parties involved.