Our Vision of Health for Future Generations: An Exploration of Proximal and Intermediary Motivations With Women of the Choctaw Nation of Oklahoma

Abstract

Health disparities and substance misuse are increasingly prevalent, costly, and deadly in Indian Country. Although women historically held positions of influence in pre-colonial Tribal societies and shared in optimum health, their current health is relegated to some of the worst outcomes across all racial groups in the United States. Women of the Choctaw Nation of Oklahoma (CNO) have some of the highest prevalence estimates in physical inactivity and excessive drinking in the United States. Building on the Indigenous Stress Coping model of indigenous health, "Our Vision of Health for Future Generations" explores the intersection of a historical event, the Trail of Tears, and its lasting impact on the contemporary health outcomes in tribal members. This inquiry is positioned within the Yappallí Choctaw Road to Health project that explores these broader issues. This culturally-centered study explores proximal and settings-based/intermediary motivations of twenty-three women who completed the Yappallí project, walked the Trail of Tears, and developed a holitobit ibbak fohki "sacred giving" community health event. Analysis was conducted using the Listening Guide method, that highlighted the contrapuntal voices of embodiment, motivation, challenges, and transformation. Participants shared stories in relation to both their individual health concerns (proximal), and deep love and commitment for the health of their family, community and for future generations (intermediary). This study provides another framework for the development of indigenized research, by using in-depth interviews, haklo "listen deeply" as a form of indigenous storywork that is centering of the experiences of marginalized people, and reflexivity as anukfilli "Deep Reflection".