The Imperative for Research to Promote Health Equity in Indigenous Communities

Abstract

Health disparities exact a devastating toll upon Indigenous people in the USA. However, there has been scant research investment to develop strategies to address these inequities in Indigenous health. We present a case for increased health promotion, prevention, and treatment research with Indigenous populations, providing context to the recent NIH investment in the Intervention Research to Improve Native American Health (IRINAH) network. We discuss the disproportionate costs and consequences of disparities borne by Indigenous groups, the limited evidence base on effective intervention for this population, how population uniqueness often makes transfer of existing intervention models difficult, and additional challenges in creating interventions for Indigenous settings. Given the history of colonial disruption that has included genocide, forced removal from lands, damaging federal, state and local policies and practices, environmental contamination, and most recently, climate change, we conclude research that moves beyond minor transformations of existing majority population focused interventions, but instead truly respects Indigenous wisdom, knowledge, traditions, and aspirations is needed, and that investment in intervention science to address Indigenous health disparities represent a moral imperative.

Promising Practices for Promoting Health Equity Through Rigorous Intervention Science with Indigenous Communities

“…The first paper, Stanley, Swaim, Kaholokula, Kelly, Belcourt, and Allen (Stanley et al, 2017), sets the stage for the rest by describing the current status, and the human and economic costs of health inequity among U.S. Indigneous populations. The authors emphasize and provide examples highighting the limited existing evidence base for effective interventions addressing these massive inequities, as well as ways in which population uniqueness often made the transfer of existing intervention models difficult and ineffective.…”

Impact of racism and discrimination on the physical and mental health among Aboriginal and Torres Strait Islander peoples living in Australia: a protocol for a scoping review

“…Evidence from other countries shows that initiatives to address racism have the potential to improve health [48]. However, advancing the creation of effective interventions requires the existence of solid evidence upon the unique characteristics of Aboriginal and Torres Strait Islander peoples [49]. This highlights the imperative need for research to guide this important work.…”

Impact of racism and discrimination on the physical and mental health outcomes among Aboriginal and Torres Strait Islander peoples living in Australia: a protocol for a scoping review

“…Evidence from other countries shows that initiatives to address racism have the potential to improve health [49]. However, advancing the creation of effective interventions requires the existence of solid evidence upon the unique characteristics of Aboriginal and Torres Strait Islander peoples [50]. This highlights the imperative need for research to guide this important work.…”