Advancing American Indian/Alaska Native Health Equity: A New Social Determinants of Health Framework for Indian Country

In 2020, I received a grant from the Montana Healthcare Foundation (MHCF) that enabled me to conduct extensive research on the array of so-called social determinants of health (SDOH) that uniquely influence American Indian/Alaska Native (AI/AN) health; this work included an international literature review with particular attention paid to research by AI/AN and other Indigenous scholars. From 2021-23, with the continued assistance of the MHCF as well as the Headwaters Foundation, I produced a lengthy report that synthesized this research and culminated in my development of an Indian country-specific SDOH theoretical framework for improving AI/AN health outcomes through policy development across numerous social domains. This framework and its undergirding research have received attention from people working in public and tribal health across Montana, now guiding the work of the American Indian Governance and Policy Institute and informing the current Montana State Health Improvement Plan. The realization that my work was rapidly beginning to fill a significant void led me to consider ways I might further its reach and impact and am thus working on a plan for securing both the time and funding to transition my 126-page policy report into a 250-page scholarly book manuscript for publication with the University of Nebraska Press. My goal is to produce a book that illuminates, breaks down, and offers recommendations for meaningfully engaging this complex subject matter—a book that can be used both inside and outside of colleges to educate a vast number of current and future policy makers and health and community leaders across the country and inform their decisions in ways that advance health equity for AI/AN for generations to come.