Learning with Indigenous Communities to Advance Health Equity

Oct 7, 2021, 11:00 AM, Posted by

Tribal Nations, resilient stewards of the natural resources that give us life, can lead the way to a more sustainable and healthy future. Indigenous Peoples' Day marks the urgent need to embrace the expertise they’ve held since time immemorial.  

A woman speaks into a microphone at a dance show. A Tlingit Native welcomes an audience to a community house. The traditions and leadership of the Tlingit, the people indigenous to Sitka, are infused throughout the community, including through educational and environmental programs.

For generations, Indigenous Peoples have known that our health is intertwined with the health of our earth. Their worldview recognizes that being healthy means ensuring the natural resources that give us life are well cared for.

In contrast, Western mindsets tend to view the natural world as an inventory of useful commodities—separate from, and existing only in service to, humanity. Overusing, polluting, and extracting without considering the long-term impacts has created conditions that fuel health inequities in our country: contaminated drinking water, food scarcity, air pollution, and extreme heat are contributing to poor health and driving up disease, particularly in low-income neighborhoods and communities of color.

Transforming our relationship with nature is key to building a sustainable, equitable, and healthy future for all. Through the forcible removal, violence, oppression, and other injustices Indigenous Peoples have experienced, they have remained powerful stewards for many of our natural resources. Their values, practices, and policies can show us the way to heal and reclaim the health of our earth and humanity.

Here are just some examples of Indigenous leadership in practice:


Tó éí  ííńá át’é. In the Navajo language, that means water is life. As sacred as Earth, fire, and air, the element cannot be taken for granted on the Navajo Nation lands in northwest New Mexico, where one-third of the tribe lacks running water at home.

A severe underinvestment in infrastructure in the Navajo nation—driven by structural racism—and mismanagement of the Colorado river by government agencies has left the Navajo Nation confronting major water resource problems. Cindy Howe, project manager at the Navajo Water Project, is helping to catalyze healing by addressing the immediate need to increase access to water with the DIGDEEP water system—plumbing that draws on a buried 1,200-gallon tank powered by solar panels to provide for a family’s basic needs.

“My hope is that one day the homes of every Navajo person will be hooked up to a water system, with indoor plumbing, a really nice shower, a commode, and a sink,” says Howe. “That is what I wish for my tribe and indeed for all in America.”


Shortly after this video was published five years ago, Charlie Four Bear—the Native elder featured—passed away. His teachings about how to build resilience, however, continue to endure.

Horses have long been integral to Native cultures, a source of both abundance and spiritual connection. Indigenous Peoples have many stories to tell about how horses entered their lives and a rich tradition of art that honors the animal as a fellow creature of the Earth. For Charlie Four Bear, an elder on the Fort Peck Indian reservation in Montana, horses also became a way to reach young people who felt disconnected from their roots: a feeling many Native young people share as a result of our country’s colonial history and assimilation policies that have led to the erasure of Indigenous culture. 

His Youth Mentor Equine Program helped to rekindle a sense of identity as it taught boys and girls how to forge a relationship with horses. Sadly, Charlie Four Bear passed away in 2017, at the age of 59, but his efforts remain an inspiration. A story in Take Us to a Better Placean RWJF-developed collection of fiction that encourages dialogue about a Culture of Health, draws on his work. 


Dams, diversion techniques, and allotments for crops and electricity that treat water as a commodity rather than an ancestral gift are doing great damage to the nation’s rivers. Coupled with rising temperatures and drought, tributaries in Arizona that were once perennial sources of a life-sustaining elixir now flow intermittently and headwaters are running dry.

New Zealand is showing how things can be done differently, thanks to legislation championed by the Māori peoples and passed by parliament. Through those efforts, the Whanganui River was granted “personhood,” recognizing its right to be healthy and protected from harm. In 2020, tribal leaders from Arizona travelled to New Zealand to immerse themselves in the culture and customs of their Indigenous relatives and draw blessings from the Whanganui. In connecting with the spiritual authority of the waters, the visitors deepened their understanding that rivers can only be reinvigorated by changing the ways in which we relate to them.

LISTEN TO Aleena Kawe of Red Star International and Herminia Frias of the Pascua Yaqui Tribal Council share practical lessons for cultivating a reciprocal relationship with nature to advance health equity.



Karabi Achary

Karabi Acharya, who has drawn upon her expertise in anthropology, public health and systems thinking in working with the citizen sector in the United States, South Asia, and Africa, joined RWJF in 2015. She directs the Foundation's strategies for global learning as it identifies best practices in other countries and adapting them to improve the social determinants of health in communities in the U.S.