Significant health disparities exist for American Indians. Our population suffers from among the highest rates of death from preventable diseases in the US, including type 2 diabetes, alcoholism, unintentional injuries and suicide. The result is that in states like Arizona, the average age of death for the general population in 72.2 years, and it is 54.7 years for American Indians (Arizona Department of Health Services, 2004). Although the high rate of preventable disease in the population is disturbing, it also represents an opportunity. It means that we can do something about it. Reducing health disparities represents a complex set of program development and implementation challenges—not the least of which is the promotion of cultural competence in the Indian health system and the successful integration of traditional healing practices. One sector in which health promotion of the American Indian population that is not yet adequately explored is the non-profit sector. 

Several national and local non-profit organizations deal with health issues and several others deal with American Indian social issues, but there is currently no non-profit entity that focuses solely on improving the health of American Indians through novel program development, cultural competency and health professions education. As a result, I decided to form the Medicine Wheel Foundation. The Medicine Wheel is an ancient symbol depicting holism and balance as a model for health. Health is defined as balance among Spiritual, Mental, Physical and Emotional realms.

These concepts are best understood from a traditional cultural perspective that teaches us that to live in a healthy way is to live at the center of the wheel, and in balance among the four directions, and that Spiritual/Cultural, Mental/Educational, Physical/Environmental and Emotional/Social realms are all equally important in promoting health in the individual, family and community. This is true for health professions education programs as well. Unfortunately, medical school training is typically not geared to meet the cultural, social and environmental needs of American Indians, and the result is a significant disparity in the number of our physicians. Although we represent nearly 2 percent of the population, we represent approximately 0.1 percent of the physicians, and the disparities are similar for nursing, dentistry and other health professions. One of the best ways to ensure the promotion of cultural competency in the healthcare system is to develop a culturally appropriate system of health professions education targeting the American Indian population. One of the most important projects through the Medicine Wheel Foundation is to develop an American Indian School of Health Sciences (see below).

The Purpose of Medicine Wheel Foundation is to optimize the health of Native People through:

• Preservation and Advancement of Traditional Healing Systems
• American Indian Health Professions Training American Indian School of Health Sciences
• Health Policy Research and Development
• Health Education and Training
• Healthcare Scholarships
• Health Systems Technical Assistance and Consulting
• Promotion of Cultural Competence

The vision of Medicine Wheel Foundation is to be a proactive organization that will act based on its core values and to the benefit Native communities. MWF will conduct itself in a goal-driven as opposed to an opportunity-driven manner. The agenda for activities and initiatives will be determined by identifying those projects with the greatest possibility of making a meaningful impact on Native health, and will not be determined simply by grant opportunities or the agendas of other organizations.

Seven Focus Areas:

1. Preservation and Advancement of Traditional Healing (PATH)
Develop apprenticeship programs to preserve and integrate local healing traditions.
• Native American Traditional Integrating Organization (NATION)
• Health policy development regarding integration of Traditional Medicine into Indian health programs (credentialing, etc)

2. Pipeline
Increase the number of Native Americans in health professions through scholarship programs, community outreach, mentoring, support and retention.

• American Indian School of Health Sciences (AISHS) that will provide culturally appropriate system of health professions training and will link clinical services to Indian Health Service and Tribal systems of healthcare.
• Medicine Root Scholars Program. Develop a formal program for scholarship recipients to become mentors for younger students
• Link with and expand existing educational and summer research programs (e.g. Four Directions, INMED, AAIP, ANAMS, AISES, etc)

3. Health Policy
Provide health policy consulting and health program development, implementation and evaluation in partnership with Native communities. Partnerships will be developed with appropriate academic institutions.

• Health System and Public Health Infrastructure Assessments
• PL93-638 Readiness (Indian Self-Determination and Education Act)
• Integrating Traditional Healing Systems into Indian Health Programs
• Develop Health Policy Recommendations at Federal, State & Local Levels
• Native American Health Policy Fellowship & Executive Education Programs

4. Political Advocacy
Ensure adequate funding of Indian Health Service, Bureau of Indian Affairs & other Indian health programs. Partner with NIHB, NCAI, etc.

• Lobbying and Educating Politicians Regarding Native Health Issues
• Native American Leadership Development Programs

5. Best Practices
Identify and study model health programs in Indian country.

• Annual Reports of “Best Practices” in Indian Health to be distributed to all interested communities. Reports can be used as templates for other communities interested in developing similar programs.

6. Health Education
Develop tribally specific health education materials with a focus on community participation in materials design and development.

• Native American Health Education Materials Repository
• Web-based Health Education Programs for Tribes

7. Research
Focus on health issues facing Native Americans following a community participatory model in which tribes develop the research agenda.

• Diabetes, Alcoholism, Health Services Research (NIH, CDC grants, etc)
• Traditional Native American Healing Systems/CAM

 

American Indian School of Health Sciences (AISHS)
The American Indian School of Health Sciences (AISHS) will combine medical, dental, nursing, and allied health professions training in partnership with Indian Health Service and Tribal Health Programs. The primary goal is to improve Indian healthcare and cultural competency by increasing the number of American Indians in the health professions. This will be accomplished by the following tasks:

• Developing a pipeline of qualified health professions students through high school training programs and tribal college-based programs focusing on graduate health professions preparedness
• Partnering with IHS and Tribal Programs for clinical training sites in which the majority of patients are American Indian

Discussions have begun with local tribes in the Phoenix area to build partnerships and collaborations to develop the AISHS on a local reservation. Other partnerships include local medical, dental, nursing, naturopathic and other allied health professions programs for pre-clinical training. The clinical training components will occur in IHS and Tribal facilities. The fund-raising process has also begun in which we will utilize initial funding to build partnerships, policies and procedures and feasibility studies. If you would like more information or if you are interested in donating to the Medicine Wheel Foundation, please write to:

Medicine Wheel Foundation
PO Box 2228
Tempe, AZ 85280