The Community Research for Health Equity (CRHE) program, managed by AcademyHealth and funded by the Robert Wood Johnson Foundation (RWJF), supports community-led research to address local health care system issues of importance to communities of color, people with disabilities, LGBTQ+ individuals, and other historically marginalized populations.
Over the next year, we will be featuring interviews with CRHE grantees to showcase and celebrate their work during relevant celebration and recognition months. In the fourth interview of this series, AcademyHealth Research Associate, Maura Dugan (she/her), speaks with Kristin Payestewa (she/her), at Arizona State University to discuss her current project and to celebrate Indigenous-led research during National Native American Heritage Month. Arizona State University’s project assesses the barriers, hurdles, and facilitators to advancing and sustaining American Indian and Alaskan Native students in undergraduate medical and nursing education programs. The conversation has been edited for length and clarity.
Maura Dugan: How does being from the community of focus, as a Native American student, inform your work?
Kristin Payestewa: My grandparents grew up in boarding school, so my culture was cut off, my language was cut off, and all the ancestral ways of knowing was cut off two generations ago. What remained was the legacy of trauma, and I dealt with a lot of childhood adversities, as many indigenous people have, due to the historical oppression and the trauma that is passed down. I always try to look for culture and language and a connection to who I am as an adult, and I have been for almost eight years by teaching myself the indigenous cultural ways, being with the communities and working with them. I want future generations to focus on the importance of having your culture and knowing your language because it can be a very lonely place when you don't know your lineage and ancestral ways
For me, being indigenous has always been the forefront of my work and will always continue to be. I want more representation in health care for indigenous people. Less than a percent of indigenous people in the U.S. hold academic medical degrees. Why are we minimally represented in the spaces of health care academia? It was significant to learn that not only do we need more indigenous representation in academia in general, but specifically in the health care setting.
We can improve the pathways to recruit and to retain indigenous students. In my work, I hope to be a person who can bring this to acknowledgement. I hope that this study is just the beginning of the change that can come culturally in alignment, in institutions and with communities. I hope to influence and motivate future students who are indigenous and may have come from various backgrounds. They should know that they have a place here in society, and that they could help their communities through research.
Maura Dugan: How did you select your research question?
Kristin Payestewa: Our research question investigated the experience of indigenous medical, nursing, and health professional students attaining those degrees. There's not a lot of representation of indigenous scholars or indigenous mentors, especially in the health care and professional fields. We have to inform our future generations about the critical need— that we need the representation of indigenous health professionals working directly with indigenous communities. That is one of the best ways that the communities will receive proper care because they are being understood. They’re looked at as a community member, an individual from their tribe. If we have indigenous representation in these professional fields that can assist our communities, then we can be prepared to help preserve and care for our future elders.
Maura Dugan: What have you learned from your study so far?
Kristin Payestewa: Some of our participants have explained walking in two worlds. This is someone who is able to understand and value the importance of Westernized medicine, that knowledge base, and has the ability to hold the cultural knowledge they may have learned from their families and their ancestry. Some of the individuals that we have interviewed are able to understand the importance of walking in two worlds but are also able to translate their experience in a way that is culturally receptive. Maybe in their own language. They can explain in Navajo, to their communities, why research is important or why we need more representation in science and in health care. Those individuals are unique, and we need to bring out more voices that amplify physicians, Ph.D. holders, and nurses that are indigenous. The inheritance and the preservation of cultural knowledge is really amplified in this study, and we really want to bring that to the forefront of administering health care.
What does that look like as a health care professional? From this study, we are learning that people have that ability to walk in both worlds, but also there is a need for representation. We need to shift into recognizing the importance of preserving our wellness and our culture as indigenous people, especially in this country.
What I've learned from the study is just the uniqueness from each lived experience, and how that coincides with some of our lived experiences as indigenous people. We experience the same kind of obstacles, maybe in different ways, but the resilience of us getting through, the resiliency of these participants talking about getting their medical degrees and then going back into their community, and how rewarding that is.
Maura Dugan: How do you want to celebrate and think about your work, and the future of Indigenous research, during Native American Heritage Month
Kristin Payestewa: I think it's important for all of us to be aware of the historical events that have happened here in this country, and to indigenous people. We don't talk about it. It is not written in our history books. But I think right now it's critical that our younger generation understand what has happened here, and how resilient our people are in surviving a lot of these very traumatic events that have been detrimental to our lineages of culture and language preservation.
Research was a new term to me and indigenous communities. Even though we have over 500 recognized tribes, sometimes people group us as one monolith. So, even though we are indigenous, there is a lot of individual traditions and customs within our cultures that we would love to be recognized in research.
There’s a lot of celebrations with our communities. I encourage others who may not know much about indigenous culture or the language to seek out events that are indigenous based. It's such an experience to be around a majority of indigenous people listening to the music and hearing the conversations and the laughter. I encourage you to take it all in. Let it speak to your curiosity of learning about cultures and learn more. I encourage you to look into the history, even by going to a museum. There's a lot rooted in indigenous culture and history. I hope that our future generations can take that on, and I hope that we can preserve our ancestral ways of knowing, and our elder knowledge to the best of our capability.
If you would like to read more about the Arizona State University’s CRHE grant, you can view that here. An interview with CRHE project team member Richard Montague of Arizona State University on the value of community-led research is available to view here. Earlier posts in this series featured CRHE grantees during Pride Month, Disability Pride Month and National Disability Employment Awareness Month. This work is made possible with a grant from the Robert Wood Johnson Foundation (RWJF). The views expressed here do not necessarily reflect the views of RWJF.