Hózhó and Holistic Well-Being: Native American Heritage Month from an OME Perspective

By Chandrika Sanapala, MS, OMS II, Burrell College of Osteopathic Medicine, Student Government Association Executive Board vice president

Recognized every November, Native American Heritage Month is an opportunity to bring awareness to the rich culture, traditions and beliefs of the Native American heritage. As current or future osteopathic physicians, this serves as an opportunity to engage with and educate ourselves on the unique needs of Native American health.  

Research has shown the persistence of health disparities among Native Americans, specifically among preventable chronic illnesses such as diabetes and heart disease. Though insufficient research has been conducted on the impact of the recent COVID-19 pandemic, initial studies show that Native Americans experience more than three times the burden and mortality risk as White persons.^{1, 2} 

In a field such as osteopathic medicine that emphasizes the importance of partnering with your patient in their care and understanding their health as a whole, it is imperative to bring greater understanding to current health practices of the Native American populations. 

Student Doctor Analekha Chesnick is a current OMS IV at Burrell College of Osteopathic Medicine, completing her clerkships in the Four Corners. She shared her experience working with patients of the Navajo Nation:  

“My experience on the Navajo reservation in Gallup, Shiprock and Chinle revealed to me the cultural importance of food as medicine, and the barriers patients face to accessing the types and quality of foods they want to.”

Student Doctor Chesnick had the opportunity to work with a Navajo-owned agricultural cooperative, Bidii Baby Foods, LLC, to better understand the metabolic health needs of her future patients. In doing so, she had the opportunity to understand what it meant to revitalize Navajo food practices in the community and be a provider in another sense of the word.  

Like Student Doctor Chesnick, learning about the traditional practices of Native Americans will help current and future health professionals enhance their cultural competence. In a field like medicine, cultural competence is crucial to continually improving physician-patient communication and trust. By making this commitment to providing culturally competent care, we may continue to uphold our patients’ “confidence and trust as a physician and a friend”. The practices of culturally competent care start in medical school, where students learn how to present a case. A recent retrospective analysis of health and clinical data among American Indian/Alaskan Native individuals commented on the importance of including race or ethnicity in a case presentation, postulating that the incorporation of such factors in case presentation may help cultivate a more “personalized and culturally sensitive” product of healthcare.³ 

Another aspect of cultural competence may involve finding commonality with your patient. A Navajo concept that DOs may find familiar is that of “Hózhó”. Encompassing ideas of both health and wellness, it may be loosely translated as peace and beauty in the world around you, and a restoration of Hózhó signaling a restoration of a holistic well-being.  

In a field where Native American voices are severely underrepresented, it is imperative to first be reminded that, as a physician, we will not always have the answer. As such, as future and current healthcare professionals, it is our responsibility to recognize the paucities in our understanding. With this in mind, we must continue educating ourselves on what it means to provide holistic and mindful care to all our patients, with the overall goal of upholding cultural competence in caring for our patients of Native American heritage.  

Citations:  

¹ Bime C, Wang Y, Carr G, Swearingen D, Kou S, Thompson P, Kusupati V, Parthasarathy S. Disparities in outcomes of COVID-19 hospitalizations in native American individuals. Front Public Health. 2023 Aug 15;11:1220582. doi: 10.3389/fpubh.2023.1220582. PMID: 37649785; PMCID: PMC10465166. 

² APM Research Lab. Color of Coronavirus. https://www.apmresearchlab.org/covid/deaths-by-race#reporting   

³ Nahian A, Jouk N. Cultural Competence in Caring for American Indians and Alaska Natives. 2023 Oct 30. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 34033381. 

To Learn More:  

Indian Health Services (IHS): Information on Disparities
https://www.ihs.gov/newsroom/factsheets/disparities/ 

U.S. Department of Health and Human Services: Office of Minority Health
https://minorityhealth.hhs.gov/american-indianalaska-native-health 

Native American Health Center
https://www.nativehealth.org/ 

National Council of Urban Indian Health
https://ncuih.org/