Dr. Chester Austin Health Equity Interview

Dr. Chester Austin Health Equity Interview

Health Equity Social Media Campaign
We had the pleasure of interviewing Dr.Chester Austin from the Northern Valley Indian Health, Inc. to discuss Tribal Health Equity where topics include health disparities, barriers, access to care, and how we can better support the Tribal community. Click here for more campaign information and view other interviews!

Kyle Willman
Dr. Chester Austin, MD
Medical Director
Northern Valley Indian Health, Inc.

Tribal Health Equity

What is a top priority we need to address for Native American health?
“We need to address improving access to healthcare resources, especially specialty care, and employment opportunities along with other upstream determinants of health. As with all communities, prevention equitably addressing upstream determinants of health such as employment opportunities, livable income, comfortable housing, and safe environments for outdoor activities can have a great impact on health in general. But this would likely be even more effective in rural settings where resources are scarcer and for a population influenced by historical/generational trauma. This needs to be done in a culturally sensitive manner where we are supporting and promoting safe and healthy behaviors through traditional tribal practices/gatherings. We can shift in a return to seeing food, activity, and relationships as good medicine.”

What is a significant barrier that prevents the Native American community from accessing health care?
“Different barriers include the complexity of health issues, rurality and distance to care, lack of insurance/cost, trust issues related to discrimination, historical trauma, and broken treaties. There may be free direct care but little specialty care coverage and also no tribal hospitals in California.”

What are the health disparities that the Native American community face?
“Higher incidence and poorer outcomes for almost all chronic diseases, but specifically diabetes, depression/anxiety/PTSD/suicide, substance use disorders, lower rates of screening, later diagnoses, and poorer cancer outcomes, lower vaccination rates in general, and increased rates of infection and lower vaccine rates per capita for COVID-19 with more serious illness.”

How can medical providers better support the Tribal community and what resources are available?
“Promote trauma-informed and culturally sensitive care throughout all stages of healthcare delivery. Foster both passion and compassion among provider groups. There are a lot of opportunities currently to learn about ACEs and how they influence health outcomes later in life and what can be done to help build resilience through buffering activities and more structured counseling interventions. Health providers should incorporate some form of screening and intervention regarding ACEs, even if just through small, informal ways. There are limited resources available through tribal clinics, not only for the service they provide onsite. But they or other tribal organizations do have programs available to assist with access to offsite care and health education through Community Health & Outreach teams. Additional creative health promotion activities hosted by others in the community but geared toward reaching the Native American community could help augment what tribal organizations are doing.”

How can we use a community health approach to address Native American health disparities?
“Although there are some designated reservations and tribal lands in our area, a large portion of Native American citizens live among the rest of the population and are a significant part of the community. The health and wellbeing of all members of a community must be addressed to have a healthy community. As with other less well-represented members of a community that has higher risks, focused support and outreach with innovative and engaging education and health-promoting activities are needed to significantly improve outcomes for Native Americans.”