By Dina Weinstein

Collaboration between colleges, universities, health systems and Virginia’s Native American tribes were key themes at the second annual Virginia Indigenous Nations in Higher Education (VINHE) Leadership Summit in mid-March. The event was attended by representatives from Virginia’s state and federally recognized tribes and higher education institutions at the VCU Health Parham Road Campus.

VINHE is a collective dedicated to collaborative instruction, research, engagement and capacity-building activities that support Native Americans’ access and equity in higher education, convened by the State Council of Higher Education for Virginia (SCHEV). VINHE’s work focuses on six areas including land and watershed management and conservation, cultural resources, higher education success, legal issues, embracing tribal history in K-12 education standards and tribal community health.

The VINHE Leadership Summit, which was attended by over 60 academic, hospital and tribal leaders, focused on the best approaches for institutions and health care organizations to use when creating collaborations that serve Native Americans.

“The summit was a great opportunity to initiate a crucial dialogue on how health disparities can be addressed within Virginia's native communities,” said Christina Davis, M.Ed., an academic advisor and instructor in the Interdisciplinary Studies Department at Virginia Commonwealth University’s University College and one of the summit organizers. “It gave the opportunity to hear from tribal citizens themselves about what they feel is most important about their healthcare needs and what the health and education system can do to improve and support them best.”

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The leadership summit was attended by representatives from Virginia’s state and federally recognized tribes, higher education institutions and health care experts. (VCU Enterprise Marketing and Communications).

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Chief Stephen Adkins of the Chickahominy Tribe urged participants of the summit to look at Native American as peers and to not make inferences about tribal communities’ wants and needs.

“The history of Black and brown people has been skillfully and artfully excluded from the textbooks that students study today,” Adkins said. “We don’t want to see in the newspaper, ‘X College is launching this studies program or this language program,’ without first talking with us. If you want support from the subject matter experts, who would be us, you need to reach out to us first. Don’t do it backwards.”

Paula Robinson, SCHEV’s associate director for equity and engagement, says these gatherings and collaborative projects are a starting point to build trust and understanding between Virginia Native Americans, their health care providers and educators.

“Particularly in the health field, in order to be compassionate and provide appropriate care, you must first honor someone's presence and significance to the communities that we all live in,” Robinson said. “Creating a deliberate space for this dialogue between Virginia's sovereign indigenous nations and higher education not only acknowledges our complicated history, but also provides recognition of our strong indigenous communities, and creates opportunities for resource sharing and partnerships for brighter futures, together.”

It’s taken decades for Virginia tribes to be recognized by the Commonwealth of Virginia and federal government. The confirmed status now means access to grant funds to collaborate with higher education institutions, leading to potentially productive partnerships in numerous areas including education, healthcare, historical preservation and wetlands restoration.

Increasing access to health care for Virginia’s tribal communities

During a session on tribal healthcare, Davis and Joanne Harris, program manager for VCU Health's Office of Diversity, Equity and Inclusion asked the panel a series of questions focusing on equity and health care. Both serve on the VINHE core leadership group and organized the summit. Davis is also a Southeastern Native whose family married into the Mattaponi/Pamunkey tribes.

One of the main health concerns discussed was the lower life expectancy of tribal communities. According to the Centers for Disease Control and Prevention, Native Americans and Alaskan Native populations have higher death rates across all age groups and the lowest life expectancy compared to other populations in the U.S., including people who are white, Black and Hispanic.

Other illnesses disproportionally affecting tribal communities include COVID-19, heart issues, cancer, diabetes, respiratory issues, tooth decay and suicide. There are a number of social and economic barriers contributing to these health disparities, such as limited access to health care options in the region and historically unequal relationships in health system settings.

The panel of medical experts from across the state included Carlos Smith, D.D.S., M.Div, associate dean for inclusive excellence, ethics and community engagement at the VCU School of Dentistry. He noted the important role health care providers play in building relationships with patients and earning the trust of historically marginalized and underserved communities.

“The pervasive way in which disparity and inequity is really entrenched, almost by design, in our health care system is a moral and ethical failure of our professions,” said Smith, who teaches ethics and professionalism in healthcare. “Our status as health care professionals should hinge on trust and particularly when you have so many maligned, marginalized, and historically forgotten communities that have a well-earned mistrust in us. It comes back to professional duty. The system has been broken for so long, we must be willing to approach the system differently if we want to see different outcomes.”

Adkins also spoke about the long-term, negative impacts Virginia eugenicist Walter Plecker has had on the health of indigenous communities. Plecker removed the Native American option on census records under the Racial Integrity Act, which Adkins says has prevented experts from tracking health issues among Native Americans. Adkins says race – or erasure of race and identities – continues to be a concern for tribal nations.

Other issues discussed during the summit include increasing the representation of Native Americans in health care careers as well as solutions some have found to boost care access, such as opening clinics on rural reservations.

Ensuring Native American populations also have access to health care options, such as dental care and cancer treatments, is key, Harris says. One example of this at VCU Health is a collaboration between Chickahominy tribal leadership and VCU Massey Comprehensive Cancer Center called the Chickahominy TRUTH (Trust, Research, Understand, Tell, Heal) Project. Through the project, tribal leaders and Massey are working together to learn about the cancer risk perceptions and experiences of Charles City County residents, to overall better understand structural and individual-level contributors to cancer risk through evidence-based approaches informed by the community.

Harris also pointed to VCU Health Tappahannock Hospital, located in the Northern Neck, as a community-focused hospital close to some of Virginia’s tribal nations. Harris says she wanted to be involved with the VINHE conference to bridge and build relationships with Virginia Native Americans, higher education leaders and health systems.

“Professionally, it’s important that we are thoughtful about being true to our mission and vision at VCU [Health], making sure that we are extending care and accessibility of that care in all of our different areas,” Harris said.

What stood out to Chief Robert Gray of the Pamunkey Tribe during the VINHE Leadership Summit was the spirit of collaboration and consultation, and the sense of peer relationships between the tribal members and institutions present.

“Something like this is opening the lines of communication regarding higher [education],” Gray said. “For tribal youth, I’d like to see more opportunities open to us, specifically more tuition assistance.”

He sees Virginia’s colleges and universities as a resource for expertise regarding healthcare, natural resources and legal issues.

“The schools in Virginia provide a lot of subject matter experts that we don’t have,” Gray said. “For projects around shoreline erosion, natural habitat and water resources that benefit the tribes and benefit the state, we’ve been working with these Ph.Ds. and graduate students, and we welcome their help. We’re reaching out to connect with experts.”

While engagement with Virginia’s tribal nations is important, Gray, along with Davis, cautioned higher education institutions that resources for tribal leaders are thin and their time is limited.

Learn more about VCU Health’s impact on the community.