Indigenous communities see increased focus on health care outcomes, job training

Indigenous nursing students at Northern Arizona University are expected to soon receive stipends to help pay for travel expenses to rural areas as part of their education, thanks to a new program focused on increasing health care workforce training in Indigenous communities.

Students at Northern Arizona University’s American Indian nursing program, the only baccalaureate nursing program on reservation land in the country, will receive $885 for travel expenses incurred when traveling to and from school and rural clinical rotation sites.

Kyle Thompson, a student in his third semester of the nursing program is one of the 17 students who will receive the stipends. He travels two hours roundtrip from Flagstaff to Cottonwood for his rotations.

Thompson funds his school expenses by working full-time at a restaurant in the summer and working a few shifts per week during the school year. He said without this stipend he would have to work even more, making it challenging to stay on top of his classes.

“Especially with gas prices right now, it adds up in the end,” he said.

Alana Holyan, a senior in the program who also studies at NAU’s Flagstaff campus, said the stipends will help her pay for gas, food and overnight stays in Cottonwood where she has clinicals.

To find funding for these trips, she has been applying for scholarships, adding to her already high stress levels.

“That also takes time and effort,” Holyan said about writing essays for scholarship applications. “You really have to put a lot of thought into what you say. All of it is exhausting, but it has to be done.”

Funding for the stipends is expected to come before the end of the year from the new Tribal Area Health Education Center, whose launch was announced in August by the University of Arizona.

The new program is being developed through a partnership by the Arizona Area Health Education Center program at the University of Arizona Health Sciences and the Arizona Advisory Council on Indian Health Care.

According to Jeffrey Axtell, the director of the council, the program will likely look at providing this stipend to students on an annual basis.

Shortage of Indigenous health care professionals

As one of six centers around the state, this is the only Arizona-area health education center focused on improving health care outcomes in tribal communities.

The regional center will collaborate with the San Carlos Apache Healthcare Corporation and Gila River Health Care to implement educational and training activities to help increase health care professionals in tribal communities, according to a University of Arizona press release.

Data from 2017 shows that 63% of American Indian and Alaska natives living in Arizona reported a lower likelihood of having a personal doctor or health care provider compared to whites (72.8%), according to the National Center for Biotechnology Information.

“The new American Indian Health Regional Center can begin to alleviate some of these shortages by working closely with our tribal health systems and enhancing their current workforce strategies,” said Leila Barraza, director of the AzAHEC Program in a University of Arizona news release.

The program will help increase access to clinical experiences in tribal settings, while also introducing health care as a career to students of all ages, said Kim Russell, director of the Arizona Advisory Council on Indian Health Care.

She noted that many tribes are already doing a lot of work in these areas.

“We want to complement what they are already doing,” Russell said. “We want to move forward programming that embraces the Grow Your Own strategy.”

In addition to having a shortage of health care professionals, American Indian communities experience huge disparities in health and health care resulting in poor health outcomes, like lower life expectancies and high rates of disease, according to a fact sheet from the Indian Health Services.

Regina Eddie, assistant professor in the School of Nursing at NAU, said many American Indian program students join because they have seen the needs of their community, even within their own family, and have a desire to give back.

Thompson, a member of the Navajo Nation, said he has seen first-hand how the lack of resources on Native American reservation land has impacted communities, and he wants to help.

“It’s rural and it’s not having the resources you would have off the reservation and ... people suffer from that.”

Eddie reiterated that with few American Indian nurses in the workforce compared to other groups there is a need for more culturally competent nurses in Indigenous communities.

Data shows a severe shortage of American Indian nurses, representing just 0.4% of the nursing workforce, according to the 2017 National Council of State Boards of Nursing survey.

“Nurses from the community understand the culture, the people, the history, you are able to provide better care, culturally tailored care,” Eddie said.

Eddie said the program is always looking for funding for the program's nursing students, and they reached out to the AHEC program for help.

"They still have many unmet needs financially, so this was a huge support," Eddie said.

This article originally appeared on Arizona Republic: Native communities increase focus on health care, workforce training