The United States has a legal obligation to provide health care to Native Americans. Yet, the Native American community faces significant health status and health care inequities when compared to other U.S. populations. Native Americans born today have a life expectancy that is 4.4 years less than the overall U.S. population, and they die at higher rates than other Americans in many categories of preventable illness, including diabetes, chronic liver disease, cirrhosis, and chronic lower respiratory diseases.
Community Health Centers, like the Native American Community Clinic (NACC) in Minneapolis, are well-positioned to address these kinds of health inequities while also recognizing that certain populations have unique cultural needs. By design, health centers are patient-centered, community-directed, and culturally and linguistically competent. They place great value in drawing leadership from within a given community. This philosophy was at work in 2016, when the Native American Community Clinic hired Dr. Antony Stately as the health center’s first Native American CEO.
As a member of the Ojibwe and Oneida tribes and someone with deep roots in the Twin Cities’ Native community, Dr. Stately knows that most Native Americans have a broader understanding of “health” than is common among the majority white culture. He approaches his job at NACC with the desire to integrate western medicine with traditional healing practices, such as the role of spirituality in health, the value of family wellness, the concept of the well-being of all vs. the few, and the importance of balance in an individual’s life and life choices.
Tapping into the wisdom of Native elders
When Dr. Stately arrived at NACC, the community was in the throes of an opiate crisis and experiencing the largest homeless encampment in local history—the Wall of Forgotten Natives, located just four blocks from the clinic. “The staff was stressed,” Dr. Stately recalls. “We were going through a difficult time, and everyone was working really hard. The community was struggling.”
Creating an Elder-in-Residence program was one of Dr. Stately’s innovative solutions. During the week of the 2018 spring equinox, Donna La Chapelle, a member of the White Earth Nation of Minnesota, became NACC’s first Elder-in-Residence.
Trained in Dakota and Ojibwe healing—as well as medical social work, mind/body medicine, and integrated healing practices—La Chapelle’s first act as Elder-in-Residence was performing a ceremony to sanctify and cleanse the patients, staff, and NACC’s building itself. She smudged the clinic with sacred herbs and sang traditional songs to welcome ancestors and create a space for healing.
During the ceremony, a long-time patient of the clinic who had experienced homelessness for a decade, walked through the doors. When he saw La Chapelle, he asked if he could have some of the traditional medicine. La Chapelle told him to put his face in the smudge bowl. With tears in his eyes, he thanked her, saying, “I haven’t had access to medicine in seven years.”
“That was a big turning point for me,” recalls Dr. Stately. “Historically, we would refer people to other places where they could access traditional practices. By bringing a healer into our clinic, our commitment to traditional healing was no longer theoretical, we were embodying it.”
Within months, the need for La Chapelle’sservices became so great that the clinic hired a second healer. With guidance from the University of Minnesota’s School of Agriculture, they also created a medicine garden from which anyone in the community can harvest traditional plants and herbs—a task that had been too difficult, if not impossible, to find in the city’s urban landscape.
Seeing people as relatives, not patients
Early in his tenure as CEO, Dr. Stately had a conversation with leadership that has served as a North Star, guiding his decisions, like the one to hire an Elder-in-Residence. The discussion centered on addressing addiction and drug abuse in the community head-on with harm reduction services, such as a syringe exchange.
“People were anxious about it,” Dr. Stately said. “Board members were worried that families wouldn’t feel safe if there were drug addicts at the clinic. That’s when I said, ‘I wonder how our model of care would change if we stopped thinking of our clients as patients and started thinking of them as our relatives. What would we do for these people if they were our family?’”
For Dr. Stately, it was not a rhetorical question. “Many of the people I see in our clinics are nieces, nephews, aunties, uncles…people I grew up with. I can’t see them as patients, I see them as relatives.”
As a South Minneapolis native, Dr. Stately views his lived experience as an invaluable asset in his role as CEO.
“So much of my job is about leveraging assets and resources—human, fiscal, and otherwise—to improve health in the community. And not just the people who walk through the door. It’s about thinking of the whole community. That’s where my lived experience is critical.”
A space that reflects the people it serves
Building a new facility with an expanded footprint, more space, and a floor of communal housing was the next step in NACC’s evolution.
Dr. Stately sat down with NACC’s operations director and asked what it would take to build a brand-new clinic. He then met with an architect and solidified his vision: a modern building where Native patients could see their culture and heritage reflected in the clinic’s design and services. The cherry on top: the design included housing on the second level—the clinic’s way of being part of the solution for homelessness within the community.
The new clinic is a crucial part of NACC’s ongoing mission to create healing spaces that better reflect the Native American community it serves.
“Before we can change the health of individuals now and communities of the future, we need to carefully consider our work—why we do it and with whom we’re doing it,” Dr. Stately said. “We’re on that path and moving forward in a new direction.”