Faculty Advocates For Paradigm Shift Regarding Indigenous Health

FUERTE faculty member Benjamín Aceves, whose mixed-methods research primarily focuses on developing interventions that aim to address multi-level factors that cause diabetes-related chronic disease health disparities among Latina/Latine/Latinx/Latino communities in the border region, was recently published in The Lancet Global Health.

This article’s authors began working together as part of the Global Alliance for Chronic Diseases’ (GACD) Indigenous Populations Working Group, of which Aceves is a founding member. After regularly attending GACD conferences and working closely with community members living along the US-Mexico border, Aceves began to realize “the need to really understand how Indigeneity plays into Latino health” and how to be more inclusive of Indigenous community needs, especially when considering that many Latinos have Indigenous roots.

While both nations often default to reductive racial categories, the United States typically uses rigid and segmented conceptions of race that can make it near impossible for an individual to acknowledge multiple ethnic heritages.

By contrast, Mexico tends to map racial categories within a neocolonial framework that more closely considers an individual’s European heritage and can result in racial categories such as mestizo – an “elevated class status” that has often reflected the attempts of powerful individuals with both indigenous and Spanish roots to “distance themselves from indigeneity,” Aceves explained.

When the GACD began developing topic-specific working groups, Aceves immediately gravitated toward the group intent to focus on “how [chronic diseases] intersect and interact with that idea of Indigenous health.”

The authors emphasize that health inequities among Indigenous peoples are mainly due to disproportionately high rates of non-communicable chronic diseases and that environmental and socioeconomic factors that negatively impact Indigenous populations have been heavily influenced by colonization and its echoes in modern societal systems.

Arguing that decolonizing research practices “must provide immediate tangible benefits to the communities being studied” and closely evaluate institutional funding structures, the authors advocate for expanding literature on Indigenous health beyond descriptive studies and instead focusing on efforts that analyze “social–cultural determinants, protective factors, and health-promoting aspects of Indigenous cultures” while fostering trusting relationships between Indigenous and non-Indigenous researchers and communities “to recognise and appreciate the value of what can be learned from each other.”

Aceves’ advocacy for this paradigm shift has largely stemmed from his background in a prevention-focused review of healthcare systems. As a young child, Aceves noticed the inaccessibility some of his family members had, particularly in regard to limited language services and well-meaning but culturally incompetent medical recommendations. 
As an undergraduate student, he studied abroad in Berlin, Germany where attempts to navigate the German healthcare system were often “stigmatizing” experiences.

“It brings something up in you that says, ‘Something’s not right here,’” Aceves explained. “You can have a great medical system, but if it’s not serving all its populations in an equitable way, it’s not really doing its job in providing quality care for all.”

Utilizing more inclusive language and not assuming that people will accept Western medicine without merging it with culturally resonant approaches are two of Aceves’ hopes for this article’s practical impact on healthcare systems. “My goal has just been to improve health equity and that’s where my research centers: to promote and to proliferate health equity efforts.”