The American Indian (AI) population suffers from significant health disparities, including nutrition-related chronic diseases (diabetes, cancer, and heart disease). Several risk factors for disease and social determinants of health have unique histories in the AI population, including historical trauma, boarding schools, adverse childhood experiences, poverty, federal food programs, and food deserts. To effectively address these disparities, a multipronged approach in collaboration with stakeholders is needed to address the upstream social determinants of health and to increase access to healthier foods. Promising practices and strategies can be considered in several focus areas, including 1) improving existing food programs, 2) promoting breastfeeding and early childhood nutrition, 3) promoting food sovereignty and access to traditional foods, 4) expanding locally cultivated foods, and 5) taxing unhealthy foods and subsidizing healthier options. As these strategies are implemented, it is vital that they are studied, evaluated, and reported to expand tribally specific evidence-based practices.
Keywords: American Indian; health disparities; historical trauma; nutrition; social determinants.