Culture as a Key to Health

By Beth Toner, MJ, RN, senior communications officer, Robert Wood Johnson Foundation

(Video caption: The Dakota are a horse tribe, and Charley, a retired reservation policeman, takes care of abandoned horses, connecting them to the tribe’s youth to help the young redefine themselves in relation to tribal history. Video used by permission; produced by Purple States LLC with support from the Robert Wood Johnson Foundation.)

I consider myself, and have been told by others that I am, an extraordinarily patient person—except behind the wheel of a car.

I commute 80 miles each way to work (that’s how much I love my job), so I spend a lot of time in the car. That, in turn, means I get annoyed—unreasonably so—by folks who are driving in such a way that forces me to spend a minute longer than I need to in that car. Now, it never leads to dangerous or aggressive driving, but it does lead to a lot of windows-up ranting while I’m on the road. One day, while I was in mid-rant, my 21-year-old daughter finally said, “Mom, you need to imagine other people complexly.”

I think of that conversation often as I listen to the polarizing dialogue that continues across our nation. What if, across the nation, we each imagined other people complexly, not just as their culture, their gender, their political party, their favorite television show? People, with all their joys and sorrows, their best qualities and their deepest flaws—uniquely themselves, yet with so much in common with each other. What would be possible?

It’s a question that’s more relevant than ever, especially for nurses. It’s a question that kept returning to me this past fall when I participated in a site visit to Crow Agency and Fort Peck Indian Reservation in Montana.

I thought I knew a bit about Native American culture. I suppose, academically, I did. But after just a few minutes at Crow Agency in a meeting with a number of representatives of the Crow Nation, I realized just how woefully minimal my understanding of Native American culture—of its richness, of its many nations—is, and just how much less of a nurse—and a person—I have been because of my ignorance.

Native Americans have suffered at the hands of European immigrants to this continent for hundreds and hundreds of years; they have been deprived of the land they cherish and have had values forced upon them—values that often run counter to their own. Yet, despite all this, I found nothing but a warm welcome and a generous sharing of their culture with all the non-natives around those tables in Crow Agency and Wolf Point, Montana. I also found:

  • Culture: culture as a central source of healing, health, and resilience. Nothing was more moving than hearing a Lakota elder sing Amazing Grace in her language—a language her mother had been punished for speaking in school. I heard the granddaughter of the first Native American registered nurse speak of the melding of nursing and culture. Their sense of connection to not just each other but to the past, present, and future—and to the land—provided me with a new perspective and a sense of what we have lost by remaining so ignorant of the cultures of this land’s indigenous peoples.
  • Respect: respect of everyone, and also of others who want to learn about their culture. In both visits, the tribe’s elders prayed for their site visitors and their families—prayed that we and our families would be blessed because we were there. It was a prayer that humbled me to the core.
  • Values: values such as sharing, honesty, and responsibility. As non-native visitors, we were allowed the privilege of raising a lodge together. As part of that process, the elder led us in each naming a pole with a value that was important to us—so that the lodge would be built upon those values. Once the lodge was in place, our entire group—Native Americans and non-natives—assembled within the lodge, women on one side and men on the other, from eldest to youngest. Then the eldest Lakota woman offered a prayer for us all.
  • Humor: always humor. The smiles, laughter, and gentle teasing continue to lift my spirits and keep me committed to raising my voice in support of this—and all—cultures.

My cross-country flight home to Philadelphia from Billings gave me an uninterrupted opportunity to view the diverse landscapes where Americans live: mountains, prairies, the Great Lakes, farmland, big cities. We are truly all connected, and connected to this land we have all come to call “home.” As I tried to make sense of all I had learned, I realized:

  • We do not know enough about these cultures—and others. Yet if we are to make the healthiest lives possible available to all, we must seek to deeply understand others’ cultures—not for the purposes of appropriating them, but to allow all of us to heal. So often, when we as nurses (and other health care providers) work with cultures other than our own, we assume our solutions for public health challenges will work best. We must support the sustaining of these cultures, which are a source of resilience for the community and a source of richness for us all.
  • We must acknowledge the historical structures and systems of oppression in our nation. We must be vulnerable with each other, have honest and open conversation about the deep divide in our nation—not to induce guilt, but to make a space for grace and healing. Until we begin bridging that divide, the opportunity for health will be out of reach for far too many.
  • We must tell stories. We talk so much in this country, with sound bites and social media posts. Yet we say so very little, know so very little about each other. We must ask others not like us to tell us stories about who they are and what is important to them. We must listen and learn. We must fight for others to sustain their culture and call upon it as a source of strength and health.

In Montana, many of the elders I talked to said, of the challenges their communities face—all of which affect their health in some way—“We deserve better.” And they do. We can start by exploring and valuing the complexity that makes us all uniquely who we are.

And I promise—I’ll try to do that even on my drive home tonight.

2017-02-02T10:33:44+00:00 February 1st, 2017|Nursing, Public health|1 Comment

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One Comment

  1. Lois Roelofs February 3, 2017 at 9:24 am

    So true. Thank you.

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