HES 3553 Native Mid term

What is wellness?

Wellness is an active, ongoing process of achieving balance among different areas of life to maintain overall health and well-being. It involves more than just being free from illness. Wellness includes physical, emotional, mental, spiritual, social, and cultural aspects of health.

What are the four main dimensions of wellness?

The four main dimensions of wellness are physical (taking care of the body through nutrition, physical activity, sleep), emotional (understanding, expressing, and managing feelings), mental (learning, thinking, problem-solving), and spiritual (finding meaning, purpose values, and connection in life).

How are the cycles of life reflected in each?

Wellness changes throughout the life cycle, from childhood through older adulthood. A person's physical abilities, emotional needs, knowledge, and spiritual understanding may change with age. Each stage of life brings different experiences and opportunities for growth.

What are the three added dimensions of wellness?

• Family: Relationships, caregiving, support, and belonging.

• Community: Social connections, shared responsibilities, and access to resources.

• Culture: Traditions, beliefs, identity, language, and cultural practices.

What elements are connected to the earth dimension?

Possible elements include land, water, air, plants, animals, and the environment. In many Indigenous wellness perspectives, relationships with nature are important for physical, spiritual, and community well-being.

Dr. Tonemah said, ““People don’t live in a vacuum. When you assess your wellness, you must also look at the dimensions of family, community and culture”? Describe in detail one of these dimensions and how it might impact an individual’s wellness.

Family is important to wellness because it provides love, support, and a sense of belonging. In AI/AN communities, elders and family members teach traditions and cultural values. Strong family relationships help reduce stress, improve emotional health, and keep people connected to their culture. This shows that family plays a big role in a person's overall wellness.

what are the three elements of culture? Be able to recognize examples of each.

• Beliefs and values: What people consider important, right, or meaningful. Example: valuing respect for elders.

• Practices and behaviors: Customs, traditions, and everyday actions. Example: participating in traditional ceremonies.

• Symbols and communication: Language, gestures, clothing, art, and other forms of expression. Example: using traditional language to communicate cultural identity.

What is cultural competence?

Cultural competence is the ability to interact and work effectively with people from different cultural backgrounds by understanding and respecting their beliefs, values, traditions, and communication styles. In healthcare, cultural competence helps providers communicate respectfully, recognize individual preferences, and provide appropriate care.

What is the process of cultural competence?

• Cultural awareness: Recognizing personal beliefs, assumptions, and biases.

• Cultural knowledge: Learning about different cultural groups and experiences.

• Cultural skill: Developing the ability to communicate and provide appropriate care.

• Cultural encounters: Gaining experience interacting with people from different backgrounds.

• Cultural desire: Having genuine motivation to continue learning and improving.

What is cultural humility?

Cultural humility is a lifelong process of self-reflection, recognizing personal biases, respecting other people's experiences, and understanding that no one can know everything about another culture.

What does cultural humility require?

It requires openness, self-awareness, respect, willingness to learn, and recognizing power differences between individuals and institutions.

What 3 factors guide cultural humility?

• Lifelong learning and critical self-reflection.

• Recognizing and addressing power imbalances.

• Institutional accountability and mutually respectful partnerships.

What is the difference between deep versus surface cultural competence skills? Be able to recognize examples of each.

Surface skills	Deep skills
Focus on visible cultural characteristics	Focus on underlying values and beliefs
Recognize foods, clothing, language, and holidays	Understand historical experiences, worldviews, and relationships
Example: Knowing a community celebrates a traditional holiday	Example: Understanding how historical trauma can influence trust in healthcare

Remember: Surface = what you can easily observe. Deep = understanding the meaning and experiences behind cultural practices.

Fill in the blank: Our sense of time is a ___________characteristic, like all of culture.

What are the challenges to providing care for communities that place other things ahead of “being on time” and “not wasting time?”

Learned

Different cultures view time differently. Some people value family and relationships more than being on time. Healthcare providers may misunderstand this, causing missed appointments or communication problems. Providers should respect cultural differences, avoid assumptions, and clearly explain scheduling expectations.

Fill in the blank: ______________ is frequently the best way to provide information, at least initially. Why is this statement true?

What are the challenges to communicating with, and collecting information from, patients with differing language or literacy backgrounds?

Oral Communication

• Language barriers and misunderstandings.

• Difficulty understanding medical terminology or written instructions.

• Inaccurate information when patients and providers cannot communicate clearly.

• Hesitation to ask questions or disclose personal information.

Healthcare professionals should use qualified interpreters when needed, communicate in plain language, and check understanding without embarrassing the patient.

Fill in the blanks: Decisions regarding medical screening and intervention may not be decided by the ______________ in a particular culture, but by __________________.

What are the challenges to providing care when cultural differences determine how decisions about care are made and what is appropriate when discussing a patient’s body?

Individual/the family as a whole

Some patients prefer making medical decisions with their families instead of alone. Cultural beliefs may also make discussing the body or certain treatments uncomfortable. Healthcare providers should be patient, respect these beliefs, and allow patients time to make decisions.

From the “Self-awareness and Etiquette” section-

What are the etiquette do’s and dont’s described in the culture card?

Do's:

• Respect cultural differences and keep an open mind.

• Listen more than you speak and be comfortable with silence.

• Be honest about your role and expectations.

• Respect the community's customs and traditions.

• Ask questions respectfully when you don't understand something.

Don'ts:

• Don't stereotype people based on appearance.

• Don't interrupt others or rush conversations.

• Don't force your personal beliefs on others.

• Don't touch sacred items or take pictures without permission.

• Don't ask personal questions too early.

From the “Communication Styles” section-

What are the recommendations regarding non-verbal messages and indirect communication?

Nonverbal Communication:

AI/AN people may communicate through gestures, silence, and body language. Looking down can show respect, especially toward elders. A gentle handshake may also be a sign of respect.

Indirect Communication:

Some AI/AN people may avoid directly criticizing others because it can be seen as disrespectful. They may use storytelling or humor to communicate messages instead.

what are the health disparities that still exist for many AI/AN communities

Health disparities are differences in health outcomes and access to healthcare between population groups.

• Type 2 diabetes and associated complications.

• Cardiovascular disease.

• Certain cancers and barriers to timely diagnosis.

• Obesity and related chronic conditions.

What are social determinants of health? What conditions are included in these determinants?

Determinant	Examples
Economic stability	Income, employment, food security
Education	School quality, literacy, educational opportunities
Healthcare access	Insurance, nearby clinics, transportation
Neighborhood and environment	Safe housing, clean water, pollution
Social and community context	Discrimination, social support, community relationships

How do they impact health?

Social determinants influence whether individuals can access nutritious food, safe housing, education, transportation, and medical services. Limited access to these resources can increase stress and contribute to poorer health outcomes.

What is at the root of health disparities for indigenous people?

Historical and ongoing effects of colonization, including displacement from ancestral lands, forced assimilation, boarding schools, discrimination, and disruptions to traditional food systems, have contributed to health inequities.

These experiences have affected cultural continuity, economic opportunities, access to resources, and relationships with institutions.

What are ACE's?

ACEs stands for Adverse Childhood Experiences.

These are potentially traumatic experiences during childhood, such as abuse, neglect, witnessing violence, or living in a household affected by serious instability.

How do ACEs impact child health?

Repeated exposure to severe stress can affect emotional regulation, learning, relationships, physical development, and long-term health. It may increase risks for anxiety, depression, and chronic health conditions.

How do ACEs impact genetic expression?

Prolonged stress may influence epigenetic processes, which help regulate how genes are expressed without changing the underlying DNA sequence. These changes may affect stress-response systems and health outcomes.

Importantly, these effects are not inevitable. Supportive relationships and safe environments can help protect children.

What is the definition of resilience?

Resilience is the ability to positively adapt and recover when facing difficult situations, stress, or trauma.

What are the 7 skills to Build personal resilience?

• Cultivate a belief in your ability to cope.

• Stay connected with sources of support.

• Talk about what you're going through.

• Be helpful to others.

• Activate positive emotions.

• Cultivate an attitude of “Thrive”-orship.

• Seek out meaning and purpose in your life.

What are the personal core cultural values that build resilience in first American people?

• Respect

• Accountability

• Honor

• Patience

• Diligence

• Purpose

• Contribution

What are the collective core values that build resilience in first American families and communities?

Value	Easy explanation
Sense of belonging / Being of value	Feeling connected to family, clan, and community
Spiritual practices	Using prayer, ceremonies, and beliefs
Language	Preserving traditional words, prayers, and songs
Cultural traditions	Caring for others and passing down traditions

What does interdependence/interconnectedness support?

Interconnectedness and interdependence support healthy communication, teamwork, and empowerment within communities. They help people build strong relationships and work together to heal from trauma.

How should we support and promote self-control and self-determination?

We can support self-regulation and self-determination by encouraging people to express emotions, forgive themselves and others, develop healthy coping skills, practice self-care, and maintain their cultural values.

Be able to complete this quote: “We are restoring our __________________ and the methods of living that we followed one hundred years ago and returning to ________________.”

Original instructions / Cultural roots

What are the myths and corresponding facts regarding AI/AN people and distinguishing physical characteristics, casinos, paying taxes and per capita payments?

Physical characteristics

Myth: All American Indian and Alaska Native people have the same physical characteristics.

Fact: AI/AN people have diverse physical appearances, skin tones, facial features, and backgrounds. Physical appearance alone cannot determine whether someone is Indigenous or belongs to a particular tribe.

Casinos

Myth: All Native Americans own casinos or receive money from casinos.

Fact: Not all federally recognized tribes operate casinos. Tribal gaming operations vary, and revenue may support tribal government services, education, healthcare, housing, and community development.

Paying taxes

Myth: Native Americans do not pay taxes.

Fact: AI/AN individuals generally pay federal income taxes and may be subject to state and local taxes depending on the circumstances. Certain tribal income and transactions may receive specific tax treatment under federal or tribal law.

Per capita payments

Myth: Every Native American receives regular payments from the government or casinos.

Fact: Not every tribe distributes per capita payments, and not every tribal citizen receives them. Payments depend on individual tribal policies, available revenue, and eligibility rules.

be able to list 2 of the contributions AI/AN people have made to modern society.

Agriculture and food cultivation

Indigenous peoples of the Americas developed and cultivated crops such as corn, potatoes, tomatoes, beans, and squash. These crops became important foods throughout the world.

Medical knowledge

Indigenous communities developed extensive knowledge of medicinal plants and healing practices. This knowledge has contributed to modern understandings of plant-based medicines and healthcare.

Fill in the blank: “Traditional foodways entail a ___________relationship that must be actively maintained.”

When hunting and gathering foods, how did AI/AN people maintain this relationship?

Reciprocal

They thanked the spirit of the food, took only what they needed, avoided overhunting or overgathering, used as much of the food as possible, and returned what they couldn't use to the Earth.

Fill in the blank: “Traditional foodways are based on an _______ and ______connection to the land.”

Intimate / Spiritual

Why is food the conveyer of?

Food is a conveyor of: Emotions and spirit, Unity and respect

Food helps bring people together, build relationships, and express emotions and spirituality.

When hunting and gathering foods, how did AI/AN people honor this connection?

They honored their connection to food through prayer, ceremonies, giving thanks, and respecting the spirits of food and ancestors. Some communities also prepared spirit plates or held feasts to honor those who passed away.

What challenges do AI/AN people face when trying to eat a healthy diet on commodity foods?

Commodity foods may include processed foods that are high in fat and less nutritious than traditional foods. Relying on these foods can make it harder to maintain a healthy diet and may contribute to obesity, diabetes, and heart disease.

What environmental challenges do AI/AN people face when trying to eat healthy?

Many rural and reservation communities have limited grocery stores, expensive healthy foods, unreliable transportation, and low incomes. This makes it difficult to access fresh, nutritious food.

what psycho-social challenges do AI/AN people face when trying to eat healthy?

Some people may not know the health benefits of traditional foods or how to make meals healthier. Traditional foods may also be viewed as “poor people's food,” while nontraditional foods are viewed as “rich people's food.”

In what ways was physical activity an integral part of everyday life?

Traditional physical activity was an important part of everyday life because people regularly participated in hunting, fishing, gathering, farming, transportation, and community activities. These activities helped maintain physical health while also supporting cultural traditions, family responsibilities, and community relationships.

What are the environmental and psychosocial challenges to performing traditional physical activity today?

• Reduced access to traditional lands.

• Urbanization and changes in land use.

• Environmental pollution.

• Climate changes affecting hunting and gathering.

• Limited access to safe outdoor recreation spaces.

• Transportation barriers.

Be able to list 2 of the 10 rules to follow in and out of the pow wow arena?

Rule 1: Ask permission before taking photographs.

Always ask permission before photographing dancers, participants, or ceremonial activities. Some moments or activities may have restrictions on photography.

Rule 2: Respect the dance arena and follow the emcee's instructions.

Do not enter the dance arena unless invited or permitted. Follow announcements and respect when certain activities are restricted to specific participants.

Fill in the blanks: Humor is a quality of perception that enables us to experience _______ even when faced with ______

joy / adversity

What is the role of humor in the pursuit of physical and psychological wellness?

Humor improves physical wellness by reducing stress and promoting health. It supports psychological wellness by helping people cope with difficult emotions, see problems differently, and feel more in control.

What is the role of razzing or teasing in Native humor?

Razzing shows closeness and respect. It helps reduce conflict, handle serious situations with humor, test cultural competence, and keep people humble.

How can you use humor in wellness programs?

Humor can be used in wellness programs through sharing meals, storytelling, and fun cultural activities. It helps people connect and feel comfortable. Teasing should never target family, disabilities, or economic status.

Be able to finish this quote by Ric Gendron: People for the most part aren’t interested in my words, but when I _______, they stop and take notice.”

make marks on paper and canvas

Be able to finish this quote by Shan Goshorn “there’s a ___ balance to my work… I’m working with the intention to ________.

spiritual / educate audiences… to try to heal historical trauma that has produced disease

Be able to finish this quote by Tom Poolaw: “My goal is to create work that reflects the state of today’s Native American individual: 1. _____, 2. ______, and 3. ______.”

complex / modern / spiritual