Resilience, Family, and Community Support Among Native American Women in the Gulf South in Accessing Healthcare

Background and Purpose: Native American (NA) women continue to experience extensive health disparities compared to both the general U.S. population and NA men. Despite these disparities, NA women are highly resilient, and value holistic individual and community health. Although resilience, here conceptualized as an individual’s, family’s, or community’s capacity to recover or bounce back following hardship or adversity, is increasingly being studied in a variety of settings, it is still infrequently used to understand healthcare experiences. NA women’s health research tends to use a deficit-framework and resilience-focused and community-based research is rare. The purpose of the study was to provide insight into the healthcare experiences of NA women.

Methods: A qualitative descriptive research methodology with “hues” of an ethnographic life-history approach was used and which is culturally congruent with conducting research with NA groups. The PI for this project worked with a community advisory board (CAB) made up of tribal members to ensure the project was culturally appropriate and to explore how to make the end product of the research beneficial for the health of the tribal community. Data were collected through qualitative semi-structured life-history interviews with female tribal members. The sample included 31 NA women from the Gulf Coast region of the United States. Interviews were conducted from October 2018 to February 2019. Interviews took place in interviewee homes and at tribal community centers. Women were recruited through the use of fliers, word-of-mouth and snow-ball sampling. Interviews were recorded and took between 1-1.5 hours and were then transcribed verbatim and analyzed with NVivo software.

Results: Results indicate that all women identified several forms of support and reported that family and their community was a consistent resource for them throughout their lives, particularly during pregnancy and childbirth. Forms of community support included (a) tribal members as healers and (b) community support with medical of health issues. Forms of family support included: (a) support with medical or health issues; (b) preference for taking care of ill family members; (c) support during pregnancy and childbirth; and (d) family members as advocates.

Conclusions and Implications: This research is unique in using a resilience and strengths-based approach to exploring the health experiences of NA women. Results indicate that tribal members value health, are highly resilient, and are supportive of each other throughout a variety of healthcare experiences. For women, support throughout their pregnancies and child-rearing is especially crucial. Results also suggest that tribal members may often take on roles to address existing gaps in healthcare services. The findings from this study have important implications for the type of training those working in healthcare receive to be more sensitive to the needs of NA women and suggest that NA women may need unique support when accessing healthcare. Incorporating family and community relationships into healthcare may lead to better outcomes.