Season 1 of the Historical Wisdom Podcast has come to an end. In this closing episode, we will hear a recap of previous episodes, important takeaways, useful resources for more learning, and a conversation with family physician Dr. Opsahl on her thoughts about the first season of the Historical Wisdom Podcast. Season 2 of the podcast is in the works and we look forward to sharing it with all of our listeners. 

So, What did you think? is a response to our first episode "Our Voices". Our guests identified their own struggles that were similar to what they heard, identified issues that we were missing, and highlighted parts of the conversation where they thought healthcare providers should really take note.

This episode focuses on providers “shock” when they begin working for Indian health. Healthcare providers often report experiencing a large number of patients with high rates of diabetes, high blood pressure, substance use, depressions and more. Our conversation with epidemiologist Delight Satter, MPH, describes how genocidal policies create a missing cohort of people, that in turn create pro-birth policies. Additionally, Satter discusses the effects of “weathering” the premature aging effects on populations who experience systematic racism and trauma. These unusual distributions in age lead to healthcare needs that the infrastructure was not designed to support. Along with the legacies of policies that were intended to physically and culturally eliminate Native Americans, the consequences of termination policies on the health care infrastructure in inland southern California, and turnover of physicians in the health system among other structural practices have led to a lack of continuity in care and a constant struggle to address high rates of diseases. Notably, Satter also discusses how the tribes in California have consistently taken the lead in addressing their healthcare needs.

This episode shares conversations with community members on how they are experiencing sheltering-in-place and health care during the coronavirus pandemic. 

One of the most important treaties in California history is the Treaty of Temecula. The Treaty of Temecula is one of 18 unratified treaties between the United States and California tribes. In our conversation with Sean Milanovich we learn that due to the Treaty of Temecula, Tribes were left vulnerable to abuse and subjugation at the hands of settlers and the policies of state lawmakers. Displacement of the tribes made it almost impossible to gather traditional foods and medicines, which took a toll on the health of Tribes. The Treaty of Temecula led to an ehtnic cleansing in which the Indian population plunged from approximately 150,000 in 1846 to around 30,000 in 1870. Notably Sean Milanovich connects the songs that open and close our podcast with the relationships with the enviornment.

This episode focuses on the history of boarding schools as a federal policy for eliminating Native knowledge and practices in favor of colonial institutions and life. Central to this policy of cultural genocide was the phrase “kill the Indian and save the man.” Boarding school separated children from their families and tribes/community, culture, language, and land. They were exposed to mental, physical, and sexual abuse, disease, loss of religious beliefs, and knowledge of how to be cared for as a child and thus as a parent. The conversation in this module examines both the hardships of Boarding Schools and the intergenerational trauma, while also recognizing that sometimes the Boarding school experience led to forms of success for some and trauma for others. While a difficult conversation, this module provides an understanding of the institutionalization of family separation and its consequences for health and wellbeing.

This episode focuses on how loss contributes to ongoing health disparities for Native Americans. This conversation examines U.S. Indian Health Policy has contributed to poor health outcomes for Native Americans through the separation of families through termination policies, the removal of Indian children from their homes and communities by Child Protective Services, to the loss of traditional foods systems, and implementation of commodity food programs. Much of this history informs trust relationships with health care providers and institutions that are supposed to provide care. Dr. Trafzer describes these events as well as the supportive ways in which the healthcare system and tribes work collaboratively to improve their well-being. 

This module defines historical trauma and its effects on health outcomes. The conversation defines historical trauma and, based on the work of Eduardo Duran, the interrelated historical periods that create historical trauma. Dr. Laurette McGuire discusses the relationship between diabetes and historical trauma. Julie Andrews from the Native American Resource Center discusses provider patient interactions where providers may feel that the patient is not listening to their advice. Rather, Andrews explains, because of historical trauma patients may not trust the institution or provider. 

This episode features a conversation with RSBCIHI Chief Operating Officer, Bill Thomsen. Mr. Thomsen shares some of the history of how the consortium of the nine tribes was started. Thinking through the history of treaty obligations that were intended to stop the killing of Native Americans, the U.S. government promised to provide health care for the tribes and thus Indian Health Services (IHS) came into existence. Despite this obligation, IHS is persistently underfunded. Nevertheless, RSBCIHI strives to deliver care that attends to both the physical and cultural needs of the Native population. RSBCIHI has a strong relationship with the tribes in the consortium and collaboratively they work together to meet the health needs of the community.