Finding the center: Decolonizing tribal health decision-making in an Indigenous community

In a small tribal community, on the border of the United States and Canada, where the Indigenous language is still spoken, a critical ethnographic approach was applied to investigate how tribal health decision-making systems function, and how they might be improved. This study aims to discover how tribal perspectives can be applied to reclaim health decision-making processes, while operating under a tribal governmental structure with limited resources, largely supported by grants and contracts with state and federal governments.

Tribal members having knowledge of tribal health and decision-making participated. Tribally defined concepts of health and decision-making can be applied to restore collective tribal responsibility for acting to improve community health, thus working to decolonize tribal systems, and embody tribal self-determination.