“A Fierce Advocate”
Native Americans face staggering health inequities. Higher rates of chronic illnesses such as diabetes, heart disease, and cancer. Higher death rates for most illnesses. Average life expectancy of 65.2 years for a Native American in 2021, compared with 76.1 years for the general U.S. population. Meanwhile, Native Americans make up only 0.4 percent of the U.S. physician workforce, and the number of Native students enrolling in medical school has declined during the past four decades.
Dr. Siobhan Wescott, a professor and director of American Indian Health at the University of Nebraska Medical Center (UNMC) College of Public Health, keeps searching for new ways to confront those daunting odds. “If we don’t try to build trusting partnerships between tribal communities and universities, we’re not going to move the needle on any of those dire statistics,” she says. “I also want to help students interested in working in healthcare decide what field might be right for them.”
Wescott recently visited the Winnebago tribe in Nebraska’s rural northeast corner to talk with health officials there about starting a nursing rotation program. It would bring tribal nurses to the University of Nebraska Omaha to improve their skills and send to Winnebago instructors as well as UNO nursing students for field experience. “The pathway for more Native people to be nurses can be difficult. They’re much more likely to stay where they’ve trained,” Wescott says. While it can be hard for rural health centers to attract and retain staff, she says having students rotate through can help. “We go to the tribes to listen and learn what they want. Then we try to figure out how the university might meet that need. It may not seem all that consequential, but you have to start somewhere, and if you’re not trusted, you get nowhere.”
Wescott says UNMC also is partnering with Johns Hopkins and tribal college leaders to create course materials to help Native students identify their own best healthcare career path.
Wescott, who is Alaskan Athabascan, spent part of her childhood in a small hut in Fairbanks. Attending college was not a sure thing for her, though her parents forged an academic path ahead of her. Her father worked as a geophysicist, and her mother was the first Alaska Native woman to earn a Ph.D. and become a full professor. Wescott decided on Dartmouth at a college fair when she spotted the Native American in the College’s logo and Jim Larimore, a Native American recruitment officer, behind the desk. “I was like, they sent an Indian to Fairbanks, Alaska? That’s gotta be a great program.” She majored in government and wrote her thesis on Machiavelli.
After graduation she briefly worked on Capitol Hill, for a South Dakota senator and for the Senate Indian Affairs Committee. But political life turned her off; she felt it brought out people’s worst instincts, just as Machiavelli had described. “I thought, if I stay here, in 15 or 20 years I will be completely burned out and I’ll have no other skills,” she says.
She earned a master’s in public health at UCLA and returned to Alaska to work in the field. But she grew frustrated as a health educator because she didn’t fully understand the science behind what she was supposed to be explaining. She decided to pursue a medical degree, which she earned at Harvard in her mid-30s.
Prior to joining UNMC in 2021, Wescott taught at the University of North Dakota School of Medicine and Health Sciences and its public health department. She also codirected its Indians Into Medicine program with Dr. Nicole Redvers, Med’20, a member of the Deninu K’ue First Nation who calls Wescott “a fierce advocate of Indigenous health.” Together they developed the university’s Ph.D. and master’s of public health programs specializing in Indigenous health.
“When you don’t have those role models growing up, you’re not able to see the possibilities that exist within your community,” says Redvers, now associate professor and director of Indigenous Planetary Health at the University of Western Ontario. “It’s very difficult for students to even imagine going into health professional fields—any field for that matter.”
A person who has Native American heritage on the other side of the desk can help. That rings true for Mackenzie Moody, a member of the Cherokee Nation who last year graduated from Oklahoma State University College of Osteopathic Medicine. Now doing a residency in obstetrics and gynecology, Moody is the first member of her family to work in medicine. “It was a really hard road to get here, trying to find people to shadow, and even as an undergrad, just trying to find people to write recommendations was incredibly challenging,” she says.
Wescott mentored Moody through the American Medical Association Foundation’s Leadership Development Institute, which works to cultivate a diverse group of physician leaders. “To have a mentor who really is passionate about the same issues that I’m passionate about is awesome,” says Moody, who as an Indian Health Service scholar will work with tribes around the country. Though it’s not a formal part of Wescott’s job, she continues to mentor some students she met upwards of 15 years ago. “Sometimes you need that insider who is on your side and available at weird and difficult times,” Wescott says.
She also focuses on using stories to get health information across. “Men are so hard to reach,” she says. In 2023, she produced, helped write, and codirected the documentary Conquering Chronic Disease with Billy Mills to inspire others, particularly Native men, to face their health challenges and take better care of themselves. Mills, an Oglala Lakota from the Pine Ridge reservation and now an advocate for diabetes prevention, stunned the world at the 1964 Tokyo Olympics in a major upset by winning gold in the 10,000-meter race a few weeks after learning he had Type 2 diabetes.
Wescott recently collaborated with the Association of American Medical Colleges (AAMC) and the Association of American Indian Physicians to produce an upcoming special issue of the AAMC’s journal, Academic Medicine, focused on Native health. Her article covers evidence-based ways to work with Native communities. The special edition is significant, she says: The bar to get research on Native issues published in scientific journals is high.
In 2022, STAT News, which covers health, medicine, and science, named Wescott to its STATUS list, citing her efforts “fighting to reverse years of long-standing neglect and promote the healing of American Indians and Alaska Natives.” That same year, the Biden administration signed an executive order that requires all federal policies, including public health policies, to consider Indigenous knowledge as a part of government processes. Despite her alarm at the current administration’s threats to cut funding to tribal colleges and impose steep layoffs at the Indian Health Service, Wescott cites the growing movement to incorporate Indigenous medical practices in Western medicine. One victory came last June when the U.S. Supreme Court ruled that the Indian Health Service had to reimburse tribal nations for their healthcare systems, meaning tribal-run health centers could bring in their own healers. “The Indigenous point of view is far more holistic,” she says.
Whenever she feels burned out, Wescott turns to the ancient art of beadwork to soothe her mind. She also wears a flower in her hair nearly every day to help her stay upbeat. And she thinks of Dr. Susan La Flesche, the first Native American to receive a medical degree, back in 1889, for whom her endowed professorship is named. “She just did not give up on anything,” Wescott says. “She was up against it 20 times worse than what I’m up against, but I’m still up against a lot.” She draws strength from people such as Mackenzie Moody in up-and-coming generations. “I feel like we have survived so much because we’re adaptable, we’re strong, and we figure stuff out,” she says. “So that’s what I keep doing. I’m just going to figure it out.”
Grace Browne is a health and science writer who lives in London.
