For Derek Jennings, Quapaw and Sac and Fox, improving health equity among Indigenous people starts by building strong relationships with their communities. Jennings, an assistant professor in health systems and population health, is the University of Washington School of Public Health’s inaugural associate dean for Indigenous affairs and engagement. This position reflects SPH’s recommitment to authentic engagement with Tribal communities, introducing Indigenous ways of knowing into work within the School to create a more supportive and robust community for Native faculty, staff and students in the health sciences at the UW. Jennings envisions his new role as helping to build these meaningful connections and create space for Indigenous thoughts, ideas and people within our institutions.
UW SPH sat down with Jennings to learn more about his thoughts on how to improve Indigenous health equity, what he hopes to accomplish in his new role, and the importance of including Indigenous health in research and training for our future public health work force.
What drew you to the field of public health?
My dad worked for various tribal entities, so I grew up spending time with different Native communities across the United States. Some of the social ills I saw made me realize these aren't things we’re born with; they are a product of our history and colonization. The interaction with the Western world created many, if not all, of these social ills that exist in Native communities.
I watched how people with certain health conditions in my family operated and wondered, “What does that mean?” Later in life, I realized they were possibly induced by certain behaviors. I saw some substance abuse growing up, and wanted to figure out what the causes were, how could I get a family member to stop abusing alcohol. I knew these were good people, smart people, but they had health issues that consumed their lives. I wanted to solve those kinds of problems that were always there, but I was also proud of where I came from, the people I knew and how they survived various tragedies in their lives.
I saw the strengths and resilience of my family too; the resilience of my grandparents going to boarding schools, and what they were able to do, and I just wanted to make my family healthier and better for my children.
In college, I started out as a biology major, then I wanted to become a sociology and film major. My academic career began in health education, but I was also a freelance photographer. I ended up photographing promotional posters for health entities, national campaigns for American Diabetes, Native Nurses Association and other health conferences.
I later learned about image-based research and photo voice methodologies and incorporated them into my research interests. Photo voice is like storytelling and a way to engage communities in the research process and is a natural extension to having those kinds of conversations with communities.
What do you hope to accomplish in your new role as associate dean for Indigenous affairs and engagement?
I believe that Washington is at the cusp of being the leader in Indigenous health. There's a lot of good work happening across the United States, but because of the Washington, Wyoming, Alaska, Montana and Idaho (WWAMI) region and the tribes in our state, I think we are in a perfect situation to solidify our commitment to Native communities and build something that's sustainable and beneficial for this region.
My initial goals are to build relationships with Indigenous communities — particularly those in our region — and to create space for Indigenous thoughts, ideas and people within our institution. It’s important to realize that tribes across our region, their strengths, and their challenges are not monolithic and that building strong relationships requires time and commitment.
Hopefully down the line we can do some cluster hiring of more Native faculty and establish an Indigenous public health program for students to get a master’s in Indigenous and rural public health. The possibility of an online program where people can stay in their communities and get their MPH while working with their tribal community intrigues me. Ultimately, I would love to see us work across the health sciences at the UW to develop and launch a school of Indigenous health.
I'd also like to reach the point where tribal communities see the University of Washington as their university. Ideally, tribal communities would come knocking on our door saying, “Hey, we have this problem that we'd like you to help us solve” instead of the more common situation where researchers are knocking on their door saying, “I'm applying for this grant and I'd like to do research in your community.”
What does the landscape for Indigenous communities look like when it comes to health equity?
It depends on the community, and some struggle more than others. If you look at tribes on the Washington coast, they tend to have access to wealthier tribes, and they even have a little more access to the university. But when you start moving towards eastern Washington, things look different.
With each community it’s important to understand what is and is not working, what their treaties look like, their tribal history and how it has affected their health outcomes. If they were removed from land, or if they were recently federally recognized, there’s all these factors to consider.
It’s the same concept across the United States, thinking of colonization, how it moved from the east coast to the west coast, how that interaction happened and affected health equity. How did disease affect the communities? Was it forced relocation? Were they moved to a reservation? These non-Native constructs were made up, and then Native people had to figure out how to operate within them.
Then you start thinking about food. How was the relationship to the land disrupted? Was it a disruption of food or relocation? How do you live in a new area? The USDA commodities were introduced to try to keep Native people on reservations. At one point, reservations were like internment camps. In some reservations and communities, you had to get permission to leave.
There are so many factors that affect health equity for Native communities: policy, geography, epidemiology and disease transmission, and access to healthy foods (how far away are you from a grocery store, the kind of foods you have access to and can afford).
When you get into more rural areas, those things are exacerbated because of location. I think you have to take into account the context of a community’s location and that the community may not even be a stagnant one. For instance, communities are much more fluid today and may travel back and forth between Seattle and a reservation. Recognizing all these factors and how they can negatively and positively influence these communities is crucial.
Why is it important to include Indigenous health in research and training our future public health work force?
As public health professionals, it’s important to learn different approaches when working with not just Native communities, but all communities. We must acknowledge where information is coming from: this is community knowledge, the University doesn't own this knowledge, but it can be shared.
Approaches like community-based participatory research are the gold standard for working with Native communities right now, and I think those approaches are good for all communities. To be able to go into the community and say, “Hey, you're the experts, let's work together.”
Turning this notion of Native people being “forced included” inside-out is a very meaningful process to understand with these activities. How do you approach a community, especially if you don't know anything about it? How do you act and interact, how do you ask appropriate questions? How do you admit you're wrong if you say something offensive? Unfortunately, we still need to work on these basic types of interactions. These are all important aspects that could help a future workforce who isn’t from those communities to get a degree that teaches them to negotiate within those communities.
In your work with Indigenous communities as a health educator addressing social determinants of health related to food, diet and improving diet, what has been most impactful?
I think the amount of cultural revitalization happening in communities has been the most impactful. For example, people are looking at food sources, food sovereignty movements, and there’s even been an explosion of and publicity around Native chefs who are doing innovative things with Indigenous foods. This is helping to show communities what is and isn’t a Native food, and what the cultural practices are around gathering and eating these foods.
In most Native teachings, there is a respect for food because whether it's an animal or plant, we acknowledge that it's a living thing. Reconnecting to that relationship is key to eating healthier, accessing healthier foods and curtailing obesity and diabetes in our communities.
What do you like to do outside of work? Any hobbies or interests outside of public health?
I have four kids – they are 23, 21, 18 and six years old, and we are a very close family. My six-year-old is in first grade, then I have one who just graduated with her MPH from the University of North Carolina and started a post-baccalaureate, one who just graduated from Dartmouth College and will start Stanford Law School, and one who just graduated from high school, and will attend Dartmouth College.
I do a lot of hunting and fishing, so my freezer always has game and things that I've gathered. I love cooking and cookbooks, and I do the majority of the cooking and grocery shopping in my house. I enjoy trying new cooking techniques and taking the game I've made into contemporary dishes. I'm still learning the flora and fauna here in Washington state though.
I also have bird dogs which I train, and they have training titles. For relaxation I go on walks with them, and I run them two or three miles every other day.
My family likes wild game and wild mushrooms; I'm learning more about the plant aspects since I’ve always known more about fishing, but it's just that connection to the natural world, and we really enjoy Washington for this reason. We knew it was an outdoor place, but Seattle has a good balance of city and outdoor life.