“It’s all about you, yet it’s not about you at all.” This is a saying that resonates with Brandi Reano. “I like this saying because it reminds me of where my place is as a public health professional and how to balance my individuality with being a community member,” said Reano, who graduated with a master of public health degree in fall 2023 from the University of Washington School of Public Health’s Department of Health Systems and Population Health.
As a Navajo and Pueblo woman, Reano grew up learning the cultures and traditions of her community and is passionate about working with other Indigenous communities on strength-based approaches to mental health and wellness. In this Q&A, Reano describes why she was drawn to public health, her thoughts on how to improve health equity among Indigenous communities, and advice for public health students entering the workforce.
Tell us the story of what first drew you to public health.
Growing up with parents who struggled with substance abuse, I’ve always been deeply curious about the influences that guide decision making. I wanted to understand how the beauty I saw in my parents could be overshadowed by their inability to stop drinking alcohol. As a young person I sought out opportunities that would give me insight; I joined peer mediating groups, became a natural helper, and took on leadership positions. I enjoyed helping others resolve their issues and make healthy decisions.
By the time I went to college, I was keenly aware of my interests in mental health. I pursued a psychology major at first but graduated with my degree in neuroscience thinking that I wanted to be a doctor. Before heading to medical school, I joined Teach For America. It wasn’t until I started teaching in a small Navajo community that I realized what I was truly searching for and where my path in health care was.
My students were smart, compassionate, creative and resilient individuals, but I couldn’t ignore how challenges outside of school affected their mental health. Despite having a counselor, it was clear the students needed more than our school could provide. As teachers, we were left to pick up the pieces of a broken system and be stand-in counselors on top of our responsibilities as educators. While caring for my students, I realized my pursuits of understanding human thought and behavior were inherently tied to the failed health care systems of Native people. I applied to graduate school wanting to address such inequities and it’s what motivates me to pursue a public health career with a focus on mental health care access.
Why did you decide to come to the UW for graduate school?
I came to the UW because it was a place where I could envision myself growing personally and professionally as an Indigenous public health professional. SPH’s interdisciplinary curriculum, experiential learning approach, and commitment to becoming an anti-racist school were all key factors that influenced my decision to come here. I was also excited at the opportunity for mentorship from some of the leading researchers in Indigenous health who are a part of the UW faculty. Likewise, I was eager to tap into the ample amount of Indigenous health resources that surround the UW, such as various Indigenous health organizations and urban Indian organizations. The natural beauty and vibrant life within and around the city were also very appealing.
Tell us about your experiences while at UW SPH.
For my capstone project, I worked with the Urban Indian Health Institute on revealing protective factors related to substance use for urban Indigenous youth living in King County. I chose to focus on protective factors to answer the call within Indigenous communities for a strength-based approach to mental health and wellness that aligns with traditional views of healing and wellness. My project was part of a larger project known as the Urban Indian Underage Usage Prevention Project. The aim of that project is to build capacity for the implementation of culturally competent, data-informed strategies to prevent underage use of alcohol and legalized marijuana among Native youth in the Seattle/King County area. I hope that the data I gathered will be used to build out an effective and impactful program that uses a strength-based approach towards underage usage prevention.
In your opinion, how do we improve health equity as it relates to Indigenous health?
As a Navajo and Pueblo woman who grew up learning our cultures and traditions, I believe the answer to improving health equity for Indigenous health lies within our own knowledge systems. Many approaches to improving Indigenous health have been based in western epistemologies that often reiterate institutional and structural barriers and perpetuate present-day health inequities. I think when such approaches are reclaimed and grounded in Indigenous cultural and traditional knowledge, health equity can improve for Indigenous health. That said, there is a lot of strength and value in western science, and when combined with the strengths of Indigenous culture and knowledge, I believe great strides can be made towards health equity. Some of this work is already being done at the UW, such as the Indigenous Evaluation Toolkit that was shared earlier this year by Seven Directions, a center for Indigenous public health.
What are the challenges in supporting and advocating for Indigenous health? Are they the same or different in an urban vs. rural setting?
I think one of the biggest challenges in supporting and advocating for Indigenous health is the lack of involvement, collaboration and empowerment of Indigenous communities and leadership within mainstream health systems and services. Early federal policies and practices concerning Indigenous populations introduced great social and health inequities that resulted in a lack of trust between Indigenous communities and such systems and services. Building that trust back requires upholding Indigenous self-determination over how these systems and services operate within Indigenous communities. Such an act compels those in positions of power to share that power by involving, collaborating and empowering Indigenous communities and leaders in creating and implementing policies that concern Indigenous health. This challenge persists in both urban and rural settings and addressing it requires building capacity and the necessary political structures that involve both urban and rural Indigenous communities and leaders.
What is your advice for public health students entering the workforce as they become our future public health leaders?
As I enter the workforce now, I would say to show up authentically. There’s this saying my previous supervisor shared with me as we approached our work as evaluators at an urban Indian organization: “It’s all about you, yet it’s not about you at all.” The first part of that saying is harping on how being reflexive and understanding where we come from is incredibly important for how we approach our work, from the frameworks we use to the indicators we choose. The second part of that saying describes how the work we do is absolutely for the communities we serve, and their values and input are equally important to incorporate into the work. I like this saying because it reminds me of where my place is as a public health professional and how to balance my individuality with being a community member.