Closing the empathy gap in health care: Connection First - before "intake".

In this article, a communication framework of Connection First is presented to help close the empathy gap in mainstream health care, including palliative and end-of-life care. Expanding beyond biomedicine, Connection First involves rethinking and restructuring business-as-usual in health care. It shifts the typical transactional process during the initial intake session into one that is transformational. Connection First is a structural intervention and skillset comprised of the following elements: disrupting diagnosis, humanizing history, and repairing ruptures. These elements combine to help close the empathy gap in health care during the initial clinical encounter, before intake, and improve outcomes.

Exposing health inequities: Surreal snapshots from the Grand Canyon to global COVID-19 pandemic.

The story presented here is central to social work because it is about crisis. Across diverse fields of practice, social workers regularly engage in crisis intervention. The story that follows is about crisis in the area of health and healthcare. Specifically, it's about exposing health/care inequities on Indigenous tribal land in the Grand Canyon and in the global COVID-19 pandemic.

Tribal Leadership and Care Services: "Overcoming These Divisions That Keep Us Apart".

American Indian and Alaska Native (AI/AN) Peoples are among groups continuing to experience health disparities. Eliminating health disparities, a national priority in the United States, requires addressing structural forces, also known as structural determinants of health. This case study examines linkages between health disparities, structural forces, and colonial trauma relevant to care services and AN Peoples in Alaska. It centers on an Inupiaq Elder with leadership experience in AN tribal care services. Guided by a conceptual lens based on division-unification processes, this study yields the following findings as represented by five in vivo themes: severing of relationship, aftereffects of colonization, striking alliances, overcoming these divisions that keep people apart, and growing together in relationship. Colonial legacies continue to linger and have a multidimensional impact on AI/AN communities, including tribal care services. Healing from colonial trauma requires collective effort among AI/AN Peoples and people from the wider community. Practice implications emphasize trauma-informed approaches to promote reconciliation and a larger collective commitment to reconciliation in a global reality of increasing interdependence.

Indigenous Elder Insights About Conventional Care Services in Alaska: Culturally Charged Spaces.

Indigenous peoples around the world endure health and social disparities. In the United States, such disparities are typically ameliorated through conventional care services and organizations. PURPOSE: To examine points of tension that characterize culturally pluralistic care services in the United States, specifically Alaska, within context of Indigenous colonial histories. DESIGN AND METHODS: The research design is ethnographic and multisited, comprising 12 months of fieldwork across urban, rural and remote village sites in Alaska. A conceptual lens that accounts for culturally diverse social spaces where relations of power are at stake frames research presented here. This work incorporates relational and participatory action research principles with Alaska Native Elders. Ethnographic evidence was collected through multiple methods, including field notes, documents, and interviews, with ethnographic analysis involving atlas.ti. FINDINGS: Alaska Native Elders describe salient points of tension characterizing Alaska's conventional care services through the following insights: generational curses--a pain, prejudice on both sides-wounded, and value-systems clash-fighting. CONCLUSION: This article concludes with discussion about collective anxieties and implications for care services.

Intersecting discourses on race and sexuality: compounded colonization among LGBTTQ American Indians/Alaska Natives.

This article examines discourses on race and sexuality in scientific literature during the late-nineteenth and early-twentieth centuries in context of U.S. settler colonialism. It uses a theoretical and methodological intersectional perspective to identify rhetorical strategies deployed in discursive representations salient to lesbian, gay, bisexual, transgender, Two-Spirit, and queer American Indians and Alaska Natives. These representations reflect a context of compounded colonization, a historical configuration of co-constituting discourses based on cultural and ideological assumptions that invidiously marked a social group with consequential, continued effects. Hence, language is a vector of power and a critical vehicle in the project of decolonization.