Indigenous healthy homes and healthy communities: A community-led initiative to improve health and support Indigenous Resilience in the US Southwest

ABSTRACT Residents of sovereign, Indigenous Nations intrinsically hold deep connections to their land, culture, and community, which positively affects Indigenous health and well-being. However, Indigenous health is diminished by multi-level structural factors that manifest in numerous ways including indoor environmental exposures; persistent fall injury hazards in the home needing repair/modification; and limited access to culturally competent medical specialists. A team led by the federally-designated Albuquerque Area Southwest Tribal Epidemiology Center (AASTEC), in partnership with the University of New Mexico and University of Arizona, proposes a multi-part intervention to enhance the home environment and Indigenous health. This novel program will incorporate community-based participatory research principles with an approach that centers Indigenous methodologies to promote Indigenous health across the societal, community, household and individual levels. A housing repair voucher program (primary intervention) will be informed by home and participant assessments, and partnered with clinical training and referral protocol development, tribal public health workforce development and capacity- building, and a multi-sectoral Healthy Tribal Homes Coalition. Creating an adaptable framework that centers upon community values to address simultaneously environmental exposures, fall injury risk, daily stressors, and respiratory health (emphasizing asthma) will increase quality of life for participants, their families, and community. This project will yield a template and set of best practices that other Indigenous and non-Indigenous communities may adapt to address their health priorities in a manner centered upon their values and identity.