American Indian Health in North Carolina

Blog | November 12, 2021



Too often, discourse about American Indians discusses members of these communities as if they are people of history alone. While history is foundationally important to many Native cultures, and we owe much to the history of the tribes and communities of the land on which we live today, Native American people currently make up approximately 2% of the U.S. population. North Carolina is home to more American Indians than any state in the Eastern United States. And people of Native American descent are disparately affected by adverse social determinants of health such as poverty, limited formal education, limited access to care, and disability.


The latest issue of the North Carolina Medical Journal focuses on the health of American Indians in North Carolina, highlighting the importance of proper classification and data gathering, health disparities, individual and community resilience, and the importance of cultural understanding. Guest edited by Ronny Bell, PhD (Lumbee), this issue includes harrowing data and stories of hardship, as well as policy recommendations for improving the health and well-being of American Indian people and communities. As the pages of this issue show, much more work – by non-Native people – needs to be done to reach equity.


Click the links below to read each article in the issue.


Access the full issue here.




Listening to the Stories of a Storied People by Editor in Chief Peter J. Morris, MD, MPH, MDiv


Issue Brief


The Health of American Indians in North Carolina: Honoring the Past, Looking to the Future by Ronny A. Bell, PhD, professor in the Department of Social Sciences and Health Policy at Wake Forest School of Medicine and director of the Office of Cancer Health Equity at the Comprehensive Cancer Center of Atrium Health.


Commentaries & Sidebars


Native Pathways to Health: A Culturally Grounded and Asset-based CBPR Project Exploring the Health of North Carolina’s American Indian Communities by Megan B. Irby, PhD, Parissa J. Ballard, PhD, Charlene Hunt (Lumbee), Sarah Langdon, MPH, and Ronny A. Bell, PhD (Lumbee), of Wake Forest School of Medicine; Tony Locklear, MS (Lumbee) of UNC-Greensboro; Vivette Jeffries-Logan, MS (Occaneechi Band of the Saponi Nation) of Biwa Consulting; and Teryn Brewington (Sappony) of the American Indian Center at UNC-Chapel Hill.


Sidebar: Impact of Racial Misclassification of Health Data on American Indians in North Carolina by Gregory A. Richardson (Haliwa-Saponi), executive director of the North Carolina Commission of Indian Affairs.


Sidebar: History Shaping the Future: How History Influences Health in North Carolina Native American Communities by Linwood Watson, MD, ABFM (Haliwa-Saponi), family medicine physician at UNC/Rex Urgent Care in Knightdale.


COVID-19 Testing and Barriers to Vaccine Hesitancy in the Lumbee Tribe of North Carolina by Tracie Locklear, PhD (Lumbee, Coharie), William F. Pilkington, DPA, MPA, MA, Undi Hoffler, PhD, Victoria Billings, Tianduo Zhang, PhD, Laurin Brown, MPH, Deepak Kumar, PhD, and Irene Doherty, PhD, MPH of NCCU; Xinyan Shi, PhD, Mary Ann Jacobs, PhD (Lumbee), Alice Kay Locklear, PhD, Zhixin (Richard) Kang, PhD, SiAhn Mehng, PhD, and Mary Beth Locklear, MPA (Lumbee), of UNC-Pembroke; and Patrick Strickland, Tammy Maynor, and Tasha Oxendine of the Lumbee Tribe of North Carolina.


Adverse Childhood Experiences and Resilience in Native American Families and Communities by Miranda Freeman, MS, of the Brody School of Medicine at ECU and Alice Ammerman, DrPH, of the Gillings School of Global Public Health and the Center for Health Promotion and Disease Prevention at UNC-Chapel Hill.


Sidebar: Community-driven Approaches to Preventing Overdoses Among American Indians by Mary E. Cox, MPH, Margaret A. Smith, MPH, Amy R. Patel, MPH, and Scott Proescholdbell, MPH, of NCDHHS and Ronny A. Bell, PhD (Lumbee) of Wake Forest.


Native Health: Making Important Connections to History, Language, and the Land by Lisa J. Lefler, PhD, director of Culturally Based Native Health Programs at Western Carolina University.


Ain’t No Sunshine When She’s Gone: Missing and Murdered Indigenous Women and Girls in North Carolina by Brittany Hunt, PhD (Lumbee), director of Indigenous Ed, LLC, and host of the Red Justice Project podcast.


The Care of American Indian Children in North Carolina: Protecting Our Future and Our Heritage by pediatrician Joseph T. Bell (Lumbee)


Cultural Competence with American Indian Clients: Workforce and Personal Development by Cherry Beasley, PhD, MS, RN, FAAN (Lumbee); Jennifer Jones-Locklear, PhD, MSN/ED, RN (Lumbee); and Mary Ann Jacobs, PhD, MSW, MEd (Lumbee), of UNC-Pembroke.


Policy Review


In this new journal feature, we review current policy and proposed legislation related to the health of American Indians in North Carolina and nationally, from federal recognition of the Lumbee Tribe to a new office focused on missing and murdered indigenous persons.




Tar Heel Footprints in Health Care: Dr. Jim Jones, the “godfather of family medicine” in North Carolina.