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.