This morning, my kitchen table is covered in fabric, feathers, and bits of superhero capes. My six grandchildren, ages two to six, will be coming by later to try on the costumes I’m making for our family float in a parade at our annual Crow Creek Sioux Tribal Fair and Pow Wow. This year’s float is a little train made of painted barrels: our “Train to Higher Education.” Each child will ride in a barrel painted in college colors, with the older ones as Spider-Men and Wonder Women, and their moms and aunties walking beside them as Ninja Turtles. It’s playful, but it’s also deeply symbolic for us.
Education is a pathway to opportunity and in our communities, those pathways are often uneven or broken. So, we make our own trains, linking together what we have, to get our children where they need to go.
I think about that same idea when I think about health equity for our Tribal Veterans and Native communities. We don’t need a new system; we need to connect what already exists — our people, our knowledge, our partnerships — to keep the health care train on track.
Health Equity Is About Relatives
In my work, I often say that our people are our greatest resource. Health equity, to me, means equipping our relatives to be helpers, not just doctors and nurses, but supporting the auntie who drives someone to their appointment, the nephew who checks on his uncle’s medication, the person at the front desk who greets a Veteran by name.
In Dakota culture, we have the Hunka ceremony: the Making of Relatives. When you choose someone as your relative, that bond becomes even stronger than blood. That’s how I see health care: we must treat each person we serve as a relative, with the same commitment, love, and responsibility.
When we equip our community members with resources to help support one another, we’re creating a sustainable network of care that is rooted in trust and cultural understanding. Because who better to help than the people we love most?
The Barriers We Face
For many Tribal Nations, health equity is not about the absence of care but about the absence of access. Specialty care can be hours away, transportation is limited or even unavailable, and financial resources are often stretched thin.
Our Veterans, in particular, face a deep distrust of systems designed to assist them. These systems were built to help but not always to listen. Many Native Veterans don’t even know how to access the benefits they’ve earned, or they’ve been discouraged by inconsistent providers, high turnover at local healthcare, and referred to VA for services.
Continuity of care matters — trust takes time, and relationships take consistency.
Building the Train Together
When I think of solutions, I think of partnerships. No one Nation can stand alone. We need to link our cars together: Tribal Nations, the VA, Indian Health Services, community clinics, educators, and organizations like PsychArmor.
Through Native America & Alaska Native Health & Wellness: In Service and Beyond, we are bringing people together who know what it takes to foster these relationships and build culturally responsive systems of care.
Our goal isn’t to replace existing systems — it’s to strengthen the connections between them, to bring whole-person care (physical, mental, spiritual, emotional, and cultural understanding) into balance. When individuals are healthy, Nations are healthy.
Carrying Culture Forward
When I travel, I stop at Native stores to buy fabric for star quilts that are recognized as gifts of honor in our communities. I once made a quilt for a friend whose Veteran father was transitioning into the Star Nation, wrapping him in our love and tradition for his journey and to honor his service to Tribal Nation and Country. .
When I gifted a quilt to a colleague after her doctoral graduation, it was part of a Hunka ceremony, making her a relative by choice. Each stitch is a promise: to honor, to protect, to care. That’s what health equity means to me: a network of care stitched together with intention, trust, and relationship.
The Train to Wellness
As I finish sewing the last of the superhero emblems on my grandchildren’s costumes, I think again about that little train we’ll pull in the parade. Each barrel, each child, represents a link in our journey — our culture, education, health, family, spirit, hope.
That’s the same way I see our work in Tribal health equity. Each partnership, each provider, each community member is a link in the train that keeps us moving forward.
If we all pull together in service, in relationship, and in good heart, we can keep that train on track, carrying our people toward healing, balance, and wellness.
About the Author
Dr. Melita “Chepa” Rank, a member of the Hunkpati Dakota Tribe, is a social worker, educator, and Mental Health First Aid national trainer dedicated to advancing holistic wellness within Tribal and Indigenous communities. Her work focuses on integrated systems of care, suicide prevention, and building community-based pathways to wellness.