American Indians’ health focus of new group

Edgar Villanueva
Edgar Villanueva

Todd Cohen

WINSTON-SALEM, N.C. — North Carolina is home to an estimated 120,000 American Indians, the largest American Indian population east of the Mississippi River and the sixth-largest in the U.S.

But among the eight American-Indian tribes in the state, only members of the Eastern Band of Cherokee qualify for services provided by the Indian Health Service of the U.S. Public Health Service.

And research shows that, because of lower incomes, lower educational levels and higher unemployment than whites, American Indians experience poorer health and higher death rates than whites from some of the leading causes of death.

Promoting quality health care and healthy lifestyles among American Indians in the state is the focus of the North Carolina American Indian Health Board.

The Board, a new agency, will not provide direct health services but will focus instead on improving the health of American Indians through research, education and advocacy, says Edgar Villanueva, the Board’s new executive director.

“American Indians suffer from cancer, heart disease and unintentional injuries in higher percentages than the rest of the population,” he says, referring to the leading cause of death for American Indians.

American Indians also are far more likely than whites to smoke, not to engage in physical activity, and to be overweight or obese, says Villanueva, former senior program officer in the health-care division of the Kate B. Reynolds Charitable Trust in Winston-Salem.

To provide operating support for the new group and help it hire its first executive director, the Trust awarded a $165,000 grant to the Maya Angelou Center for Health Equity at the Wake Forest School of Medicine. The Center serves as fiscal agent for the Board.

And the Blue Cross Blue Shield of North Carolina Foundation last year awarded a $15,000 grant to help the Board develop a strategic plan.

In the area of education, Villanueva says, the Board wants to create a network among physicians in the state who are American Indians and convene a health summit for American-Indian doctors, nurses and other clinicians.

The summit would focus on understanding how to deliver “culturally-appropriate care” to American Indians, and help those attending become ambassadors to the broader medical community, Villanueva says.

North Carolina is home to at least 50 American-Indian physicians, representing one of the largest population of American-Indian physicians in the U.S., he says.

The Board also aims to serve as a clearinghouse for research, and as an advocate, on issues involving the health of American Indians.

Research will be tracked on its website at, and the Board will push for better collection of data on the health of American Indians in the state.

Data collection is a critical issue, Villanueva says, because it drives funding and research, and because current data reflects a “huge underrepresentation of the true need for health care for American Indians in North Carolina.”

The Board is partnering with the National Indian Health Board and the National Council of Urban Indian Health, two nonprofits that do health-policy work on the federal level, and will disseminate information from those two groups in North Carolina and on its website.

And it is working to promote the representation of American Indians on boards and commissions in the state involved with health care.

Villanueva, for example, has been named to the Governor’s Task Force for Healthy Carolinians, and to a task force of the N.C. Institute for Medicine that is looking into childhood obesity.

The Board also is pushing for passage of federal legislation that would grant full recognition to the Lumbee tribe, including health and other benefits available to federally-recognized tribes.

The Lumbee tribe is the biggest tribe in North Carolina, and Lumbee Indians living in Robeson County account for 45 percent of American Indians living in North Carolina.

“Most American Indians in North Carolina,” says Villanueva, a Lumbee who was born in Cumberland County and raised in Raleigh, “do not receive any service from the Indian Health Service.”

The Board’s 10 members represent tribes from throughout the state.

Villanueva says he will focus on fundraising and hopes over the next year to secure enough funds to support an annual operating budget of $300,000.

He also hopes to add new staff positions that will focus on policy, education and research.

“This board is the result of a lot of planning and effort from leaders around the state,” he says, “and we have great hopes it is going to improve the health of all American Indians in North Carolina.”

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