NHS 8002 Assessment 2 Demonstrating Effective Leadership

NHS 8002 Assessment 2 Demonstrating Effective Leadership

Demonstrating Effective Leadership

Effective leadership is crucial in healthcare coalition formation, particularly when tackling complex issues such as reducing health disparities faced by American Indian communities in South Dakota. Leaders play a pivotal role in guiding diverse groups of stakeholders toward a shared mission and fostering an environment of inclusion and collaboration. The purpose of this assessment is to provide insights and actionable strategies for effective leadership in healthcare coalition formation, with a specific focus on applying principles of diversity and inclusion to address health disparities within American Indian communities in South Dakota.

Contributing Factors to Health Disparities for American Indians in South Dakota

American Indians make up nearly 9% of the population in South Dakota, with over 71,000 enrolled tribal members residing in the state (South Dakota Department of Health, 2021). The health disparities faced by American Indians in South Dakota are complex and influenced by a combination of factors (South Dakota Advisory Committee, 2021). The high percentage of American Indians in South Dakota and the associated health disparities can be attributed to various socioeconomic factors. Socioeconomic factors play a crucial role in determining the health outcomes and overall well-being of a population.

Socioeconomic Factors

The poverty rate for American Indians in South Dakota is around 49% (World Population Review, 2023). This is much higher than the poverty rate for White South Dakotans, which is around 13% (Statista, 2023). The poverty rate for American Indians in South Dakota is also the highest in the nation among all states (World Population Review, 2023). Poverty limits access to high-quality housing, nutrition, transportation, and other prerequisites for health (World Population Review, 2023. Knifton and Inglis (2020) show that poverty is linked to higher rates of chronic disease, mental illness, and premature mortality.

Chronic conditions like obesity, diabetes, and cardiovascular disease also disproportionately impact American Indians (Breathett et al., 2020). For example, the obesity rate for American Indian adults is 42%, versus 28% for White adults (Centers for Disease Control and Prevention, 2022). American Indians also have a diabetes prevalence of 18%, which is three times higher than the state average (Centers for Disease Control and Prevention, 2022). These disparities start early, with nearly 30% of American Indian youth classified as obese (Centers for Disease Control and Prevention, 2019). Chronic diseases are interlinked with poverty, food insecurity, lack of recreation opportunities, and other social determinants.

Maternal and Child Health

American Indian mothers and infants experience worse maternal and child health outcomes compared to other groups (Office of Minority Health, n.d.). The infant mortality rate for American Indians is twice the rate for Whites (Office of Minority Health, n.d.). Contributing factors include inadequate prenatal care, substance use, teenage pregnancy, and chronic health issues. Barriers to accessing Medicaid and reproductive health services also disproportionately impact American Indian women in rural tribal areas (Liddell & Doria, 2022).

Healthcare Access

Limited access to care presents major obstacles to addressing health disparities. Nearly 20% of American Indians in South Dakota are uninsured, mostly due to a lack of Medicaid expansion in the state (Harker, 2022). Many live in isolated, rural tribal areas where healthcare facilities are scarce (Harker, 2022). Long distances and lack of transportation options impede access to care (Cochran et al., 2022). Culturally incompetent care and discrimination in health systems also deter healthcare utilization (Hickson, 2022).

Coalition to Address Health Disparities for American Indians in South Dakota

To effectively address the multidimensional health disparities faced by American Indians in South Dakota, an interprofessional coalition would be formed representing diverse stakeholders (Togioka et al., 2023). A coalition with members from different professions, sectors, and communities gets broader input on the problem and potential solutions. This diversity of thought leads to more creative and comprehensive strategies. Each member contributes unique expertise, networks, data, tools, and other assets. Combined, these resources can be leveraged for a bigger impact (Tadele Degu et al., 2023). A coalition breaks down traditional silos between professions, agencies, and systems (Tadele Degu et al., 2023). Working together avoids duplication of efforts and builds synergy in the team.

NHS 8002 Assessment 2 Demonstrating Effective Leadership

The table below outlines the coalition members and their value in achieving the goal of reducing health disparities.

Coalition Team Members


A.H. – Executive Director of the Great Plains Tribal Health Board

Provides leadership, community engagement, and insight into the needs of tribal nations (Ramachandran et al., 2023).

J.S. – Director of South Dakota Department of Health Office of Health Equity

Brings expertise in policy, data collection, and health equity frameworks (Lilly et al., 2023).

R.L. – American Indian liaison from the South Dakota Department of Social Services

Facilitates coordination with social safety programs and services

D.C. and N.S. – Representatives from Indian Health Services clinics

Deliver clinical services and understand access issues (Aleksandra Bendowska & Baum, 2023).

J.R. and T.W. – Community health workers from Pine Ridge Reservation

Engage community members and support culturally competent care (Hickson, 2022).

H.S. and F.L. – Tribal elders

Share cultural wisdom, traditions, and historical perspectives (Hickson, 2022).

J.F. and S.P. – American Indian patients and family members

Give direct input on healthcare experiences and needs (Liddell & Doria, 2022).

Y.C. and T.J. – Academic researchers

Analyze data to identify evidence-based interventions (Asrat Hailu Dagne & Mekonnen Haile Beshah, 2021).

M.A. and R.K. – State legislators

Champion policy changes to address health disparities (Lilly et al., 2023).

Strategies for Optimizing Communication and Collaboration

A review of evidence-based practices by Tennant et al. (2023) indicates several strategies that can optimize collaboration and communication within interprofessional coalitions aiming to address population health concerns. Establishing mutually agreed-upon goals, values, and a common mission early on unites diverse members around a shared purpose (Aleksandra Bendowska & Baum, 2023). Additionally, leadership should promote collaborative problem-solving through frequent meetings focused on equitable participation and rotating facilitation roles, as opposed to top-down decision-making models (Ramachandran et al., 2023). Fostering communication norms of active listening, non-judgmental dialogue, and asking clarifying questions encourages respectful interactions between members with differing (Tennant et al., 2023).

Moreover, developing a joint action plan outlining coordinated interventions based on community priorities and member expertise promotes alignment across the coalition (Thornhill-Miller et al., 2023). Data-sharing agreements can bolster information exchange to identify collective gaps, assets, and progress markers. Ongoing assessment of team dynamics and processes pinpoints areas needing improvement (Klibert et al., 2023). With proactive efforts to nurture shared purpose, open communication, collaborative planning, and continuous learning, coalitions can optimize synergy and impact.

Ethical Considerations for the Coalition

Ethics in healthcare is of paramount importance because it governs the moral and professional conduct of healthcare providers, institutions, and the entire healthcare system (Haddad & Geiger, 2023). The coalition needs to carefully examine relevant ethical issues that may arise in pursuing its goals of reducing health disparities through policy, system, and community-level changes. On an individual level, the coalition must ensure interventions respect the autonomy, dignity, and voices of American Indian community members (Haddad & Geiger, 2023). This includes honoring unique cultural values, traditions, and perspectives during outreach, education, and clinical encounters. Patient privacy must also be protected through careful data-sharing protocols.

Justice and Fairness

Broader decisions around resource allocation, programs, and policies should promote just distribution to those most in need (Haddad & Geiger, 2023). The coalition should apply procedural justice principles by engaging American Indian communities in collaborative decision-making roles, not just as tokens. Policy changes should advance equity and address root determinants like poverty, racism, and trauma (Rachel & Yang, 2022).

Beneficence and Non-maleficence

On a systems level, the coalition is ethically obligated to advocate for policy and care models that maximize benefits and minimize harm for American Indian communities (Rachel & Yang, 2022). This requires questioning current models that perpetuate disparities. Interventions must be rigorously evaluated to ensure effectiveness and avoid unintended consequences (Peng et al., 2022).

Principles of Diversity and Inclusion in Healthcare Coalition Formation

Diversity and inclusion principles are essential when forming a healthcare coalition to address health disparities faced by American Indian communities. These principles ensure that the coalition reflects the diversity of the communities it serves and that it fosters a sense of belonging and equitable participation among its members (Barnabe et al., 2023). Here are some key principles:

Representation and Equity

In order to foster inclusivity and representation, it is imperative for a coalition to encompass individuals from many professions, sectors, groups, and backgrounds (Coleman & Taylor, 2023). It is imperative that representation be inclusive of individuals who are disproportionately impacted by health inequities, including members of the American Indian community. The incorporation of equity as a fundamental principle in the process of decision-making is vital, since it guarantees the inclusion and acknowledgement of all perspectives (Coleman & Taylor, 2023).

Cultural Competency

Coalition members should undergo cultural competency training to understand and respect the cultural values, traditions, and perspectives of American Indian communities. This knowledge helps in tailoring interventions and communication to be culturally sensitive (Owusu‐Ansah et al., 2023).

Community Engagement

Actively involving the affected communities in coalition activities can help in better coordination of care (Coleman & Taylor, 2023). This includes seeking input, feedback, and collaboration from American Indian individuals and organizations. Community engagement ensures that interventions are relevant and aligned with community needs and priorities (Coleman & Taylor, 2023).

Strategies and Best Practices for Achieving Coalition Goals

To apply principles of diversity and inclusion effectively within the healthcare coalition, the following strategies and best practices, supported by credible evidence, can be implemented:

Shared Mission, Leadership and Facilitation

Early in the coalition’s formation, establishing a shared mission and core values that prioritize diversity, equity, and inclusion is important. These principles should guide all coalition activities and decision-making processes (Ashcroft et al., 2023). Moreover, promoting inclusive leadership by rotating facilitation roles during meetings and decision-making processes. This approach ensures that no single group or individual dominates discussions and encourages diverse perspectives (Ashcroft et al., 2023).

Active Listening and Respectful Communication

Promoting communication norms that facilitate active listening, impartial discussion, and the practice of seeking clarification through questioning. Establish an environment that fosters a sense of safety and encourages individuals to freely articulate their perspectives and critically examine underlying assumptions (Thornhill-Miller et al., 2023). According to Tennant et al. (2023), the healthcare coalition can foster an environment characterized by respect and inclusivity through the implementation of strategies such as active listening, non-judgmental discussion, and the use of clarifying questions. The active participation of members is expected to enhance the exchange of distinct perspectives, personal experiences, and apprehensions, so fostering the development of more comprehensive and efficacious approaches to mitigate health inequalities prevalent in American Indian communities situated in South Dakota (Tennant et al., 2023).

Literature Review to Address Healthcare Disparities

Ehrenpreis & Ehrenpreis (2022) provides a historical and legal context of the health challenges faced by Native Americans, such as infectious diseases, chronic conditions, and social determinants of health. This can help raise awareness and advocacy for the needs and rights of this population. The paper also reviews the current impact of COVID-19 on Native Americans, highlighting the disproportionate incidence and mortality rates, as well as the factors that contribute to their vulnerability. This can help identify the gaps and barriers in the prevention and treatment of COVID-19 and inform the development of culturally appropriate and effective interventions.

Another paper by Garcia et al. (2019) can be used to address healthcare disparities within American Indian communities in South Dakota. The paper provides a comprehensive overview of the health systems and challenges faced by this community, especially in urban areas. It can help health professionals and policymakers in South Dakota to understand the historical, legal, and cultural factors that shape the health outcomes and access to care within American Indian communities in their state.

NHS 8002 Assessment 2 Demonstrating Effective Leadership

The literature review and research analysis also offer recommendations and best practices for improving the health and well-being of within American Indian community, such as doing a land acknowledgment, respecting the American Indian’s identity and sovereignty, and developing culturally appropriate and effective interventions. It can help health professionals and policymakers in South Dakota to collaborate within these population communities and organizations to address health disparities and promote health equity (Garcia et al., 2019).

Similarly, research by Elise Trott Jaramillo & Willging (2021) provide evidence of the persistent gaps in health outcomes and access to health care and insurance for American Indians, especially elders, who face higher rates of chronic diseases, dementia, and mortality than other aging populations. Elise Trott Jaramillo & Willging (2021) also highlight the need for long-term provider- and system-level changes that can improve the trust and confidence of American Indian elders in their healthcare and insurance systems, such as reducing provider turnover, increasing transparency and information, and securing their collective right to health care.


In conclusion, effective leadership in healthcare coalition formation involves a combination of strategic planning, ethical considerations, and a commitment to diversity and inclusion. By following these principles and implementing evidence-based strategies, healthcare coalitions can work collaboratively to reduce health disparities and promote health equity in American Indian communities in South Dakota.


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