In this promotional trailer, Dr. Célène Gounder reflects on her years working with the Indian Health Service and tribal clinics, describing how long‑standing structural violence, under‑investment, and harmful policies have produced severe health disparities for Indigenous peoples. She highlights the Navajo Nation’s devastating COVID‑19 outbreak, chronic lack of basic infrastructure (water, electricity, broadband), the multigenerational impact of uranium mining, food insecurity, limited access to quality medical care, and the mental‑health toll of centuries of oppression. The conversation also points to broader forces such as Manifest Destiny‑era policies and economic stagnation that continue to undermine Indigenous health. Amid these challenges, speakers emphasize the deep resilience of tribal communities and preview the upcoming Season 4 of “American Diagnosis,” titled “Resilience,” which will explore these histories and the ways Indigenous peoples are reclaiming control over their lands, health, and futures.
Chapters
I'm Dr. Celine Gounder. From 2017 up until the coronavirus pandemic in 2020, I spent time working at Indian Health Service and tribal hospitals and clinics, work that's taken me from the Southwest to the far Northeast of the United States. I bore witness to many of the struggles Indigenous communities face when it comes to health and wellness. These health disparities culminated in one of the deadliest COVID outbreaks in the United States. In the early months of the pandemic, the Navajo Nation had the highest SARS-CoV-2 infection rate per capita in the And what's happening with this crisis is that the lack of funding and lack of resources isn't new.
The coronavirus pandemic is sort of highlighting where the system is broken.
To many living on the reservation, this was not surprising. The health problems that Indigenous Americans face don't exist in a vacuum. They are the result of centuries of structural violence and lack of investment in the most basic of infrastructure.
When you have a nation of 175,000 tribal members without access to water, without access to electricity, without access to broadband. You have to ask yourself, how is this occurring?
In our next season of American Diagnosis, we're going to look at the history that shaped the health of Indigenous communities. Things like the repercussions of toxic uranium mines on Native lands.
We have health reports on newborns being born with trace elements of uranium in their systems. And so this has gone from the miners to their families, and now we're seeing the fourth generation be impacted by uranium.
Struggles to access healthy and culturally appropriate foods.
Simply not having access to sufficient quantities of food and natural resources to be self-sufficient had profound lasting impacts that we are still reeling from today.
A lack of access to quality medical care.
I used to say you can wait in the waiting room so long you'll heal yourself and just walk out.
And how the weight of centuries of oppression is impacting the mental health of communities.
I remember being a teenager and going through my own little mental health crisis and not really knowing where to turn and being afraid to turn anywhere because of the fear of the government, the fear of the system.
Many Americans don't realize how the policies of Manifest Destiny continue to affect Indigenous people and their health today.
All the clinical care in the world isn't going to fix what's wrong with Indian Country. What's wrong with Indian Country is lack of economic development, lack of jobs, lack of the resources to realize your ambitions and hopes and dreams for a future.
In our next season of American Diagnosis, we're going to explore how these policies have shaped the lives and health of Indigenous communities, and what they're doing to regain control over their people, their lands, and their health.
Resiliency is— it's really something built into Indian people. I mean, if you think about it, How long Indians have been on reservations in this country, how long they have been experiencing disparities, policies directed at destruction, and yet tribes are still here.
Hear these stories and more on American Diagnosis Season 4: Resilience, coming January 18th. Subscribe now to American Diagnosis wherever you listen to podcasts.
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