Yale News

On April 8, STEM and Health Equity Advocates at Yale, or SHEA, invited Patricia Nez Henderson SPH ’94 MED ’00 to discuss diverse perspectives on tobacco cessation intervention for Native American populations.

Henderson, president-elect of the Society for Research on Nicotine and Tobacco, detailed the challenges she faced as the first Indigenous woman to graduate from the Yale School of Medicine and discussed her research on tobacco cessation intervention in Indigenous communities. As the Vice President of the Black Hills Center for American Indian Health, Henderson said her commercial tobacco research aims to incorporate tribal values and customs into effective intervention strategies for tobacco cessation in Indigenous populations. Tobacco use in these groups is especially elevated due to the history of colonization, according to Henderson.

“When you say tobacco, let’s make sure we make that distinction between ceremonial versus commercial tobacco products,” Henderson said. “The issue now is to decolonize tobacco. The word tobacco is an Indigenous word, and the Spaniards in the 1500s took that and ran with it, and all of the tobacco industries now stole the plant and use it to benefit them. They destroyed so many Indigenous communities and I want for people to know that history, that the tobacco industry is a racist organization.”

According to Henderson, there is a prevalence of smoking-related diseases caused by commercial tobacco in Indigenous communities, and understanding commercial tobacco’s role in these communities stems from colonization.

The history of tobacco usage in America is based in Native American exclusion, Henderson said. A federal government policy passed in the 1800s banned all ceremonies and plant medicines used by American Indians and Alaska Native communities, which forced Indigenous people to use commercial tobacco for ceremonies rather than the native plant they had been using for centuries, according to Henderson.

According to Emma Rutan ’21+1, a member of SHEA who moderated the talk and works under Henderson’s mentorship at the Black Hills Center, this distinction between ceremonial and commercial tobacco should be at the center of future conversations about tobacco cessation.

“Because there wasn’t a lot of education around the topic, many people thought that commercial tobacco, which is full of cancer-causing agents, could be a replacement for Ċanśaśa [sacred tobacco] when it was federally banned along with many other ceremonial practices,” Rutan said. “One of Patricia’s goals in her work is to educate her Indigenous peers on this distinction, and also educate people in tobacco research on being careful in talking about tobacco and understanding its history in indigenous communities.”

Henderson grew up on a Navajo reservation in Arizona. During her time as an undergraduate at the University of Arizona, Henderson received a document from the federal government that forced her to relinquish her ties to the Navajo nation and move off of the land. As someone whose cultural values revolve heavily around her ancestral land, she felt as though signing those documents “severed [her] head from [her] heart.” Prior to this, about ten thousand Navajo people had been forcibly relocated from their ancestral lands due to coal disputes, according to Henderson.

As the only Native person in her healthcare classes at the Yale School of Medicine and the Yale School of Public Health, Henderson said she was forced to reckon with her own trauma from her family’s forced relocation alone. She opened up to the audience of the SHEA talk about her struggles with mental health during medical school, and the importance of creating spaces in which mental health can be destigmatized.

“I got my MPH and MD degrees all while trying to process what had just happened,” Henderson said. “As a Navajo woman, the land is so important. It grounds you spiritually, and I just didn’t have that. No one knew at the School of Medicine what I was going through. I don’t think anyone understands what it’s like to be forcefully removed from lands that you’re so tied to. In the Navajo culture, we believe that home is where your umbilical cord is buried. And so, to be severed from that, and in a place with no other Indigenous people, it was very challenging. It wasn’t until after I graduated that I began to address those issues.”

It took Henderson a long time to figure out how to heal from her trauma, she said. One faculty mentor that Henderson felt comfortable talking to about her predicament was the financial aid director of the School of Medicine. Still, Henderson said that most faculty members she interacted with at YSM did not provide resources or spaces where Henderson felt like she could be vulnerable and open up about her trauma.

In fact, Henderson recounted her experiences of racism while at the School of Medicine. She recounted a time when a “renowned” faculty member had called her aside and told her “there was something about the way she spoke that would throw people off,” and that she should let the Chief Resident know that English was not her first language — Henderson’s first language was Navajo. She was confused as to why other international students were not told this.

Henderson spoke of another incident which caused her to almost quit medical school, when a faculty member suggested she should probably transfer to a school that caters more to Indigenous students, she explained. Immediately following this exchange, Henderson went to see one of her mentors at the American Indians in Science and Engineering Society, an organization Henderson had been a part of since its creation.

“One of my mentors, Wilma Mankiller, who was the chief of the Cherokee Nation was there with Gloria Steinen, and they were there for a book signing,” Henderson said. “[Mankiller said,] ‘You need to stay at Yale. If you can’t do it for yourself, do it for the next Patricias, the next Indigenous women that are going to be coming through the School of Medicine.’”

Henderson successfully finished her medical school training several years later. But by her second year, she had realized that she was not as inclined to becoming a physician as she had previously thought. She realized that she much preferred her health policy and management coursework.

After medical school, Henderson participated in a two-year postdoctoral program — the Native Elder Research Center at the University of Colorado Denver —  in which Indigenous students are trained by Indigenous mentors in health policy research. This was the first time Henderson was mentored and taught by Indigenous people, and she said it made her feel grounded. After this program, Henderson considered researching the high rates of smoking in Indigenous communities.

Attendee Annie Nields ’21 appreciated Henderson’s perspectives on holistic approaches to tobacco cessation.

“I think her assertion that the mind, body and spirit are interconnected, and that you can’t disentangle the connections between them, is so powerful and particularly impactful in the fields of healthcare and medicine,” Nields, who is a former editor for the News, said. “She radiates love and care for her mentees and clearly approaches all of her research questions from a place of deep compassion.”

Henderson lives with her husband from the Lakota tribe and her two children in the Black Hills of South Dakota.

Anjali Mangla | anjali.mangla@yale.edu

Anjali Mangla is a Science & Technology Editor for the News. She previously covered the intersection of STEM and social justice. Anjali is a sophomore in Ezra Stiles College planning to study Neuroscience, Global Affairs and Global Health Studies.