A Multi-Sited Ethnographic Study in Alaska: Examining the Culture-Communication Nexus Salient to Alaska Native Elders and Conventional Health and Social Services.

Abstract

Purpose. Research shows severe health and social disparities among particular groups in the United States. Foremost among these are indigenous American Indian and Alaska Native (AI/AN) peoples. These disparities are typically addressed through conventional health and social service organizations in Native North America. Because communication is the vehicle through which services are delivered, this study investigates the culture-communication nexus among Alaska Native peoples, particularly older adults, and Alaska’s conventional community-based health and social service organizations. It aims to improve the well being of this population by identifying culture-communication hindrances and solutions in service delivery. Methodology. This multi-sited, qualitative study in Alaska resulted from 12 non-consecutive months of ethnographic fieldwork. It integrates a human rights framework, ecosystems theory, and a dialogic perspective of language-culture connections in an interdisciplinary theoretical lens. Data were collected from interviews, field notes, and documents. Among data collected were 22 formal interviews with Alaska Native Elders followed by member-checking and docements from community-based public activities and sites. Data collection took place in urban, rural hub, and remote village sites and at micro-(individual), mezzo-(community), and macro-(social, legislative policy) levels. This study incorporates older adult participatory action, community engaged, and relational research principles with Alaska Native Elders. Qualitative methods and software (ATLAS.ti) were used to analyze data. Findings. Findings indicate a cultural disjuncture between the rhetoric of care associated with Alaska’s conventional care organizations and service-delivery practices for Alaska Native peoples, particularly older adults. This cultural disjuncture results from rhetorical ruptures—gaps or discontinuities between an organizational rhetoric of care and Alaska Native ideologies of culture and language. This cultural disjuncture is evident across multiple levels in service domains of the greeting, interpersonal practice, and the model of care. Consequently, I assert these organizations exacerbate intercultural anxieties. Implications. Findings suggest collective accountability and responsibility are necessary to address intercultural anxieties and achieve health equity among Alaska Native peoples. Recommendations include developing welcoming, comforting, and personalizing services within a paradigm of intercultural care. This paradigm connects AI/AN colonial histories to contemporary healing, cultural ideologies to communication codes, and rhetorical ruptures to violations of indigenous human rights. Recommendations emphasize solidarity strategies.