Indigenous health: Challenging but rewarding

Path leads Colorado doctor to Native American issues

A “medical anthropologist,” Dr. Spero Manson has worked at the Colorado School of Public Health since 1986. He chose the field because he didn’t do well in calculus in college. Enlarge photo

Courtesy of University of Colorado at Denver/AP

A “medical anthropologist,” Dr. Spero Manson has worked at the Colorado School of Public Health since 1986. He chose the field because he didn’t do well in calculus in college.

AURORA (AP) – Spero Manson never set out to become a medical anthropologist. It was a college calculus class that changed the trajectory of his career.

Manson is a professor of psychiatry and public health at University of Colorado at Denver’s Nighthorse Campbell Native Health Building at the Anschutz Medical Campus. He is also director of the Centers for American Indian and Alaska Native Health at the Colorado School of Public Health. And he originally set his sights on becoming a medical doctor.

But in the late 1960s, during the second quarter of his freshman year at the University of Washington, he found himself bamboozled by calculus.

His academic adviser told him that if he wasn’t able to master calculus, he probably wasn’t cut out for medicine. Shortly after he dropped his pre-med major, he happened to sit in on a lecture by a medical anthropologist who specialized in studying the health of native people in foreign lands. Manson became inspired.

“I realized what I really wanted to do was make my life’s work about understanding how social and cultural factors affect people’s risks of physical health, emotional and psychological problems,” he said.

Since then, his singular career focus was to study medical anthropology. Manson has worked at the Colorado School of Public Health at the University of Colorado since 1986 and specializes in health issues in the Native American and Alaska Native populations. He teaches topics ranging from psychiatric assessment and diagnosis to epidemiology.

Manson was drawn to studying indigenous cultures and health because of his own heritage.

He is an Native American from the Pembina Chippewa tribe. Manson was the second of 67 grandchildren on his father’s side, born in the Turtle Mountain Indian Reservation in North Dakota, where he lived until he was 5 years old.

Manson’s father worked for the Great Northern Railway, causing his family to move 11 times in 12 years. “Every move west from one depot town to the next was a promotion,” Manson said.

Manson graduated from the University of Washington with a bachelor’s degree in anthropology in 1972, then went on to receive a master’s degree in anthropology in 1975 from the University of Minnesota and a doctorate in anthropology in 1980, also from the University of Minnesota.

In the mid-1970s, motivated by advisers he met during school, he decided to travel to Pakistan.

“My advisers, who were very senior and well-respected people, said a real anthropologist needed to go overseas, learn a new language and get outside of my own culture,” he said.

While in Pakistan, Manson learned Urdu and researched medical systems.

That was the beginning of a lifelong commitment to studying health systems in native populations.

During his early studies of Native Americans and Alaska Natives, he found that the most prevalent health issues in those populations were communicable diseases. As the diseases became better controlled over the years through public health measures and vaccinations, the life expectancy of native people began to increase, he said. But as those life expectancy rates increased, so did the chances for obesity and diabetes.

“The challenge now has been to figure out how primary care, which is fairly good in Indian and native communities, can be used to identify individuals at risk for more chronic diseases,” Manson said.

Health problems among Native American are issues that Manson is keenly familiar with, because they are rampant in his own family. About two-thirds of his 66 cousins have suffered from health problems, including diabetes, alcoholism and cardiovascular disease, he said.

Manson also has researched myriad mental-health issues currently facing Native Americans.

“Between 70 and 75 percent of American Indians experience in their lifetimes horrific trauma that is outside of the range of normal human exposure,” Manson said.

Those traumas include car accidents, incidences of domestic violence and mental-health issues as a result of military duty.

Up to 40 percent of males in tribal communities serve in the military, Manson said. Because they are exposed to those types of traumas, Native Americans are at a greater risk for depression, post-traumatic stress disorder, and alcohol and substance abuse problems.

To address the gap in mental-health resources, which are scarce among Native Americans, Manson helped launch a tele-psychiatry project 16 years ago.

Currently, the Centers for American Indian and Alaska Native Health hosts 14 tele-psychiatry clinics in states including Montana, Wyoming, South Dakota and Alaska.

“The opportunity to work with Indian and Native American communities as we do gives me a chance to reinvest the knowledge and experience I’ve had in improving the lives and welfare of my people,” he said.