Table 1.

Disease etiology, barriers to treatment, and social determinants of health themes.

Theme	Example
Disease etiology
Postcolonial distress	“There's a brutal side to this too…but I think her [non-Native] husband used to get mean to her when I wasn't there. Because sometimes I’d see bruises on her arms and stuff. They did find out later on after I wasn't caring for her anymore, they moved her out of there. So, I don't know I think he would get frustrated with her and hit her sometimes.”
Substance misuse	“I personally know people who’ve taken drugs and caused memory problems to their brain and stuff. They remember some things, but you can tell. You can see it's affected them…like is eventually dementia.”
Barriers to treatment
Distrust of Western medicine	“A lot of these kids that grew up in the villages, they went deaf because of that because they’d get these really bad ear infections, and nobody ever did anything about it and didn't know how. I think a lot of the Native people from the villages are deaf and it's because of those reasons.”
Structural inequities	“I don't think he's a person that went to the doctor unless he was really, really sick ‘cause in the [village] your teeth got rotten. There was no dentist or nothin’…The parents, whoever, just pulled your teeth.”
Social determinants of health
Walking in two worlds	“Well, stay away from drinking, stay away from drugs, stay away from smoking, try to eat things that are better for you, but again, these are newer things that they didn't know back in the olden days.”
Decolonizing and indigenizing medicine	“You want justice and for you and your people and it hasn't come about yet. But all the word I read says it's going to be coming and I’m not supposed to give up.”