The Navajo struggle with some of the worst health outcomes in the United States. Take just diabetes. Historically, almost no Navajo suffered from it. But now, thanks in part to the scarcity of wholesome groceries available within the Navajo Nation, one in three Navajo are diabetic or pre-diabetic. In some regions, health care workers report diagnosing diabetes in every other patient.

Partners In Health began working in the Navajo Nation in 2009. Under the name Community Outreach and Patient Empowerment, we support the backbone of the health care system: community health workers, known locally as Community Health Representatives.

Roughly 100 Representatives have been consulting patients in their homes since the 1960s, making them one of the most established community health worker programs in the U.S. In collaboration with local partners, we offer monthly and quarterly skill-building trainings, leadership workshops, and materials to use when visiting patients, including iPad presentations designed for people who don’t speak English as a first language.

We are also part of the growing movement to improve health via access to nutritious food. With Harvard University Law School and other experts, we created Good Laws, Good Food: Putting Food Policy to Work in the Navajo Nation. The roughly 100-page document builds on previous studies and provides a clear overview of the complicated laws that govern food in the desert nation straddling state lines. It is available for free to any person or group pushing for change.

With Indian Health Service, country stores, and grocery stores, we also operate the Fruit and Vegetable Prescription Program. Doctors “prescribe” fruits and vegetables to overweight families by giving them certificates for free produce. Small local shops stock fruits and vegetables. And patients use the coupons to “buy” the newly stocked items. Launched in 2015, the program aims to make produce available to three quarters of the population by 2017.