AAMC Reporter: August 2006

Nickens Award Winner Balances Two Worlds

Spero M. Manson Mentors Native American Leaders

Spero M. Manson, Ph.D., founder and director of the American Indian and Alaska Native Programs at University of Colorado at Denver and Health Sciences Center

Reflecting on his status as the 2006 recipient of the AAMC Herbert W. Nickens Award, Spero M. Manson, Ph.D., quoted a traditional Native American saying: "The honor of one is the honor of all."

Indeed, Manson's work reflects the meaning of this time-honored adage. He has spent the past two decades pursing his passion to develop students, residents, physicians, and fellows, with special emphasis on Native American populations. Now, at 56, Manson said he plans to spend the second half of his career training young American Indian and Alaska Native students to nurture subsequent generations of indigenous American physicians and scientists.

"Ultimately, what I've been focusing on now and will continue to emphasize in my career is the preparation of new generations of American Indian and Alaska Native M.D.s and Ph.D.s to carry forward their work as scientists," said Manson, who is trained as a medical anthropologist. "Not as subordinates to other people, but in leadership roles that really begin to contribute substantially to the definition of what the agendas should be for us as we move forward in the identification of the most pressing questions of the day."

Manson's efforts to mentor young Native American scientists and improve the health of American Indian and Alaska Native people are two of the main reasons the award committee chose him over nearly 20 other qualified nominees to receive the seventh annual award, according to Juan Amador, staff associate in the AAMC's Division of Diversity Policy and Programs, and program administrator for the Nickens Award.

"Most of the individuals he has mentored in the past are in medical schools, and they're not only teaching but they're also doing research, and they are certainly becoming the next leaders within the American Indian and Alaska Native communities," Amador said. "In terms of his clinical research, it has helped to improve the health of American Indian and Alaska Native people."

The annual $10,000 AAMC Nickens Award is given to an individual whose work has significantly contributed to promoting equality in U.S. medical education and health care.

Two of Manson's past American Indian students praised his leadership and mentoring of more than 300 trainees in the past 20 years.

"As former mentees, and now peers, we speak with direct knowledge of the extensive commitment — and success — Dr. Manson has had in advancing the health and welfare of our people through his work," wrote Jeffrey A. Henderson, M.D., M.P.H., and Patricia Nez Henderson, M.D., M.P.H., in a letter to the AAMC nominating Manson for the Nickens Award. "Virtually all of us trace our success in part to Dr. Manson's mentorship." In addition to holding assistant-professorship positions at University of Colorado at Denver and Health Sciences Center (UCDHSC) in Aurora, Colo., the Hendersons, who are married, direct the Black Hills Center for American Indian Health in Rapid City, S.D.

Early in his career, Manson founded the American Indian and Alaska Native Programs (AIANP), one of the largest centers in the country devoted to Alaska Native and American Indian health. Part of the psychiatry department at the UCDHSC, AIANP represents Manson's vision of health equality for American Indians and Alaska Natives.

"Our program has really moved to develop a critical mass of junior and senior American Indian and Alaska Native M.D.s and Ph.D.s to provide the kind of support — academically, scientifically, programmatically, and personally — that will enable our younger colleagues to move past barriers and to join the ranks of successful individuals in science and medicine," Manson said.

In 1986, the AIANP launched the National Center for American Indian and Alaska Native Mental Health Research. Supported by the National Institute of Mental Health, the center's scientists study the assessment, treatment, and prevention of mental illness in these populations.

AIANP's accomplishments over the years include a deal by which the Department of Veterans Affairs agreed to reimburse the Navajo Nation between $250 and $750 per person for performing any of 13 specific tribal healing rituals after AIANP proved the rituals helped Native American military personnel recover more quickly from post-traumatic stress disorder.

"I'm very proud of our research because I think it's proven to be very applied and resulted in major benefits to Indian and native people,"Manson said.

Part of this success is due to the AIANP's training programs. For example, the Native Investigator Development Program is a fellowship-training initiative that prepares scientists with advanced degrees, including M.D.s and Ph.D.s., as well as doctorates of social work and education, for faculty positions focused on improving health care among elderly American Indians and Alaska Natives without relocating from their home communities for long periods.

"Basically, what distinguishes our program is that we don't seek to uproot young Indian and native professionals from their home communities or institutions," Manson said. "What that does is rip them out of the social networks that are so supportive of them. It displaces them from the home institutions in which they've already begun to establish a place and a career.

"It has had phenomenal success,"Manson said of the program. "Publishing over 60 or 70 articles now, acquiring tens of millions of dollars in NIH research funding, and more than tripling the number of American Indians and Alaska Natives who are principal investigators on NIH research awards."

In keeping with the theme of fostering community, the AIANP's program development initiatives emphasize local health care. As an example, Manson cites a program called Circles of Care, which, for nearly nine years, has helped American Indian and Alaska Native tribes, tribal consortiums, and urban Indian programs plan and implement culturally appropriate, comprehensive, and continuous mental-health services for children and families.

Today, Manson continues to direct the AIANP, which now comprises nine centers throughout the country, serving 102 American Indian and Alaska Native communities and representing $63 million in funding for research, program development, and training. In addition to overseeing the AIANP, Manson is a UCDHSC psychiatry professor.

Born in Everett, Wash., in 1950, Manson, a Pembina Chippewa American Indian, completed his clinical internship at Oregon Health Sciences University (now known as the University of Oregon Health Sciences Center) in Portland, Ore. He received his Ph.D. in anthropology from the University of Minnesota and holds master's and bachelor of arts degrees in anthropology from the University of Minnesota and the University of Washington, respectively. Manson is married to Dedra S. Buchwald, M.D., and has three children.

The Nighthorse Campbell Native Health Building at at University of Colorado at Denver and Health Sciences Center

The AIANP is located in the Nighthorse Campbell Native Health Building, a three-story, 50,000-squarefoot building, completed in 2002, that blends modern technology with traditional Native American symbols. For example, the building's entrance faces east because greeting the morning sun is a guiding tenet within Native American architecture, Manson said.

The entire facility is based on a circular design, said Manson, who led the committee that oversaw its design and construction. The circle "is a central metaphor in Indian and native communities for life, underscoring our connection with one another," he said.

Recounting the early development of the Nighthorse Building (named for former U.S. Sen. Ben Nighthorse Campbell), Manson said he tried to plan ahead for the time when the campus of the UCDHSC would grow, which proved prescient, as the campus is in the midst of major development.

Growth usually means paving over acres of land. But since humanity's connection to the earth is of fundamental importance to Native American communities, Manson insisted building plans include a round circle of exposed ground in the middle of the council ring. Four native communities from New York, Florida, Alaska, and California each sent 16 ounces of soil, which were then mixed with a sample from Colorado "to keep us connected with Mother Earth and remind us that our world is really not one of asphalt and cement but of the earth in which we are rooted," Manson said.

Ultimately, Manson hopes that his work mentoring young Native American scientists will prepare them for leadership roles in which they will define their communities' own health care needs and solutions while remaining true to their native heritage.

"We can creatively bring together qualitative and quantitative research methods that capture the unique local cultural experiences of Indian and native people and do it in a way that is still subject to the exacting standards of science," he said. "We want to show [native peoples] ways in which they can continue to walk this balance between the multiple worlds in which we live, as scientists, as native people, who have both professional and personal lives."

Past recipients of the Nickens Award include Joan Y. Reede, M.D., M.P.H., M.S. (2005); Michael V. Drake, M.D. (2004); Anna Cherrie Epps, Ph.D. (2003); David Satcher, M.D., Ph.D. (2002); Lee C. Bollinger, J.D. (2001); and Donald E. Wilson, M.D. (2000).

— By Anne Blank, Special to the Reporter

For more information:

American Indian and Alaska Native Programs at the University of Colorado at Denver and Health Sciences Center

Herbert W. Nickens Award

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