Abstract
Health disparities can be especially dramatic for American Indians because of a variety of powerful forces that include poverty, isolation, low educational achievement, and a unique political relationship that dictates the design of special healthcare delivery mechanisms. The challenge facing nursing leaders in these setting is addressed with consideration to culture, an examination of why leadership is needed to change the forces that lead to health disparities, the role of leadership in reducing ethnic disparities in health outcomes, as well as an examination of the most productive ways to mobilize nurses and nursing leadership to address the problems. A model for nursing leadership in Native American communities is proposed and a case study that illustrates how culturally diverse leadership in a public health setting can maximize results is presented.