In the summer of 2015, the American Heart Association (AHA) and the Shakopee Mdewakanton Sioux Community (SMSC) began a partnership focused on improving the health of Indigenous Americans. Following the high interest of the participants for the "Fertile Ground: Planting the Seeds for Native American Nutrition and Health" roundtable, a second conference "Fertile Ground II: Growing the Seeds for Native American Health" was held in May 2016 and focused on advocacy and policy change to improve health and nutrition within Native communities.

This report summarizes the key discussions and learnings at Fertile Ground II. It presents a strategic framework for diverse engagement and investment that can build on new and existing proven models, develop community and tribal government capacity to instigate tribal and federal policy changes, and begin to address the root causes of the state of Native American health.