This article provides an example of a culturally responsive, community-based project for addressing social determinants of health in rural American Indian (AI) communities through: 1) empowering youth and community voices to set directions for HIV, sexually transmitted infections, and unintended pregnancy prevention and education efforts; 2) using Photovoice to promote healthy relationships among AI youth; 3) using the socioecological model (Centers for Disease Control and Prevention, 2004; 2011) as a framework for organizing the creation and subsequent sharing of Photovoice messages from individual empowerment, to relationships, communities, institutions, and general society; and 4) framing analysis of Photovoice projects in alignment with Bell's (2010) model of storytelling for social justice that connects narrative and the arts in anti-racist teaching. A discussion on future steps and recommendations for future research is provided. (Contains 4 figures.)