Experiences of chronic stress and mental health concerns among urban Indigenous women

Abstract

We measured stress, depression and post-traumatic stress disorder (PTSD) levels of urban Indigenous women living with and without HIV in Ontario, Canada, and identified correlates of depression. We recruited 30 Indigenous women living with HIV and 60 without HIV aged 18 years or older who completed socio-demographic and health questionnaires and validated scales assessing stress, depression and PTSD. Descriptive statistics were conducted to summarize variables and linear regression to identify correlates of depression. 85.6 % of Indigenous women self-identified as First Nation. Co-morbidities other than HIV were self-reported by 82.2 % (n = 74) of the sample. High levels of perceived stress were reported by 57.8 % (n = 52) of the sample and 84.2 % (n = 75) had moderate to high levels of urban stress. High median levels of race-related (51/88, IQR 42-68.5) and parental-related stress (40.5/90, IQR 35-49) scores were reported. 82.2 % (n = 74) reported severe depressive symptoms and 83.2 % (n = 74) severe PTSD. High levels of perceived stress was correlated with high depressive symptoms (estimate 1.28 (95 % CI 0.97-1.58), p < 0.001). Indigenous women living with and without HIV reported elevated levels of stress and physical and mental health concerns. Interventions cutting across diverse health care settings are required for improving and preventing adverse health outcomes.

The Efficacy of a Health Promotion Intervention for Indigenous Women: Reclaiming Our Spirits

“…Elsewhere, we report on strategies to mitigate these limitations including further privileging Indigenous knowledge ( McKenzie, Varcoe, Browne, & Ford-Gilboe, 2018 ). Some women enrolled but were unable participate, reflecting the extreme economic deprivation and high levels of trauma many Indigenous women face ( Benoit et al, 2016 ; Daoud et al, 2013 ; Kubik, Bourassa, & Hampton, 2009 ). For many women who did participate, high levels of support were required from the nurses to remind women of appointments and the Circle schedule, and to help them attend, given the difficult circumstances of their lives and their limited resources and poor health (e.g., over half had histories of head injuries and memory problems).…”

Late diagnosis, delayed presentation and late presentation among persons enrolled in a clinical HIV cohort in Ontario, Canada (1999–2013)

“…In our study, there was a higher prevalence of late and very late diagnosis among African, Caribbean, Black and Indigenous participants, with Indigenous individuals also more likely to be delayed presenters. Several Canadian studies have identified barriers to HIV testing and health care for these populations [32][33][34][35][36][37][38][39][40][41][42], and Ontario's recently released provincial HIV/ AIDS Strategy names both as priority populations for HIV testing campaigns that 'de-stigmatize testing . .…”

Intimate Partner Violence, Depression, and Anxiety Are Associated With Higher Perceived Stress Among Both Young Men and Women in Soweto and Durban, South Africa

“…The stress-generation hypothesis further suggests that exposure to elevated life stressors and negative life events plays a role in predicting future sensitivity to stress and adverse health ( 22 ). Recurring or ongoing life-stressors, which include socio-economic and family strains ( 26 ), violence (including intimate partner violence) ( 13 , 27 ), as well as structural and socio-political factors ( 28 ) such as poverty ( 29 ), colonization ( 30 ), and heightened chronic stress due to gender inequity, racism, and homophobia ( 25 , 31 , 32 ), have been recognized as having a significant effect on poor physical and psychological health. As such, high, chronic psychological stress is an important contributor to the global disease burden, in particular for structurally marginalized communities ( 28 ) due to the high prevalence of life stressors, structural inequities, healthcare exclusion, and limited mental health and social supports ( 33 , 34 ).…”