Historical trauma and oppression: Associations with internalizing outcomes among American Indian adults with type 2 diabetes

Abstract

American Indian (AI) people experience disproportionate exposure to stressors and health inequities, including type 2 diabetes (T2D) and mental health problems. There is increasing interest in how historical trauma and ongoing experiences of discrimination and marginalization (i.e., historical oppression) interact to influence AI health. The purpose of this study is to examine the relationships between historically traumatic experiences (i.e., boarding schools, relocation programs, and foster care), current reports of historical cultural loss, microaggressions, and their relationship to internalizing symptoms among AI adults living with T2D. This community-based participatory research study with five AI tribal communities includes data from 192 AI adults with T2D recruited from tribal clinics. Results from structural equation modeling revealed that personal experiences in foster care and ancestral experiences in boarding schools and/or relocation were associated with increased reports of historical loss, and indirectly associated with internalizing symptoms through racial microaggressions and historical losses. The findings highlight the importance of considering multiple dimensions of historical trauma and oppression in empirical and practice-based assessments of mental health problems.

Filipino Americans’ Social and Cultural Experiences of Type 2 Diabetes Management: Cultural Paradox, Ownership, and Success Definition

“…Colonial mentality is a type of internalized racism marked by a perception of ethnic or cultural inferiority or inadequacy (David, 2013;David & Nadal, 2013). The effects of colonialism on psychological health have been studied before on various ethnic groups (Chandanabhumma & Narasimhan, 2020;Decena, 2014;Eni et al, 2021;Gillson et al, 2022). Not surprisingly, a colonialist view is observed in many FilAms (David, 2013), including in their food practices (Orquiza, 2020).…”

Unsilencing the Echoes of Historical Trauma: A Comparative Analysis

“…Ultimately, the present generation carries not only current day racism and microaggressions but also the past lived experiences of their ancestors, resulting in intergenerational accumulation of trauma [38]. The increased health disparities that we see today among Indigenous people are, at least in part, the result of these traumas [39][40][41][42].…”