The Framework of Historical Oppression, Resilience and Transcendence to Understand Disparities in Depression Amongst Indigenous Peoples

Abstract

Given chronic experiences of historical oppression, Indigenous peoples tend to experience much higher rates of depression than the general US population, which then, drives disproportionately high rates of suicide and other health disparities. The purpose of this research was to examine the core components of the culturally grounded Framework of Historical Oppression, Resilience, and Transcendence as they relate to depressive symptoms experienced by Indigenous peoples. As part of a larger convergent mixed-methods study, in this quantitative survey component, we utilised data from a sample of 127 Indigenous adults across two Southeastern US tribes. Regression analysis results signified support for the framework, indicating that historical oppression and proximal stress (daily stressors and lower incomes) were risk factors, whereas family resilience and life satisfaction (a measure of transcendence) were protective factors related to depressive symptoms. The results provide a foundation for future research to build upon in identifying culturally relevant risk and protective factors to ameliorate depression and other health disparities.

Adverse Childhood Experiences and Resilience in Native American Families and Communities

“…McKinley (formerly Burnette) and colleagues have developed a framework of historical oppression, resilience, and transcendence (FHORT). This is an American Indianfocused approach, developed over a period of 10 years in collaboration with partner tribal organizations to frame risk and protective factors within this cultural context [18]. The FHORT framework (Figure 1) defines historical oppression to include contemporary oppression (psychological trauma, ACEs, intimate partner violence, and economic inequality) exacerbated by historical traumas such as boarding schools that removed children from their homes and cultural environments.…”

“…It provides a culturally relevant framework, which can be used to explain, predict, and prevent violence. The FHORT characterizes well-being (harmony across physical, social, psychological, and spiritual domains) as a balance between ecological risk and protective factors [18].…”

Experiences of psychiatrists and support staff providing telemental health services to Indigenous peoples of Northern Quebec

“…Indigenous peoples around the globe are resilient, and their identity and culture are a fundamental source of strength. However, the high incidence of mental health issues within this population is troubling, which may be attributed to the historical oppression, colonization and the continuous social, political and environmental challenges that they often face [1]. Besides difficulties associated with colonization and geographical remoteness [2], these Indigenous communities are confronted with a high turnover and a lack of qualified mental healthcare providers [3,4].…”

“It's in the family circle”: Communication promoting Indigenous family resilience

“…Family resilience enables families' successful coping under duress; a recent review of family resilience factors identified family communication (i.e., clarity, open emotional expression, and collaborative problem solving) as one essential tool promoting family resilience (Black & Lobo, 2008;Walsh, 2016). Family resilience promotes Indigenous health equity (Burnette, 2018;Burnette & Hefflinger, 2016;Burnette, Renner, & Figley, 2019;Burnette, Roh, et al, 2019;McKinley, Lesesne, et al, 2020).…”