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Indigenous Historical Trauma’s Impact on Health Outcomes

Indigenous historical trauma (IHT) is the trauma that can accumulate across generations that develops as a result of the historical ramifications of colonization that have caused mental and physical health hardships and population decline (Gone et al., 2019). This unique trauma affects many different people in a multitude of ways, understandably so, since the indigenous community and their history is diverse. Many studies have been conducted to determine if IHT is associated with negative health outcomes of indigenous communities from the United States and Canada. IHT is a difficult term to standardize and measure because the diversity of ingenious people who experience it is so vast and variable. Therefore, it is an arduous task to assign an operational definition and systematically collect data for IHT. Many of the studies that incorporate IHT measure it in different ways making it hard to compile data and review it holistically. This is an important point to mention to provide context for the following studies that attempt to connect IHT and adverse health impacts.

Some of the methodologies to measure IHT include a “Historical Losses Scale (HLS),” “Historical Losses Associated Symptoms Scale (HLASS),” and residential school ancestry studies (Whitbeck et al., 2004). HLS uses a survey format that includes “12 kinds of historical losses” such as “loss of our language” and “loss of our land” and asks participants how often they think of those losses (Whitbeck et al., 2004). The HLASS includes 12 emotional reactions and asks participants how they feel when they think about those losses (Whitbeck et al., 2004). Lastly, the residential school ancestry studies ask respondents if their parents, grandparents, great-grandparents or “elders from their community” went to residential schools and use these yes or no responses to understand if family or community history in a residential school are associated with negative health outcomes (Brockie, 2012). All these different measures of IHT were compiled and compared to the health outcomes of the respondents. Negative health outcomes include but are not limited to anxiety, suicidal ideation, suicidal attempts, polysubstance abuse, PTSD, depression, binge-eating, anger, and sexual abuse (Gone et al., 2019).

The connection between IHT and health conditions is complicated because of the difficult nature of measuring IHT, the unknown directionality of IHT and health outcomes, and because the term “indigenous people” used in the various samples comprises a huge population of individuals with drastically different experiences and history. That being said, some studies found that indigenous respondents with a connection to residential schools have more negative heath outcomes than those who did not have a connection to residential schools including suicide ideation, attempts, and depression. Additionally, indigenous respondents with higher HLS and HLASS scores had one or more negative health outcomes (Gone et al., 2019). While there are plenty of studies such as, Anastasio et al. (2013), Armenta et al. (2016), Brockie (2012), Clark & Winterowd (2012), Ehlers et al. (2013), Tucker et al. (2016) to name a few, that did find an association to IHT and adverse health outcomes, it remains difficult to compile all this data until IHT can be systematically measured and until indigenous people are separated into categories based on similar experiences, location, and background as opposed to one monolithic group (Gone et al., 2019).

References

􏰂Anastario, M. P., FourStar, K., & Rink, E. (2013). Sexual risk behavior and symptoms of historical loss in American Indian men. Journal of Community Health: The Publication for Health Promotion and Disease Prevention, 38, 894–899. http://dx.doi.org/10.1007/s10900-013-9695-8

􏰂Armenta, B. E., Whitbeck, L. B., & Habecker, P. N. (2016). The Historical Loss Scale: Longitudinal measurement equivalence and prospective links to anxiety among North American indigenous adolescents. Cultural Diversity and Ethnic Minority Psychology, 22, 1–10. http://dx.doi .org/10.1037/cdp0000049

􏰂Brockie, T. N. (2012). Historical and contemporary factors influencing non-lethal suicidal behavior among reservation-based Native American youth (Unpublished doctoral dissertation). Johns Hopkins University, Baltimore, MD.

􏰂Clark, J. D., & Winterowd, C. (2012). Correlates and predictors of binge eating among Native American women. Journal of Multicultural Coun- seling and Development, 40, 117–127. http://dx.doi.org/10.1002/j.2161- 1912.2012.00011.x

Ehlers, C. L., Gizer, I. R., Gilder, D. A., Ellingson, J. M., & Yehuda, R. (2013). Measuring historical trauma in an American Indian community sample: Contributions of substance dependence, affective disorder, con- duct disorder and PTSD. Drug and Alcohol Dependence, 133, 180 –187. http://dx.doi.org/10.1016/j.drugalcdep.2013.05.011

Gone, J. P., Hartmann, W. E., Pomerville, A., Wendt, D. C., Klem, S. H., & Burrage, R. L. (2019). The impact of historical trauma on health outcomes for indigenous populations in the USA and Canada: A systematic review. American Psychologist, 74(1), 20-35. http://dx.doi.org/10.1037/amp0000338

􏰂Tucker, R. P., Wingate, L. R., & O’Keefe, V. M. (2016). Historical loss thinking and symptoms of depression are influenced by ethnic experi- ence in American Indian college students. Cultural Diversity and Ethnic Minority Psychology, 22, 350 –358. http://dx.doi.org/10.1037/ cdp0000055

Whitbeck, L. B., Chen, X., Hoyt, D. R., & Adams, G. W. (2004). Discrimination, historical loss and enculturation: Culturally specific risk and resiliency factors for alcohol abuse among American Indians. Jour- nal of Studies on Alcohol, 65, 409–418. http://dx.doi.org/10.15288/jsa .2004.65.409

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