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Cueva K, Peterson M, Chaliak AJ, Young RI. A qualitative exploration of the impacts of COVID-19 in two rural Southwestern Alaska communities. Int J Circumpolar Health 2024; 83:2313823. [PMID: 38563298 PMCID: PMC10989197 DOI: 10.1080/22423982.2024.2313823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/30/2024] [Indexed: 04/04/2024] Open
Abstract
This manuscript presents a qualitative exploration of the experiences of people in two Southwestern Alaska communities during the emergence of COVID-19 and subsequent pandemic response. The project used principles of community based participatory research and honoured Indigenous ways of knowing throughout the study design, data collection, analysis, and dissemination. Data was collected in 2022 through group and individual conversations with community members, exploring impacts of the COVID-19 pandemic. Participants included Elders, community health workers, Tribal council members, government employees, school personnel, and emergency response personnel. Notes and written responses were coded using thematic qualitative analysis. The most frequently identified themes were 1) feeling disconnected from family, friends, and other relationships, 2) death, 3) the Tribal councils did a good job, and 4) loss of celebrations and ceremonies. While the findings highlighted grief and a loss of social cohesion due to the pandemic, they also included indicators of resilience and thriving, such as appropriate and responsive local governance, revitalisation of traditional medicines, and coming together as a community to survive. This case study was conducted as part of an international collaboration to identify community-driven, evidence-based recommendations to inform pan-Arctic collaboration and decision making in public health during global emergencies.
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Affiliation(s)
- Katie Cueva
- Institute of Social and Economic Research (ISER), University of Alaska, Anchorage, AK, USA
| | - Malory Peterson
- Department of Human Development and Community Health, Montana State University, Bozeman, USA
| | - Ay’aqulluk Jim Chaliak
- Center for Alaska Native Health Research (CANHR), University of Alaska Fairbanks, Bethel, AK, USA
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2
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Nayakarathna R, Patel N, Currie C, Faulkner G, Riazi N, Tremblay MS, Trudeau F, Larouche R. Correlates of Physical Activity in Children from Families Speaking Non-official Languages at Home: a Multi-site Canadian Study. J Racial Ethn Health Disparities 2024; 11:815-825. [PMID: 36913115 DOI: 10.1007/s40615-023-01563-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/22/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Children from families speaking a non-official language at home may be particularly at risk for low physical activity (PA), underscoring a need to investigate correlates of PA in this subpopulation. METHODS We recruited 478 children in 37 schools stratified by area-level socioeconomic status (SES) and type of urbanization within three regions of Canada. Steps/day were measured using SC-StepRx pedometers. We assessed potential social-ecological correlates with child and parent surveys. We used gender-stratified linear mixed models to examine the correlates of steps/day. RESULTS Outdoor time was the strongest correlate of boys' and girls' PA. Lower area-level SES was associated with less PA among boys, but outdoor time attenuated this difference. The strength of association between outdoor time and PA decreased with age in boys and increased with age in girls. DISCUSSION Outdoor time was the most consistent correlate of PA. Future interventions should promote outdoor time and address socioeconomic disparities.
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Affiliation(s)
| | - Nimesh Patel
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Cheryl Currie
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Negin Riazi
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada
| | - François Trudeau
- Département des Sciences de l'Activité Physique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
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3
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Luo J, Tang L, Kong X, Li Y. Global, regional, and national burdens of depressive disorders in adolescents and young adults aged 10-24 years from 1990 to 2019: A trend analysis based on the Global Burden of Disease Study 2019. Asian J Psychiatr 2024; 92:103905. [PMID: 38262303 DOI: 10.1016/j.ajp.2023.103905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/21/2023] [Accepted: 12/31/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Depressive disorders (DD) including dysthymia and major depressive disorder (MDD) are common among adolescents and young adults. However, global trends in DD burden remain unclear. METHODS We analysed data from the Global Burden of Disease 2019 study on incidence, prevalence, disability-adjusted life years (DALYs), and mortality due to DD from 1990 to 2019 at global, regional and national levels. RESULTS Globally, dysthymia incidence increased notably in females, older age groups, and lower-middle income countries from 1990 to 2019. In contrast, MDD incidence decreased slightly over this period except in high-income North America. Females and middle-income countries had the highest dysthymia burden while North America had the highest MDD incidence and DALYs. Oman and Malaysia experienced largest increases in dysthymia and MDD burden respectively. CONCLUSION Despite certain global indicators suggesting a leveling off or decrease, it's clear that depressive disorders continue to be a significant and increasing issue, particularly among women, teenagers, and young adults. Differences between regions and countries indicate that specific interventions aimed at addressing economic inequalities, improving healthcare systems, and taking cultural factors into account could make a real difference in lessening the burden of depressive disorders. More research is needed to understand what's driving these trends so that we can develop better strategies for preventing and managing these conditions.
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Affiliation(s)
- Jianzhang Luo
- Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Lijuan Tang
- Institute of Prevention and Control of Non‑communicable Chronic Diseases, Hebei Province Center for Disease Prevention and Control, Shijiazhuang 050021, China
| | - Xiangjun Kong
- Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Yu Li
- Department of Cardiovascular Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China.
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John-Henderson NA, White EJ, Crowder TL. Resilience and health in American Indians and Alaska Natives: A scoping review of the literature. Dev Psychopathol 2023; 35:2241-2252. [PMID: 37345444 PMCID: PMC10739606 DOI: 10.1017/s0954579423000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
American Indians and Alaska Natives suffer from disproportionately high rates of chronic mental and physical health conditions. These health inequities are linked to colonization and its downstream consequences. Most of the American Indian and Alaska Native health inequities research uses a deficit framework, failing to acknowledge the resilience of American Indian and Alaska Native people despite challenging historical and current contexts. This scoping review is based on a conceptual model which acknowledges the context of colonization and its consequences (psychological and health risk factors). However, rather than focusing on health risk, we focus on protective factors across three identified domains (social, psychological, and cultural/spiritual), and summarize documented relationships between these resilience factors and health outcomes. Based on the scoping review of the literature, we note gaps in extant knowledge and recommend future directions. The findings summarized here can be used to inform and shape future interventions which aim to optimize health and well-being in American Indian and Alaska Native peoples.
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Affiliation(s)
- Neha A John-Henderson
- Department of Psychology, Montana State University, Bozeman, MT, USA
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA
| | - Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Tony L Crowder
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA
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Richardson M, Waters SF. Indigenous Voices Against Suicide: A Meta-Synthesis Advancing Prevention Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7064. [PMID: 37998295 PMCID: PMC10671466 DOI: 10.3390/ijerph20227064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 11/25/2023]
Abstract
Rates of suicidality amongst Indigenous Peoples are linked to historical and ongoing settler-colonialism including land seizures, spiritual oppression, cultural disconnection, forced enculturation, and societal alienation. Consistent with decolonial practices, Indigenous voices and perspectives must be centered in the development and evaluation of suicide prevention programs for Indigenous Peoples in the United States to ensure efficacy. The current study is a meta-synthesis of qualitative research on suicide prevention among Indigenous populations in the United States. Findings reveal little evidence for the centering of participant voices within existing suicide prevention programs. Applied thematic analysis of synthesis memos developed for each article in the final sample surfaced four primary themes: (1) support preferences; (2) challenges to suicide prevention; (3) integration of culture as prevention; and (4) grounding relationships in prevention. The need for culturally centered programming and the inadequacy of 'pan-Indian' approaches are highlighted. Sub-themes with respect to resiliency, kinship connection, and safe spaces to share cultural knowledge also emerge. Implications of this work to further the decolonization of suicide prevention and aid in the promotion of culturally grounded prevention science strategies are discussed.
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Affiliation(s)
- Meenakshi Richardson
- Prevention Science Program, Washington State University Vancouver, Vancouver, WA 98686, USA
| | - Sara F. Waters
- Department of Human Development, Washington State University Vancouver, Vancouver, WA 98686, USA;
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Sittner KJ, Herman KA, Gonzalez MB, Walls ML. A longitudinal study of positive mental health and coping among Indigenous adults with type 2 diabetes. ANXIETY, STRESS, AND COPING 2023; 36:339-352. [PMID: 35587950 PMCID: PMC9674796 DOI: 10.1080/10615806.2022.2076082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Indigenous Peoples and scholars call for strengths-based approaches to research inclusive of Indigenous resiliency and positive outcomes. The purpose of this study was to examine positive mental health for Indigenous adults with type 2 diabetes and to determine if positive mental health is linked to community connectedness (a coping resource) and active coping (a coping response). METHODS Participants (N = 194 at baseline) were randomly selected from clinical records, at least 18 years old with a type 2 diabetes diagnosis, and self-identified as American Indian. RESULTS Latent growth curve models revealed that average positive mental health was predicted to decrease over the four waves of the study, although not for participants with above-average active coping at baseline. Community connectedness at baseline was associated with higher initial levels of positive mental health. Within-person change in active coping and community connectedness were both associated with increases in positive mental health. CONCLUSION This study aligns with previous research demonstrating that coping can influence health outcomes, and furthers the stress process literature by showing that active coping and community connectedness can impact positive mental health for Indigenous adults with Type 2 Diabetes.
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Affiliation(s)
| | - Kaley A. Herman
- Johns Hopkins Bloomberg School of Public Health, Department of International Health; Center for American Indian Health; Duluth, MN
| | - Miigis B. Gonzalez
- Johns Hopkins Bloomberg School of Public Health, Department of International Health; Center for American Indian Health; Duluth, MN
| | - Melissa L. Walls
- Johns Hopkins Bloomberg School of Public Health, Department of International Health; Center for American Indian Health; Duluth, MN
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Olko J, Galbarczyk A, Maryniak J, Krzych-Miłkowska K, Tepec HI, de la Cruz E, Dexter-Sobkowiak E, Jasienska G. The spiral of disadvantage: Ethnolinguistic discrimination, acculturative stress and health in Nahua indigenous communities in Mexico. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023. [PMID: 37060286 DOI: 10.1002/ajpa.24745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 02/21/2023] [Accepted: 03/22/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES The aim of this study was to test the hypothesis that ethnic and ethnolinguistic discrimination, and Post-Traumatic Stress Disorder (PTSD) related to being Indigenous as well as different aspects of acculturative stress, are associated with poorer health and higher levels of depression among the Nahua Indigenous communities. MATERIALS AND METHODS Our quantitative survey was carried out in four different regions inhabited by the Nahua people in Mexico. Self-rated health and depression, the symptoms of PTSD, two facets of acculturative stress and ethnolinguistic discrimination were assessed by questionnaires. The data were analyzed using binary logistic regression models. RESULTS The symptoms of PTSD and acculturative stress experienced in the workplace were significantly associated with a higher risk of poor self-rated health, adjusted for various socio-demographic characteristics. Acculturative stress, discouragement of language use, language avoidance and ethnolinguistic discrimination were related to a higher risk of depression and PTSD. DISCUSSION Our research implies that ethnic and linguistic discrimination, acculturative stress and the memory of harm linked to being Indigenous reflected in the symptoms of PTSD, are important predictors of poorer health and depression among Nahua groups in Mexico. These adverse effects could be significantly counteracted by effective dealing with stigmatization and discrimination against Indigenous people in Mexico and by replacing strong assimilation pressures with integrational approaches that respect ethnolinguistic diversity and reduce socioeconomic marginalization.
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Affiliation(s)
- Justyna Olko
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Andrzej Galbarczyk
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Joanna Maryniak
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Karolina Krzych-Miłkowska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | | | - Eduardo de la Cruz
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
- Instituto de Docencia e Investigación Etnológica de Zacatecas, Zacatecas, Mexico
| | - Elwira Dexter-Sobkowiak
- Center for Research and Practice in Cultural Continuity, Faculty of "Artes Liberales", University of Warsaw, Warsaw, Poland
| | - Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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Ajaero CK, Ebimgbo S, Ezeibe C, Ugwu C, Nzeadibe C, Osabede N. Life Satisfaction in South Africa: The Influence of Inter-Provincial Migration Status. PSYCHOLOGICAL STUDIES 2023. [DOI: 10.1007/s12646-022-00697-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Fried R, Hahn M, Gillott L, Cochran P, Eichelberger L. Coping strategies and household stress/violence in remote Alaska: a longitudinal view across the COVID-19 pandemic. Int J Circumpolar Health 2022; 81:2149064. [PMID: 36419229 PMCID: PMC9704083 DOI: 10.1080/22423982.2022.2149064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic has introduced novel stressors. Remote/rural communities have experienced additional difficulties, while also potentially benefitting from unique sources of resilience against such stressors. However, very little research has been conducted in remote/rural communities regarding coping and stress/violence. This study examines coping strategies and household stress/violence in remote Alaska communities across the pandemic through three online survey waves (November 2020-September 2021) (total n = 1,020). Across all waves, personal care was reported most frequently followed by social activities, religious activities, and traditional/subsistence activities. Substance use combined (alcohol, nicotine, marijuana) and seeking counselling were less frequently reported, with significant differences across gender and age categories. Less than 10% of individuals reported physical violence towards children and/or other adults within the household. Overall, these findings indicate that individuals are primarily relying on positive coping strategies to contend with additional stress brought into their lives by the COVID-19 pandemic.
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Affiliation(s)
- Ruby Fried
- University of Alaska Anchorage, Institute for Circumpolar Health Studies, AK, USA,CONTACT Ruby Fried University of Alaska Anchorage, Institute for Circumpolar Health Studies
| | - Micah Hahn
- University of Alaska Anchorage, Institute for Circumpolar Health Studies, AK, USA
| | - Lauren Gillott
- Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | | | - Laura Eichelberger
- Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Feliz VA, Hobbs SD, Borunda R. Strengthen and Respect Each Thread. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14117. [PMID: 36361028 PMCID: PMC9654091 DOI: 10.3390/ijerph192114117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/04/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
Through a culturally grounded epistemology, this article provides mental health practitioners and researchers an overview of how generational trauma can impact the well-being of Black, Indigenous, Latinx, and other historically marginalized communities. Historically, deficit-based lenses frame the experiences of Black, Indigenous, and other People of Color (BIPOC). Discussion of white supremacy as a factor that creates divisiveness, discontinuity, and othering is necessary to understand mental healthcare for marginalized communities. Research has shown that behaviors, identities, and expressions that are respected in indigenous cultures and communities are most often misrepresented, ignored, erased, and ultimately misidentified as requiring rehabilitation. In fact, researchers assert that the organizational culture of the mental health industry limits access for minoritized communities due to lack of practitioner relational capacity, and inclusive practices. This article illustrates examples of white supremist practices through Native American storytelling to trace generational trauma from its origins, when Eurocentric perspectives were imposed upon America's original inhabitants, to trauma caused by placement of BIPOC children in the foster care and adoption system. While fully aware of the complexities of mental health care, the authors argue that diverse cultural representations of identity, knowledge, and collectivism should inform mental health practice, and research.
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Gonzalez MB, Sittner KJ, Walls ML. Cultural efficacy as a novel component of understanding linkages between culture and mental health in Indigenous communities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:191-201. [PMID: 35285956 PMCID: PMC9452443 DOI: 10.1002/ajcp.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 05/22/2023]
Abstract
We used a novel measure of cultural efficacy to examine empirical pathways between enculturation, efficacy, and two wellbeing outcomes. Cultural factors are not consistently linked to better wellbeing in the academic literature despite widespread understanding of these processes in Indigenous communities. Healing pathways is a community-based participatory study with eight reservations/reserves in the upper Midwest and Canada. This study uses data collected in 2017-2018 (n = 453, 58.1% women, mean age = 26.3 years) and structural equation modeling to test the relationships between enculturation, cultural efficacy, and mental health. The direct effect of enculturation on anxiety was positive. The indirect effect of enculturation via cultural efficacy was negatively associated with anxiety and positively associated with positive mental health. Cultural efficacy is an important linking variable through which the protective effects of culture manifest. The complex nature of culture must be met with innovative measures and deep understanding of Indigenous peoples to fully capture the protective role of culture.
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Affiliation(s)
- Miigis B. Gonzalez
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes HubDuluthMinnesotaUSA
| | - Kelley J. Sittner
- Department of SociologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Melissa L. Walls
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes HubDuluthMinnesotaUSA
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Mallett RK, Patrianakos J, Swim J. Indigenous Alaskan and mainstream identification explain the link between perceived discrimination and acculturative stress. THE JOURNAL OF SOCIAL PSYCHOLOGY 2021; 161:593-607. [PMID: 33399032 DOI: 10.1080/00224545.2020.1867040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
Drawing from the rejection-identification model, acculturation, and acceptance threat literatures, we examined how Indigenous and mainstream identification influence the effect of discrimination on acculturative and physical stress. A community sample of 126 Indigenous Alaskans reported discrimination, identification with Indigenous Alaskans and mainstream Americans, and acculturative and physical stress. As perceptions of personal discrimination increased, so did Indigenous identification and reports of acculturative and physical stress. Contrary to the rejection-identification hypothesis, Indigenous identification did not reduce the effect of discrimination on stress. Instead, following personal discrimination, Indigenous and mainstream identification interacted to predict acculturative stress. As Indigenous identification increased, so did acculturative stress - particularly among those who strongly identified with mainstream culture. These associations were not present for group-based discrimination. Thus, experiencing personal rejection from mainstream society may be particularly stressful for Indigenous people who strongly identify with their ethnic group, placing them at higher risk for mental and physical illness.
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Gameon JA, Skewes MC. Historical trauma and substance use among American Indian people with current substance use problems. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:295-309. [PMID: 33829816 PMCID: PMC8084991 DOI: 10.1037/adb0000729] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In the United States, American Indian and Alaska Native (AI/AN) people suffer health inequities associated with alcohol and other drug use and also experience historical trauma symptoms resulting from colonization. Research suggests that historical trauma may be associated with substance use among AI/ANs. METHOD As part of a Community-Based Participatory Research project with tribal partners from a rural AI reservation, our team collected cross-sectional survey data from 198 tribal members who self-identified as having substance use problems. We examined associations between historical trauma thoughts, historical trauma symptoms, and substance use outcomes. We also examined historical trauma symptoms, current trauma symptoms, awareness of systemic discrimination, and ethnic identity as moderators of the associations between historical trauma thoughts and substance use variables. RESULTS Historical trauma thoughts, controlling for symptoms, were associated with greater abstinent days, fewer heavy alcohol use days, fewer drinks per drinking day, and fewer drug use days; historical trauma symptoms, controlling for thoughts, were associated only with fewer abstinent days. Moderation analyses showed that historical trauma thoughts were associated with better substance use outcomes when historical trauma symptoms were low, current trauma symptoms were low, awareness of systemic discrimination was high, and ethnic identity was high. CONCLUSION When distressing trauma symptoms are low, historical trauma thoughts may act as a protective factor or as a marker for other factors associated with better substance use outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Ren Q, Jiang S. Acculturation Stress, Satisfaction, and Frustration of Basic Psychological Needs and Mental Health of Chinese Migrant Children: Perspective from Basic Psychological Needs Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4751. [DOI: https:/doi.org/10.3390/ijerph18094751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Acculturation stress is prevalent among migrant populations. The current study examines whether acculturation stress influences migrant children’s mental health through the mediators of the satisfaction and frustration of basic psychological needs for autonomy, relatedness, and competence. A sample of 484 migrant children is obtained in Kunming, China using a multi-stage cluster random sampling. Data are analyzed through structural equation modeling in Mplus 8.0. Results indicate that acculturation stress has a direct impact on children’s depression but no significant direct effect on children’s happiness. Acculturation stress also has indirect effects on depression and happiness via the mediators of need satisfaction and frustration. Acculturation stress is negatively associated with need satisfaction and positively associated with need frustration, which is further significantly predictive of children’s happiness and depression. Overall, this study validates the basic psychological needs theory in the context of China’s internal migration. Findings contribute to the understanding of the mechanisms that underlie the relationship between acculturation stress and psychological outcomes and provide practical implications for future interventions.
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Acculturation Stress, Satisfaction, and Frustration of Basic Psychological Needs and Mental Health of Chinese Migrant Children: Perspective from Basic Psychological Needs Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094751. [PMID: 33946882 PMCID: PMC8124301 DOI: 10.3390/ijerph18094751] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/23/2022]
Abstract
Acculturation stress is prevalent among migrant populations. The current study examines whether acculturation stress influences migrant children’s mental health through the mediators of the satisfaction and frustration of basic psychological needs for autonomy, relatedness, and competence. A sample of 484 migrant children is obtained in Kunming, China using a multi-stage cluster random sampling. Data are analyzed through structural equation modeling in Mplus 8.0. Results indicate that acculturation stress has a direct impact on children’s depression but no significant direct effect on children’s happiness. Acculturation stress also has indirect effects on depression and happiness via the mediators of need satisfaction and frustration. Acculturation stress is negatively associated with need satisfaction and positively associated with need frustration, which is further significantly predictive of children’s happiness and depression. Overall, this study validates the basic psychological needs theory in the context of China’s internal migration. Findings contribute to the understanding of the mechanisms that underlie the relationship between acculturation stress and psychological outcomes and provide practical implications for future interventions.
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Shepherd SM. Can a Connection to Culture Reduce Mental Illness Symptoms and Risk for Future Violence? AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12362] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Stephane M. Shepherd
- Centre for Forensic Behavioural Science, Victorian Institute of Forensic Mental Health, Swinburne University of Technology, and
- National Centre for Cultural Competence, University of Sydney
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Gonzalez MB, Herman KA, Walls ML. Culture, Social Support, and Diabetes Empowerment Among American Indian Adults Living With Type 2 Diabetes. Diabetes Spectr 2020; 33:156-164. [PMID: 32425453 PMCID: PMC7228815 DOI: 10.2337/ds19-0036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE | Type 2 diabetes represents a major health disparity for many American Indian/Alaska Native (AIAN) communities, in which prevalence rates are more than double that of the general U.S. population. Diabetes is a major indicator for other comorbidities, including the leading cause of death for AIANs (i.e., cardiovascular disease). This study investigated associations between protective factors (social support and cultural factors) and self-reported empowerment to manage illness. DESIGN AND METHODS | Participants were drawn from a random sample of tribal clinic records. Data included results from computer-assisted personal interviews with 192 American Indian adults with a diagnosis of type 2 diabetes living on or near a reservation. Community Research Councils, developed at each of the five partnering Anishinaabe reservations, oversaw protocols and procedures in this community-based participatory research collaboration. RESULTS | Multiple ordinary least squares regression models determined that general social support and diabetes-specific social support are positively related to diabetes empowerment. These associations persisted when both social support measures were added to the model, indicating independent effects of different types of social support. Cultural identity and cultural practices were positively related to diabetes empowerment in bivariate analyses; however, both measures dropped from statistical significance after accounting for all other covariates. An interaction term revealed a moderation effect through which cultural identity amplified the positive relationship between social support and diabetes empowerment. CONCLUSION | Results moderately support policy and risk-reduction efforts aiming at expanding social support networks into multiple domains and reinforcing cultural identity and cultural practices.
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Affiliation(s)
| | - Kaley A Herman
- Johns Hopkins Bloomberg School of Public Health, Duluth, MN
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Gameon JA, Skewes MC. A Systematic Review of Trauma Interventions in Native Communities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 65:223-241. [PMID: 31518009 PMCID: PMC7243818 DOI: 10.1002/ajcp.12396] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
American Indian/Alaska Native and First Nations communities suffer from health disparities associated with multiple forms of trauma exposure. Culturally appropriate interventions are needed to heal current and historical trauma wounds. Although there are evidence-based trauma interventions for other populations, few have been implemented or evaluated with Native communities. Understanding the extant research on trauma interventions in Native communities is crucial for advancing science and filling gaps in the evidence base, and for meeting the needs of underserved people. In this systematic review of the literature on trauma interventions in Native communities in the United States, Canada, Australia, and New Zealand, we identified 15 studies representing 10 interventions for historical and/or current trauma. These studies involved the community to some extent in developing or culturally adapting the interventions and suggested positive outcomes with regard to historical and interpersonal trauma symptoms. However, notable limitations in study design and research methods limit both internal validity and external validity of these conclusions. Only one study attempted (but did not achieve) a quasi-experimental design, and small sample sizes were persistent limitations across studies. Recommendations for researchers include working in partnership with Native communities to overcome barriers to trauma intervention research and to increase the rigor of the studies so that ongoing efforts to treat trauma can yield publishable data and communities can secure funding for intervention research.
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Affiliation(s)
- Julie A Gameon
- Department of Psychology, Montana State University, Bozeman, MT, USA
| | - Monica C Skewes
- Department of Psychology, Montana State University, Bozeman, MT, USA
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Burnette CE, Ka'apu K, Scarnato JM, Liddell J. Cardiovascular Health among U.S. Indigenous Peoples: A Holistic and Sex-Specific Systematic Review. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:24-48. [PMID: 32133411 PMCID: PMC7055486 DOI: 10.1080/26408066.2019.1617817] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
PURPOSE The purpose of this systematic review is to examine mental, sociocultural, behavioral, and physical risk and protective factors related to cardiovascular disease (CVD) and related outcomes among U.S. Indigenous peoples. METHODS A total of 51 articles met the inclusion criteria of research focusing factors for CVD among U.S. Indigenous peoples (Mental n= 15; Sociocultural, n =17; Behavioral/Physical, n =19). RESULTS This review reveals clear risks for CVD, which tended to be elevated for females. Mental health problems (depression, anxiety, PTSD/trauma, alcohol and other drug (AOD) abuse) were clearly associated with CVD, along with enculturation, social support, and the social environment-including discrimination and trauma. Poor diet and obesity, diabetes, hypertension, cholesterol were behavioral or physical factors. DISCUSSION Overall, identified research was limited and in beginning stages, lacking more information on etiology of the interconnections across sex and the mental, sociocultural, and behavioral determinants of CVD.
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Affiliation(s)
| | | | | | - Jessica Liddell
- City, Culture, & Community Doctoral Program, Tulane University
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Bersamin A, Izumi BT, Nu J, O’brien DM, Paschall M. Strengthening adolescents' connection to their traditional food system improves diet quality in remote Alaska Native communities: results from the Neqa Elicarvigmun Pilot Study. Transl Behav Med 2019; 9:952-961. [PMID: 31570921 PMCID: PMC6937549 DOI: 10.1093/tbm/ibz087] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In remote Alaska Native communities, traditional foods are inextricably linked to health and food security. Degradation of the traditional food system over the past several decades has resulted in a shift in dietary patterns that have contributed to increased rates of chronic diseases and food insecurity among Alaska Native People. Interventions are needed to address this. Our objectives were to evaluate the preliminary efficacy of a school-based intervention-Neqa Elicarvigmun or the Fish-to-School Program-on diet quality, fish intake, and attitudes and beliefs around traditional foods (specifically fish) using a pre-post comparison group design with data collection occurring at three time points. Study participants were 76 middle and high school students in two remote Alaska Native communities (population <900) in southwestern Alaska. We used a participatory approach to design the school-based, multilevel intervention that included activities in the cafeteria, classroom, and community. Multilevel analyses showed that students in the experimental community showed significant improvements in diet quality compared to the comparison community (Beta = 4.57; p < .05). Fish intake, measured using the stable nitrogen isotope ratio of hair, a validated biomarker, also increased significantly in the experimental community (Beta = 0.16; p < .05). Leveraging the cultural and physical resources of the traditional food system for the Neqa Elicarvigmun program represents a strength-based approach that improves diet quality, increases adolescents' connection to their traditional culture, and by promoting the local food system supports food security. Embedding the program into the local culture may result in faster adoption and greater sustainability of the program.
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Affiliation(s)
- Andrea Bersamin
- Center for Alaska Native Health Research and Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, USA
| | - Betty T Izumi
- Oregon Health & Science University - Portland State University School of Public Health, Portland, USA
| | - Jennifer Nu
- Center for Alaska Native Health Research and Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, USA
| | - Diane M O’brien
- Center for Alaska Native Health Research and Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, USA
| | - Mallie Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
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Walls ML, Whitesell NR, Barlow A, Sarche M. Research with American Indian and Alaska Native populations: Measurement matters. J Ethn Subst Abuse 2019; 18:129-149. [PMID: 28441113 PMCID: PMC7670846 DOI: 10.1080/15332640.2017.1310640] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Research is an important tool in addressing myriad American Indian and Alaska Native (AIAN) health disparities; however, tensions exist between common empirical measurement approaches that facilitate cross-cultural comparisons and measurement specificity that may be more valid locally and/or culturally appropriate. The tremendous diversity of AIAN communities, small population sizes of distinct AIAN cultural groups, and varying cultural contexts and worldviews should influence measurement decisions in health research. We provide a framework for guiding measurement in collaboration with AIAN communities using examples from substance abuse research for illustration. Our goal is to build upon ongoing efforts to advance measurement validity for AIAN research by engaging community-researcher partnerships and critical thinking in the selection, adaptation, creation, and implementation of measures.
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Affiliation(s)
- Melissa L Walls
- a University of Minnesota Medical School , Duluth , Minnesota
| | - Nancy Rumbaugh Whitesell
- b Colorado School of Public Health , University of Colorado Anschutz Medical Campus , Aurora , Colorado
| | - Allison Barlow
- c Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland
| | - Michelle Sarche
- b Colorado School of Public Health , University of Colorado Anschutz Medical Campus , Aurora , Colorado
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22
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Ryman TK, Boyer BB, Hopkins SE, Philip J, Thompson B, Beresford SAA, Thummel KE, Austin MA. Association between iq'mik smokeless tobacco use and cardiometabolic risk profile among Yup'ik Alaska Native people. ETHNICITY & HEALTH 2018; 23:488-502. [PMID: 28116909 PMCID: PMC5796859 DOI: 10.1080/13557858.2017.1280136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The traditional lifestyle of Yup'ik Alaska Native people, including a diet abundant in marine-based foods and physical activity, may be cardio-protective. However, iq'mik, a traditional form of smokeless tobacco used by >50% of Yup'ik adults, could increase cardiometabolic (CM) risk. Our objective was to characterize the associations between iq'mik use and biomarkers of CM status (low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], systolic blood pressure [SBP] and diastolic blood pressure [DBP], glycated hemoglobin [HbA1c], fasting blood glucose [FBG], waist circumference [WC], and body mass index [BMI]). DESIGN We assessed these associations using data from a cross-sectional sample of Yup'ik adults (n = 874). Current iq'mik use, demographic, and lifestyle data were collected through interviews. Fasting blood samples were collected to measure LDL-C, HDL-C, TG, HbA1c, and FBG. SBP, DBP, WC, and BMI were obtained by physical examination. We characterized the association between current iq'mik use and continuous biomarkers of CM status using multiple approaches, including adjustment for measures of Yup'ik lifestyle and a propensity score. RESULTS Based on either adjustment method, current iq'mik use was significantly and positively associated with at least 5% higher HDL-C, and significantly associated but in an inverse direction with multiple biomarkers of CM status including 7% lower TG, 0.05% lower HbA1c, 2% lower FBG, 4% lower WC, and 4% lower BMI. Observed associations for LDL-C, SBP, and DBP varied by adjustment method. CONCLUSIONS This inverse association between iq'mik use and cardiometabolic risk status has not been previously reported. Additional research is needed to replicate these findings and explore physiological mechanisms and/or confounding factors.
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Affiliation(s)
- Tove K Ryman
- a Department of Epidemiology, School of Public Health , University of Washington , Seattle , WA , USA
| | - Bert B Boyer
- b Center for Alaska Native Health Research , University of Alaska Fairbanks , Fairbanks , AK , USA
| | - Scarlett E Hopkins
- b Center for Alaska Native Health Research , University of Alaska Fairbanks , Fairbanks , AK , USA
| | - Jacques Philip
- b Center for Alaska Native Health Research , University of Alaska Fairbanks , Fairbanks , AK , USA
| | - Beti Thompson
- c Department of Health Services , University of Washington , Seattle , WA , USA
| | - Shirley A A Beresford
- a Department of Epidemiology, School of Public Health , University of Washington , Seattle , WA , USA
| | - Kenneth E Thummel
- d Department of Pharmaceutics , University of Washington , Seattle , WA , USA
| | - Melissa A Austin
- a Department of Epidemiology, School of Public Health , University of Washington , Seattle , WA , USA
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23
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Philip J, Ryman TK, Hopkins SE, O'Brien DM, Bersamin A, Pomeroy J, Thummel KE, Austin MA, Boyer BB, Dombrowski K. Bi-cultural dynamics for risk and protective factors for cardiometabolic health in an Alaska Native (Yup'ik) population. PLoS One 2017; 12:e0183451. [PMID: 29091709 PMCID: PMC5665420 DOI: 10.1371/journal.pone.0183451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/06/2017] [Indexed: 11/17/2022] Open
Abstract
Alaska Native people experience disparities in mortality from heart disease and stroke. This work attempts to better understand the relationships between socioeconomic, behavioral, and cardiometabolic risk factors among Yup'ik people of southwestern Alaska, with a focus on the role of the socioeconomic, and cultural components. Using a cross-sectional sample of 486 Yup'ik adults, we fitted a Partial Least Squares Path Model (PLS-PM) to assess the associations between components, including demographic factors [age and gender], socioeconomic factors [education, economic status, Yup'ik culture, and Western culture], behavioral factors [diet, cigarette smoking and smokeless tobacco use, and physical activity], and cardiometabolic risk factors [adiposity, triglyceride-HDL and LDL lipids, glycemia, and blood pressure]. We found relatively mild associations of education and economic status with cardiometabolic risk factors, in contrast with studies in other populations. The socioeconomic factor and participation in Yup'ik culture had potentially protective associations with adiposity, triglyceride-HDL lipids, and blood pressure, whereas participation in Western culture had a protective association with blood pressure. We also found a moderating effect of participation in Western culture on the relationships between Yup'ik culture participation and both blood pressure and LDL lipids, indicating a potentially beneficial additional effect of bi-culturalism. Our results suggest that reinforcing protective effects of both Yup'ik and Western cultures could be useful for interventions aimed at reducing cardiometabolic health disparities.
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Affiliation(s)
- Jacques Philip
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska, United States of America
| | - Tove K. Ryman
- Bill and Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Scarlett E. Hopkins
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska, United States of America
| | - Diane M. O'Brien
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska, United States of America
| | - Andrea Bersamin
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska, United States of America
| | - Jeremy Pomeroy
- Marshfield Clinic Research Institute, Marshfield, Wisconsin, United States of America
| | - Kenneth E. Thummel
- Department of Pharmaceutics, University of Washington, Seattle, Washington, United States of America
| | - Melissa A. Austin
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Bert B. Boyer
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska, United States of America
| | - Kirk Dombrowski
- Department of Sociology, University of Nebraska, Lincoln, Nebraska, United States of America
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Gonzalez MB, Aronson BD, Kellar S, Walls ML, Greenfield BL. Language as a Facilitator of Cultural Connection. ACTA ACUST UNITED AC 2017; 1:176-194. [PMID: 29782622 DOI: 10.5325/aboriginal.1.2.0176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Understanding culture as a means of preventing or treating health concerns is growing in popularity among social behavioral health scientists. Language is one component of culture and therefore may be a means to improve health among Indigenous populations. This study explores language as a unique aspect of culture through its relationship to other demographic and cultural variables. Participants (n = 218) were adults who self-identified as American Indian, had a type 2 diabetes diagnosis, and were drawn from two Ojibwe communities using health clinic records. We used chi-squared tests to compare language proficiency by demographic groups and ANOVA tests to examine relationships between language and culture. A higher proportion of those living on reservation lands could use the Ojibwe language, and fluent speakers were most notably sixty-five years of age and older. Regarding culture, those with greater participation and value belief in cultural activities reported greater language proficiency.
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Walls ML, Whitbeck L, Armenta B. A Cautionary Tale: Examining the Interplay of Culturally Specific Risk and Resilience Factors in Indigenous Communities. Clin Psychol Sci 2016; 4:732-743. [PMID: 28138417 DOI: 10.1177/2167702616645795] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Efforts to build empirical evidence for the protective effects of Indigenous cultural factors on psychological health have yielded mixed findings. We examine the interplay of previously hypothesized culturally relevant risk (discrimination, historical loss) and protective (spiritual activities) factors among Indigenous people. The sample includes 569 Indigenous adolescents (M age = 17.23, SD = 0.88; 51.0% girls) and 563 Indigenous adult caregivers (M age = 44.66, SD = 9.18; 77.4% women). Our central finding was that indigenous spirituality was associated with poorer psychological outcomes across several domains (depressive symptoms, anger, anxiety, somatization and interpersonal difficulties), but observed effects were attenuated once perceived discrimination and historical losses were added to statistical models. Thus, consideration of relevant stressors drastically changed our conclusions, underscoring the uncertain dynamics through which specific Indigenous cultural factors impact mental health. Researchers should work in collaboration with Indigenous communities to improve measurement and empirical investigation of these complex constructs.
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Affiliation(s)
- Melissa L Walls
- University of Minnesota Medical School-Duluth 1035 University Drive 235 SMed Duluth, MN 55812 218-726-8367 (telephone) 218-726-7559 (fax)
| | - Les Whitbeck
- University of Nebraska-Lincoln 711 Oldfather Hall Lincoln, NE 68588-0324
| | - Brian Armenta
- Department of Psychological Sciences, 200 S. 7th Street, University of Missouri, Columbia, MO 65211
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26
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Rex KF, Krarup HB, Laurberg P, Andersen S. Liver biochemistry and associations with alcohol intake, hepatitis B virus infection and Inuit ethnicity: a population-based comparative epidemiological survey in Greenland and Denmark. Int J Circumpolar Health 2016; 75:29528. [PMID: 26928535 PMCID: PMC4772703 DOI: 10.3402/ijch.v75.29528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 01/05/2023] Open
Abstract
Background Hepatitis B virus (HBV) infection is common in Arctic populations and high alcohol intake has been associated with an increased risk of a number of diseases. Yet, a description of the influence of alcohol intake in persons with HBV infection on liver biochemistry is lacking. Objective We aimed to describe the association between reported alcohol intake and liver biochemistry taking into account also HBV infection, ethnicity, Inuit diet, body mass index (BMI), gender and age in an Arctic population. Design and methods Population-based investigation of Inuit (n=441) and non-Inuit (94) in Greenland and Inuit living in Denmark (n=136). Participants filled in a questionnaire on alcohol intake and other life style factors. Blood samples were tested for aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), bilirubin, albumin, hepatitis B surface antigen, hepatitis B surface antibody and hepatitis B core antibody. We also performed physical examinations. Results Participation rate was 95% in Greenland and 52% in Denmark. An alcohol intake above the recommended level was reported by 12.9% of non-Inuit in Greenland, 9.1% of Inuit in East Greenland, 6.1% of Inuit migrants and 3.4% of Inuit in the capital of Greenland (p=0.035). Alcohol intake was associated with AST (p<0.001) and GGT (p=0.001), and HBV infection was associated with ALP (p=0.001) but not with AST, GGT, bilirubin or albumin in the adjusted analysis. Inuit had higher AST (p<0.001), GGT (p<0.001) and ALP (p=0.001) values than non-Inuit after adjustment for alcohol, diet, BMI and HBV exposure. Ethnic origin modified the association between alcohol and AST, while HBV infection did not modify the associations between alcohol and liver biochemistry. Conclusions Non-Inuit in Greenland reported a higher alcohol intake than Inuit. Ethnic origin was more markedly associated with liver biochemistry than was alcohol intake, and Greenlandic ethnicity modified the effect of alcohol intake on AST. HBV infection was slightly associated with ALP but not with other liver biochemistry parameters.
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Affiliation(s)
- Karsten Fleischer Rex
- Department of Internal Medicine, Queen Ingrid's Hospital, Nuuk, Greenland.,Arctic Health Research Centre, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark;
| | - Henrik Bygum Krarup
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Laurberg
- Arctic Health Research Centre, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.,Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Stig Andersen
- Department of Internal Medicine, Queen Ingrid's Hospital, Nuuk, Greenland.,Arctic Health Research Centre, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.,Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
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Kading ML, Hautala DS, Palombi LC, Aronson BD, Smith RC, Walls ML. Flourishing: American Indian Positive Mental Health. SOCIETY AND MENTAL HEALTH 2015; 5:203-217. [PMID: 28966866 PMCID: PMC5619867 DOI: 10.1177/2156869315570480] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Positive mental health (PMH) is an important construct for understanding the full continuum of mental health. Some socially disadvantaged populations experience a paradoxically high level of PMH despite negative social experiences including discrimination. The purpose of this study is to examine the prevalence and culturally salient correlates of PMH among a cross-sectional sample of 218 American Indian adults living with type 2 diabetes mellitus. Although 17.1 percent of individuals in this sample met Patient Health Questionnaire (PHQ-9) criteria for depression, 51.5 percent were in flourishing PMH. Perceived discrimination was negatively associated with PMH, and participation in traditional cultural activities was positively associated with PMH. Traditional cultural activities did not appear to buffer the impact of discrimination on PMH. This study contributes to strengths-based research with American Indian communities, furthers our understanding of correlates of PMH, and documents comparatively high rates of flourishing mental health in our sample relative to previously published studies with diverse samples.
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Affiliation(s)
| | | | | | | | - Reid C Smith
- University of Minnesota, College of Pharmacy-Duluth
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28
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Bersamin A, Wolsko C, Luick B, Boyer B, Lardon C, Hopkins S, Stern JS, Zidenberg-Cherr S. Enculturation, perceived stress, and physical activity: implications for metabolic risk among the Yup'ik--the Center for Alaska Native Health Research Study. ETHNICITY & HEALTH 2014; 19:255-69. [PMID: 23297688 PMCID: PMC3644025 DOI: 10.1080/13557858.2012.758691] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES American Indians and Alaska Natives (ANs) report among the lowest levels of physical activity in the USA, but there is very little systematic research examining the determinants of physical activity patterns in these populations. This study investigated the relationships between enculturation (or cultural traditionality), psychosocial stress, and physical activity in a community-based sample of Yup'ik women and men living in rural AN communities. Associations between these variables and several metabolic risk factors were also examined. DESIGN A sample of 488 Yup'ik participants (284 women and 204 men) from six villages in the Yukon-Kuskokwim Delta region completed a wellness survey and an array of physiological assessments [e.g., body mass index (BMI), blood pressure]. A subset of 179 participants also completed a 3-day pedometer assessment of physical activity. RESULTS Multivariate linear regression models indicated that participants who were more enculturated (i.e., living more of a traditional lifestyle) and who experienced lower levels of psychosocial stress were significantly more physically active. In turn, both lower levels of psychosocial stress and higher levels of physical activity were associated with lower BMI, lower percent body fat, and lower waist circumference. CONCLUSIONS Findings underscore the importance of gaining a culturally specific understanding of physical activity patterns in indigenous groups in order to inform effective health promotion strategies.
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Affiliation(s)
- Andrea Bersamin
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska
| | | | - Bret Luick
- Natural Resource Management, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Bert Boyer
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Cecile Lardon
- Psychology Department, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Scarlett Hopkins
- Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, Alaska
| | - Judith S. Stern
- Department of Nutrition, University of California, Davis, Davis, California
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McNulty Eitle T, Eitle D. Race, coping strategies, and substance use behaviors: a preliminary analysis examining white and American Indian adolescents. Subst Use Misuse 2014; 49:315-25. [PMID: 24041130 PMCID: PMC3971635 DOI: 10.3109/10826084.2013.832329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The association between stress exposure and substance use has been the subject of numerous studies. However, no prior study has explored the role of coping strategies in moderating the stress-substance use association for American Indian adolescents. Our preliminary study of coping strategies and substance use among a sample (n = 568) of rural American Indian and white adolescents revealed a number of similarities across both groups, but also some important differences. Results of logistic regression analyses revealed that the relationship between an avoidant coping strategy and marijuana use differed for whites and American Indians. Study limitations and future research directions are discussed.
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Affiliation(s)
- Tamela McNulty Eitle
- Department of Sociology & Anthropology, Montana State University , Bozeman, Montana , USA
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Abstract
Indigenous circumpolar populations have experienced profound transitions in lifeways over the past half-century as a result of economic development. Although there have been positive aspects of this social transformation, most circumpolar groups today have a triple burden of disease, with a modestly elevated infectious disease level, an elevated and increasing burden of chronic conditions such as obesity and cardiovascular disease, and high rates of mental health–related challenges. The health of contemporary circumpolar populations is not easily characterized because of dramatic regional differences that stem from socioeconomic disparities among nonindigenous groups, individual population histories, lifestyle factors, environmental pollution, and underlying biological variation. Overall health and well-being range from excellent among the Sami of Sweden and Norway to extremely poor among marginalized native populations in northern Russia. Circumpolar groups today are not only threatened by continued regional economic development and pollution, but also uniquely vulnerable to global climate change.
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Affiliation(s)
- J. Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon 97403
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31
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Rivkin I, Trimble J, Lopez EDS, Johnson S, Orr E, Allen J. Disseminating research in rural Yup'ik communities: challenges and ethical considerations in moving from discovery to intervention development. Int J Circumpolar Health 2013; 72:20958. [PMID: 23984272 PMCID: PMC3753057 DOI: 10.3402/ijch.v72i0.20958] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background The native people of Alaska have experienced historical trauma and rapid changes in culture and lifestyle patterns. As a consequence, these populations shoulder a disproportionately high burden of psychological stress. The Yup'ik Experiences of Stress and Coping project originated from rural Yup'ik communities’ concerns about stress and its effects on health. It aimed to understand the stressful experiences that affect Yup'ik communities, to identify coping strategies used to deal with these stressors and to inform culturally responsive interventions. Objectives Here, we examine the process of moving from research (gaining understanding) to disseminating project findings to translation into intervention priorities. We highlight the importance of community participation and discuss challenges encountered, strategies to address these challenges and ethical considerations for responsible intervention research with indigenous communities that reflect their unique historical and current socio-cultural realities. Design Community-wide presentations and discussions of research findings on stress and coping were followed by smaller Community Planning Group meetings. During these meetings, community members contextualized project findings and discussed implications for interventions. This process placed priority on community expertise in interpreting findings and translating results and community priorities into grant applications focused on intervention development and evaluation. Results Challenges included translation between English and Yup'ik, funding limitations and uncertainties, and the long timelines involved in moving from formative research to intervention in the face of urgent and evolving community needs. The lack of congruence between institutional and community worldviews in the intervention research enterprise highlights the need for “principled cultural sensitivity”. Conclusions Cultural sensitivity requires sharing results that have practical value, communicating openly, planning for sustainability and incorporating indigenous knowledge and expertise through a community-guided process. Our research findings will inform continued work within our partnership as we co-develop culturally based strategies for multilevel community interventions to address stress.
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Affiliation(s)
- Inna Rivkin
- Department of Psychology, Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK 99775, USA.
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Eliassen BM, Braaten T, Melhus M, Hansen KL, Broderstad AR. Acculturation and self-rated health among Arctic indigenous peoples: a population-based cross-sectional study. BMC Public Health 2012; 12:948. [PMID: 23127197 PMCID: PMC3497910 DOI: 10.1186/1471-2458-12-948] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 10/31/2012] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Acculturation is for indigenous peoples related to the process of colonisation over centuries as well as the on-going social transition experienced in the Arctic today. Changing living conditions and lifestyle affect health in numerous ways in Arctic indigenous populations. Self-rated health (SRH) is a relevant variable in primary health care and in general public health assessments and monitoring. Exploring the relationship between acculturation and SRH in indigenous populations having experienced great societal and cultural change is thus of great importance. METHODS The principal method in the Survey of Living Conditions in the Arctic (SLiCA) was standardised face-to-face interviews using a questionnaire. Very high overall participation rates of 83% were obtained in Greenland and Alaska, whilst a more conventional rate of 57% was achieved in Norway. Acculturation was conceptualised as certain traditional subsistence activities being of lesser importance for people's ethnic identity, and poorer spoken indigenous language ability (SILA). Acculturation was included in six separate gender- and country-specific ordinal logistic regressions to assess qualitative effects on SRH. RESULTS Multivariable analyses showed that acculturation significantly predicted poorer SRH in Greenland. An increased subsistence score gave an OR of 2.32 (P<0.001) for reporting poorer SRH among Greenlandic men, while an increased score for Greenlandic women generated an OR of 1.71 (P=0.01). Poorer SILA generated an OR of 1.59 in men (p=0.03). In Alaska, no evidence of acculturation effects was detected among Iñupiaq men. Among Iñupiaq women, an increased subsistence score represented an increased odds of 73% (p=0.026) for reporting poorer SRH. No significant effects of acculturation on SRH were detected in Norway. CONCLUSIONS This study shows that aggregate acculturation is a strong risk factor for poorer SRH among the Kalaallit of Greenland and female Iñupiat of Alaska, but our cross-sectional study design does not allow any conclusion with regard to causality. Limitations with regard to wording, categorisations, assumed cultural differences in the conceptualisation of SRH, and confounding effects of health care use, SES and discrimination, make it difficult to appropriately assess how strong this effect is though.
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Affiliation(s)
- Bent-Martin Eliassen
- Department of Community Medicine, Centre for Sami Health Research, University of Tromsø, Tromsø N-9037, Norway.
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Dillard DA, Smith JJ, Ferucci ED, Lanier AP. Depression prevalence and associated factors among Alaska Native people: the Alaska education and research toward health (EARTH) study. J Affect Disord 2012; 136:1088-97. [PMID: 22138285 PMCID: PMC3289282 DOI: 10.1016/j.jad.2011.10.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 10/26/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Few studies have investigated depression among Alaska Native people (ANs). Depression prevalence and associated factors among EARTH Alaska study participants are described. METHODS The nine-item Patient Health Questionnaire (PHQ-9) assessed depression among 3771 ANs. Participants with PHQ-9 scores≥10 out of 27 were classified as positive for depression. Logistic regression analyses evaluated odds of scoring positive versus negative for depression by demographic, cultural, then health and lifestyle factors. RESULTS Twenty percent of women and 13% of men scored positive for depression. Univariate and multivariate models were fit separately for men and women. Among demographic factors, below median income was associated with positive depression scores for both genders. Among men, odds of depression were higher if unmarried and/or if highest educational level was less than high school. Women 34 to 59 years of age had increased odds of scoring positive. Little or no identification with tribal tradition was associated with increased odds of depression in women and decreased odds in men. For both genders, chronic physical conditions and poorer self-reported health were associated with positive depression scores then binge alcohol drinking and current tobacco use increased odds of depression among women only. LIMITATIONS Factors analyzed were self-reported without clinician follow-up in a non-random convenience sample of adults. CONCLUSIONS Depression is common among ANs with rates comparable to other indigenous cross-sectional investigations. Depression is associated with lower income and poorer physical health. Prevention and intervention efforts should consider gender as other associated factors varied between men and women.
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Affiliation(s)
- Denise A. Dillard
- Research Department, Southcentral Foundation, 4501 Diplomacy Drive, Suite 200, Anchorage, AK, 99508, USA
,(907) 729-8518, (907) 729-5464 fax,
| | - Julia J. Smith
- Research Department, Southcentral Foundation, 4501 Diplomacy Drive, Suite 200, Anchorage, AK, 99508, USA
| | | | - Anne P. Lanier
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Natalia K. Climate change effects on human health in a gender perspective: some trends in Arctic research. Glob Health Action 2011; 4:7913. [PMID: 21949499 PMCID: PMC3179263 DOI: 10.3402/gha.v4i0.7913] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 08/19/2011] [Accepted: 08/21/2011] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Climate change and environmental pollution have become pressing concerns for the peoples in the Arctic region. Some researchers link climate change, transformations of living conditions and human health. A number of studies have also provided data on differentiating effects of climate change on women's and men's well-being and health. OBJECTIVE To show how the issues of climate and environment change, human health and gender are addressed in current research in the Arctic. The main purpose of this article is not to give a full review but to draw attention to the gaps in knowledge and challenges in the Arctic research trends on climate change, human health and gender. METHODS A broad literature search was undertaken using a variety of sources from natural, medical, social science and humanities. The focus was on the keywords. RESULTS Despite the evidence provided by many researchers on differentiating effects of climate change on well-being and health of women and men, gender perspective remains of marginal interest in climate change, environmental and health studies. At the same time, social sciences and humanities, and gender studies in particular, show little interest towards climate change impacts on human health in the Arctic. As a result, we still observe the division of labour between disciplines, the disciplinary-bound pictures of human development in the Arctic and terminology confusion. CONCLUSION Efforts to bring in a gender perspective in the Arctic research will be successful only when different disciplines would work together. Multidisciplinary research is a way to challenge academic/disciplinary homogeneity and their boundaries, to take advantage of the diversity of approaches and methods in production of new integrated knowledge. Cooperation and dialogue across disciplines will help to develop adequate indicators for monitoring human health and elaborating efficient policies and strategies to the benefit of both women and men in the Arctic.
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Affiliation(s)
- Kukarenko Natalia
- Department of Social Sciences, Northern Research Institute (NORUT), Tromsø, Norway.
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Loring PA, Duffy LK, Murray MS. A risk-benefit analysis of wild fish consumption for various species in Alaska reveals shortcomings in data and monitoring needs. THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:4532-4541. [PMID: 20673961 DOI: 10.1016/j.scitotenv.2010.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 06/29/2010] [Accepted: 07/01/2010] [Indexed: 05/29/2023]
Abstract
Northern peoples face a difficult decision of whether or not to consume wild fish, which may contain dangerous levels of contaminants such as methylmercury (MeHg), but which also offer a number of positive health benefits, and play an important role in rural household economies. Here, new methods for developing consumption advice are applied to an existing data-set for methylmercury (MeHg) levels in Alaskan fish. We apply a quantitative risk-benefit analysis for eight freshwater, saltwater and anadromous fish species, using dose-response relationships to weigh the risks of MeHg bioaccumulation against the benefits of omega-3 fatty acids (EPA and DHA) toward cardiovascular and neurodevelopmental health endpoints. Findings suggests that consumption of many of the fish species reviewed here, including northern pike, Pacific Halibut, and arctic grayling, may lead to increased risk of coronary heart disease and declines in infant visual recognition memory. However, we also identify significant variation among regions, among studies within the same region, and also within studies, which make it difficult to craft consistent consumption advice. Whereas salmon consistently shows a net-benefit, for instance, data for arctic grayling, pike, sablefish, and some halibut are all too imprecise to provide consistent recommendations. We argue for more detailed local-scale monitoring, and identification of possible thresholds for increased risk in the future. We caution that MeHg and omega-3 FA are just two variables in a complicated calculus for weighing the risks and benefits of locally-available and culturally-significant foods, and argue for future work that takes both a place-based and plate-based approach to diet and contamination.
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Affiliation(s)
- Philip A Loring
- Center for Cross Cultural Studies, University of Alaska Fairbanks, PO Box 756730, Fairbanks, AK 99775, USA.
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Fazzino DV, Loring PA. FROM CRISIS TO CUMULATIVE EFFECTS: FOOD SECURITY CHALLENGES IN ALASKA. ACTA ACUST UNITED AC 2009. [DOI: 10.1111/j.1556-4797.2009.01033.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lehti V, Niemelä S, Hoven C, Mandell D, Sourander A. Mental health, substance use and suicidal behaviour among young indigenous people in the Arctic: a systematic review. Soc Sci Med 2009; 69:1194-203. [PMID: 19700231 DOI: 10.1016/j.socscimed.2009.07.045] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Indexed: 11/15/2022]
Abstract
The Arctic has been a subject to various socio-cultural changes; indigenous people living in the region have experienced injustice and oppression in different forms. Furthermore, there are currently various new social, political and environmental challenges. It has been assumed that the continuous socio-cultural transition has an influence on indigenous people's wellbeing. We conducted a systematic literature review with regard to epidemiological mental health research on Arctic indigenous children and adolescents. The aim was to describe the nature and scope of research conducted and to explore for possible regional and ethnic differences in mental health. It was found that current epidemiological knowledge is based mainly on cross-sectional studies from selected regions and limited to substance use and suicidal behaviour. Youth suicide rates are alarmingly high in many parts of the Arctic, particularly in Greenland and Alaska. Differences between indigenous and non-indigenous groups are also most evident and uniform across suicide studies, with rates being systematically higher among indigenous youth. Substance use is common throughout the Arctic, however, regional and ethnic differences in usage vary considerably. Other psychosocial problems remain largely unexplored. In addition, very little is known about the causes of mental health problems in general and the impact of rapid socio-cultural changes in particular. There are several methodological limitations in the studies included here, many related to the validity of research instruments in different cultural contexts. There is a need for longitudinal comparative studies from the entire Arctic with culturally relevant instruments addressing mental health in early childhood as well.
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Affiliation(s)
- Venla Lehti
- Department of Child Psychiatry, University of Turku, Turku, Finland.
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