Restricted accessResearch articleFirst published online 2022-5
Why Are So Many Indigenous Peoples Dying and No One Is Paying Attention? Depressive Symptoms and “Loss of Loved Ones” as a Result and Driver of Health Disparities
Indigenous peoples have not only experienced a devastating rate of historical loss of lives, they are more likely to experience mortality disparities. The purpose of this article is to examine Indigenous women’s lived experiences of grief and loss in two Southeastern tribes and the relationship between depressive symptoms and recent loss of a loved one. Our exploratory sequential mixed-methods research was informed by the Indigenous based Framework of Historical Oppression, Resilience, and Transcendence (FHORT). We summarized key qualitative themes from ethnographic data from 287 female participants across the two tribes, collected through focus groups, family interviews, and individual interviews. We then quantitatively examined how these themes predicted depressive outcomes among 127 respondents. Specifically, we examined associations between depressive symptoms and components of historical oppression—historical loss, loss of lives, and the presence of PTSD symptoms—along with resilience and transcendence.
BealsJ.Belcourt-DittloffA.GarroutteE. M.CroyC.JervisL. L.WhitesellN. R., Mitchell, C. M., Manson, S. M. & The AI-SUPERPFP Team. (2013). Trauma and conditional risk of posttraumatic stress disorder in two American Indian reservation communities.Social Psychiatry and Psychiatric Epidemiology, 48, 895–905. https://doi.org/10.1007/s00127-012-0615-5
2.
BealsJ.MansonS. M.CroyC.KleinS. A.WhitesellN. R.MitchellC. M. (2013). Lifetime prevalence of posttraumatic stress disorder in two American Indian reservation populations.Journal of Traumatic Stress, 26, 512–520. https://doi.org/10.1002/jts.21835
3.
BreidingM. J.ChenJ.BlackM. C. (2014). Intimate partner violence in the Unites States—2010. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
4.
BrodyD. J.PrattL. A.HughesJ. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016 (NCHS Data Brief No 303). National Center for Health Statistics.
BurnetteC. E.CannonC. (2014). “It will always continue unless we can change something”: Consequences of intimate partner violence for Indigenous women, children, and families. European Journal of Psychotraumatology, 5(1), 1–8. https://doi.org/10.3402%2Fejpt.v5.24585
7.
BurnetteC. E.RennerL. (2017). A pattern of cumulative disadvantage: Risk factors for violence across Indigenous women’s lives. British Journal of Social Work, 47(4), 1166–1185. https://doi.org/10.1093/bjsw/bcw075
8.
BurnetteC. E.SandersS.ButcherH. K.RandJ. T. (2014). A toolkit for ethical and culturally sensitive research: An application with Indigenous communities. Ethics and Social Welfare, 8(4), 364–382. https://doi.org/10.1080/17496535.2014.885987
9.
CarspeckenP. (1996). Critical ethnography in educational research, a theoretical and practical guide. Routledge.
10.
CreswellJ. W. (2015). A concise introduction to mixed methods research. Sage Publications.
11.
Evans-CampbellT. (2008). Historical trauma in American Indian/Native Alaska communities. Journal of Interpersonal Violence, 23(3), 316–338. https://doi.org/10.1177/0886260507312290
12.
Fisher, J. (2010). Development and application of a spiritual well-being questionnaire called SHALOM. Religions, 1(1), 105–121.
13.
GoneJ. P.TrimbleJ. E. (2012). American Indian and Alaska Native mental health: Diverse perspectives on enduring disparities.Annual Review of Clinical Psychology, 8, 131–160. https://doi.org/10.1146/annurev-clinpsy-032511-143127
14.
GuestG.MacQueenK. M. (Eds.) (2008). Handbook for team-based qualitative research. Altamira Press.
IrwinL. (1997). Freedom, law, and prophecy: A brief history of Native American religious resistance. American Indian Quarterly, 21(1), 35–55. https://doi.org/10.2307/1185587
KlostermannK.KelleyM. L.MignoneT.PusateriL.Fals-StewartW. (2010). Partner violence and substance abuse: Treatment interventions. Aggression and Violent Behavior, 15(3), 162–166. https://doi.org/10.1016/j.avb.2009.10.002
19.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.
20.
MastenA. S. (2018). Resilience theory and research on children and families: Past, present, and promise. Journal of Family Theory & Review, 10(1), 12–21. https://doi.org/10.1111/jftr.12255
MoranJ. R.BusseyM. (2007). Results of an alcohol prevention program with urban American Indian youth. Child and Adolescent Social Work Journal, 24(1), 1–21. https://doi.org/10.1007/s10560-006-0049-6
24.
Prins, A., & Ouimette, P. (2004). “The primary care PTSD screen (PC-PTSD): Development and operating characteristics” (vol 16, pg 257, 2003). Primary Care Psychiatry, 9(4), 151–151.
25.
RohS.BurnetteC. E.Lee.Y. (2018). Prayer and faith: Spiritual coping among American Indian women cancer survivors.Health & Social Work, 43(3), 185–192. https://doi.org/10.1093/hsw/hly015
26.
TedeschiR. G.CalhounL. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18. https://doi.org/10.1207/s15327965pli1501_01
27.
ThayerZ.Barbosa-LeikerC.McDonellM.NelsonL.BuchwaldD.MansonS. (2017). Early life trauma, post-traumatic stress disorder, and allostatic load in a sample of American Indian adults. American Journal of Human Biology, 29(3), 1–10. https://doi.org/10.1002/ajhb.22943
28.
UmbersonD.OlsonJ. S.CrosnoeR.LiuH.PudrovskaT.DonnellyR. (2017). Death of family members as an overlooked source of racial disadvantage in the Unites States. Proceedings of the National Academy of Sciences of the Unites States of America, 114(5), 915–920. https://doi.org/10.1073/pnas.1605599114
29.
U.S. Civil Rights Commission. (2004). Broken promises: Evaluating the Native American health care system.
WalshF.McGoldrickM. (2004). Living beyond loss: Death in the family. WW Norton & Company.
32.
WhitbeckL. B.AdamsG. W.HoytD. R.ChenX. (2004). Conceptualizing and measuring historical trauma among American Indian people. American Journal of Community Psychology, 33(3–4), 119–130. https://doi.org/10.1023/B:AJCP.0000027000.77357.31
33.
WordenW. J. (2009). Grief counseling and grief therapy: A handbook for the mental health professional. Springer Publishing Company.
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