The impact of historical trauma on American Indian health
Trauma has profound implications for mental and physical health. Historical trauma can create health inequities centuries later. American Indian health experts have pointed out that reckoning with historical trauma and the impact it has had on the health and well-being of entire populations is the first step in achieving health equity.
When it comes to health inequities, few groups are as underserved as American Indian and Alaska Native (AI/AN) populations. The health disparities in this group are stark.
At an Infectious Disease Summit, Dr. Roger Dale Walker, Professor Emeritus of Psychiatry in the Oregon Health and Science University School of Medicine, noted the disparities in morbidity that affected AI/AN populations in the United States before the pandemic started.
He mentioned an alarmingly higher prevalence and severity of various conditions among AI/AN than among the general population, such as:
- sixfold higher risk of alcohol use disorder among AI/AN than the general population
- sixfold higher risk of tuberculosis
- 3.5 times higher risk of diabetes
- threefold higher risk of depression
- twofold higher risk of suicide
Dr. Donald Warne — associate dean of Diversity, Equity, and Inclusion at the University of North Dakota School of Medicine and Health Sciences — made similar points.
In his talk, titled “Impact of Unresolved Trauma on American Indian Health Equity,” Dr. Warne gives the example of the region he hails from — Kyle, South Dakota, located within the Pine Ridge reservation.
Here, the average age of death for men is 48 years. For women, it is 54. By comparison, the average age at death in North Dakota is 77.4 for the white population.
“We have a lot of built-in inequity because of our distribution of population,” Dr. Warne notes. He mentions that 15 states in the U.S. do not have federally recognized tribes, which means that these people do not benefit from health policies that serve American Indians.
While reflecting on the truths of history can feel uncomfortable for many of us, the experts featured in this article urge us to do so for the sake of evening out health disparities and achieving equity. As Dr. Warne notes in his talk, "If we are ever going to get to equity, we have to walk through truth, even when it’s unpleasant, even when it makes us uncomfortable.”