Understanding the Link Between Racial Trauma and Substance Use Among American Indians
Understanding the Link Between Racial Trauma and Substance Use Among American Indians
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DOI：
10.1037/amp0000331
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发表时间：
2019-01-01
影响因子：
16.4
通讯作者：
Blume, Arthur W.
中科院分区：
文献类型：
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作者：
Skewes, Monica C.;Blume, Arthur W.
来自不同学科的历史学家和学者记录了种族主义对美国社会和文化的普遍影响，包括对美国印第安人的健康和福祉的影响。在历史上和当前受种族歧视和压迫影响的许多健康问题中，药物使用障碍是其中之一。流行病学研究表明，与其他族裔群体相比，阿拉斯加原住民中与药物和酒精有关的发病率和死亡率更高，迫切需要文化上适当的有效干预措施。作为一个更大的基于社区的参与性研究项目的一部分，我们收集了来自蒙大拿州边境保留地的25名AI关键线人的定性访谈数据，以解决农村AI社区的物质使用差异。使用半结构化的采访指南，我们要求参与者讨论他们的看法的原因，物质使用的问题和障碍，以恢复的保留。虽然没有具体询问歧视问题，但主要的信息提供者指出，种族主义造成的压力是使用药物的重要诱因，也是康复的障碍。正如一位与会者所说：“压迫是所有毒品和酒精引起的疾病的总伞。“参与者还将殖民化造成的历史创伤确定为导致行为健康问题的种族压力的表现。研究结果表明，对患有物质使用障碍和其他慢性健康问题的人工智能的干预措施，如果能够解决健康的社会决定因素，如种族歧视和历史创伤，可能会更有效。
Historians and scholars from various disciplines have documented the pervasive influence of racism on American society and culture, including effects on the health and well-being of American Indian ( AI) people. Among the many health problems affected by racial discrimination and oppression, both historical and current, are substance use disorders. Epidemiological studies have documented greater drug and alcohol-related morbidity and mortality among AI/AN Alaska Natives compared to other ethnic groups, and culturally appropriate, effective interventions are sorely needed. We collected, as part of a larger community-based participatory research project to address substance use disparities in rural AI communities, qualitative interview data from 25 AI key informants from a frontier reservation in Montana. Using a semistructured interview guide, we asked participants to discuss their perceptions of the causes of substance use problems and barriers to recovery on the reservation. Although no questions specifically asked about discrimination, key informants identified stress from racism as an important precipitant of substance use and barrier to recovery. As one participant stated: "Oppression is the overarching umbrella for all sickness with drugs and alcohol." Participants also identified historical trauma resulting from colonization as a manifestation of race-based stress that drives behavioral health problems. Findings suggest that interventions for AIs with substance use disorders, and possibly other chronic health problems, may be more effective if they address social determinants of health such as racial discrimination and historical trauma.