Du Bois Review: Social Science Research on Race

Unpacking Racism and its Health Consequences

BODIES DON'T JUST TELL STORIES, THEY TELL HISTORIES

Embodiment of Historical Trauma among American Indians and Alaska Natives1

Karina L. Waltersa1 c1, Selina A. Mohammeda2, Teresa Evans-Campbella3, Ramona E. Beltrána4, David H. Chaea5 and Bonnie Durana6

a1 School of Social Work and Indigenous Wellness Research Institute, University of Washington

a2 Nursing Program, University of Washington Bothell

a3 School of Social Work and Indigenous Wellness Research Institute, University of Washington

a4 Department of Psychiatry and Behavioral Sciences and Indigenous Wellness Research Institute, University of Washington

a5 Rollins School of Public Health, Emory University

a6 Department of Health Services and Indigenous Wellness Research Institute, University of Washington

Abstract

Increasingly, understanding how the role of historical events and context affect present-day health inequities has become a dominant narrative among Native American communities. Historical trauma, which consists of traumatic events targeting a community (e.g., forced relocation) that cause catastrophic upheaval, has been posited by Native communities and some researchers to have pernicious effects that persist across generations through a myriad of mechanisms from biological to behavioral. Consistent with contemporary societal determinants of health approaches, the impact of historical trauma calls upon researchers to explicitly examine theoretically and empirically how historical processes and contexts become embodied. Scholarship that theoretically engages how historically traumatic events become embodied and affect the magnitude and distribution of health inequities is clearly needed. However, the scholarship on historical trauma is limited. Some scholars have focused on these events as etiological agents to social and psychological distress; others have focused on events as an outcome (e.g., historical trauma response); others still have focused on these events as mechanisms or pathways by which historical trauma is transmitted; and others have focused on historical trauma-related factors (e.g., collective loss) that interact with proximal stressors. These varied conceptualizations of historical trauma have hindered the ability to cogently theorize it and its impact on Native health. The purpose of this article is to explicate the link between historical trauma and the concept of embodiment. After an interdisciplinary review of the “state of the discipline,” we utilize ecosocial theory and the indigenist stress-coping model to argue that contemporary physical health reflects, in part, the embodiment of historical trauma. Future research directions are discussed.

(Online publication April 15 2011)

Keywords

  • Historical Trauma;
  • Embodiment;
  • Stress;
  • American Indian;
  • Alaska Native;
  • Native American;
  • First Nations;
  • Indigenous

Correspondence:

c1 Karina L. Walters, School of Social Work, University of Washington, Box 354900, 4101 Fifteenth Avenue NE, Seattle, WA 98105. E-mail: kw5@uw.edu

Karina L. Walters is Associate Professor at the University of Washington School of Social Work, Director of the Indigenous Wellness Research Institute, and Endowed Professor, William P. and Ruth Gerberding University Professorship. Dr. Walters is an enrolled member of the Choctaw Nation of Oklahoma. Her research focuses on historical, social, and cultural determinants of health and substance abuse among American Indians and Alaska Natives. Currently, Dr. Walters is the Principal Investigator of a NHLBI-funded CVD risk prevention study among a Northwest tribe and an Indigenous HIV/AIDS Research Training grant. She serves on the Ad Hoc Committee on Racial and Ethnic Diversity for the Office of AIDS Research and the Native American Research Advisory Council for the National Institute of Drug and Alcohol Abuse.

Selina A. Mohammed is Assistant Professor in the Nursing Program at the University of Washington Bothell. Dr. Mohammed holds a BS in Nursing from the University of Cincinnati, MS in Nursing from the University of Michigan, MPH from the University of Washington, and PhD in Nursing Science from the University of Washington. Her scholarship interests include racial discrimination and health, as well as the use of critical research methodologies to explore how historical, socio-cultural, political, and economic contexts contribute to health disparities in chronic illness for American Indians. Currently, she is supported by NHLBI to study cardiovascular disease and diabetes prevention among a Northwest indigenous tribe.

Teresa Evans-Campbell is Associate Professor at the University of Washington School of Social Work, Associate Director of the Indigenous Wellness Research Institute, and Director of the Center for Indigenous Child Welfare and Family Research. Dr. Evans-Campbell serves as principle investigator on several sponsored research and training projects. She is an enrolled member of the Snohomish Tribe of Indians and served on her Tribal Council for two years. Dr. Evans-Campbell has also served on numerous advisory boards and committees related to indigenous health and wellness. Her research interests include historical trauma, resistance, and healing; cultural buffers of trauma; substance use and mental health; and indigenous family wellness.

Ramona E. Beltrán is a Postdoctoral Fellow in the Department of Psychiatry Center for Studies on Health and Risk Behaviors (CSHRB) and affiliate of the School of Social Work Indigenous Wellness Research Institute (IWRI) at the University of Washington in Seattle. She holds a PhD in Social Welfare and specializes in using an interdisciplinary approach to health and wellness in indigenous communities. Her scholarship focuses on relationships among space and place, historical trauma, embodiment, and health and mental health processes among indigenous populations, specifically in the area of chronic disease and substance abuse disparities and their connection to colonization and environmental justice.

David H. Chae is Assistant Professor in the Department of Behavioral Sciences and Health Education at Emory University, Rollins School of Public Health. He received his Doctor of Science degree from Harvard University, School of Public Health. He is a social epidemiologist with a background in sociology and psychology. He was a Robert Wood Johnson Health and Society Scholar, a W. K. Kellogg Predoctoral Fellow in Health Policy, and Research Fellow at the Cambridge Center for Multicultural Mental Health Studies. His research interests are in studying psychobiological stress-pathways linking social inequalities and health. Chae is currently investigating the impact of interpersonal forms of discrimination and dimensions of group identity in health and disease processes, including via inflammatory mechanisms and cellular aging.

Bonnie Duran is Associate Professor in the Department of Health Services, University of Washington School of Public Health and Community Medicine, and Director of the Center for Indigenous Health Research at the Indigenous Wellness Research Institute. Dr. Duran has worked in public health research, evaluation, and education among Native Americans and other communities of color for twenty-seven years. In the past decade, she has conducted studies of mental disorder prevalence, victimization risk factors and treatment seeking among Native American women attending Indian Health Service primary care facilities, and men and women from rural reservation communities. The overall aims of her research are to work with communities to design treatment and prevention efforts that are empowering, culture-centered, assessable, and sustainable.

Footnotes

1 The theoretical development of this work was supported in part by the Network for Multicultural Research on Health and Healthcare, Dept. of Family Medicine, David Geffen School of Medicine, UCLA, funded by the Robert Wood Johnson Foundation; as well as supported in part by the National Heart, Lung, and Blood Institute (5U01HL087322-05), National Institute of Mental Health (MH65821), the Office of Research on Women's Health, The Office of AIDS Research, and the National Center on Minority Health and Health Disparities.

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