COVID-19 vaccine hesitancy among American Indian and Alaska native college students: the roles of discrimination, historical trauma, and healthcare system distrust.

For American Indians and Alaska Native (AIAN) and other communities of color, experiences with discrimination and historical trauma may contribute to healthcare system distrust and negatively affect health care decisions, including vaccination. A saturated path analysis was conducted to examine the direct and indirect associations of thoughts regarding historical losses (of culture, language, and traditional ways) and AIAN racial discrimination with historical loss associated distress, healthcare system distrust, and COVID-19 vaccine hesitancy among AIAN college students (N = 391). Historical loss thoughts and experiences with racial discrimination were strongly associated with each other, and both were uniquely associated with greater historical loss associated distress. In turn, historical loss associated distress was associated with greater healthcare system distrust, which in turn was associated with greater likelihood of being COVID-19 vaccine hesitant. While further research is needed, the findings suggest that to address health disparities for AIAN people it is necessary to consider how to best overcome healthcare system distrust and factors that contribute to it, including historical trauma and contemporary experiences with discrimination.

Community-Focused Policy Advocacy: Evaluating Hawai'i's Historical Trauma Legislation.

Research aimed at reducing health disparities must move beyond the academic and provide practical value. Developing policy briefs that provide a description of the current policy framework along with evidence-based recommendations that can be shared with decision-makers is one way to accomplish this. Researchers, then, can lend their authority to increase awareness moving the policy process forward. The purpose of this paper is to outline a way to develop policy briefs and provide an example of this methodological framework through a case study. The case study was developed as part of a community-engaged research project exploring the conceptualization of historical trauma among Native Hawaiian youth. The policy brief was developed by first searching the Hawai'i State Legislature database in Westlaw limiting the search to the past 10 years for legislation related to historical trauma, structural racism, or related concepts. The results encompassed 104 bills and resolutions, of which 11 passed and 93 failed to pass. Successful legislation acknowledged the role of racism to health and supported the use of trauma-informed care but stopped short of addressing historical trauma. Several gaps were identified including a failure to address collective trauma or trauma specific to colonization suggesting a reluctance to acknowledge intergenerational trauma as an element of present experiences. The policy brief developed for this project was provided to community partners to support their advocacy efforts. This manuscript showcases a process researchers can use to analyze legislative records and develop policy briefs that can support their community partners.

Parental Preconception Adversity and Offspring Health in African Americans: A Systematic Review of Intergenerational Studies.

Background: This systematic review explores the empirical literature addressing the association between parental preconception adversity and offspring physical health in African-American families. Method: We conducted a literature search in PubMed, Web of Science, PsycINFO, CINAHL, and Scopus through June 2021. Articles were included if they: reported data about at least two generations of African-American participants from the same family; measured parental preconception adversity at the individual level; measured at least one offspring physical health outcome; and examined associations between parental adversity and child health. Results: We identified 701 unique articles; thirty-eight articles representing 30 independent studies met inclusion criteria. Twenty-five studies (83%) reported that parental preconception adversity was associated with child health; six studies (20%) reported that parental preconception adversity was not associated with at least one offspring outcome; several studies reported both. Only six studies (20%) reported an association specific to African Americans. Conclusion: Empirical evidence linking parental preconception adversity with offspring physical health in African Americans is limited and mixed. In the current literature, very few studies report evidence addressing intergenerational associations between parental preconception adversity and offspring physical health in the African-American population, specifically, and even fewer investigate forms of parental preconception adversity that have been shown to disproportionately affect African Americans (e.g., racism). To better understand root causes of racial health disparities, more rigorous systematic research is needed to address how intergenerational transmission of historical and ongoing race-based trauma may impact offspring health among African Americans.

The 'Oscar curse' or the price of women's development.

This article aims to reflect on the unconscious dynamics that sustain the shocking increase in feminicide in the world. It is observed that psychological and physical violence by the intimate partner has numerous facets, especially when the woman gains more or has more professional success than her partner. This violence can take a subtle form as rejection and betrayal in order to hurt the woman and destroy her self-esteem and success. Based on numerous studies and bibliography it is demonstrated that the main cause of violence by the intimate partner is the fear of the power of the feminine that has been present throughout history. Despite the evolution of women, historical violence reverberates in the 21st century as an intergenerational trauma causing great suffering in families and disturbances in interpersonal relationships.

Cet article vise à réfléchir aux dynamiques inconscientes qui sous-tendent l'accroissement choquant de féminicides dans le monde. On observe que la violence physique et psychologique par le mari ou le compagnon a de multiples facettes, particulièrement quand la femme gagne plus ou a plus de réussite professionnelle. Cette violence peut prendre la forme subtile de rejet et de trahison afin de blesser la femme et détruire son estime d'elle-même et son succès. En s'appuyant sur de nombreuses études et des travaux bibliographiques nous démontrons que la principale cause de violence par le mari ou le compagnon est la peur de la puissance du féminin, une peur qui est présente à travers toute l'histoire de l'humanité. Malgré l'évolution des femmes la violence historique retentit dans le 21ième siècle comme traumatisme intergénérationnel, produisant de grandes souffrances dans les familles et des perturbations dans les relations interpersonnelles.

Este artículo busca reflexionar sobre las dinámicas inconscientes que sostienen el impactante incremento de femicidios en el mundo. Se observa que la violencia psicológica y física ejercida por la pareja íntima tiene numerosas facetas, especialmente cuando la mujer gana más o tiene un mayor éxito profesional que su compañero. Esta violencia puede adquirir formas sutiles como el rechazo y la traición para lastimar a la mujer y destruir su autoestima y éxito. A partir de numerosos estudios y bibliografía se demuestra que la causa principal de violencia por un compañero íntimo es el miedo al poder del femenino presente a través de la historia. Aún la evolución de la mujer, la violencia histórica reverbera en el siglo XXI como un trauma intergeneracional causando grandes sufrimientos en las familias y perturbaciones en las relaciones interpersonales.

Este artigo tem como objetivo refletir sobre a dinâmica inconsciente que sustenta o aumento chocante do feminicídio no mundo. Observa-se que a violência psicológica e física pelo parceiro íntimo tem inúmeras facetas, especialmente quando a mulher ganha mais ou tem mais sucesso profissional do que seu parceiro. Essa violência pode assumir uma forma sutil como rejeição e traição, a fim de prejudicar a mulher e destruir sua autoestima e sucesso. Com base em inúmeros estudos e bibliografias, demonstra-se que a principal causa de violência pelo parceiro íntimo é o medo do poder do feminino que esteve presente ao longo da história. Apesar da evolução das mulheres, a violência histórica reverbera no século XXI como um trauma intergeracional causando grande sofrimento nas famílias e distúrbios nas relações interpessoais.

Land Rights and Health Outcomes in American Indian/Alaska Native Children.

American Indian and Alaska Native (AI/AN) land rights, sovereignty conflicts, and health outcomes have been significantly influenced by settler colonialism. This principle has driven the numerous relocations and forced assimilation of AI/AN children as well as the claiming of AI/AN lands across the United States. As tribes across the country begin to reclaim these lands and others continue to struggle for sovereignty, it is imperative to recognize that land rights are a determinant of health in AI/AN children. Aside from the demonstrated biological risks of environmental health injustices including exposure to air pollution, heavy metals, and lack of running water, AI/AN children must also face the challenges of historical trauma, the Missing and Murdered Indigenous Peoples crisis, and health care inequity based on land allocation. Although there is an undeniable relationship between land rights and the health of AI/AN children, there is a need for extensive research into the impacts of land rights and recognition of sovereignty on the health of AI/AN children. In this article we aim to summarize existing evidence describing the impact of these factors on the health of AI/AN children and provide strateg ies that can help pediatricians care and advocate for this population.

Transgenerational Trauma and Mental Health Needs among Armenian Genocide Descendants.

The trauma of a genocide can be transmitted to subsequent generations though familial mental health, sociopolitical trauma, and cultural narratives, thereby impacting mental health and well-being. Understanding specific mechanisms that are unique to each ethnic group impacted by genocide illuminates cultural, sociopolitical, and individual factors related to the transmission. For the Armenian community, the unresolved historical loss of the Armenian Genocide of 1915, with the threat of acculturation for such a large diasporic population, a continued denial by the perpetrators, as well as subsequent generations' refugee experiences, may further exasperate the impact of transgenerational trauma from the genocide. This literature review explores the mental health needs of Armenian youth in the current sociopolitical context and provides implications for how schools and communities may use this knowledge to inform supports that center Armenian community healing. Future directions for research are also discussed.

Understanding Racism as a Historical Trauma That Remains Today: Implications for the Nursing Profession.

In order to promote health equity and support the human rights mandate contained in the American Nurses Association's Code of Ethics for Nurses with Interpretive Statements, the nursing profession must understand historically the creation of race, white supremacy in the United States, and entrenched racial terror and brutality toward black and brown racialized populations. Considering the limited racial diversity in the nursing profession despite its stated mission to increase diversity, the profession must build a path to understanding antiblack racism as a historical trauma that remains to this day, a path that encompasses antiracist ideology. Antiracism education is critically needed at the pre-professional and professional levels, for nursing students, providers, educators, administrators, and researchers to inform our own understanding of bias within the contexts of our educational and health-care systems. Dismantling racism requires an enduring commitment to the ultimate goal of social justice for ourselves, our patients, and our communities. This article presents antiracism actions that nurses should employ to dismantle racism, focusing primarily on personal-level initiatives, with self-work as the starting point.

The Black Lives Matter Movement: A Call to Action for Couple and Family Therapists.

The frequent police killings during the COVID-19 pandemic forced a reckoning among Americans from all backgrounds and propelled the Black Lives Matter movement into a global force. This manuscript addresses major issues to aid practitioners in the effective treatment of African Americans via the lens of Critical Race Theory and the Bioecological Model. We place the impacts of racism on Black families in historical context and outline the sources of Black family resilience. We critique structural racism embedded in all aspects of psychology and allied fields. We provide an overview of racial socialization and related issues affecting the parenting decisions in Black families, as well as a detailed overview of impacts of structural racism on couple dynamics. Recommendations are made for engaging racial issues in therapy, providing emotional support and validation to couples and families experiencing discrimination and racial trauma, and using Black cultural strengths as therapeutic resources.

Las frecuentes muertes a manos de la policía durante la pandemia de la COVID-19 obligaron a los estadounidenses de todos los orígenes a hacer una evaluación e impulsaron el movimiento Black Lives Matter hasta convertirlo en una fuerza mundial. Este manuscrito aborda las cuestiones principales con el fin de ayudar a los profesionales en el tratamiento eficaz de los afroestadounidenses desde la perspectiva de la teoría crítica de la raza y el modelo bioecológico. Ubicamos los efectos del racismo en las familias negras en un contexto histórico y describimos las fuentes de resiliencia de estas familias. Analizamos el racismo estructural incorporado en todos los aspectos de la psicología y en áreas afines. Ofrecemos un resumen de la socialización racial y de cuestiones relacionadas que afectan las decisiones de crianza en las familias negras, así como un panorama detallado de los efectos del racismo estructural en la dinámica de pareja. Se dan recomendaciones para integrar las cuestiones raciales en la terapia, brindar apoyo emocional y validación a parejas y familias que sufren discriminación y trauma racial, y usar las ventajas culturales de las personas de color como recursos terapéuticos.

Black Lives Matter: We are in the Same Storm but we are not in the Same Boat.

Black Lives Matter is a clarion call for racial equality and racial justice. With the arrival of Africans as slaves in 1619, a racial hierarchy was formed in the United States. However, slavery is commonly dismissed as that less than noble aspect of the United States' history without really confronting the legacies of racial inequality and racial injustice left in its wake. White supremacy, based on the myths of white superiority and Black inferiority, have obscured racial inequality and racial injustice, resulting in blaming the victims. Using Black Lives Matter as a platform, we focus on some key considerations for theory, research, education, training, and practice in clinical, community, and larger systems contexts. Broadly, we focus on Black Lives Matter, literally; Black dehumanization; historical oppression; healing; and implications for the field of family therapy. More specifically, we draw attention to health disparities, mass incarceration and aggressive policing, intergenerational racial trauma, restorative justice, and antiracist work.

El movimiento Black Lives Matter (Las vidas de los negros son importantes) es un llamamiento a la igualdad y la justicia racial. Con la llegada de los africanos como esclavos en el año 1619, se formó una jerarquía racial en los Estados Unidos. Sin embargo, la esclavitud generalmente se desestima como el aspecto menos noble de la historia de los Estados Unidos sin afrontar realmente los legados de desigualdad e injusticia raciales que dejó. La supremacía blanca, basada en los mitos de la superioridad blanca y la inferioridad negra, han ocultado la desigualdad y la injusticia raciales, lo cual condujo a la culpabilización de las víctimas. Utilizando el movimiento Black Lives Matter como plataforma, nos centramos en algunas consideraciones clave para la teoría, la investigación, la educación, la capacitación y la práctica en contextos clínicos, comunitarios y en sistemas más grandes. En líneas generales, nos centramos en Black Lives Matter, literalmente; en la deshumanización de los negros, la opresión histórica, la recuperación, y las consecuencias para el área de la terapia familiar. Más específicamente, visibilizamos las desigualdades sanitarias, el encarcelamiento masivo y la vigilancia policial agresiva, el trauma racial intergeneracional, la justicia reparadora y la labor antirracista.

Elder Abuse in American Indian Communities: An Integrative Review.

BACKGROUND: American Indian elders have one of the lowest life expectancies in the United States. Disproportionate disease burden, socioeconomic disparities, and higher rates of violence across the lifespan are thought to contribute to higher rates of elder abuse. Elder abuse and higher rates of trauma exposure are linked with adverse outcomes. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the methodology and assessment of the literature on elder abuse among American Indians. RESULTS: Of the nine studies published in the last 30 years, rates of elder abuse varied by study, location, and tribal affiliation from 4.3% to 45.9%. Large studies with comparison populations found higher rates for American Indians. There was a consensus for three risk factors: substance abuse, mental health problems, and caregiving issues. Importance of tribal norms, the notion of respect conferred to elders, and the concept of acculturation were major culturally relevant themes. Perceived tribal norms and strengths, for example, respect for elders, were at odds with abuse experiences, particularly financial exploitation and neglect. Historical trauma, shame, and fear impacted reporting. There was little consistency in study designs, most were qualitative or mixed methods, samples were small, there was no common measurement tool or time frame for abuse, and there was only one intervention study. IMPLICATIONS: High rates of abuse suggest healthcare providers should be encouraged to screen and intervene despite the lack of empirical evidence. Providers should not assume that traditional culturally ascribed strengths, such as honor and respect for elders, provide any degree of protection against elder abuse.

Biological pathways for historical trauma to affect health: A conceptual model focusing on epigenetic modifications.

Despite their unique histories, environments, and lifestyles, historically subjugated populations consistently show poorer health outcomes compared to the general population. The theory of historical trauma, which argues that a collective trauma experienced by one generation can negatively impact the wellbeing of future generations, is a potential framework to understand the adverse health outcomes seen among populations with histories of subjugation. However, the biological pathways through which historical trauma actually impacts health have been unclear. In this paper, we present a cumulative, two pathway model that describes how historical trauma can impact health in contemporary generations. The first pathway suggests that personal exposure to trauma or stressors, which are more common among populations that have experienced historical trauma, can induce epigenetic modifications that can contribute to the development of poor health. The second pathway posits that poor health can occur through intergenerational epigenetic modifications in response to parental and grandparental trauma or stressor exposures. Taken together, these pathways can provide insight into the higher rates of adverse health outcomes among individuals from populations that have historically endured collective trauma. Importantly, the potential reversible nature of epigenetic modifications suggests that these trauma-induced epigenetic effects are not necessarily permanent and that improvements in environmental conditions could reduce the high prevalence of poor health among historically disadvantaged communities.