Sources of stress among midwest American Indian adults with type 2 diabetes

Jessica H.L. Elm, Melissa L Walls, Benjamin D. Aronson

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Despite alarming health disparities among American Indians (AIs) and acknowledgement that stressors negatively influence health, conceptualization of the full spectrum of stressors that impact Indigenous communities is underdeveloped. To address this gap, we analyze focus group transcripts of AI adults with type 2 diabetes from five tribal communities and classify stressors using an inductive/deductive analytical approach. A Continuum of American Indian Stressor Model was constructed from categorization of nineteen stressor categories within four domains. We further identified poverty, genocide, and colonization as fundamental causes of contemporary stress and health outcomes for AIs and conclude that stressors are generally experienced as chronic, regardless of the duration of the stressor. This work on AI-specific stressors informs future health research on the stress burden in AI communities and identifies target points for intervention and health promotion.

Original languageEnglish (US)
JournalAmerican Indian and Alaska Native Mental Health Research
Volume26
Issue number1
DOIs
StatePublished - 2019

Bibliographical note

Funding Information:
Research reported in this manuscript is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (DK091250; M. Walls, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. B. Aronson gratefully acknowledges support from the Agency for Healthcare Research and Quality (1R36HS024180-01). J. Elm gratefully acknowledges support from the National Institute of Drug Abuse (HSN271201500717P, HHSN-271201200663P, 3R01DA039912-03S1) and the Minority Fellowship Program from the Substance Abuse Mental Health Services Administration.

Funding Information:
We gratefully acknowledge the dedicated Community Research Council and Clinical Project Members of the Gathering for Health team, which includes Sidnee Kellar, Rose Barber, Robert Miller, Tweed Shuman, Lorraine Smith, Sandy Zeznanski, Patty Subera, Tracy Martin, Geraldine Whiteman, Lisa Perry, Trisha Prentice, Alexis Mason, Charity Prentice-Pemberton, Kathy Dudley, Romona Nelson, Eileen Miller, Geraldine Brun, Murphy Thomas, Mary Sikora-Petersen, Tina Handeland, GayeAnn Allen, Frances Whitfield, Phillip Chapman, Sr., Hope Williams, Betty Jo Graveen, Daniel Chapman, Jr., Doris Isham, Stan Day, Jane Villebrun, Beverly Steel, Muriel Deegan, Peggy Connor, Michael Connor, Ray E. Villebrun, Sr., Pam Hughes, Cindy McDougall, Melanie McMichael, Robert Thompson, and Sandra Kier. The authors would like to thank Dr. Karina Walters and Leo Egashira from the Indigenous Wellness Research Institute for their help and support, as well as Dr. Miigis Gonzales and Stephanie Willie. Research reported in this manuscript is supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (DK091250; M. Walls, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. B. Aronson gratefully acknowledges support from the Agency for Healthcare Research and Quality (1R36HS024180-01). J. Elm gratefully acknowledges support from the National Institute of Drug Abuse (HSN271201500717P, HHSN-271201200663P, 3R01DA039912-03S1) and the Minority Fellowship Program from the Substance Abuse Mental Health Services Administration.

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