Department of Community and Behavioral Health,Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, Aurora, CO, 80045, USA.
Soc Psychiatry Psychiatr Epidemiol. 2018 May;53(5):521-530. doi: 10.1007/s00127-018-1494-1. Epub 2018 Feb 22.
Research on American Indian and Alaska Native (AIAN) mental health disparities is based largely on either tribal populations or national samples of adults that do not account for multiracial AIANs, even though over 40% of AIANs identify with multiple racial groups. The present investigation extends this research by assessing mental health status in a national sample of multiracial AIAN adults relative to adults who identify exclusively as either AIAN or White.
2012 BRFSS data were used to conduct multinomial logistic regression analyses comparing mental health outcomes among respondents who identified as either AIAN and one or more other races (AIAN-MR), AIAN-Single Race (AIAN-SR), or White-SR.
After demographic adjustment, the AIAN-MR group reported a higher lifetime prevalence of diagnosed depressive disorder, more days of poor mental health, and more frequent mental distress compared to both the AIAN-SR and White-SR groups. AIAN-MR individuals also had higher levels of Kessler 6 (K6) non-specific psychological distress compared to White-SR individuals but not AIAN-SR adults. Differences between AIAN-SR and White-SR adults were found in days of poor mental health, frequent mental distress, and total K6 scores.
These findings help gauge the magnitude of mental health disparities in the U.S. AIAN population and pinpoint AIAN subgroups for whom mental health is particularly problematic. As such, they raise concerns about restrictions that limit the identification of national survey respondents who report multiple race designations. Such restrictions will thwart efforts to understand the causal mechanisms and pathways leading to mental distress among AIAN individuals.
美国印第安人和阿拉斯加原住民（AIAN）心理健康差异的研究主要基于部落人群或不考虑多种族 AIAN 的成年人的全国样本，尽管超过 40%的 AIAN 认同多个种族群体。本研究通过评估全国多种族 AIAN 成年人群相对于仅认同 AIAN 或白人的成年人的心理健康状况，扩展了这一研究。
使用 2012 年 BRFSS 数据，通过多项逻辑回归分析比较了自认为是 AIAN 和一个或多个其他种族（AIAN-MR）、AIAN 单一种族（AIAN-SR）或白人-SR 的受访者的心理健康结果。
在人口统计学调整后，AIAN-MR 组报告的终生诊断为抑郁障碍的患病率、心理健康不佳的天数和精神困扰的频率均高于 AIAN-SR 和白人-SR 组。与白人-SR 个体相比，AIAN-MR 个体的 Kessler 6（K6）非特异性心理困扰水平也更高，但与 AIAN-SR 成年人没有差异。AIAN-SR 和白人-SR 成年人在心理健康不佳的天数、频繁的精神困扰和总 K6 评分方面存在差异。
这些发现有助于评估美国 AIAN 人群中心理健康差异的程度，并确定心理健康问题特别突出的 AIAN 亚群。因此，这些发现引发了对限制识别报告多种族身份的全国调查受访者的限制的关注。这些限制将阻碍理解导致 AIAN 个体精神困扰的因果机制和途径的努力。
