Radford Abbey, Toombs Elaine, Zugic Katie, Boles Kara, Lund Jessie, Mushquash Christopher J
Department of Psychology, Lakehead University, Thunder Bay, ON Canada.
Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada.
J Child Adolesc Trauma. 2021 Aug 18;15(2):401-421. doi: 10.1007/s40653-021-00393-7. eCollection 2022 Jun.
Health concerns in Indigenous people are often greater in comparison to those in non-Indigenous populations, including increased rates of chronic diseases and mental health concerns. Adverse childhood experiences (ACEs) may be an explanatory variable for such heightened rates of mental and physical health difficulties for Indigenous populations as these communities have experienced a lack of adequate health care due to remoteness, historical traumas, cultural insensitivity, racism, and perpetuating systemic discrimination. To date, relatively few studies have examined ACEs within an Indigenous population and their relevance to both physical and mental health outcomes. The present study explored existing ACE literature relevant to Indigenous populations and mental or physical health outcomes by retrieving and organizing available ACE literature. A systematic review was conducted using 14 electronic databases of peer-reviewed literature and 18 grey literature databases. Twenty-one publications investigating general health outcomes and prevalence of ACEs met eligibility criteria. ACEs were reported to be higher in Indigenous populations when compared to non-Indigenous population. Higher ACE scores for Indigenous participants were associated with increased rates of suicidality and psychological distress. Protective factors to reduce the impact of ACEs were cultural identity and connectedness, education, social support, and psychological resilience. Future research may further explore the relationship between ACE scores and protective factors, varying prevalence within specific sub-populations, and consistent reporting of outcomes across studies. Ongoing research has the potential to clarify existing dose-response relationships between early traumatic experiences and current health disparities experienced within some Indigenous communities.
与非原住民人口相比，原住民的健康问题往往更为严重，包括慢性病发病率上升和心理健康问题。童年不良经历（ACEs）可能是原住民人群身心健康问题发生率较高的一个解释变量，因为这些社区由于地处偏远、历史创伤、文化不敏感、种族主义以及持续存在的系统性歧视而缺乏足够的医疗保健。迄今为止，相对较少的研究考察了原住民群体中的ACEs及其与身心健康结果的相关性。本研究通过检索和整理现有的ACE文献，探讨了与原住民群体以及身心健康结果相关的ACE文献。使用14个同行评审文献的电子数据库和18个灰色文献数据库进行了系统综述。21项调查一般健康结果和ACEs患病率的出版物符合纳入标准。与非原住民人口相比，据报告原住民群体中的ACEs更高。原住民参与者的ACE得分较高与自杀率和心理困扰增加有关。减少ACEs影响的保护因素包括文化认同和联系、教育、社会支持以及心理复原力。未来的研究可以进一步探讨ACE得分与保护因素之间的关系、特定亚群体中不同的患病率以及跨研究结果的一致报告。正在进行的研究有可能阐明早期创伤经历与一些原住民社区目前经历的健康差距之间现有的剂量反应关系。
