National Native Children's Trauma Center, University of Montana, Missoula, MT 59812, USA.
School of Counseling, Walden University, Minneapolis, MN 55401, USA.
Int J Environ Res Public Health. 2023 Feb 25;20(5):4108. doi: 10.3390/ijerph20054108.
For over two decades, extensive research has demonstrated significant associations between adverse childhood events (ACEs) and a wide range of negative health, mental health, and social outcomes. For Indigenous communities globally, colonization and historical trauma are commonly associated with ACEs, and these effects reverberate through generations. While the ACEs conceptual framework expanded pyramid is a useful model and a visual aid for understanding the historical and present-day dimensions of ACEs in Indigenous communities, a healing conceptual framework is needed to outline a path toward increased community well-being. In this article, we provide a holistic Indigenous Wellness Pyramid that represents the other side of the ACEs pyramid to guide pathways toward healing in Indigenous communities. In this article, the authors describe the Indigenous Wellness Pyramid according to each of the following contrasts with the ACEs pyramid: Historical Trauma-Intergenerational Healing/Indigenous Sovereignty; Social Conditions/Local Context-Thriving Economic and Safe Communities; ACEs-Positive Childhood, Family, and Community Experiences; Disrupted Neurodevelopment-Consistent Corrective Experiences/Cultural Identity Development; Adoption of Health Risk Behaviors-Cultural Values and Coping Skills; Disease Burden and Social Problems-Wellness and Balance; Early Death-Meaningful Life Longevity. We provide examples, supporting research, and implications for implementing the Indigenous Wellness Pyramid.
二十多年来，大量研究表明，不良的儿童期经历（ACEs）与广泛的负面健康、心理健康和社会结果之间存在显著关联。对于全球的原住民社区来说，殖民化和历史创伤通常与 ACEs 相关，这些影响会代代相传。虽然 ACEs 概念框架扩展金字塔是一个有用的模型，也是理解原住民社区 ACEs 的历史和当前维度的视觉辅助工具，但需要一个治愈的概念框架来概述一条增加社区福祉的道路。在本文中，我们提供了一个整体的原住民健康金字塔，代表 ACEs 金字塔的另一面，为原住民社区的治愈之路提供指导。在本文中，作者根据以下每一个方面与 ACEs 金字塔进行对比来描述原住民健康金字塔：历史创伤-代际疗愈/原住民主权；社会条件/当地背景-繁荣的经济和安全社区；ACEs-积极的童年、家庭和社区经历；神经发育中断-一致的纠正经历/文化认同发展；采用健康风险行为-文化价值观和应对技能；疾病负担和社会问题-健康和平衡；早逝-有意义的长寿人生。我们提供了实施原住民健康金字塔的例子、支持研究和影响。
