Palimaru Alina I, Malika Nipher, Brown Ryan A, Holmes Pierrce, Dickerson Daniel L, Rodriguez Anthony, Johnson Carrie L, Sanchez Virginia Arvizu, D'Amico Elizabeth J
RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA.
RAND Corporation, Boston, MA, USA.
J Racial Ethn Health Disparities. 2025 Mar 3. doi: 10.1007/s40615-025-02328-6.
Centuries of trauma, displacement, and discrimination have taken a toll on American Indian/Alaska Native (AI/AN) life expectancy and health outcomes. Despite resilience, AI/AN emerging adults (EAs) face mental and behavioral health disparities, including substance use, posttraumatic stress, and suicide. Research has consistently shown that AI/AN EAs are at risk of experiencing discrimination, which can range from linguistic taunts to physical threats and violence, as well as institutional discrimination. Discrimination is a key driver of health, and yet, there has been limited research to understand what types of discrimination events occur in this population, and how these experiences may be perceived and processed by AI/AN EAs. Interviews with a subsample of 20 participants from a larger clinical trial explored dimensions of discrimination, including types of experiences; perceived motivation and impact; and how participants coped. Results highlight nuances in experienced discrimination, including vivid accounts of verbal and physical aggression. Some participants identified teachers or highly educated colleagues who were perceived to contribute to the problem. A surprising finding was the experience of discrimination in social interactions with tribal communities and other minority groups. This complements prior evidence of discrimination in and around AI/AN areas, suggesting that additional mechanisms of discrimination should be studied further. Results also highlight how participants were resilient, for example, by accessing support in the form of tribal workshops or professional mentoring. This study highlights opportunities for additional research, as well as actionable details that could inform programming to help AI/AN EAs cope with discrimination.
几个世纪以来的创伤、流离失所和歧视对美国印第安人/阿拉斯加原住民（AI/AN）的预期寿命和健康状况造成了损害。尽管具备复原力，但AI/AN的新兴成年人（EA）仍面临心理和行为健康方面的差异，包括药物使用、创伤后应激障碍和自杀问题。研究一直表明，AI/AN的EA有遭受歧视的风险，歧视形式多样，从言语嘲讽到身体威胁和暴力，以及制度性歧视。歧视是健康问题的一个关键驱动因素，然而，对于该人群中发生何种类型的歧视事件，以及AI/AN的EA如何看待和处理这些经历，相关研究却很有限。对来自一项更大规模临床试验的20名参与者的子样本进行访谈，探讨了歧视的各个方面，包括经历的类型；感知到的动机和影响；以及参与者的应对方式。结果突出了所经历歧视中的细微差别，包括对言语和身体攻击的生动描述。一些参与者指出教师或受过高等教育的同事被认为是问题的一部分。一个令人惊讶的发现是在与部落社区和其他少数群体的社会互动中也存在歧视现象。这补充了此前关于AI/AN地区内外存在歧视的证据，表明应进一步研究其他歧视机制。结果还突出了参与者的复原力，例如，通过参加部落研讨会或获得专业指导等形式获得支持。这项研究突出了进一步开展研究的机会，以及可为帮助AI/AN的EA应对歧视的项目提供信息的可操作细节。
