American Indian health disparities: Psychosocial influences

The American Indian (AI) population suffers from significant health disparities. Death rates from diabetes, cancer, infant mortality, and other causes are higher among AIs. Numerous psychosocial influences, including a history of genocide and boarding school experiences, have led to unresolved historical trauma and its associated poor health outcomes. Adverse childhood experiences are also a strong predictor of risk for numerous chronic and behavioral health conditions. Food programs for impoverished populations historically have led to high rates of formula feeding of infants and intake of high-calorie, low nutritional value foods. Adverse adulthood experiences, including poverty, racism, and substance abuse, lead to depression, anxiety, and poor health outcomes. These social circumstances can have an impact on the quality of parenting skills for the next generation, leading to continued intergenerational health disparities. Additional research into the psychosocial influences and social determinants of health is needed to ensure improved policy and program development.