4.5 Article

The Generational Impact Of Racism On Health: Voices From American Indian Communities

Journal

HEALTH AFFAIRS
Volume 41, Issue 2, Pages 281-288

Publisher

PROJECT HOPE
DOI: 10.1377/hlthaff.2021.01419

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Almost every policy and action towards American Indians and Alaska Natives since initial contact with non-Natives exhibits structural racism. This has resulted in intergenerational effects that marginalized the health and healthcare system of these populations. The devastating psychological impact erodes their communal values and the sanctity of creation. By sharing stories and case studies, we shed light on the historical trauma and its connection to the health disparities faced by American Indians and Alaska Natives, and propose policy measures to address systemic racism and promote their well-being.
Structural racism toward American Indians and Alaska Natives is found in nearly every policy regarding and action taken toward that population since non-Natives made first contact with the Indigenous peoples of the United States. Generations of American Indians and Alaska Natives have suffered from policies that called for their genocide as well as policies intended to acculturate and dominate them-such as the sentiment from Richard Henry Pratt to kill the Indian..., save the man. The intergenerational effect is one that has left American Indians and Alaska Natives at the margins of health and the health care system. The effect is devastating psychologically, eroding a value system that is based on community and the sanctity of all creation. Using stories we collected from American Indian people who have experienced the results of racist policies, we describe historical trauma and its links to the health of American Indians and Alaska Natives. We develop two case studies around these stories, including one from a member of the Navajo Nation's experiences during the COVID-19 pandemic, to illustrate biases in institutionalized structures. Finally, we describe how the American Indian and Alaska Native Cultural Wisdom Declaration can help policy makers eliminate the effect of systemic racism on the health of American Indians and Alaska Natives-for instance, by lifting constraints on federal funding for American Indian and Alaska Native initiatives and allowing payment to traditional healers for their health services.

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