Historical Trauma, Discrimination, and Alcohol Use Among Indigenous Peoples in Taiwan

Purpose: Alcohol use has become one of significant health challenges among Taiwanese indigenous communities. In recent decades, certain studies have examined determinants of alcohol use among Taiwanese indigenous peoples, and the majority of them have primary focused on biological factors, family dynamics, peer pressure, socioeconomic status, and acculturation. Few studies have explored the influences of historical factors and discrimination on indigenous peoples' alcohol use in Taiwan. Increasing research in indigenous communities globally has focused on the effects of historical trauma and discrimination on indigenous health. Historical Trauma framework emphasizes that contemporary indigenous health outcomes (e.g., substance use) are the far-reaching effects of collective and generational historical traumatic events due to colonial oppression. The negative impact of discrimination on mental health and health risk behaviors is also widely supported. Driven by historical trauma and discrimination literature, this study aimed to investigate the impact of historical trauma and discrimination on alcohol use disorder among Taiwanese indigenous communities.

Method: The study used a cross-sectional survey, which was conducted between 2015 and 2016, among 245 indigenous tribal members (20- 83 years) who live in the East Taiwan. Alcohol use disorder was measured by the Mandarin version of the Alcohol Use Disorder Identification Test, which has been verified as a reliable and valid instrument for use with Taiwanese populations (10 items; α=0.86). Historical trauma was assessed by the Intergenerational Historical Trauma Adversity Scale (9 items; α=0.86), which was designed based on the context of Taiwanese indigenous communities and measured their generational historical traumatic experiences. Perceived discrimination was measured by the Everyday Discrimination Scale, which evaluated subjective experiences of discrimination (9 items, α=0.88). Multiple regression analysis was conducted to examine the association between historical trauma and discrimination on alcohol use disorders after controlling demographic variables (i.e., age, gender, education and employment). 

Findings: A multiple linear regression analysis was employed to predict alcohol use disorder, and the results indicated that both predictors (i.e., exposure to historical trauma and perceived discrimination) are positively associated with alcohol use disorder (β= .37, p < .001; β =. 20, p < .01, respectively). Moreover, the multiple linear regression model's degree of explaining the variance in the alcohol use disorder was R²=.395 [F (6, 238) = 24.38, p < .001]. Implications/Conclusions: The findings of the study expand the literature of determinants of alcohol use among Taiwanese indigenous peoples and suggest the importance of considering the influence of historical trauma and perceived discrimination on alcohol use disorder. To address alcohol use disorder among indigenous communities in Taiwan, those who work with indigenous communities should acknowledge the influences of historical trauma and discrimination on their drinking behaviors.