Discrimination and Environmental Changes As Stressors Among Indigenous Peoples in South Louisiana

Background and Purpose: Indigenous coastal communities, given their attachment to and dependence on the land, are especially vulnerable to environmental changes (Ford, 2012). In addition, indigenous peoples worldwide have poorer health compared to their majority groups (Anderson et al., 2006; Castor et al., 2006; Gracey & King, 2009; King, Smith, & Gracey, 2009; Lama, 2012). The aim of this study is to understand the mental health outcomes of environmental changes and shared cultural experiences among indigenous peoples in south Louisiana. A community advisory council was developed to guide culturally relevant research procedures.

Methods: This community- engaged study uses a concurrent mixed methods design that involves collecting interviewer-administered surveys (n=160) and in-depth qualitative interviews (n=19) simultaneously, analyzing both sets of data, and then merging those results with the purpose of comparing the results with each other using non-probability sampling strategies. Participants were over 30 years of age, enrolled tribal members, and earned income from subsistence activities. Independent sociodemographic variables including age, gender, first language, “Indian” school attendance, education, relationship status and poverty were examined in relation to meeting criteria of DSM-IV diagnosis for anxiety, depression, and post-traumatic stress disorder. Independent indigenous-specific factors including social support, ethnic identity, discrimination, and historical loss were also examined to test the extent to which observed variation in meeting criteria for a mental health diagnosis was driven by the variation in indigenous-specific factors and environmental change exposure. Qualitative interviews were coded using thematic analysis.

 

Results: Logistic regression model suggested that, when controlling for sociodemographic variables and indigenous-specific variables, those who experience discrimination were 5.34 times as likely as those who do not experience discrimination (OR = 5.34, CI = 1.56 – 18.92) and those who were exposed to environmental changes were 17% more likely (OR = 1.17, CI = 1.01-1.35) of meeting criteria for a mental health diagnosis. Participants reported institutional barriers to education and economic resources based on their race. Participants also reported how they observed and experienced changes to their environment.

Conclusion and Implications: Indigenous peoples’ relationship with land is spiritual, cultural, and place-specific (Pierotti & Wildcat, 2000; Rosier, 2003; Schultz, et al., 2016; Settee, 2008). Interruption of Indigenous Peoples’ ability to interact with land and discrimination are contemporary forms of trauma. Interventions aimed to address poor mental health with indigenous peoples should include considerations of access to care, cultural adaptations of effective treatments, and systems approaches.