Historical Loss: Implications for Health of American Indians in the Blackfeet Community

Abstract

Background: Historical loss in American Indians (AIs) is believed to contribute to high incidence of mental health disorders, yet less is known about the associations between historical loss and physical health.

Purpose: To investigate whether frequency of thought about historical loss predicts risk factors for chronic physical health conditions in an AI community.

Methods: Using Community Based Participatory research (CBPR) and Ecological Momentary Assessment (EMA), we measured frequency of thoughts about historical loss in 100 AI adults residing on the Blackfeet reservation. Participants completed a 1-week monitoring period, during which ambulatory blood pressure and daily levels of psychological stress were measured. At the end of the week, we collected a dried blood spot sample for measurement of C-reactive protein (CRP).

Results: In hierarchical linear regression models controlling for demographics and relevant covariates, greater frequency of thoughts about historical loss predicted higher average daily psychological stress (B = .55, t = 6.47, p < .001, ΔR2 = .30) and higher levels of CRP (B = .33, t = 3.93, p < .001, ΔR2 = .10). Using linear mixed modeling with relevant covariates, we found that greater thoughts about historical loss were associated with higher systolic ambulatory blood pressure (B = .32, 95% CI = .22-.42, t = 6.48, p < .001, ΔR2 = .25; Fig. 1c) and greater diastolic ambulatory blood pressure (B = .19, 95% CI = .11-.27, t = 4.73, p < .001, ΔR2 = .19).

Conclusions: The data suggest that frequency of thought about historical loss may contribute to increased subclinical risk for cardiovascular disease in the Blackfeet community.

Keywords: Ambulatory blood pressure; American Indians; Historical loss; Inflammation; Psychological stress ∙ Ecological Momentary Assessment.

Figure 1.

Associations between historical loss and indicators of stress. (a) Association between historical loss and average daily stress. (b) Association between historical loss and CRP. (c) Association between historical loss and systolic ambulatory blood pressure. (d) Association between historical loss and diastolic ambulatory blood pressure.