American Indian and Alaskan Native Resilience: A Life Course Approach

For American Indian and Alaskan Natives (AIAN) the life-course approach holds promise for understanding the role of political and social determinants of resilience and health disparities. The etiology of AIAN health disparities is rooted in a history of policy change and social discrimination. Yet AIAN public health tends to focus on individual behavioral change and the contemporary context. Using a historical framework a series of systematic reviews were conducted of the peer-reviewed literature. Social science and medical literature databases were surveyed. Inclusion criteria: 1) English, 2) peer- reviewed, available, and published between January 1, 1970 – December 31, 2013; 3) identify American Indian and Alaska Native; 4) identify life-course and 5) identify social and political factors. The studies were grouped chronologically to provide a context for the life course approach for AIAN health. In the public health literature, AIAN resilience and disparities are described as individual processes. Yet the socio-cultural literature suggests AIAN resilience and equity is linked to the collective processes of navigating and negotiating uncertain resources. This series of literature reviews reveals current approaches to AIAN public health does not use a life course and social determinant framework. The political and social environment is a significant driver in AIAN health disparities. To better understand AIAN resilience and positive health outcomes, a greater focus is needed on the socio-ecological stressors and protective factors through the life course. Studying AIAN resilience requires tools to capture the interaction between collective behaviors, and social and political determinants.