Abstract

Conceptualization of Historical Trauma in Native Hawaiian Youth

Lorinda Riley, Anamalia Suʻesuʻe, Kristina Hulama University of Hawaiʻi Mānoa

APHA 2022 Annual Meeting and Expo

The traumatic effects of colonization, especially the forced relocation from land have led to complex, interconnected health disparities seen among Indigenous people today. Native Hawaiians have described a collective feeling of kaumaha (heavy, oppressive sadness) resulting from collective land dispossession, overthrow of the Hawaiian Kingdom, cultural loss, and more. Historical trauma or the cumulative emotional and psychological wounding over one’s lifespan and across generations is rooted in a history of colonization and linked to high rates of substance misuse, depression, suicidality, and other mental health disparities in American Indian populations. Historical trauma is further compounded in the present day through persistent racism, microaggressions, and epigenetic expressions reflecting environmental trauma in genetic makeup. While historical trauma has been explored in American Indian populations, less work has been done among Native Hawaiians.

This qualitative study used Indigenous talk story interviews to explore how Native Hawaiian youth understand and experience historical trauma. An Indigenous research team conducted sessions with 10 justice-involved Native Hawaiian youth and 15 service providers and/or legislators to identify the unique constructs of historical trauma among Native Hawaiian youth. A series of themes and constructs were identified among the youth and confirmed by the service providers, including loss of access to land, anger, cultural loss, persistent poverty, and tourism. This study addresses the community’s desire for empirical research on Native Hawaiian historical trauma and provides the first step to quantify historical trauma among Native Hawaiian youth as well as identifying barriers for addressing historical trauma at the state level.

Abstract

E Kolo Ana Nō Ka I Ēwe i ka ʻIewe: Indigenous-Focused Federal Grants Done Indigenously

Ikaika Ramones, PhDc, MPhil, CAGS, and Johnny Aldan, MPH. University of Hawaiʻi - Center for Indigenous Innovation & Health Equity

APHA 2022 Annual Meeting and Expo

The University of Hawaiʻi Center for Indigenous Innovation and Health Equity (CIIHE) was established through the U.S. Department of Health and Human Services Office of Minority Health to advance Indigenous innovation (the restoration of ancestral and cultural practices to solve contemporary problems) to improve health equity among Native Hawaiian and Pacific Islander communities. This presentation will share Indigenous frameworks that have laid the foundation for operationalizing CIIHE, including the Pewa framework, Papakū Makawalu, and the ‘Aelike process. The Pewa framework creates a space that facilitates co-design and co-leadership with researchers and community partners based on the values of equity, transparency, and reciprocity. With this co-leadership partnership, the research approach is founded upon the Papakū Makawalu and ʻAelike processes. The Papakū Makawalu hermeneutic practice shared by the Edith Kanakaʻole Foundation (EKF) orients our work through its interpretation of ancestral texts to understand and engage with the natural world. Examining these texts as a group produced an agreed-upon set of kapu (sacred restrictions) for the ʻAelike (agreement). It is through this ʻAelike process that the Indigenous organizing methodology of creating a consensus around roles and responsibilities is practiced, and provides a method of adding to our knowledge using evidence-based practices. This step is critical to the success of the project through the meaningful inclusion of experts bringing knowledge from diverse backgrounds. Key themes identified from these Indigenous processes will be described, in addition to key findings and potential impacts of how this process may be applied in other Indigenous communities.

Abstract

Use of Visual Storytelling to Study the Impact of the 1918 Pandemic Influenza in Alaska

Riley Witte, MPH, Philippe Amstislavski, PhD University of Alaska Anchorage

APHA 2022 Annual Meeting and Expo

The 1918 Pandemic Influenza arrived in Alaska later than in lower latitudes of North America. The vast majority (81.7%) of the deaths were among Alaska Native people, compared to 10.7% deaths among the non-Indigenous individuals. Termed the Great Death the pandemic created transgenerational trauma that has continuing impacts. This student-led research sought to create a narrative of how Nenana, Alaska experienced the influenza pandemic of 1918-1920.

Methods: Qualitative data from primary and secondary historical sources were used, most centrally contemporary articles, and death certificates from 1918-1919. Archived source materials, memoirs and period newspaper articles were reviewed. Historic photographs and archived source materials were geocoded and cataloged.

Findings: Nenana experienced an outbreak of influenza late in the global pandemic that killed nearly 10% of the residents and severely impacted the population of the nearby Alaska Native village of Toghotthele. Combining text, interactive maps, and other multimedia content this novel research approach provides a new platform to publish and share data on health disparities.

Conclusions: Findings reveal that it is possible to study historical health disparities in Alaska Native and other Circumpolar communities by linking archival materials and vital statistics data using the socio-economic model of health. This study improves our understanding of community health disparities in healthcare in Alaska in a historical context. Further research is needed on using digital storytelling in communicating the findings to the families of the victims of pandemics, the survivors and to increase cultural competence of the healthcare providers and policy makers.

Abstract

Assessing a targeted water and sanitation intervention during the COVID-19 pandemic

Tricia Howe, MS¹, Jackie Qatalina Schaeffer, Program Manager², Olivia Harmon, MS², Laura Eichelberger, MPH, PhD² (1)Alaska Native Tribal Health Organization, (2)Alaska Native Tribal Health Consortium

APHA 2022 Annual Meeting and Expo

Household water security is a health equity issue affecting Alaska Native and American Indian (ANAI) communities nationwide. Early in the COVID-19 pandemic, it was recognized that residents of unpiped ANAI communities had among the highest rates of infection in the country. In response, the Alaska Native Tribal Health Consortium (ANTHC) collaborated with Alaska Native tribes and regional tribal health organizations to implement a targeted in-home water and sanitation intervention known as the “Mini Portable Alternative Sanitation System (Mini-PASS). The Mini-PASS is a targeted intervention to facilitate handwashing through increased in-home access to gravity-fed running water and protected storage, and to improve quality of life through a vented non-flushing toilet. By the end of 2021, ANTHC and its partners had installed Mini-PASS units in over 100 homes, with another 150 active installations occurring mid-2022 statewide. In order to assess whether the Mini-PASS improved household water security and health, we conducted a community-based longitudinal study comparing pre- and post- installation using semi-structured interviews.
In this presentation, we describe the data behind the development of the Mini-PASS as an intervention to reduce water-wash disease disparities in ANAI households. We identify how each Mini-PASS component is linked to a desired outcome related to water use, health, and quality of life. We then use these measures and stakeholder reported outcomes to assess the impacts of the mini-PASS on household water security and health.