Skip to main content

Advertisement

SpringerLink
Log in

Overt Perceived Discrimination and Racial Microaggressions and their Association with Health Risk Behaviors among a Sample of Urban American Indian/Alaska Native Adolescents

  • Published:
Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Background

Urban American Indian/Alaska Native (AI/AN) adolescents are an understudied population in the USA who are at risk for a variety of health problems. Perceived discrimination (PD), including both overt PD and racial microaggressions (RMA), is known to adversely affect health. However, studies analyzing associations between overt PD and RMA and various health behaviors are limited.

Methods

This study measured past-year alcohol use, heavy drinking, marijuana use, commercialized tobacco use, consequences experienced from alcohol and marijuana use in the past 3 months, mental and physical health status, AI/AN traditional activity participation, and overt PD and RMA among 182 urban AI/AN adolescents in California. To assess the association between overt PD and RMAs and health outcomes, we conducted either logistic regression (for dichotomous outcomes: past-year alcohol use, past-year heavy drinking, past-year marijuana use, consequences of alcohol and marijuana use, commercialized tobacco use) or linear regression (for continuous outcomes: mental and physical health, AI/AN traditional practices).

Results

In contrast to our hypotheses, overt PD and RMA were not significantly associated with substance use or mental or physical health among this sample of urban AI/AN adolescents. After adjusting for age and gender, overt PD and RMA were only correlated with past-year cigarette use and alcohol-related consequences experienced in the past 3 months.

Conclusion

Potential factors that may play a role in decreasing effects of overt PD and RMA among urban AI/AN adolescents are discussed, including participation in AI/AN traditional practices and community engagement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control. American Indian and Alaska Natives Tobacco Use. 2018. https://www.cdc.gov/tobacco/disparities/american-indians/index.htm. Accessed 8 May 2018.

  2. Chen HJ, Balan S, Price RK. Association of contextual factors with drug use and binge drinking among White, Native American, and mixed-race adolescents in the general population. J Youth Adolesc. 2012;41:1426–41.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Friese B, Grube JW, Seninger S, Paschall MJ, Moore RS. Drinking behavior and sources of alcohol: differences between native American and White youths. J Stud Alcohol Drugs. 2011;72:53–60.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Stanley LR, Swaim RC. Initiation of alcohol, marijuana, and inhalant use by American-Indian and white youth living on or near reservations. Drug Alcohol Depend. 2015;155:90–6.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Swaim RC, Stanley LR. Multivariate family factors in lifetime and current marijuana use among American Indian and white adolescents residing on or near reservations. Drug Alcohol Depend. 2016;169:92–100.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Urban Indian Health Institutes. Urban American Indian and Alaska native youth: an analysis of select National Data Sources. 2009. http://www.uihi.org/wp-content/uploads/2012/10/2009-Youth-Report.pdf. Accessed 4 Feb 2018.

  7. Bullock A, Sheff K, Moore K, Manson S. Obesity and overweight in American Indian and Alaska native children. 2006-2015. Am J Public Health. 2017;107(9):1502–7.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Dabelea D, Mayer-Davis EJ, Saydah S. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. 2014;311(17):1778–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Indian Health Service. Disparities. 2018. https://www.ihs.gov/MedicalPrograms/Diabetes/HomeDocs/Resources/FactSheets/Fact sheet AIAN 508c.pdf. Assessed 10 Aug 2018.

  10. U.S. Census Bureau. (2010). Census 2010 American Indian and Alaska native summary file; table: PCT2; urban and rural; universe total population; population group name: American Indian and Alaska native alone or in combination with one or more races.

    Google Scholar 

  11. Rutman S, Park A, Castor M, Taualii M, Forquera R. Urban American Indian and Alaska native youth: youth risk behavior survey 1997–2003. Matern Child Health J. 2008;12:S76–81.

    Article  Google Scholar 

  12. Serafini K, Donovan DM, Wendt DC, Matsumiya B, McCarty CA. A comparison of early adolescent behavioral health risks among urban American Indians/Alaska natives and their peers. Am Indian Alsk Native Ment Health Res. 2017;24(2):1–17. https://doi.org/10.5820/aian.2402.2017.1.

    Article  PubMed Central  Google Scholar 

  13. Brave Heart MYH. Substance abuse, co-occurring mental health disorders, and the historical trauma response among American Indians/Alaska natives (research monograph). Washington: Bureau of Indian Affairs, Division of Alcohol and Substance Abuse Prevention; 2005.

    Google Scholar 

  14. Duran E, Duran B. Native American post-colonial psychology. Albany: State University of New York; 1995.

    Google Scholar 

  15. Johnson CL. An innovative healing model: empowering urban native Americans. In: Witko T, ed. mental health care for urban Indians: clinical insights from native practitioners (pp. 189–204). Washington: American Psychological Association; 2006.

    Google Scholar 

  16. Oklahoma State University. Indian affairs: laws and treaties. n.d. http://dc.library.okstate.edu/digital/collection/kapplers. Accessed 3 March 2018.

  17. Blume, A. Social issues in living color: volume 1: challenges and solutions from the perspective of ethnic minority psychology [3 volumes]. 2017. http://publisher.abc-clio.com/9781440833373. Accessed 15 May 2018.

  18. Evans-Campbell T, Walters KL. Indigenist practice competencies in child welfare practice: a decolonization framework to address family violence and substance abuse among first nations peoples. In: Fong R, McRoy R, Ortiz Hendricks C, editors. Intersecting child welfare, substance abuse, and family violence: culturally competent approaches. Alexandria: CSWE Press; 2006.

    Google Scholar 

  19. LaFromboise TD, Berman JS, Sohi BK. American Indian women. In: Comas-Diza L, Green B, editors. Women of color: integrating ethnic and gender identities in psychotherapy. New York: Guilford Press; 1994.

    Google Scholar 

  20. Myhra LL. “It runs in the family”: intergenerational transmission of historical trauma among urban American Indians and Alaska Natives in culturally specific sobriety maintenance programs. Am Indian Alsk Native Ment Health Res. 2011;18(2):17–40.

    Article  PubMed  Google Scholar 

  21. Myhra LL, Wieling E. Intergenerational patterns of substance abuse among urban American Indian families. J Ethn Subst Abus. 2014;13(1):1–22.

    Article  Google Scholar 

  22. de Rus JA, Tambe MA, Ma SY, McCabe GP, Vest JHC, Rochet JC. Pikuni-Blackfeet traditional medicine: Neuroprotective activities of medicinal plants used to treat Parkinson's disease-related symptoms. J Ethnopharmacol. 2017;12(206):393–407.

    Google Scholar 

  23. Joe JR, Young RS, Moses J, Knoki-Wilson U, Dennison J. A collaborative case study: the office of native medicine. Am Indian Alsk Native Ment Health Res. 2016;23(2):50–63.

    Article  PubMed  Google Scholar 

  24. Jernigan, V. B., D’Amico, E. J., & Keawe‘aimoku Kaholokula, J. Prevention research with indigenous communities to expedite dissemination and implementation efforts. Prev Sci In Press.

  25. Weaver HN. Urban and indigenous: the challenges of being a native American in the City. J Community Pract. 2012;20(4):470–88. https://doi.org/10.1080/10705422.2012.732001.

    Article  Google Scholar 

  26. Jeffries R, Nix M, Singer C. American Indians “dropping” out of traditional high schools: barriers & bridges to success. High Sch J. 2002;85(3):38–46.

    Article  Google Scholar 

  27. Brown RA, Dickerson DL, D’Amico EJ. Cultural identity among urban American Indian/Alaska native youth: implications for alcohol and drug use. Prev Sci. 2016;17(7):852–61.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Jones ML, Galliher RV. Daily racial microaggressions and ethnic identification among Native American young adults. Cultur Divers Ethnic Minor Psychol. 2015;21(1):1–9.

    Article  PubMed  Google Scholar 

  29. Tobler AL, Maldonado-Molina MM, Staras SA, O’Mara RJ, Livingston MD, Komro KA. Perceived racial/ethnic discrimination, problem behaviors, and mental health among minority urban youth. Ethn Health. 2013;18(4):337–49.

    Article  PubMed  Google Scholar 

  30. Brodish AB, Cogburn CD, Fuller-Rowell TE, Peck S, Malanchuk O, Eccles JS. Perceived racial discrimination as a predictor of health behaviors: the moderating role of gender. Race Soc Probl. 2011;3(3):160–9.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Unger JB, Soto DW, Baezconde-Garbanati L. Trajectories of perceived discrimination from adolescence to emerging adulthood and substance use among Hispanic youth in Los Angeles. Addict Behav. 2016;53:108–12.

    Article  PubMed  Google Scholar 

  32. Nadimpalli SB, Hutchinson MK. An integrative review of relationships between discrimination and Asian American health. J Nurs Scholarsh. 2012;44(2):127–35.

    Article  PubMed  Google Scholar 

  33. Melander LA, Sittner Hartshorn KJ, Whitbeck LB. Correlates of bullying behaviors among a sample of North American Indigenous adolescents. J Adolesc. 2013;36(4):675–84.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Whitbeck LB, Walls ML, Johnson KD, Morrisseau AD, McDougall CM. Depressed affect and historical loss among North American indigenous adolescents. Am Indian Alsk Native Ment Health Res. 2009;16(3):16–41.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Yoder KA, Whitbeck LB, Hoyt DR, LaFromboise T. Suicidal ideation among American Indian youths. Arch Suicide Res. 2006;10(2):177–90.

    Article  PubMed  Google Scholar 

  36. Whitbeck LB, Hoyt DR, McMorris BJ, Chen X, Stubben JD. Perceived discrimination and early substance abuse among American Indian children. J Health Soc Behav. 2001;42(4):405–24.

    Article  CAS  PubMed  Google Scholar 

  37. Armenta BE, Sittner KJ, Whitbeck LB. Predicting the onset of alcohol use and the development of alcohol use disorder among indigenous adolescents. Child Dev. 2016;87(3):870–82.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Solorzano D, Ceja M, Yosso T. Critical race theory, racial microaggressions, and campus racial climate: the experiences of African American college students. J Negro Educ. 2000;69:60–73.

    Google Scholar 

  39. Chae DH, Walters KL. Racial discrimination and racial identity attitudes in relation to self-rated health and physical pain and impairment among two-spirit American Indians/Alaska Natives. Am J Public Health. 2009; Apr;99Suppl 1:S144–51.

  40. Clark DA, Spanierman LB, Reed TD, Soble JR, Cabana S. Documenting weblog expressions of racial microaggressions that target American Indians. J Divers High Educ. 2011;4(1):39–50. https://doi.org/10.1037/a0021762.

    Article  Google Scholar 

  41. Senter MS, Ling DA. “It’s almost like they were happier when you were down”: microaggressions and overt hostility against native Americans in a community with gaming. Sociol Inq. 2017;87(2):256–81. https://doi.org/10.1111/soin.12171.

    Article  Google Scholar 

  42. Sittner KJ, Greenfield BL, Walls ML. Microaggressions, diabetes distress, and self-care behaviors in a sample of American Indian adults with type 2 diabetes. J Behav Med. 2018;41(1):122–9.

    Article  PubMed  Google Scholar 

  43. Walls ML, Gonzalez J, Gladney T, Onello E. Unconscious biases: racial microaggressions in American Indian health care. J Am Board Fam Med. 2015;28(2):231–9.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Gonzales NA, Gunnoe ML, Jackson KM, Samaniego RY. Validation of a multicultural events scale for urban adolescents. Paper presented at the Biennial Conference of the Society for Community Research and Action. Chicago; 1995.

  45. Gonzales NA, Tein JY, Sandler IN, Friedman RJ. On the limits of coping interaction between stress and coping for inner-city adolescents. J Adolesc Res. 2001;16:372–95. https://doi.org/10.1177/0743558401164005.

    Article  Google Scholar 

  46. Walters K. Lessons from the field: race, culture and children’s mental health. Center for Excellence in Children’s Mental Health 2009; University of Minnesota.

  47. Dickerson DL, Brown RA, Johnson CL, Schweigman K, D'Amico EJ. Integrating motivational interviewing and traditional healing to address alcohol and drug use among urban American Indian/Alaska native youth. J Subst Abus Treat. 2016;65:26–35.

    Article  Google Scholar 

  48. Jernigan VB, D’Amico EJ, Duran B, Buchwald D. Multilevel and community-level interventions with native Americans: challenges and opportunities. Prev Sci. 2018, 2018. https://doi.org/10.1007/s11121-018-0916-3.

  49. Dickerson DL, Johnson CL, Castro C, Naswood C, Leon JMP. CommUNITY voices: integrating traditional healing services for urban American Indians/Alaska natives in Los Angeles County. In: Learning collaborative summary report. Los Angeles: Los Angeles County Department of Mental Health; 2012.

    Google Scholar 

  50. Native American Health Center. Native vision: a focus on improving behavioral health wellness for California native Americans-California reducing disparities project native American population report. Oakland: Native American Health Center; 2012.

    Google Scholar 

  51. Kaufman CE, Black K, Keane EM, Big Crow CK, Shangreau C, Arthur-Asmah R, et al. Planning for a group-randomized trial with American Indian youth. J Adolesc Health Care. 2014;54(3):S59–63.

    Article  Google Scholar 

  52. D'Amico EJ, Parast L, Meredith LS, Ewing BA, Shadel WG, Stein BS. Screening in primary care: what is the best way to identify at-risk youth for substance use? Pediatrics. 2016;138:1–9.

    Article  Google Scholar 

  53. D’Amico EJ, Tucker JS, Miles JNV, Ewing BA, Shih RA, Pedersen ER. Alcohol and marijuana use trajectories in a diverse longitudinal sample of adolescents: examining use patterns from age 11 to 17. Addiction. 2016;111(10):1825–35.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Stewart AL, Ware JE, Sherbourne CD, Wells KB. Psychological distress/well-being and cognitive functioning measures. In: Stewart A, Ware JE, editors. Measuring functioning and well-being: the medical outcomes study approach. Durham: Duke University Press; 1992. p. 102–42.

    Google Scholar 

  55. Ware JE, Kosinski M, Keller SD. A 12-item short form health survey: construction of scales and preliminary tests. Med Care. 1996;34:220–33.

    Article  Google Scholar 

  56. Norton I, Manson S. Research in American Indian and Alaska native communities: navigating the cultural universe of values and process. J Consult Clin Psychol. 1996;64:856–60.

    Article  CAS  PubMed  Google Scholar 

  57. Meredith LS, Ewing BA, Stein BS, Shadel WG, Brooks Holliday S, Parast L, et al. Influence of mental health and alcohol or other drug use risk on adolescent reported care received in primary care settings. BMC Fam Pract. 2018;19(1):10.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Olani S, et al. Racial/ethnic disparities in tobacco product use among middle and high school students -- United States, 2014-2017. MMWR. 2018;67(34):952–7.

    Google Scholar 

  59. Levine A, Huang Y, Drisaldi B, Griffin EA Jr, Pollak DD, Xu S, et al. Molecular mechanism for a gateway drug: epigenetic changes initiated by nicotine prime gene expression by cocaine. Sci Transl Med. 2011;3(107):107ra109.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Soto C, Baezconde-Garbanati L, Schwartz SJ, Unger JB. Stressful life events, ethnic identity, historical trauma, and participation in cultural activities: associations with smoking behaviors among American Indian adolescents in California. Addict Behav. 2015;50:64–9.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Walls ML, Whitbeck L, Armenta B. A cautionary tale: examining the interplay of culturally specific risk and resilience factors in indigenous communities. Clin Psychol Sci. 2016;4(4):732–43.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Galliher RV, Jones MD, Dahl A. Concurrent and longitudinal effects of ethnic identity and experiences of discrimination on psychosocial adjustment of Navajo adolescents. Dev Psychol. 2011;47(2):509–26.

    Article  PubMed  Google Scholar 

  63. Committee on Improving the Health, Safety, and Well-Being of Young Adults; Board on Children, Youth, and Families; Institute of Medicine; National Research Council; Bonnie RJ, Stroud C, Breiner H, editors. Washington (DC): National Academies Press (US); 2015 Jan 27.

  64. Ashburn-Nardo L, Monteith MJ, Arthur SA, Bain A. Race and the psychological health of African Americans. Group Process Intergroup Relat. 2007;10:471–91. https://doi.org/10.1177/1368430207081536.

    Article  Google Scholar 

  65. Hughes D, Rodriguez J, Smith EP, Johnson DJ, Stevenson HC, Spicer P. Parents' ethnic-racial socialization practices: a review of research and directions for future study. Dev Psychol. 2006;42(5):747–70.

    Article  PubMed  Google Scholar 

  66. Walsh SD, Kolobox T, Simanovskaya O. What is it about perceived discrimination that can lead immigrant adolescents to alcohol use and delinquency? The mediating role of feelings of alienation. Subst Use Misuse. 2018;26:1–13. https://doi.org/10.1080/10826084.2018.1495738.

    Article  Google Scholar 

  67. D’Amico, EJ, Dickerson DL, Brown RA, Klein D, Agniel D, Johnson CL. Unveiling an “invisible population”: health, substance use, sexual behavior, culture, and discrimination among urban American Indian/Alaska native adolescents in California. Accepted for Publication Ethn Health.

  68. Brown RA, D’Amico EJ, Dickerson DL, Klein D, Agniel D, Johnson CL. Identifying as American Indian/Alaska native: implications for adolescent behavioral health and well-being. Accepted for Publication Youth Soc.

  69. Cernin PA, Cresci K, Jankowski TB, Lichtenberg PA. Reliability and validity testing of the short-form health survey in a sample of community-dwelling African American older adults. J Nurs Meas. 2010;18(1):49–59.

    Article  PubMed  Google Scholar 

  70. Boardman JD. Self-rated health among U.S. adolescents. J Adolesc Health. 2006;38(4):401–8.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

Work on this article was supported by a grant from the National Institute of Alcohol Abuse and Alcoholism R01AA022066 to Drs. D’Amico and Dickerson, with co-funding from the National Institute on Drug Abuse.

Author information

Authors and Affiliations

  1. UCLA Integrated Substance Abuse Programs; Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA, 90025, USA

    Daniel L. Dickerson

  2. RAND Corporation, 1776 Main St., Santa Monica, CA, 90401, USA

    Ryan A. Brown, David J. Klein, Denis Agniel & Elizabeth J. D’Amico

  3. Sacred Path Indigenous Wellness Center, Los Angeles, CA, 90017, USA

    Carrie Johnson

Authors
  1. Daniel L. Dickerson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryan A. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David J. Klein
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Denis Agniel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carrie Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elizabeth J. D’Amico
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel L. Dickerson.

Ethics declarations

The study protocol was approved by the institution’s Internal Review Board.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dickerson, D.L., Brown, R.A., Klein, D.J. et al. Overt Perceived Discrimination and Racial Microaggressions and their Association with Health Risk Behaviors among a Sample of Urban American Indian/Alaska Native Adolescents. J. Racial and Ethnic Health Disparities 6, 733–742 (2019). https://doi.org/10.1007/s40615-019-00572-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40615-019-00572-1

Keywords

Search

Navigation