Health inequity scholars, particularly those engaged with questions of structural and systemic racism, are increasingly vocal about the limitations of “resilience.” This is true for Indigenous health scholars, who have pushed back against resilience as a descriptor of modern Indigeneity and who are increasingly using the term survivance. Given the growing frequency of survivance in relation to health, we performed a scoping review to understand how survivance is being applied in health scholarship, with a particular interest in its relationship to resilience. Results from 32 papers indicate that health scholars are employing survivance in relation to narrative, temporality, community, decolonization, and sovereignty, with varying degrees of adherence to the term’s original conception. Overwhelmingly, authors employed survivance in relation to historical trauma, leading us to propose the analogy: as resilience is to trauma, so survivance is to historical trauma. There may be value in further operationalizing survivance for health research and practice through the development of a unified definition and measurement tool, ensuring comparability across studies and supporting future strengths-based Indigenous health research and practice.

Racism is now widely recognized as a fundamental cause of health inequali­ties in the United States. As such, health scholars have rightly turned their attention toward examining the role of struc­tural racism in fostering morbidity and mortality. However, to date, much of the empirical structural racism-health dispari­ties literature limits the operationalization of structural racism to a single domain or orients the construct around a White/ Black racial frame. This operationaliza­tion approach is incomprehensive and overlooks the heterogeneity of historical and lived experiences among other racial and ethnic groups.To address this gap, we present a theoreti­cally grounded framework that illumi­nates core mutually reinforcing domains of structural racism that have stratified opportunities for health in the United States. We catalog instances of structural discrimination that were particularly con­straining (or advantageous) to the health of racial and ethnic groups from the late 1400s to present. We then illustrate the utility of this framework by applying it to American Indians or Alaska Natives and discuss the framework’s broader implica­tions for empirical health research. This framework should help future scholars across disciplines as they identify and interrogate important laws, policies, and norms that have differentially constrained opportunities for health among racial and ethnic groups.Ethn Dis. 2021;31(Suppl 1):301-310; doi:10.18865/ed.31.S1.301

Contemporary American Indian communities experience a disproportionately high rate of specific mental health concerns, including psychiatric disorders as defined by professional psychology. Although integrating mainstream mental health services and Indigenous traditional healing (ITH) has been presented as a promising approach to addressing these inequities, such integration necessitates in-depth exploration and consideration of ITH. To that effect, this article provides a thematic analysis of an interview with an urban American Indian traditional healer who reflected on more than 4 decades of therapeutic experience. Based on this analysis, we identified two major themes. The first theme, Expansive View of ITH, reflects this healer's conceptualization and understanding of the therapeutic process while the second theme, Guiding Principles of ITH, explicates the foundational commitments that shape and guide this healer's application and practice of ITH. These insights reinforce previous observations made by scholars of Indigenous health and well-being that challenge dominant Euro-American perspectives and call for transformative change in psychology research and practice, advocating for professional consideration of a broader range of therapeutic rationales, traditions, and practices than what is common within the field. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Commercial salmon fishing in Alaska is one of the most dangerous occupations in the United States. Between 1992 and 2008, the average annual industry mortality rate was 128 deaths per 100,000 workers, and despite an increase in industry regulations, there has not been a significant decrease in mortality rate since 2000. Unpredictable fishing openings and fierce competition for limited resources result in periods of intense sleep deprivation and physical strain during the short commercial salmon seasons in Alaska. We hypothesize that the combined effect of sleep deprivation, intense physical workload and significant short-term chronic stress may be deleterious to health in both the short and long-term among commercial salmon drift gillnet fisherman in Alaska. The study design utilizes mixed methods and includes biometric monitoring consisting of heart rate variability, respiration, and movement collected via a personal wearable biometric device in combination with observational data on activity, including duration of sleep, weather, catch, and financial gain, as well as the collection of salivary cortisol. As such, the study will provide a holistic assessment of individual stress on multiple simultaneous timescales: immediately and continuously through the personal wearable biometric device, on the minute-hour level through the multiple daily collections of salivary cortisol, and by the hour-day through the use of observational data collection. We anticipate that the use of a biometric device will be crucial in establishing measures of stress and physical activity within a population and environment uniquely challenged by physical isolation, strong weather patterns, and the potential for significant financial gain by fisherman. The potential exists for individuals engaged long-term in the fishing industry, through repeat and extended exposure to periods of intense sleep deprivation and chronic stress, to be at increased risk of cardiovascular disease.

Background Systemic racial and ethnic inequities continue to be perpetuated through scientific methodology and communication norms despite efforts by medical institutions. We characterized methodological practices regarding race and ethnicity in U.S. research published in leading medical journals. Methods We systematically reviewed randomly selected articles from prominent medical journals: Annals of Internal Medicine, BMJ, JAMA, The Lancet, and NEJM within five periods: 1995-99, 2000-04, 2005-09, 2010-14, 2015-18. Original human-subjects research conducted in the U.S. was eligible for inclusion. We extracted information on definitions (conceptualization), measurement/coding (operationalization), use in analysis (utilization), and justifications. We reviewed 1050, including 242 (23%) in analyses. Findings The proportion of U.S. medical research studies including race and/or ethnicity data increased between 1995 and 2018. However, no studies defined race or ethnicity. Studies rarely delineated between race and ethnicity, frequently opting for a combined “ethno-racial” construct. In addition, most studies did not state how race and/or ethnicity was measured. Common coding schemes included: “Black, other, White,” “Hispanic, Non-Hispanic,” and “Black, Hispanic, other, White.” Race and/or ethnicity was most often used as a control variable, descriptive covariate, or matching criteria. Under 30% of studies included a justification for their methodological choices regarding race and/or ethnicity. Interpretation Despite regular efforts by medical journals to implement new policies around race and ethnicity in medical research, pertinent information around methodology was systematically absent from the majority of reviewed literature. This stymies critical disciplinary reflection and progress towards equitable practice. Funding Funding was provided through training grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development [T32 HD091058] and the Department of Sociology, UNC Chapel Hill. Carolina Population Center provided general support [P2C HD050924, P30 AG066615]. NRS received additional support from the National Cancer Institute [T32 CA057711].