Search tips
Search criteria 


Logo of pubhealthrepLink to Publisher's site
Public Health Rep. 2002; 117(Suppl 1): S104–S117.
PMCID: PMC1913706

Substance use among American Indians and Alaska natives: incorporating culture in an "indigenist" stress-coping paradigm.


OBJECTIVES: This article proposes a new stress-coping model for American Indians and Alaska Natives (AIs) that reflects a paradigmatic shift in the conceptualization of Native health. It reviews sociodemographic information on AIs, rates of substance abuse and related health outcomes, and the research supporting the model's pathways. OBSERVATIONS: Although health outcomes among AIs are improving, large disparities with other racial and ethnic groups in the United States remain. Many health-related problems are directly linked to high rates of substance use and abuse. CONCLUSION: Eurocentric paradigms focus on individual pathology. An "indigenist" perspective of health incorporates the devastating impact of historical trauma and ongoing oppression of AIs. The model emphasizes cultural strengths, such as the family and community, spirituality and traditional healing practices, and group identity attitudes.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.5M), or click on a page image below to browse page by page.

Articles from Public Health Reports are provided here courtesy of Association of Schools of Public Health