Main Article Content
This study used a parallel, convergent, mixed-methods design with TribalCrit theory and intersectionality as analytical frameworks to identify how the identities of American Indian men intersect with broader structures and systems in shaping their eating and physical activity choices and behaviors, and in eliciting recommendations for a men’s lifestyle intervention. American Indian men were recruited in Minneapolis, Minnesota, and Portland, Oregon, between March and December 2017, and in Phoenix, Arizona, in December 2019 to participate in a survey and focus groups. The survey included questions on demographics and physical and cultural activities men engage in, perceived social support for lifestyle behaviors, masculine characteristics, and values important to American Indian men. The six-item Kessler Psychological Distress Scale was used to assess psychological distress. Focus groups were audio recorded and transcribed for a phenomenological analysis. Descriptive statistics and correlations were computed for survey data. We conducted 15 focus groups with 151 adult American Indian men in three urban sites. The mean age of participants ranged from 36 to 51 across the sites; 7–32% were college graduates; 13–22% were currently married, and 28–41% were working full time. The most important values reported by participants were being strong mentally and emotionally, a good parent, responsible, spiritual, and a good spouse or partner. On the K6 psychological distress scale, 63–70% scored ≥5 but <13 (moderate mental distress), and 8–15% scored ≥13, indicating severe mental distress. Younger age was significantly correlated with higher mean K6 score (P < 0.0001). Settler colonialism that took root in the United States imposed cultural and gender hegemony, which in turn enforced a patriarchal capitalist system that has had long-lasting and deleterious effects on American Indians, particularly American Indian men.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright of articles published in all DPG titles is retained by the author(s). The author(s) grants DPG the rights to publish the article and identify itself as the original publisher. The author grants DPG exclusive commercial rights to the article. The author grants any party the rights to use the article freely for non-commercial purposes provided that the original work is properly cited.
2. Fenn E. Pox Americana: The great smallpox epidemic of 1775–1782. 1st ed. Hill and Wang; 2001.
3. Robertson R. Rotting face: Smallpox and the American Indian. 1st ed. University of Nebraska Press; 2001.
4. Walters K, Brown D. History through a native lens [Internet]. 2020 [cited 2020 Jun 28]. Available from: https://nativephilanthropy.candid.org/timeline/
5. Hixson W. American settler colonialism: A history. New York, NY: Palgrave Macmillan; 2013.
6. Wilkins D, Lomawaima K. Uneven ground: American Indian Sovereignty and Federal Indian Law. Norman, OK: University of Oklahoma Press; 2001.
7. Wolfe P. Settler colonialism and the elimination of the native. J Genocide Res. 2006:387–409. http://dx.doi. org/10.1080/14623520601056240
8. Getches D, Wilkinson C, Williams R. Cases and mate-rials on Federal Indian Law. St. Paul, MN: Thomson/ West; 2005.
9. Wilkinson C. Blood struggle: The rise of modern Indian nations. New York: W. W. Norton & Company; 2006.
10. Walls M, Whitbeck L. The intergenerational effects of relocation policies on Indigenous families. J Fam Issues. 2012;33(9):1272–93. http://dx.doi.org/10.1177/0192513X12447178
11. Robbins R. Self-determination and subordination: The past, present, and future of American Indian Governance. South End Press; 1999.
12. Bodley J. Victims of progress. 2nd ed. Palo Alto, CA: Mayfield Publishing; 1982.
13. Colson E. Forced migration and the anthropological response. J Refugee Stud. 2003;16:1–18. http://dx.doi. org/10.1093/jrs/16.1.1
14. O’Sullivan M, Handal P. Medical and psychological effects of the threat of compulsory relocation for an American Indian Tribe. Am Indian Alaska Nat Mental Health Res. 1988;2:3–19. http://dx.doi.org/10.5820/ aian.0201.1988.3
15. Trudelle-Schwarz M. Unraveling the anchoring cord: Navajo relocation, 1974 to 1996. Am Anthropol. 1997;99:43–55. http://dx.doi.org/10.1525/aa.19184.108.40.206
16. Walters K, Beltran R, Huh D, Evans-Campbell T. Dis-placement and dis-ease: Land, place, and health among American Indians and Alaska Natives. New York, NY: Springer; 2011.
17. Fixico D. Termination and relocation. Federal Indian Policy, 1945–1960. Albuquerque, NM: University of New Mexico Press; 1986.
18. Cooper D, Delormier T, Taualii M. “It’s always a part of you”: The connection between sacred spaces and Indigenous/Aboriginal health. Int J Hum Rights Educ. 2019;3(1).
19. National Urban Indian Family Coalition. Making the invisible visible: A policy blueprint from urban Indian America. 2018.
20. Innes R, Anderson K, eds. Indigenous men and masculinities: Legacies, identities, regeneration. Manitoba, CAN: University of Manitoba Press; 2015.
21. Brave Heart M. Gender differences in the historical trauma response among the Lakota. J Health Soc Policy. 1999;10(4):1–21. http://dx.doi.org/10.1300/ J045v10n04_01
22. Men’s Health Network. A vision for wellness and health equity for American Indian and Alaska native boys and men [Internet]. 2013. Available from: www. menshealthlibrary.com
23. Rich J, Ro M. A poor man’s plight: Uncovering the disparity in men’s health [Internet]. W.K. Kellogg Foundation; 2002. Available from: www.communi-tyvoices.org
24. U.S. Department of Health and Human Services. A demographic and health profile of adult males (ages 19 to 64 years) in the United States by race and ethnicity [Internet]. 2015. Available from: https://www. minorityhealth.hhs.gov/Assets/PDF/FINAL_Mens_ Health_Data_Brief.pdf
25. Men’s Health Network. Men’s health network applauds creation of Office of Indian Men’s Health. Washington, DC; 2013.
26. Curtin S, Hedegaard H. Suicide rates for females and males by race and ethnicity: United States, 1999 and 2017. 2019.
27. Centers for Disease Control and Prevention. National vital statistic report. Vol. 602012:Table 17 and Table 16.
28. Health characteristics of the American Indian and Alaska Native adult population: United States, 2004–2008 [Internet]. 2010. Available from: http://www.cdc.gov/nchs/data/ad/ad356.pdf
29. Summary health statistics for U.S. adults: National Health Interview Survey [Internet]. National Center for Health Statistics. Vital and Health Statistics; 2010 [cited 2013 Sept 21]. Available from: http://www.cdc.gov/nchs/data/series/sr_10/sr10_252.pdf
30. Health characteristics of the American Indian and Alaska Native adult population: United States, 2004–2008 [Internet]. 2010. Available from: http://www.cdc.gov/ nchs/data/nhsr/nhsr020.pdf
31. U.S. Department of Education. Status and trends in the education of racial and ethnic groups 2017 [Internet]. 2017 [cited 2020 Mar 1]. Available from: https://nces. ed.gov/pubs2017/2017051.pdf
32. U.S. Census Bureau. Current Population Survey (CPS). Department of Commerce; 2015:Table 302.360.
33. The Sentencing Project. Native disparities in youth incarceration [Internet]. 2017 [cited 2020 Jun 1]. Avail-able from: file:///C:/Users/kaimi.sinclair/Downloads/ Native-Disparities-in-Youth-Incarceration.pdf
34. Brave Heart M, Chase J, Elkins J, Altschul D. Historical trauma among Indigenous peoples of the Americas: Concepts, research, and clinical considerations. J Psychoactive Drugs. 2011;43(4):282–90. http://dx.doi. org/10.1080/02791072.2011.628913
35. Courtenay W. Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Soc Sci Med. 2000;50:1385–401. http://dx.doi. org/10.1016/S0277-9536(99)00390-1
36. Schippers M. Recovering the feminine other: Masculinity, femininity, and gender hegemony. Theory Soc. 2007;36(1):85–102. http://dx.doi.org/10.1007/ s11186-007-9022-4
37. Krech P. Envisioning a healthy future: A re-becoming of Native American men. J Sociol Soc Welfare. 2002;29(1):77–95.
38. Marak A, Tuennerman L. At the border of empires: The Tohono O’odham, gender, and assimilation 1880–1934. Tucson, AZ: University of Arizona Press; 2013.
39. Davis S. Captain Richard Henry Pratt, 10th Cavalry Buffalo Soldiers, Founder of the Carlisle School for Indian Students [Internet]. 2002 [cited 2020 Jan 4]. Available from: http://www.buffalosoldier.net/Cap tainRichardH.Pratt.htm
40. Glenn E. Unequal freedome: How race and gender shaped American citizenship and labor. Cambridge, MA: Harvard University Press; 2002.
41. Sotero MM. A conceptual model of historical trauma: Implications for public health practice and research. J Health Dispar Res Pract. 2006;1:93–108.
42. Brave Heart M, Elkins J, Tafoya G, Bird D, Salvador M. Wicasa Was’aka: Restoring the traditional strength of American Indian boys and men. AJPH. 2012;102(S2):S177–83. http://dx.doi.org/10.2105/ AJPH.2011.300511
43. Delgado R. Storytelling for oppositionists and others: A plea for narrative. Michigan Law Rev. 1989;87:2411–41. http://dx.doi.org/10.2307/1289308
44. Harris C. Whiteness as property. Harvard Law Rev. 1993;106:1701–91. http://dx.doi.org/10.2307/1341787
45. Brayboy B. Toward a tribal critical race theory in education. Urban Rev. 2005;37(5):425–46. http://dx.doi.org/10.1007/s11256-005-0018-y
46. Gonzales K, Jiang L, Garcia-Alexander G, Jacob M, Chang J, Williams D, et al. Perceived racial discrimination, retention, and outcomes among American Indians and Alaska Natives in diabetes lifestyle interventions. J Health Aging. Forthcoming.
47. Bowleg L. The problem with the phrase women and minorities: Intersectionality—An important theoretical framework for public health. AJPH. 2012;102:1267–73. http://dx.doi.org/10.2105/AJPH.2012.300750
48. Wong Y, Liu T, Klann E. The intersction of race, ethnicity, and masculinities: Progress, problems, and prospects. Washington, DC: American Psychological Association; 2017.
49. Shields S. Gender: An intersectionality perspective. Sex Roles. 2008;59:301–11. http://dx.doi.org/10.1007/ s11199-008-9501-8
61. Creswell J, Plano Clark V. Designing and conducting mixed methods research. 2nd ed. Thousand Oaks, CA: Sage Publications, Inc.; 2011.
62. Campbell A. How America’s past shapes native Americans’ present [Internet]. 2016 [cited 2020 Jun 29]. Available from: https://www.theatlantic.com/business/ archive/2016/10/native-americans-minneapolis/503441/
63.Osife M. The roots of Portland’s Native American community [Internet]. 2017 [2020 Jun 30]. Available from: https://www.oregonmetro.gov/news/roots-portlands-native-american-community#:~:text=Portland%20 is%20home%20to%20the%20nation%E2%80%99s%20ninth%20largest,Americans%20that%20represent%20more%20than%20380%20tribal%20affiliations
64. Phoenix Indian Center [Internet]. 2020 [2020 Jun 29]. Available from: https://phxindcenter.org/history-2/
65. Resnicow K, Jackson A, Braithwaite R, DiIorio C, Blisset D, Rahotep S, et al. Healthy body/healthy spirit: A church-based nutrition and physical activity intervention. Health Educ Res. 2002;17(5):562–73. http://dx.doi.org/10.1093/her/17.5.562
66. Prochaska J, Sung H, Max W, Shi Y, Ong M. Valid-ity study of the K6 Scale as a measure of moderate mental sistress based on mental health treatment need and utilization. Int J Methods Psychiatr Res. 2012;21(2):88–97. http://dx.doi.org/10.1002/mpr.1349
67. Mitchell C, Beals J. The utility of the Kessler Screening Scale for psychological distress (K6) in two American Indian communities. Psychol Assess. 2011;23(3):752–61. http://dx.doi.org/10.1037/a0023288
68. Sallis JF, Grossman RM, Pinski RB, Patterson TL, Nader PR. The development of scales to measure social support for diet and exercise behaviors. Prev Med. 1987;16(6):825–36. http://dx.doi. org/10.1016/0091-7435(87)90022-3
69. Tashakkori A, Teddlie C. Quality of inferences in mixed methods research: Calling for an integrative framework. London: Sage Publications; 2008.
70. Creswell J. Qualitative inquiry and research design. Thousand Oaks, CA: Sage Publishers, Inc; 1998.
71. Creswell J, Clark V. Designing and conducting mixed methods research. 3rd ed. Thousand Oaks, CA: Sage publications; 2018.
72. United States Commission on Civil Rights. Broken promises: Continuing federal funding shortfall for native Americans. Washington, DC; 2018.
73. Evans J, Frank B, Oliffe J, Gregory D. Health, illness, men and masculinities (HIMM): A theoretical frame-work for understanding men and their health. J Mens Health. 2011;8(1):7–15. http://dx.doi.org/10.1016/j. jomh.2010.09.227
74. Griffith D, Thorpe J. Men’s physical health and health behaviors. Washington, DC: American Psychological Association; 2016.
75. Evans-Campbell T. Historical trauma in American Indian/ Native Alaska communities: A multilevel framework for exploring impacts on individuals, families, and communities. J Interpers Violence. 2008;23(3):316–38. http://dx.doi.org/10.1177/0886260507312290
76. Kessler R, Andrews G, Colpe L, Hiripi E, Mroczek DK, Normand SLT, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76. http://dx.doi.org/10.1017/S0033291702006074
77. Wade J. African American men’s gender role conflict: The significance of racial identity. Sex Roles. 1996;34:17–33. http://dx.doi.org/10.1007/BF01544793
78. Griffith D, Ellis K, Allen J. An intersectional approach to social determinants of stress for African American men: Men’s and women’s perspectives. Am J Mens Health. 2013;7(Suppl. 4):19S–30S. http://dx.doi. org/10.1177/1557988313480227
79. National Center for Education Statistics. Table 322.20 Bachelor’s degrees conferred by postsecondary institutions, by race/ethnicity and sex of student: Selected years, 1976–77 through 2016–17 [Internet]. 2018 [cited 2020 Jun 28]. Available from: https://nces. ed.gov/programs/digest/d18/tables/dt18_322.20.asp
80. Morgan P, Lubans D, Plotnikoff RC, Callister R, Bur-rows T, Fletcher R, et al. The “healthy dads, healthy kids” randomized controlled trial: Efficacy of a healthy lifestyle program for overweight fathers and their children. Int J Obes. 2011;35:436–47. http://dx.doi. org/10.1038/ijo.2010.151
81. Norgaard K. Salmon and acorns feed our people: Colonialism, nature, and social action. Rutgers University Press; 2019.
82. Vizenor G. Survivance: Narratives of native presence. Omaha, NE: University of Nebraska Press; 2008.
83. Jacob M. Yakama rising: Indigenous cultural revitalization, activism, and healing. Phoenix, AZ: University of Arizona Press; 2013.