TBI in the Indigenous Community
Author: Cassie Wang
Prevalence of TBI
Findings from hospitals, rehabilitation, trauma centers etc suggest that the incidence rate of indigenous people is highest among the entire population. For example, the rate of stroke is higher in American Indians and Alaska Natives and they suffer from strokes at a younger age than non-Hispanic White. Dementia is also more prevalent in indigenous people. Moreover, the morbidity and mortality rate of TBI is highest among AI/ANs.
Alcoholism is more common in indigenous communities. About 50% of TBI patients that are indigenous have high Blood Alcohol Levels. One study concludes that “alcohol consumption at the time of a TBI injury could hurt American Indian patients' odds of survival.” Furthermore, high rates of diabetes and cardiovascular diseases, most importantly, socio-economic structure in aboriginal communities serve as significant risk factors of neurodegenerative diseases.
Assessment and Treatment
Dudley, et al. conducted interviews with Māori people to share their experience and opinions of modem neurological assessment and treatment. Spiritual healing is an important part of Māori culture. Although their encounters with neuropsychologists are generally positive, most feel that their cultural identity was not acknowledged and they were not informed what to expect in an assessment. Many would like to see Māori neuropsychologists or have Māori clinicians work with them.
The prevalence of TBI in aboriginal people is caused by multiple factors, including socioeconomic status and overall physical health etc. Aboriginal people should be more informed on causes, risk factors, treatment and intervention of TBI. More resources need to be given to rehabilitation programs in the reserve and neuropsychologists would receive training on incorporating indigenous culture into their sessions. Last but not least, effort needs to be devoted to academic research and data collection on TBI in aboriginal people around the world.
D;, H. R. (n.d.). Stroke in American Indians and Alaska Natives: A Systematic Review. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26066955/
Dudley, M., Wilson, D., & Barker-Collo, S. (2014, November). Cultural invisibility: Māori people with traumatic brain injury and their experiences of neuropsychological assessments. Retrieved from http://civilforensicpsychiatry.com.au/wp-content/uploads/2016/03/Cultural-Invisibility-Maori-people-with-head-injuries.pdf
Nelson LA;Rhoades DA;Noonan C;Manson SM; ;. (n.d.). Traumatic brain injury and mental health among two American Indian populations. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17414312/
The Moderation of Blood Alcohol Levels on Higher Odds of Survival among American Indians with Violent, Blunt-Force Traumatic Brain Injuries. (n.d.). Retrieved from https://www.tandfonline.com/doi/full/10.1080/19371918.2015.1087920
Traumatic brain injury amongst indigenous people: A systematic review. (n.d.). Retrieved from https://www.tandfonline.com/doi/full/10.1080/02699052.2017.1374468
Warren LA;Shi Q;Young K;Borenstein A;Martiniuk A;. (n.d.). Prevalence and incidence of dementia among indigenous populations: A systematic review. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26088474/