ABSTRACT
Background: American Indian and Alaska Native (AI/AN) peoples are disproportionately impacted by substance use disorders (SUDs) and health consequences in contrast to all racial/ethnic groups in the United States. This is alarming that AI/AN peoples experience significant health disparities and disease burden that are exacerbated by settler-colonial traumas expressed through prejudice, stigma, discrimination, and systemic and structural inequities. One such compounding disease for AI/AN peoples that is expected to increase but little is known is Alzheimer's disease and related dementias (ADRD). AI/AN approaches for understanding and treating disease have long been rooted in culture, context, and worldview. Thus, culturally based prevention, service, and caregiving are critical to optimal outcomes, and investigating cultural beliefs regarding ADRD can provide insights into linkages of chronic stressors, disease, prevention and treatment, and the role of substance misuse. Method: To understand the cultural practices and values that compose AI/AN Elder beliefs and perceptions of ADRD, a grounded theory, qualitative study was conducted. Twelve semistructured interviews with AI/AN Elders (M age = 73; female = 8, male = 4) assessed the etiology, course, treatment, caregiving, and the culturally derived meanings of ADRD, which provides a frame of understanding social determinants of health (SDH; eg, healthcare equity, community context) and impacts (eg, historical trauma, substance misuse) across the lifespan. Results: Qualitative analyses specific to disease etiology, barriers to treatment, and SDH revealed 6 interrelated and nested subthemes elucidating both the resilience and the chronic stressors and barriers faced by AI/AN peoples that directly impact prevention, disease progression, and related services: (1) postcolonial distress; (2) substance misuse; (3) distrust of Western medicine; (4) structural inequities; (5) walking in two worlds; and (6) decolonizing and indigenizing medicine. Conclusion: Barriers to optimal wellbeing and SDH for AI/AN peoples are understood through SUDs, ADRD, and compounding symptoms upheld by colonial traumas and postcolonial distress. En masse historical and contemporary discrimination and stress, particularly within Western medicine, both contextualizes the present and points to the ways in which the strengths, wisdom, and balance inherent in AI/AN culture are imperative to the holistic health and healing of AI/AN peoples, families, and communities.
ABSTRACT
Within the context of national traditions in colonial science, the scientific activities of Jesuit missionaries present us with a unique combination of challenges. The multinational membership of the Society of Jesus gave its missionaries access to virtually every Portuguese, Spanish, and French colony. The Society was thus compelled to engage an astonishingly diverse array of cultural and natural environments, and that diversity of contexts is reflected in the range and the complexity of Jesuit scientific practices. Underlying that complexity, however, was what I see as a unique combination of institutional structures; namely, European colleges, overseas mission stations, and the regular circulation of personnel and information. With this institutional framework as a backdrop, I briefly trace what I see as the most salient themes emerging from recent studies of Jesuit overseas science: (1) the Societys ability to use scientific expertise to its advantage amid the complex web of dependencies upon which it missionary activities rested; (2) the ability of its missionaries to become intimate with a wide range of cultures and to appropriate natural knowledge held by indigenous peoples, especially in the fields of material medica and geography; and (3) the different ways Jesuits used published accounts of "remote nature" (i.e., natural histories of overseas colonies) to advance their corporate and religious causes.
