Reflections on Dr. Donald A.B. Lindberg and Native Voices

Personal reflections on Donald A.B. Lindberg M.D. are offered by four Native American leaders who were instrumental in the successful development of the National Library of Medicine’s (NLM) Native Voices Exhibition: Stories of Health and Wellness from American Indians, Alaska Natives and Native Hawaiians. A uniquely collaborative effort, the exhibition features nearly 100 videographed interviews conducted by Dr. Lindberg with Native elders, healers, leaders, and people. He is credited with the incorporation of indigenous peoples’ healing knowledge in a personal and relational way, making for a wonderful journey together that was a very large chapter in his life and that of the authors.

Discrimination and Sleep Impairment in American Indians and Alaska Natives

Background Sleep impairment may be a key pathway through which discrimination undermines health. Links between discrimination and sleep in American Indians and Alaska Natives (AI/AN) have not been established. Further, it is unclear if such links might depend on the timing of discrimination or if socioeconomic status (SES) might buffer the impact of discrimination. Purpose To investigate associations between interpersonal discrimination and sleep impairment in urban AI/AN, for both lifetime and recent discrimination, and controlling for other life stressors. Education and income, indices of SES, were tested as potential moderators. Methods A community sample of urban AI/AN (N = 303, 18–78 years old, 63% female) completed self-report measures of sleep impairment, lifetime and recent discrimination, depressive symptoms, perceived stress, other life stressors (childhood adversity and past year major events), and socio-demographic characteristics. Results Lifetime discrimination was associated with impaired sleep in AI/AN after adjustment for socio-demographic characteristics, recent depressive symptoms, perceived stress, and other life stressors. Past-week discrimination was associated with sleep in unadjusted but not adjusted models. Education, but not income, was found to buffer the effects of both lifetime and past-week discrimination on sleep in adjusted models. Conclusion Lifetime discrimination uniquely accounts for sleep impairment and may be especially harmful in those with less education. These findings suggest targeting interventions to those most in need. Limitations include the cross-sectional nature of the data. Longitudinal and qualitative work is needed to understand how education may buffer the effects of discrimination on sleep and perhaps other health problems in AI/AN.

Assessing Social Determinants of Health in a Prenatal and Perinatal Cultural Intervention for American Indians and Alaska Natives

American Indians and Alaska Natives (AIANs) refer to cultural traditions and values to guide resilient and strength-based practices to address maternal and infant health disparities. Methods: A case study of a culturally-based educational intervention on AIAN maternal and child health. Results: Cultural teachings have successfully been applied in AIAN behavioral interventions using talking circles and cradleboards, but maternal and child health interventions are not well-represented in peer-reviewed literature. Zero publications included interventions centered around cradleboards and safe sleep. Discussion: There is a need for rigorous published research on culturally based interventions and effectiveness on health outcomes for mothers and babies. Conclusions: This paper discusses how a cradleboard educational intervention incorporates national guidelines to address maternal and infant health while mediating social determinants of health.