Settler colonialism is quite unhealthy (some data): Nicole A. Thomas, Settler Colonial Determinants Of Indigenous Health: Relationship Between Indigenous Women’s Level Of Allostatic Load And High Blood Pressure During Pregnancy, PhD dissertation, University of Wisconsin, 2024 | settler colonial studies blog

Settler colonialism is quite unhealthy (some data): Nicole A. Thomas, Settler Colonial Determinants Of Indigenous Health: Relationship Between Indigenous Women’s Level Of Allostatic Load And High Blood Pressure During Pregnancy, PhD dissertation, University of Wisconsin, 2024

14Jun24

Abstract: There is a dearth of comprehensive literature relevant to the relationship between settler colonialism and health outcomes of Indigenous peoples residing in the United States (U.S.). Critical analysis of settler colonial determinants of Indigenous health will help to further shape discourse, research priorities, and policy relevant to Indigenous population health and disease distribution. This thesis will bring awareness to settler colonialism, propose relationships between settler colonialism and health outcomes, and identify specific settler colonial determinants of Indigenous health to help guide development and use of nursing theory. This dissertation argues that the structure of settler colonialism threatens and implicates the health of Indigenous peoples residing in colonized nations. The dissertation supports Patrick Wolfe’s assertion that settler colonialism is a current-day structure of elimination and will build upon this notion by providing analyses to identify pathways, processes, and determinants of the embodiment of settler colonialism. The project further encourages readers to identify the presence and influence of Eurocentric power relationships between structural and systemic settler colonial determinants and Indigenous peoples, often resulting in oppressive and traumatic experiences. The exposure to exogenous hazards and continual stress and trauma resulting from settler colonialism may lead to high levels of allostatic load and/or epigenetic dysregulation. For example, Indigenous women in particular are affected by settler colonialism which may result in disproportionate maternal health disparities such as high blood pressure during pregnancy. This project will increase understanding and awareness of settler colonialism as a current-day structure and a significant determinant of Indigenous health. This dissertation consists of three manuscripts. The first manuscript is a literature review that informed the development of a conceptual framework identifying six settler colonial determinants of Indigenous health. Frameworks describing how the structural determinants of settler colonialism result in historical and cultural trauma, and negatively impact health outcomes via biological and social pathways, have not been developed. Therefore, I identified six interconnected settler colonial determinants of Indigenous health that I hypothesize will result in the embodiment of settler colonialism and ultimately lead to adverse health outcomes, such as hypertensive disorders of pregnancy (HDP). The six determinants are historical context, land, environmental justice, culture, settler-colonial societal context, and structural violence. The second manuscript is a published literature review that explores the processes and pathways of the embodiment of historical trauma secondary to settler colonialism of Indigenous peoples. Guided by EcoSocial Theory, Historical Trauma Theory, and the Allostatic Load (AL) Model, this literature review provides evidence that sources of stress rooted in experiences of historical trauma resulting from the structure of settler colonialism should be investigated as sources of stress for women who are vulnerable to experiencing settler colonialism. The third manuscript documents the results of a secondary data analysis from the Strong Heart Study (SHS) that investigates the relationship between Indigenous women’s level of AL and high blood pressure during pregnancy. This secondary analysis is a quantitative, retrospective, cross-sectional, cohort design analysis using data from the Phase IV Strong Heart Study. Given that Indigenous women are at risk of experiencing settler colonialism and experience greater maternal health disparities than most all other racial/ethnic groups, I examined relationships among high blood pressure during pregnancy, AL, and factors of culture. I selected variables of settler colonialism, historical trauma, and cultural trauma (i.e., loss of access to traditional values/cultures, and native lifestyle) for this secondary analysis based on findings from the first two manuscripts. This dissertation concludes with a final chapter that describes implications for theory, policy, nursing practice, and further research. Evidence generated from this dissertation has the potential to move the nursing field forward in ways that can lead to broad, transformative impacts for Indigenous communities. It further provides a theoretical foundation for advancing nursing knowledge and guiding future research studies.

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