Risk Assessment in Indigenous Populations

A new study is exploring the deeper issues underlying cancer-risk behaviour in Indigenous populations

Illustration by Glenn Harvey.

When people think of cancer, they don’t typically consider the role psychological trauma can play in the development of the disease.

Cancer risk is often associated with unhealthy behaviours such as smoking, hazardous alcohol use and poor diet. “Persistent engagement in all of these behaviours has been linked to psychological trauma,” says Dr. Cheryl Currie, who is the Alberta Innovates Translational Chair in Aboriginal Health and an associate professor of public health at the University of Lethbridge.

Currie is co-leading a study to examine the impacts of psychological trauma on cancer risk within Indigenous populations. “Through the important work of the Truth and Reconciliation Commission [TRC], Canadians are now becoming conscious of the generations of psychological trauma experienced by Indigenous peoples in residential schools,” says Currie. “The last residential school closed in Canada in 1996. I have students in my classes in their 30s who attended residential school. Yet the role that psychological trauma plays in the development of chronic disease among Indigenous Canadians is often overlooked both in medicine and in the field of health promotion.”

Study co-lead Dr. Susan Tallow Christenson, a Blackfoot primary care physician in Kainai Nation in southern Alberta, agrees. Many of her patients are dealing with addictions and mental illness, as well as chronic diseases like cancer, heart disease and diabetes — health outcomes that have been scientifically linked to the physical and mental toll of severe stress in childhood. Christenson says in her community, health-risk behaviour is usually a response to unrelieved stress.

“It’s about trying to get a break from the pain of life and not having any useful tools to help you process what you’re going through,” she says.

Currie and Christenson, along with a team that includes Indigenous Elders and Knowledge Holders, are conducting the study to better understand and address root causes of cancer-risk behaviour among Indigenous adults.

“Typically, interventions to address cancer risk behaviour are focused on educating people that certain behaviours are not good for their health. But that’s short-sighted,” says Currie. “The field of neuroscience tells us that motivations for behaviour go beyond knowing what is good for us. We have designed a study focused on addressing psychological trauma as a root cause of behaviour, and a door to behaviour change.”

The study will randomize people to four groups — education alone, group talk therapy, trauma-sensitive yoga classes or Indigenous drumming classes. “Trauma lives in the body, not just the mind,” says Currie. “We have designed interventions informed by Indigenous Knowledge Systems about health and healing — Knowledge Systems that recognize the role of healing the body in healing the mind.”

Christenson believes finding healthy stress-management strategies is part of a group of larger solutions for improving health outcomes in Indigenous populations. She says it can be difficult to get people to engage in positive, rejuvenating therapies at first, but it’s worth it.

“People who actually manage to learn to live in a constructive way with what they’ve been through actually become very powerful leaders,” she says. “They start to grow, and then they lead others along.”

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