Recommendations for Addressing Historical Trauma and Oppression, Adverse Childhood Experiences and Toxic Stress, Substance Abuse Causing Premature Mortality

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TITLE: Recommendations for Addressing Historical Trauma and Oppression, Adverse Childhood Experiences and Toxic Stress, Substance Abuse Causing Premature Mortality

WHEREAS, we, the members of the National Congress of American Indians of the United States, invoking the divine blessing of the Creator upon our efforts and purposes, in order to preserve for ourselves and our descendants the inherent sovereign rights of our Indian nations, rights secured under Indian treaties and agreements with the United States, and all other rights and benefits to which we are entitled under the laws and Constitution of the United States, to enlighten the public toward a better understanding of the Indian people, to preserve Indian cultural values, and otherwise promote the health, safety and welfare of the Indian people, do hereby establish and submit the following resolution; and

WHEREAS, the National Congress of American Indians (NCAI) was established in 1944 and is the oldest and largest national organization of American Indian and Alaska Native tribal governments; and

WHEREAS, Tribal Epidemiology Centers (TECs) are a Public Health Authority established by Congress under the 2010 Affordable Care Act to work directly with American Indian Tribes to collect data, evaluate delivery systems and data systems and programs, identify the highest health priorities based on data, make recommendations for health service needs and improving health care delivery systems, provide epidemiologic technical assistance and disease surveillance to promote public health with Tribal health departments; and

WHEREAS, historical trauma is a collective emotional and psychological injury that disproportionately affects American Indian and Alaska Natives over a life span and occurs across generations as is the same with any population with a history of genocide. Research findings support that unresolved historical trauma can lead to unsettled emotional trauma, depression, child abuse and neglect, domestic violence, and higher rates of alcohol, drug use, suicide, and other causes of premature mortality; and

WHEREAS, adverse childhood experiences, physical and emotional abuse, chronic neglect, caregiver substance abuse and behavioral health challenges, exposure to violence, and/or economic hardship without positive adult relationships, may lead to toxic stress (which is not specific to Indian Country, but affects the entire nation and many communities in the United States). Toxic stress may cause developmental delays in children and increase their risk of chronic diseases (such as, heart disease, diabetes, substance abuse, depression) and suicidal behavior; and

WHEREAS, historical trauma, adverse childhood experiences, toxic stress, and other root causes of chronic diseases and behavioral health challenges are often undescribed due to lack of quality data leading to underfunded programs; and

WHEREAS, historical trauma, adverse childhood experiences and toxic stress, and substance abuse are critical public health concerns identified by Tribal public health professionals and TECs impacting behavioral health and premature mortality that need to be addressed immediately within Tribal communities.

NOW THEREFORE BE IT RESOLVED, NCAI urges that the following actions are taken:
• The Health and Human Services (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA), Administration for Children and Families (ACF), and Office of Minority Health (OMH), Indian Health Service (IHS), and the Centers for Disease Control and Prevention (CDC), and National Institutes of Health (NIH) should coordinate to ensure that adequate resources are made available to address this public health crisis.
• SAMHSA, OMH, IHS, ACF, NIH, CDC, and other appropriate federal agencies should partner directly with TECs and Tribes to establish a “core set” of culturally appropriate Tribal behavioral health data.
• SAMHSA, OMH, IHS, ACF, NIH, CDC, and other appropriate federal agencies partner directly with TECs to assist Tribes at the community level with public health projects that address root causes of substance abuse and premature mortality, providing appropriate technical assistance.
• SAMHSA, OMH, IHS, ACF, NIH, CDC, and other appropriate federal agencies should partner directly with TECs and Tribes to ensure appropriate American Indian expertise in the areas of Tribal public health and epidemiology on working groups and committees; and

BE IT FURTHER RESOLVED, that this resolution shall be the policy of NCAI until it is withdrawn or modified by subsequent resolution.


CERTIFICATION

The foregoing resolution was adopted by the General Assembly at the 2015 Midyear Session of the National Congress of American Indians, held at the St. Paul River Centre, St. Paul, MN, June 28 to July 1, 2015, with a quorum present.