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 FUTURE HEALTH NEEDS OF WOMEN OF COLOR  Reconceptualizing Native Women’s Health: An “Indigenist” Stress-Coping Model | Karina L. Walters, PhD, MSW, and Jane M. Simoni, PhD A people is not defeated until the O’Neil,3 fourth world refers to sit- 520 | Future Health Needs of Women of Color | Peer Reviewed | Walters and Simoni American Journal of Public Health | April 2002, Vol 92, No. 4  FUTURE HEALTH NEEDS OF WOMEN OF COLOR  94.2 and 161.7; cerebrovasculardisease, 40.1 and 59.6; lung can-cer, 25.0 and 41.3; and pneumo-nia and influenza, 22.4 and29.0.14 higher death rates due to dia-betes (45.4 vs 22.4), all types ofaccidents combined (38.1 vs22.0), motor vehicle accidents(22.7 vs 10.5), chronic liver dis-ease and cirrhosis (20.5 vs 6.1),alcohol abuse (20.3 vs 3.5), andsuicide (5.2 vs 4.4). Nativewomen are second only to Afri-can American women in terms ofdeath rates due to homicide (4.8vs 9.0) and drug abuse (4.7 vs4.8). Native women’s age-adjusted cervical cancer deathrate during the period 1994 to1996 was 52% higher than theall-race rate in 1995 (3.8 vs.
2.5).10 Note. PTSD = posttraumatic stress disorder.
FIGURE 1—Indigenist model of trauma, coping, and health outcomes for American Indian women.
state IHS area is 22% higherthan the overall US rate (9.3 vs April 2002, Vol 92, No. 4 | American Journal of Public Health Walters and Simoni | Peer Reviewed | Future Health Needs of Women of Color | 521  FUTURE HEALTH NEEDS OF WOMEN OF COLOR  522 | Future Health Needs of Women of Color | Peer Reviewed | Walters and Simoni American Journal of Public Health | April 2002, Vol 92, No. 4  FUTURE HEALTH NEEDS OF WOMEN OF COLOR  HIV/AIDS and Native Americans.
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of Psychology, University of Washington. Requests for reprints should be sent to and health: models of interaction for In- Karina L. Walters, PhD, MSW, School of dian and Native populations. Behav Social Work, University of Washington, Health Issues Am Indians Alaska Natives. 4101 15th Ave NE, Seattle, WA 98105- 6299 (e-mail: [email protected]). This commentary was accepted Decem- 13. Krieger N. Embodying inequality:a review of concepts, measures, and quences of discrimination. Int J Health 14. Death Rates and Number of Deaths contributions and drafted the paper.
by State, Race, Sex, Age, and Cause, K. L. Walters and J. M. Simoni jointly ed- 1994–1998. Atlanta, Ga: Centers for Disease Control and Prevention; 2001.
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can Indian and Alaska Native Communi- ties and the Role of the Indian Health Ser- vice. Washington, DC: National Indian Gerrity ET, Scurfield RM, eds. Ethnocul- tural Aspects of Posttraumatic Stress Dis- order: Issues, Research, and Clinical Ap- plications. Washington, DC: American ried Mexican immigrant women. Psychol nomic status, stress, and discrimination.
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RM, eds. Ethnocultural Aspects of Post-traumatic Stress Disorder: Issues, Re- search, and Clinical Applications. Wash- ceived discrimination in the UnitedStates. J Health Soc Behav. 1999;40: 524 | Future Health Needs of Women of Color | Peer Reviewed | Walters and Simoni American Journal of Public Health | April 2002, Vol 92, No. 4

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