Stress and cardiometabolic disease risk for indigenous populations throughout the lifespan

Melissa E. Lewis, Hannah I. Volpert-Esmond, Jason F. Deen, Elizabeth Modde, Donald Warne

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Background: Indigenous people experience the greatest cardiometabolic disease disparity in the Unites States, yet high cardiometabolic disease risk factors do not fully explain the extent of the cardiometabolic disease disparity for Indigenous people. Stress, trauma, and racism occur at high rates within Indigenous communities and have not been well explored as significant contribu-tors to cardiometabolic disease disparities despite emerging literature, and therefore will be de-scribed here. Methods: This descriptive study explores the relationship between cardiometabolic disease risks and Indigenous-specific stressors (e.g., early childhood stress and trauma, adulthood stress and trauma, and historical and intergenerational trauma) using current literature. Indige-nous-specific protective factors against cardiometabolic disease are also reviewed. Results. Increas-ing research indicates that there is a relationship between Indigenous-specific stressful and traumatic life experiences and increased cardiometabolic disease risk. Mental health and psychophysi-ology play an important role in this relationship. Effective interventions to reduce cardiometabolic disease risk in Indigenous communities focus on ameliorating the negative effects of these stressors through the use of culturally specific health behaviors and activities. Conclusions: There is increas-ing evidence that cultural connection and enculturation are protective factors for cardiometabolic disease, and may be galvanized through Indigenous-led training, research, and policy change.

Original languageEnglish (US)
Article number1821
Pages (from-to)1-24
Number of pages24
JournalInternational journal of environmental research and public health
Issue number4
StatePublished - Feb 2 2021


  • Adverse childhood experiences
  • Cardiometabolic disease
  • Historical trauma
  • Indigenous population
  • Stress

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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