CHamorus' Narratives and Perceptions of Historical Trauma and Contemporary Health in Guam

Abstract

Historical trauma refers to the generationally transferred human consequences of cultural oppression in a population associated with colonization, slavery, and genocide. Historical trauma theory suggests that such trauma functions as a social determinant of health influencing mental and physical health problems of members in the present. On the Pacific Island of Guam, the Indigenous population of CHamorus has over 300 years of colonization history. The CHamorus’ profile of present-day health disparities follows a pattern similar to those of other Indigenous populations, who often experience poorer health outcomes than non-Indigenous people. Yet few researchers have explored the influences of historical trauma from the CHamorus’ perspective. This is important because historical trauma may have implications for perceptions about disease and healing and may influence health behaviors. As a result of this oversight, the historical trauma experiences and perceptions of CHamorus that relate to their health beliefs, practices, and outcomes risk going unrecognized and their health needs misunderstood. The purpose of the study was to provide a basis for more Indigenous-centered and historical trauma-informed nursing and other health care for CHamorus. The study aimed to establish a better understanding of how the collective experience of loss and violence among the CHamoru people is perceived relative to contemporary health beliefs and practices. Using narrative inquiry methodology, I conducted repeat, in-depth, story-eliciting interviews with 10 CHamoru adults. Using thematic narrative analysis, I identified a common overarching narrative of liminality in which participants described how they navigated between health practices of Traditional and Western cultures. I identified specific repeated themes in the narratives of struggle with history and unequal relationship with the dominant culture that represented CHamorus’ strategies for managing meanings and practices around health and illness in the context of ongoing, centuries-long involvement with a colonizing culture. This research provides a description of the ways in which the CHamoru people conceptualize historical trauma in relation to health behaviors and health beliefs. The result will be useful in guiding future research and practice recommendations to better ensure that nursing and other care is historical trauma-informed, Indigenous-centered, and culturally safe.