PROJECT SUMMARY American Indians (AIs) have a lower life expectancy by 5.5 years less compared to all other U.S. races. Cardiovascular disease prevalence has been increasing among AIs and serves as the leading cause of mortality among AIs. Trauma confers risk for poor cardiovascular health. AIs have disproportionately higher incidence of childhood trauma compared to other racial and ethnic groups. Additionally, AIs deal with the ongoing implications from historical trauma, which is the emotional and psychological wounding associated with the loss of land, language, and cultural traditions. It remains possible that both childhood and historical traumas may contribute to persisting AI health disparities. The relationship between trauma and health in other racial and ethnic groups has been studied for many years, and research indicates differences in physiological responses to acute stress may contribute to the negative effects of trauma on health. To date, the relationship between trauma and markers of risk for cardiometabolic disease and poor mental health, and the role of physiological responses to stress in this relationship, have not been studied in an exclusively AI community. To address this critical research gap, the present study will elucidate relationships between trauma and health in the Blackfeet community in Montana. The life expectancy for members of the Blackfeet is 13 years less than the life expectancy of non-Hispanic Whites living in the same county, in part due to the disproportionality high incidence of cardiometabolic disease and mental health conditions in the community which suffers from both high rates of trauma. A sample of AI adults (N=400, 50% female, age range: 18-25 years) residing on the same reservation will participate in a cross-sectional study. Participants will report childhood and historical trauma, alcohol use, and depressive and anxiety symptomology and will complete two in-person visits. During Visit 1, participants will have their resting blood pressure assessed, waist circumference measured, and blood samples taken for biomarkers of cardiometabolic risk. During Visit 2, participants will have arterial stiffness measured and complete a validated acute psychological laboratory paradigm. Participants will have cardiovascular, neuroendocrine, and inflammatory responses to the acute stress measured. The findings will ultimately inform future intervention efforts and provide the basis for longitudinal work to capture trajectories of cardiometabolic and mental health in the context of past and ongoing trauma.

Project Narrative This project addresses a critical gap in knowledge regarding the relationship between historical and childhood trauma and health risk in an American Indian (AI) community. Using a community based participatory approach, gold-standard physiological reactivity methods, and comprehensive assessments of behavioral and biological risk for cardiometabolic disease and mental health, the findings will provide important knowledge on the relationship between trauma and disease risk in AIs. The study will provide the basis for future longitudinal work to track the impact of trauma on long-term trajectories in cardiometabolic and mental health risk and will provide foundational knowledge that can be applied to future health interventions aimed at reducing AI health disparities.