What if your cultural identity was a risk factor for poor health?

UMN Morris Professor Heather Peters, PhD, will never forget the day she told Teresa Peterson, a colleague with whom she has since had a near two decade research partnership, that many health professionals consider Native identity just that.

Peterson, a member of the Upper Sioux Community, was taken aback. “It blew my mind,” she says.

It’s true that many Native communities have higher rates of some health issues: obesity and diabetes, coronary heart disease and substance misuse. But Peters says the way in which Western medicine often frames these issues, coupled with one-size-fits-all research and medical approaches that can disregard Native culture, has ingrained such a negativity around Native health that Western-based measurement tools and interventions may very well be part of the problem.

Peters would hear Dakota youth saying things like, “You’re Native, you’re going to be overweight, you’re going to have diabetes, so why do anything if there’s nothing you can do that’s going to make a difference?” That, she says, is when she recognized that this stereotype was leading to learned helplessness.

Breaking the cycle

It’s what is called an external locus of control, Peters says — the idea that your destiny is predetermined by outside forces you cannot control, which then exacerbates unhealthy behaviors.

And there is plenty of research that clearly links an external locus of control to poor health outcomes, she adds, like higher levels of stress, depression, intake of junk food, substance misuse and physical illness.

Ultimately, says Peters, it leads to what she and Peterson call the “cycle of Native health disparities.” And so they decided to do something about it — with an approach to health that views Native culture as an asset.

Improving ‘wicozani’

Peters partnered with Dakota Wicohan (DW), a Native nonprofit organization near the Upper and Lower Sioux Communities that is dedicated to preserving the Dakota language and Dakota ways of life. Peterson was then the director of DW. She and other DW staff wanted to evaluate whether DW’s cultural programming was improving community members’ “wicozani” — a Dakota term for overall health and well-being.

The result was the creation of the Wicozani Instrument, a nine-item self-report tool that measures mental, physical and spiritual health from an Indigenous worldview, as well as the perceived importance of those measures to an individual’s quality of life. Gifts to UMM’s donor-supported Psychology Endowment funded student research assistants for the project.

They found that the Wicozani Instrument worked.

By focusing on overall health and well-being rather than on ailments and sickness, individuals had the space to consider what health looks and feels like and to take control of their own health.

Today, the UMN Morris collaboration with DW has resulted in the development of five additional Indigenous measures, which have been used by Native and non-Native health professionals and school counselors alike, Peters says.

The Wicozani Instrument itself is being used in many different research and Native health organizations across the country and in Finland.

“We always held a glimmer of hope that it would make a difference, especially for our Indigenous communities,” Peters says, “and now we know it is.”

Make a gift to support research like Peters’ through the UMM Psychology Endowment.