Despite histories of loss and discrimination, more American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) people are living into old age. Risk and protective factors for AI/AN/NH Elder mental health are poorly described. Data from the 2017-2020 Identifying Our Needs (ION): A Survey of Elders needs assessment of 19,143 AI/AN/NH Elders receiving nutrition, socialization, and caregiver-assistance services through Title VI of the Older Americans Act were analyzed. We hypothesized that (1) family, cultural, and social engagement are protective factors, (2) limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) are risk factors for mental health status, and (3) status of grandparent caregiver is associated with lower mental health scores. As hypothesized, frequent engagement in traditional cultural activities was protective for mental health status. ADL/IADL limitations were the largest risk factor for poor mental health among AI/AN/NH Elders, while engagement in social activity was the strongest protective factor. Additionally, the status of a grandparent as a primary caregiver for their grandchildren was associated with poorer mental health. Indigenous-serving programs need expanded funding to support both cultural and personal/family services to the growing population of AI/AN/NH Elders in the United States.
Adamsen et al. (Thu,) studied this question.