Unveiling an ‘invisible population’: health, substance use, sexual behavior, culture, and discrimination among urban American Indian/Alaska Native adolescents in California

ABSTRACT

Objectives: There are limited public health data on urban American Indian/Alaska Native (AI/AN) populations, particularly adolescents. The current study attempted to address gaps by providing descriptive information on experiences of urban AI/AN adolescents across northern, central, and southern California.

Design: We describe demographics and several behavioral health and cultural domains, including: alcohol and other drug (AOD) use, risky sexual behavior, mental and physical health, discrimination experiences, involvement in traditional practices, and cultural pride and belonging. We recruited 185 urban AI/AN adolescents across northern, central, and southern California from 2014 to 2017 who completed a baseline survey as part of a randomized controlled intervention trial.

Results: Average age was 15.6 years; 51% female; 59% of adolescents that indicated AI/AN descent also endorsed another race or ethnicity. Rates of AOD use in this urban AI/AN sample were similar to rates for Monitoring the Future. About one-third of adolescents reported ever having sexual intercourse, with 15% reporting using alcohol or drugs before sex. Most reported good mental and physical health. Most urban AI/AN adolescents participated in traditional practices, such as attending Pow Wows and learning their tribal history. Adolescents also reported discrimination experiences, including being a victim of racial slurs and discrimination by law enforcement.

Conclusions: This study describes a select sample of California urban AI/AN adolescents across several behavioral health and cultural domains. Although these adolescents reported numerous discrimination experiences and other stressors, findings suggest that this sample of urban AI/AN teens may be particularly resilient with regard to behavioral health.

KEYWORDS:

• Native American adolescents
• American Indian/Alaska Native adolescents
• urban
• alcohol and drug use
• sexual behavior
• culture
• discrimination

Acknowledgement

Work on this article was supported by a grant from the National Institute of Alcohol Abuse and Alcoholism R01AA022066 to Drs. D’Amico and Dickerson, with co-funding from the National Institute on Drug Abuse. We would also to thank our Elder and youth advisory boards and the communities and organizations that helped us recruit adolescents for this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Work on this article was supported by a grant from the National Institute of Alcohol Abuse and Alcoholism R01AA022066 to Drs. D’Amico and Dickerson, with co-funding from the National Institute on Drug Abuse.