Journal of Ethnicity in Substance Abuse, 8:330–340, 2009 Copyright # Taylor & Francis Group, LLC ISSN: 1533-2640 print=1533-2659 online DOI: 10.1080/15332640903110500
Mexican Americans and Historical Trauma Theory: A Theoretical Perspective ANTONIO L. ESTRADA Mexican American Studies and Research Center, The University of Arizona, Tucson, Arizona
The observed intergenerational stress response to negative social and historical events is at the core of historical trauma theory, which has been applied to Native Americans, African Americans, and Pacific Islanders, among others. The historical and social experiences of the Mexican population living in the United States have many parallels that lend themselves to the application of historical trauma theory to macro-level and micro-level influences on access to health care, physical health status, and mental health status, including substance abuse among Mexican Americans. This article highlights the legacy of Spanish colonialism and Anglo–American neo-colonialism on Mexicans and Mexican Americans in the southwestern United States through a potential application of historical trauma theory. KEYWORDS historical trauma, Mexican Americans, stress
INTRODUCTION Within the past decade, the field of stress research has seen an explosion of scientific articles on the theory of historical trauma (Brave Heart 1999a, b; Brave Heart & DeBruyn, 1998; Brunello et al., 2001; Schnurr & Green, 2004). Not to be confused with post-traumatic stress disorder (which largely examines stress responses to a severe event on those principally affected), the concept of historical trauma is, at its core, intergenerational. Researchers in this field examine historical and social events that have led to observed intergenerational stress responses among individuals and groups. Thus, the Address correspondence to Antonio L. Estrada, Ph.D., Mexican American Studies and Research Center, Cesar E. Chavez Bldg., Rm. 208C, The University of Arizona, Tucson, AZ 85721. E-mail: [email protected] 330
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identification and examination of these social and historical determinants of health that have influenced the health status of an individual within a particular racial=ethnic group at the macro-level of society are important in developing interventions that help resolve the negative health outcomes of historical trauma.
HISTORICAL TRAUMA THEORY Brave Heart (1999a) defines historical trauma as ‘‘. . . cumulative trauma over both the life span and across generations that results from massive cataclysmic events . . .’’ (p. 111). It manifests itself by’’ . . . depression, self-destructive behavior, substance abuse, identification with ancestral pain, fixation to trauma, somatic symptoms, anxiety, guilt, and chronic bereavement’’ (Brave Heart, 1999a, p. 111). The essential elements of historical trauma are that it is cumulative, intergenerational, and linked to multiple negative health outcomes. Sotero (2006) developed a conceptual model of historical trauma that includes the following three sequential stages: (1) a mass trauma experience where the dominant group subjugates a population, resulting in segregation and displacement, physical and psychological violence, economic destruction, and cultural dispossession; (2) a trauma response is elicited in the first or primary generation that includes physical, social, and psychological responses; (3) the responses are transmitted to subsequent generations through environmental factors, psychosocial factors, social=economic= political systems, and legal and social discrimination.
THE EVOLUTION OF THE CONCEPT Historical trauma is known by several names in the research literature: ‘‘survivor guilt,’’ ‘‘stressful life events,’’ ‘‘intergenerational grief and bereavement,’’ ‘‘post-traumatic slave syndrome,’’ and ‘‘cultural trauma’’ (Brave Heart & DeBruyn, 1998; Cook, Withy, & Tarallo-Jensen, 2003; Danieli, 1998; Degruy Leary, 2005; Kellerman, 2001; Krieger, 2001). Holocaust survivors of German concentration camps in World War II, the historical consequence of slavery on African Americans, the grief and cultural loss experienced by Native Hawaiians, and the multiple social and genocidal acts perpetrated on American Indians have a consistent theme of the intergenerational transmission of social, physical, and psychological disorders that affect the descendents of those who have experienced trauma. More recently, the research literature on historical trauma is predominantly based on American Indian populations (Brave Heart, 1999a, b, 2003; Duran & Duran, 1995; Faimon, 2004; Walters & Simoni, 2002). For example, Weaver and Brave Heart (1999) examined unresolved grief among the Lakota, linking
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suicide rates, depression, anxiety, and substance abuse disorders with the mass trauma experience of Wounded Knee. Given the social and historical experiences of Mexicans and Mexican Americans in Mexico and the southwestern United States, can the concept of historical trauma be fruitfully applied to examine health issues among this population?
HISTORICAL TRAUMA AND THE MEXICAN-ORIGIN POPULATION The term ‘‘Hispanic’’ refers to people whose origin is Mexican, Puerto Rican, Cuban, Central or South American, or other Hispanic=Latino regardless of race (U.S. Census, 2006). Hispanics are the largest ethnic minority group in the United States, comprising slightly more than 14% of the total population (U.S. Census, 2006). Mexican-origin Hispanics, inclusive of Mexican Americans, Mexicans, and Chicana=os, represent 65% of the U.S. Hispanic population. Mexican-origin Hispanics have the highest poverty rates, the highest uninsured rates, and the lowest educational attainment rates of any other Hispanic subgroup in the United States (U.S. Census, 2006). A majority of Mexican-origin Hispanics are born in the United States (61%) and are younger than other Hispanic subgroups. Interestingly, 33% of Hispanics reported they were of at least two races in the 2000 U.S. Census, and of this group, 48% reported they were ‘‘White,’’ but only 1.2% indicated their ‘‘second’’ race as ‘‘American Indian or Alaska Native’’ (U.S. Census, 2000). Nevertheless, Mexican-origin Hispanics are in large part indigenous, being primarily ‘‘mestizo’’ and having their biological and cultural roots among the indigenous tribes of Mexico as well as the Spanish colonizers. Mexican-origin individuals have had a 500-year legacy of domination and subordination by European powers, including the Spanish, English, Portuguese, and French, in Mexico and by Anglo–Americans in what is now the southwestern United States. One must remember that prior to the arrival of Hernan Cortez and the Conquest of Mexico in 1521, there was a flourishing civilization in the Americas. Three hundred years of Spanish Colonialism have led to the oppression and exploitation of indigenous populations, the establishment of a colonial relationship to serve the social and economic interests of the Spanish, the institutionalization of social classes based on race and place of birth, and the internalization of racial inferiority. Even today in Mexico it is an insult to call someone ‘‘Indio.’’ After the initial conquest, the Spanish instituted elements of social order that marginalized and subordinated the indigenous groups in favor of the Spanish elite (Vigil, 1984). For example, the establishment of the Encomienda system forced Indians to become laborers and to provide tribute on the lands of the Spanish ruling class. The Hacienda system further
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exploited Indians as forced labor and made them indentured servants to the owners of various haciendas through the advancement of credit, also known as ‘‘debt peonage.’’ Indians who wished to move up the social ladder had to adapt into mainstream Spanish culture. Those with a European phenotype could enjoy the fruits of Spanish colonialism. Those with an Indian phenotype had little chance of climbing the social ladder and were typically relegated to the lower classes.
THE LEGACY OF MANIFEST DESTINY With the westward expansion of the United States coupled with the peculiar notion of ‘‘manifest destiny,’’ America gradually became a neighbor of Mexico. In 1836, a mini-revolt among a group of settlers turned into a large-scale conflict for the possession of Tejas (Texas), a northern state of Mexico, which was eventually won by the rebels and shortly afterward became an independent republic. Even though they had fought beside the rebels, many Mexican citizens were dispossessed of their lands and human rights violations were perpetrated, especially by the Texas Rangers, who killed Mexicans and Mexican Americans with impunity (Acuna, 2004; Rosenbaum, 1998). A decade later in 1846, the United States declared war on Mexico to further its westward expansion. The war was won by the United States and a treaty was signed in 1848 (The Treaty of Guadalupe Hidalgo). However, a key omission to the Treaty ratified by the U.S. Senate was the exclusion of Article X, which protected the rights of Mexican citizens in lands ceded to the United States. As a result of this treaty, Mexico ceded almost half of its territory, including California, New Mexico, Nevada, and parts of Utah, Arizona, Oklahoma, and Colorado (Acuna, 2004). Mexicans became a conquered people and many were soon displaced from their lands. Those who decided to stay in what was now the United States would become U.S. citizens after 1 year, thus resulting in the origins of Mexican Americans. Both Mexicans and Mexican Americans were discriminated against, exploited as cheap labor, and not given the same political and land rights as Anglo Americans. For many generations, Mexicans and Mexican Americans have had to endure being scapegoated in times of economic downturns and viewed as a source of cheap, expendable labor in economic upturns. Mexican-origin people living in the United States were subjected to deportation if they could not provide documentation that they were U.S. citizens. Mexican Americans were forced to attend segregated schools (Mexican Schools), live in segregated neighborhoods, and were often viewed as inferior to Anglo Americans. The promulgation of cultural deficit models by social scientists during the 20th century was a direct assault on Mexican American culture (Heller,
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1966; Madsen, 1964; Saunders, 1954; Tuck, 1946). Mexican Americans were viewed as passive, irrational, unscientific, masochistic, apathetic, fatalistic, lazy, lacking initiative, and prone to commit criminal acts. Perceived social pathologies of Mexican Americans were blamed on ‘‘Mexican culture’’ and schools forced assimilation by emphasizing English only. Anglo–Americans perceived Mexican and Mexican American culture to be deficient in the values that were needed to be economically successful and believed that Mexicans and Mexican Americans needed to acculturate into Anglo– American society to be successful. The legacy of Spanish colonialism compounded by Anglo–American neo-colonialism has led to the internalization of negative perceptions and stereotypes by Mexican Americans, leading to self-hate and alienation, lowered self-esteem, ethnic identity conflict, discrimination, racism, and marginalization. The application of the concept of historical trauma to describe this internalization process has some appeal when contextualized by 500 years of oppression and subordination of Mexican-origin peoples, which continues today through anti-Mexican sentiment and the militarization of the United States–Mexico border as a result of the immigration dispute.
MILITARIZATION OF THE UNITED STATES–MEXICO BORDER The border between the United States and Mexico was established with the signing of the Treaty of Guadalupe Hidalgo coupled with the Gadsden Purchase in 1853. However, not until 1924 when the Border Patrol was created was the U.S. military presence increased in the region. Economic downturns and anti-Mexican sentiment led to massive deportations of Mexican-origin peoples during the 1930s, which continued through the 1950s with ‘‘Operation Wetback.’’ Physical and psychological violence continues today as Homeland Security ‘‘safeguards’’ the United States–Mexico border with repressive tactics such as ‘‘Operation Hold the Line’’ and ‘‘Operation Safeguard.’’ Subordination and social control of Mexican nationals, Mexican Americans, and Native Americans has led to documented civil rights violations of U.S. citizens of Mexican and Native American descent (Koulish, Escobedo, Rubio-Goldsmith, & Warren, 1994). Through subordination and repression of Mexican-origin peoples, Anglo America has created an ‘‘Internal Colonial Model’’ in the southwestern United States (Barrera, 1979). This model is characterized by the exploitation of the population as cheap and expendable labor, by dispossessing then of their land, by gerrymandering voting districts, and by treating them as a conquered people in their own land to serve the economic and political interests of the larger society. One hundred fifty years of Anglo–American neocolonialism have led to two-thirds of what was originally Mexico being ‘‘occupied,’’ the subjugation and exploitation of Mexican American land
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owners and laborers throughout the southwest, ethnocentrism, discrimination and racism, increased police and Department of Homeland Security surveillance, and the establishment of an Internal Colonial Model.
POTENTIAL INFLUENCES ON HEALTH The social, cultural, and historical events that have impacted generations of Mexicans and Mexican Americans living in the United States today have both micro and macro influences on health status (Table 1). The hypothesized connection between historical trauma and health is complex. Principally, historical and social events have created institutions and perceptions that are racist and discriminatory toward Mexicans and Mexican Americans and, in turn, have negatively influenced their eligibility for health insurance coverage and access and availability to health care through cultural or institutional barriers that prevent them from obtaining health care when needed. Over time, with limited or no access to health care, generations of Mexicans and Mexican Americans have begun to show increased rates of substance abuse, hypertension, metabolic syndrome, anti-social personality disorders, and Type 2 diabetes mellitus. It is precisely these diseases that are influenced by the psychosocial stressors (e.g., anti-Mexican sentiment, discrimination, and racism) that generations of Mexicans and Mexican Americans have experienced from the dominant culture. Cumulative intergenerational stress is believed to be the main cause of these disorders acting through a psychobiological stress response mechanism that influences neuroendocrine hyperactivity, autonomic and metabolic responses, and the immune system (Brunello et al., 2001; Schnurr & Green, 2004; Sotero, 2006). An example of historical trauma theory applied to Mexicans and Mexican Americans is shown in the Figure 1, which is an adaptation of the Indigenist Stress-Coping Model developed by Walters and Simoni (2002). Within this theoretical model, historical trauma (negative social and historical events) has laid a foundation for the socioeconomic characteristics of Mexicans and Mexican Americans, including poverty, underemployment, and low educational attainment, through structured and institutionalized oppression, discrimination, and racism. Sociocultural and socioenvironmental influences include targeted marketing of alcohol, accessibility to drugs, disorganized neighborhoods, and increased police surveillance. Potential cultural buffers include such concepts as ethnic pride and cultural identity, which are potentially eroded by discrimination and racism. These factors, in turn, are hypothesized to influence alcohol and drug abuse among Mexican Americans. Understanding the cumulative historical and social events that Mexican-origin people in the southwestern United States have endured over
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FIGURE 1 An etiological model of historical trauma and substance abuse among Mexicans and Mexican Americans in the United States (adapted from Walters and Simoni, AJPH, 93(4):520–524, 2002).
the past 150 years makes the theory of historical trauma applicable. Several elements of the theory, including massive socio-historical events, cultural dispossession, and the establishment of an economic system that serves the larger majority, plus the physical, social, and psychological impact of trauma on dispossessed peoples indicate that historical trauma theory may be a viable explanation for some of the micro-level health effects experienced by this population.
MEXICAN AND MEXICAN AMERICAN INDIGENIETY The application of historical trauma theory will depend on which identity one perceives and how one values either their Spanish or Indigenous roots. TABLE 1 Historical Trauma Influences on Health and Health Care Health Services (Macro-Level Influences) Health Insurance Coverage Regular Source of Care Access and Availability Cultural and Institutional Barriers Patient-Physician Communication Mental and Physical Health (Micro-Level Influences) Substance Abuse Depression Anxiety Disorders Anti-Social Personality Hypertension Heart Disease Metabolic Syndrome Diabetes Infectious Diseases (HIV)
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From an indigenous perspective, our elders tell us stories about the dispossession of land and the discrimination and racism they endured at the hands of Anglo Americans. In the Anglo–American mind, 1848 was a long time ago, too long for anyone to claim some ancestral heritage to a territory that comprised almost half of Mexico. If we consider a generation to be a 25-year period, approximately 20 generations have passed since the first Spanish contact with the indigenous peoples of Mexico 500 years ago, and 6 generations have passed since the United States made war on Mexico in 1848, giving birth to Mexican Americans. Our Native American brothers and sisters tell us that cataclysmic events extend 7 generations into the future. Mexican Americans born today represent the 7th generation since the North American invasion, and the 20th generation since the initial conquest of the Aztec’s by the Spanish. Mexican Americans are descended from Spanish colonists and the indigenous peoples of the Americas. The ancestral claim of territory under the concept of ‘‘Aztlan’’ has galvanized a generation of Mexican Americans to examine their indigenous roots (Garcia, 1997). Aztlan is regarded by many Chicana=o scholars as the ancestral homeland of the Aztecs prior to their migration to Tenochitlan (Mexico City). For example, the Disturnell Map used to demarcate territory ceded to the United States in the Treaty of Guadalupe Hidalgo notes that the ancestral homeland of the Aztecs was in present day Utah (Rodriguez & Gonzales, 2004). This claim, supported by archival evidence, more than implies that Mexican Americans, Mexicans, and Chicana=os believe their ancestors lived within the United States. It also implies a deeply-rooted connection to the land and a sense of commonality with American Indians in the Southwest.
LIMITATIONS There are measurement and conceptual limitations of historical trauma theory itself as well as its potential application to Mexican-origin people residing in the southwestern United States. One of the problems with the concept of historical trauma is how it is measured. There are few quantitative measures that capture the concept directly (Whitbeck, Adams, Hoyt, & Chen, 2004). A related issue is specificity, that is, what are the specific causes and effects of historical trauma. Public health views causes as multi-factorial— there are few specific causes and specific effects related to psychosocial stressors. And, as with post-traumatic stress disorder, is the concept of historical trauma differentiating between recency and latency effects in a temporal sense? These limitations are important to rectify to increase the veracity of historical trauma theory and its application to physical and psychological disorders.
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The application of historical trauma theory to Mexican-origin people may also have limitations. For example, some have argued that the Mexican government dispossessed land from indigenous populations throughout Mexico, including what is now California, Arizona, New Mexico, Nevada, and Texas. How can a people (Mexicans) dispossess one group (Indians) and feel dispossessed themselves when another government (the United States) takes over through conquest? These issues should be closely examined from both a historical and contemporary perspective. Governmental policies regarding indigenous populations in Mexico should be coupled with an examination of social and political interactions between the affected groups. For example, during the Spanish colonial period and the period of Mexican rule, mestizos and those Indians who adopted Spanish customs and values oppressed and exploited other Indians in the southwest. Additionally, some concerns over misappropriation of Native American philosophy, culture, and symbolism have been expressed by some North American Indians (Hernandez-Avila, 2004). Some have described the application of historical trauma theory to Mexican Americans as inappropriate based on the groups’ mestizo origins, claiming that they have relinquished their indigeniety in favor of Spanish language and culture (Hernandez-Avila & Perez, 2004). Alternatively, proponents of historical trauma theory and its application to Mexican Americans argue that most seek their indigenous cultural roots among the tribes of Mexico, including the Maya, Aztec, Tarahumara, Yaqui, and Zapotec (Anzaldua, 1987; Chavez-Leyva, 2004). There are also many Mexican Americans with cultural, linguistic, and biological ties to American Indian tribes of the southwest, including the Navajo, Apache, Kickapoo, Chumash, Comanche, and Hopi. Linguists have long known that Nahuatl, the language spoken by the Aztecs and still spoken in many parts of Mexico today, is similar to other Uto-Aztecan dialects spoken in the southwestern American and Mexico (Steele, 1979). Much more research needs to be conducted on the application of historical trauma theory to Mexicans and Mexican Americans residing in the southwest. This article has highlighted several social and historical events that theoretically could have a cumulative effect on the health and mental health status of Mexicans and Mexican Americans. Clearly, the notion of cumulative causation effects from historical and social events should not be discounted.
REFERENCES Acuna, R. (2004). Occupied America: The history of Chicanos. (5th ed.). New York: Pearson Longman. Anzaldua, G. (1987). Borderlands=La Frontera: The new Mestiza. San Francisco: Spinsters=Aunt Lute.
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Barrera, M. (1979). Race and class in the southwest: A theory of racial inequality. Notre Dame, IN: The University of Notre Dame Press. Brave Heart, M. (1999a). Oyate ptayela: Rebuilding the Lakota Nation through addressing historical trauma among Lakota parents. Journal of Human Behavior in the Social Environment, 2, 109–126. Brave Heart, M. (1999b). Gender differences in the historical trauma response among the Lakota. Journal of Health and Social Policy, 10(4), 1–21. Brave Heart, M. (2003). The historical trauma response among Natives and its relationship with substance abuse: A Lakota illustration. Journal of Psychoactive Drugs, 35, 7–13. Brave Heart, M., & DeBruyn, L. (1998). The American Indian holocaust: Healing historical unresolved grief. American Indian=Alaska Native Mental Health Research, 8, 56–78. Brunello, N., Davidson, J. R., Deahl, M., Kessler, R. C., Mendlewicz, J., Racagni, G., et al. (2001). Posttraumatic stress disorder: Diagnostic and epidemiology, comorbidity and social consequences, biology and treatment. Neuropsychobiology, 43, 150–162. Chavez-Leyva, Y. (2004). In ixtli in yollotl=A face and a heart: Listening to the ancestors. Studies in American Indian Literatures, 15, 96–127. Cook, B. P., Withy, K., & Tarallo-Jensen, L. (2003). Cultural trauma, Hawaiian spirituality, and contemporary health status. Californian Journal Health Promotion, 1, 10–24. Danieli, Y. (Ed.) (1998). International handbook of multigenerational legacies of trauma. New York: Plenum Press. Degruy Leary, J. (2005). Post traumatic slave syndrome: America’s legacy of enduring injury and healing. Baltimore, MD: Uptone Press. Duran, E., & Duran, B. (1995). Native American postcolonial psychology. Albany, NY: State University of New York Press. Faimon, M. (2004). Ties that bind. American Indian Quarterly, 28, 238–250. Garcia, I. M. (1997). Chicanismo. Tucson, AZ: The University of Arizona Press. Heller, C. S. (1966). Mexican–American youth: Forgotten youth at the crossroads. New York: Random House. Hernandez-Avila, I. (2004). Indigenous intersections: introduction. Studies in American Indian Literatures, 15(3=4), 1–6. Hernandez-Avila, L., & Perez, D. (2004). Speaking across the divide. Studies in American Indian Literatures, 15(3=4), 7–22. Kellerman, N. (2001). Transmission of holocaust trauma: An integrative view. Psychiatry: Interpersonal & Biological Processes, 64, 256–268. Koulish, R. E., Escobedo, M., Rubio-Goldsmith, R., & Warren, J. R. (1994). U.S. immigration authorities and victims of human and civil rights abuses: The border interaction project study of South Tucson, Arizona, and South Texas. Mexican American Studies and Research Center Working Paper No. 20. Tucson, AZ: The University of Arizona. Krieger, N. (2001). Theories for social epidemiology in the 21st century: An ecosocial perspective. International Journal of Epidemiology, 30, 668–677. Madsen, W. (1964). Mexican Americans of south Texas. New York: Holt, Rinehart, and Wilson.
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Rodriguez, R., & Gonzales, P. (2004). Amoxtli san ce tojuan: We are one–nosotros somos unos [DVD]. San Fernando, CA: Xicano Records and Film. Rosenbaum, R. J. (1998). Mexicano resistance in the Southwest. Dallas, TX: First Southern Methodist University Press. Saunders, L. (1954). Cultural difference and medical care: The case of Spanish-speaking people of the Southwest. New York, Russell Sage Foundation. Schnurr, P., & Green, B. (Eds.) (2004). Trauma and health: Physical health consequences of exposure to extreme stress. Washington, DC: American Psychological Association. Sotero, M. M. (2006). A conceptual model of historical trauma: Implications for public health practice and research. Journal of Health Disparities Research and Practice, 1, 93–108. Steele, S. (1979). Uto-Aztecan: An assessment for historical and comparative linguistics. In L. Campbell & M. Mithun (Eds.), The languages of Native America: Historical and comparative assessment (pp. 444–544). Austin, TX: University of Texas Press. Tuck, R. (1946). Not with the first, Mexican Americans in a Southwest City. New York: Harcourt, Brace and Company. U.S. Census. (2000). Overview of race and Hispanic origin. U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. Washington, D.C. U.S. Census. (2006). U.S. Hispanic population. U.S. Census Bureau. Current population survey annual social and economic supplement. U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. Washington, D.C. Vigil, J. D. (1984). From Indians to Chicanos: The dynamics of Mexican American culture. Prospect Heights, IL: Waveland Press, Inc. Walters, K., & Simoni, J. (2002). Reconceptualizing Native women’s health: An ‘‘Indigenist’’ stress-coping model. American Journal of Public Health, 93, 520–524. Weaver, H. N., & Brave Heart, M. Y. H. (1999). Examining two facets of American Indian identity: Exposure to other cultures and the influence of historical trauma. Journal of Human Behavior in the Social Environment, 2, 19–33. Whitbeck, L., Adams, G., Hoyt, D., & Chen, X. (2004). Conceptualizing and measuring historical trauma among American Indian people. Journal of Community Psychology, 33, 119–130.
Mexican Americans and Historical Trauma Theory: A Theoretical Perspective ANTONIO L. ESTRADA Mexican American Studies and Research Center, The University of Arizona, Tucson, Arizona
The observed intergenerational stress response to negative social and historical events is at the core of historical trauma theory, which has been applied to Native Americans, African Americans, and Pacific Islanders, among others. The historical and social experiences of the Mexican population living in the United States have many parallels that lend themselves to the application of historical trauma theory to macro-level and micro-level influences on access to health care, physical health status, and mental health status, including substance abuse among Mexican Americans. This article highlights the legacy of Spanish colonialism and Anglo–American neo-colonialism on Mexicans and Mexican Americans in the southwestern United States through a potential application of historical trauma theory. KEYWORDS historical trauma, Mexican Americans, stress
INTRODUCTION Within the past decade, the field of stress research has seen an explosion of scientific articles on the theory of historical trauma (Brave Heart 1999a, b; Brave Heart & DeBruyn, 1998; Brunello et al., 2001; Schnurr & Green, 2004). Not to be confused with post-traumatic stress disorder (which largely examines stress responses to a severe event on those principally affected), the concept of historical trauma is, at its core, intergenerational. Researchers in this field examine historical and social events that have led to observed intergenerational stress responses among individuals and groups. Thus, the Address correspondence to Antonio L. Estrada, Ph.D., Mexican American Studies and Research Center, Cesar E. Chavez Bldg., Rm. 208C, The University of Arizona, Tucson, AZ 85721. E-mail: [email protected] 330
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identification and examination of these social and historical determinants of health that have influenced the health status of an individual within a particular racial=ethnic group at the macro-level of society are important in developing interventions that help resolve the negative health outcomes of historical trauma.
HISTORICAL TRAUMA THEORY Brave Heart (1999a) defines historical trauma as ‘‘. . . cumulative trauma over both the life span and across generations that results from massive cataclysmic events . . .’’ (p. 111). It manifests itself by’’ . . . depression, self-destructive behavior, substance abuse, identification with ancestral pain, fixation to trauma, somatic symptoms, anxiety, guilt, and chronic bereavement’’ (Brave Heart, 1999a, p. 111). The essential elements of historical trauma are that it is cumulative, intergenerational, and linked to multiple negative health outcomes. Sotero (2006) developed a conceptual model of historical trauma that includes the following three sequential stages: (1) a mass trauma experience where the dominant group subjugates a population, resulting in segregation and displacement, physical and psychological violence, economic destruction, and cultural dispossession; (2) a trauma response is elicited in the first or primary generation that includes physical, social, and psychological responses; (3) the responses are transmitted to subsequent generations through environmental factors, psychosocial factors, social=economic= political systems, and legal and social discrimination.
THE EVOLUTION OF THE CONCEPT Historical trauma is known by several names in the research literature: ‘‘survivor guilt,’’ ‘‘stressful life events,’’ ‘‘intergenerational grief and bereavement,’’ ‘‘post-traumatic slave syndrome,’’ and ‘‘cultural trauma’’ (Brave Heart & DeBruyn, 1998; Cook, Withy, & Tarallo-Jensen, 2003; Danieli, 1998; Degruy Leary, 2005; Kellerman, 2001; Krieger, 2001). Holocaust survivors of German concentration camps in World War II, the historical consequence of slavery on African Americans, the grief and cultural loss experienced by Native Hawaiians, and the multiple social and genocidal acts perpetrated on American Indians have a consistent theme of the intergenerational transmission of social, physical, and psychological disorders that affect the descendents of those who have experienced trauma. More recently, the research literature on historical trauma is predominantly based on American Indian populations (Brave Heart, 1999a, b, 2003; Duran & Duran, 1995; Faimon, 2004; Walters & Simoni, 2002). For example, Weaver and Brave Heart (1999) examined unresolved grief among the Lakota, linking
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suicide rates, depression, anxiety, and substance abuse disorders with the mass trauma experience of Wounded Knee. Given the social and historical experiences of Mexicans and Mexican Americans in Mexico and the southwestern United States, can the concept of historical trauma be fruitfully applied to examine health issues among this population?
HISTORICAL TRAUMA AND THE MEXICAN-ORIGIN POPULATION The term ‘‘Hispanic’’ refers to people whose origin is Mexican, Puerto Rican, Cuban, Central or South American, or other Hispanic=Latino regardless of race (U.S. Census, 2006). Hispanics are the largest ethnic minority group in the United States, comprising slightly more than 14% of the total population (U.S. Census, 2006). Mexican-origin Hispanics, inclusive of Mexican Americans, Mexicans, and Chicana=os, represent 65% of the U.S. Hispanic population. Mexican-origin Hispanics have the highest poverty rates, the highest uninsured rates, and the lowest educational attainment rates of any other Hispanic subgroup in the United States (U.S. Census, 2006). A majority of Mexican-origin Hispanics are born in the United States (61%) and are younger than other Hispanic subgroups. Interestingly, 33% of Hispanics reported they were of at least two races in the 2000 U.S. Census, and of this group, 48% reported they were ‘‘White,’’ but only 1.2% indicated their ‘‘second’’ race as ‘‘American Indian or Alaska Native’’ (U.S. Census, 2000). Nevertheless, Mexican-origin Hispanics are in large part indigenous, being primarily ‘‘mestizo’’ and having their biological and cultural roots among the indigenous tribes of Mexico as well as the Spanish colonizers. Mexican-origin individuals have had a 500-year legacy of domination and subordination by European powers, including the Spanish, English, Portuguese, and French, in Mexico and by Anglo–Americans in what is now the southwestern United States. One must remember that prior to the arrival of Hernan Cortez and the Conquest of Mexico in 1521, there was a flourishing civilization in the Americas. Three hundred years of Spanish Colonialism have led to the oppression and exploitation of indigenous populations, the establishment of a colonial relationship to serve the social and economic interests of the Spanish, the institutionalization of social classes based on race and place of birth, and the internalization of racial inferiority. Even today in Mexico it is an insult to call someone ‘‘Indio.’’ After the initial conquest, the Spanish instituted elements of social order that marginalized and subordinated the indigenous groups in favor of the Spanish elite (Vigil, 1984). For example, the establishment of the Encomienda system forced Indians to become laborers and to provide tribute on the lands of the Spanish ruling class. The Hacienda system further
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exploited Indians as forced labor and made them indentured servants to the owners of various haciendas through the advancement of credit, also known as ‘‘debt peonage.’’ Indians who wished to move up the social ladder had to adapt into mainstream Spanish culture. Those with a European phenotype could enjoy the fruits of Spanish colonialism. Those with an Indian phenotype had little chance of climbing the social ladder and were typically relegated to the lower classes.
THE LEGACY OF MANIFEST DESTINY With the westward expansion of the United States coupled with the peculiar notion of ‘‘manifest destiny,’’ America gradually became a neighbor of Mexico. In 1836, a mini-revolt among a group of settlers turned into a large-scale conflict for the possession of Tejas (Texas), a northern state of Mexico, which was eventually won by the rebels and shortly afterward became an independent republic. Even though they had fought beside the rebels, many Mexican citizens were dispossessed of their lands and human rights violations were perpetrated, especially by the Texas Rangers, who killed Mexicans and Mexican Americans with impunity (Acuna, 2004; Rosenbaum, 1998). A decade later in 1846, the United States declared war on Mexico to further its westward expansion. The war was won by the United States and a treaty was signed in 1848 (The Treaty of Guadalupe Hidalgo). However, a key omission to the Treaty ratified by the U.S. Senate was the exclusion of Article X, which protected the rights of Mexican citizens in lands ceded to the United States. As a result of this treaty, Mexico ceded almost half of its territory, including California, New Mexico, Nevada, and parts of Utah, Arizona, Oklahoma, and Colorado (Acuna, 2004). Mexicans became a conquered people and many were soon displaced from their lands. Those who decided to stay in what was now the United States would become U.S. citizens after 1 year, thus resulting in the origins of Mexican Americans. Both Mexicans and Mexican Americans were discriminated against, exploited as cheap labor, and not given the same political and land rights as Anglo Americans. For many generations, Mexicans and Mexican Americans have had to endure being scapegoated in times of economic downturns and viewed as a source of cheap, expendable labor in economic upturns. Mexican-origin people living in the United States were subjected to deportation if they could not provide documentation that they were U.S. citizens. Mexican Americans were forced to attend segregated schools (Mexican Schools), live in segregated neighborhoods, and were often viewed as inferior to Anglo Americans. The promulgation of cultural deficit models by social scientists during the 20th century was a direct assault on Mexican American culture (Heller,
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1966; Madsen, 1964; Saunders, 1954; Tuck, 1946). Mexican Americans were viewed as passive, irrational, unscientific, masochistic, apathetic, fatalistic, lazy, lacking initiative, and prone to commit criminal acts. Perceived social pathologies of Mexican Americans were blamed on ‘‘Mexican culture’’ and schools forced assimilation by emphasizing English only. Anglo–Americans perceived Mexican and Mexican American culture to be deficient in the values that were needed to be economically successful and believed that Mexicans and Mexican Americans needed to acculturate into Anglo– American society to be successful. The legacy of Spanish colonialism compounded by Anglo–American neo-colonialism has led to the internalization of negative perceptions and stereotypes by Mexican Americans, leading to self-hate and alienation, lowered self-esteem, ethnic identity conflict, discrimination, racism, and marginalization. The application of the concept of historical trauma to describe this internalization process has some appeal when contextualized by 500 years of oppression and subordination of Mexican-origin peoples, which continues today through anti-Mexican sentiment and the militarization of the United States–Mexico border as a result of the immigration dispute.
MILITARIZATION OF THE UNITED STATES–MEXICO BORDER The border between the United States and Mexico was established with the signing of the Treaty of Guadalupe Hidalgo coupled with the Gadsden Purchase in 1853. However, not until 1924 when the Border Patrol was created was the U.S. military presence increased in the region. Economic downturns and anti-Mexican sentiment led to massive deportations of Mexican-origin peoples during the 1930s, which continued through the 1950s with ‘‘Operation Wetback.’’ Physical and psychological violence continues today as Homeland Security ‘‘safeguards’’ the United States–Mexico border with repressive tactics such as ‘‘Operation Hold the Line’’ and ‘‘Operation Safeguard.’’ Subordination and social control of Mexican nationals, Mexican Americans, and Native Americans has led to documented civil rights violations of U.S. citizens of Mexican and Native American descent (Koulish, Escobedo, Rubio-Goldsmith, & Warren, 1994). Through subordination and repression of Mexican-origin peoples, Anglo America has created an ‘‘Internal Colonial Model’’ in the southwestern United States (Barrera, 1979). This model is characterized by the exploitation of the population as cheap and expendable labor, by dispossessing then of their land, by gerrymandering voting districts, and by treating them as a conquered people in their own land to serve the economic and political interests of the larger society. One hundred fifty years of Anglo–American neocolonialism have led to two-thirds of what was originally Mexico being ‘‘occupied,’’ the subjugation and exploitation of Mexican American land
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owners and laborers throughout the southwest, ethnocentrism, discrimination and racism, increased police and Department of Homeland Security surveillance, and the establishment of an Internal Colonial Model.
POTENTIAL INFLUENCES ON HEALTH The social, cultural, and historical events that have impacted generations of Mexicans and Mexican Americans living in the United States today have both micro and macro influences on health status (Table 1). The hypothesized connection between historical trauma and health is complex. Principally, historical and social events have created institutions and perceptions that are racist and discriminatory toward Mexicans and Mexican Americans and, in turn, have negatively influenced their eligibility for health insurance coverage and access and availability to health care through cultural or institutional barriers that prevent them from obtaining health care when needed. Over time, with limited or no access to health care, generations of Mexicans and Mexican Americans have begun to show increased rates of substance abuse, hypertension, metabolic syndrome, anti-social personality disorders, and Type 2 diabetes mellitus. It is precisely these diseases that are influenced by the psychosocial stressors (e.g., anti-Mexican sentiment, discrimination, and racism) that generations of Mexicans and Mexican Americans have experienced from the dominant culture. Cumulative intergenerational stress is believed to be the main cause of these disorders acting through a psychobiological stress response mechanism that influences neuroendocrine hyperactivity, autonomic and metabolic responses, and the immune system (Brunello et al., 2001; Schnurr & Green, 2004; Sotero, 2006). An example of historical trauma theory applied to Mexicans and Mexican Americans is shown in the Figure 1, which is an adaptation of the Indigenist Stress-Coping Model developed by Walters and Simoni (2002). Within this theoretical model, historical trauma (negative social and historical events) has laid a foundation for the socioeconomic characteristics of Mexicans and Mexican Americans, including poverty, underemployment, and low educational attainment, through structured and institutionalized oppression, discrimination, and racism. Sociocultural and socioenvironmental influences include targeted marketing of alcohol, accessibility to drugs, disorganized neighborhoods, and increased police surveillance. Potential cultural buffers include such concepts as ethnic pride and cultural identity, which are potentially eroded by discrimination and racism. These factors, in turn, are hypothesized to influence alcohol and drug abuse among Mexican Americans. Understanding the cumulative historical and social events that Mexican-origin people in the southwestern United States have endured over
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FIGURE 1 An etiological model of historical trauma and substance abuse among Mexicans and Mexican Americans in the United States (adapted from Walters and Simoni, AJPH, 93(4):520–524, 2002).
the past 150 years makes the theory of historical trauma applicable. Several elements of the theory, including massive socio-historical events, cultural dispossession, and the establishment of an economic system that serves the larger majority, plus the physical, social, and psychological impact of trauma on dispossessed peoples indicate that historical trauma theory may be a viable explanation for some of the micro-level health effects experienced by this population.
MEXICAN AND MEXICAN AMERICAN INDIGENIETY The application of historical trauma theory will depend on which identity one perceives and how one values either their Spanish or Indigenous roots. TABLE 1 Historical Trauma Influences on Health and Health Care Health Services (Macro-Level Influences) Health Insurance Coverage Regular Source of Care Access and Availability Cultural and Institutional Barriers Patient-Physician Communication Mental and Physical Health (Micro-Level Influences) Substance Abuse Depression Anxiety Disorders Anti-Social Personality Hypertension Heart Disease Metabolic Syndrome Diabetes Infectious Diseases (HIV)
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From an indigenous perspective, our elders tell us stories about the dispossession of land and the discrimination and racism they endured at the hands of Anglo Americans. In the Anglo–American mind, 1848 was a long time ago, too long for anyone to claim some ancestral heritage to a territory that comprised almost half of Mexico. If we consider a generation to be a 25-year period, approximately 20 generations have passed since the first Spanish contact with the indigenous peoples of Mexico 500 years ago, and 6 generations have passed since the United States made war on Mexico in 1848, giving birth to Mexican Americans. Our Native American brothers and sisters tell us that cataclysmic events extend 7 generations into the future. Mexican Americans born today represent the 7th generation since the North American invasion, and the 20th generation since the initial conquest of the Aztec’s by the Spanish. Mexican Americans are descended from Spanish colonists and the indigenous peoples of the Americas. The ancestral claim of territory under the concept of ‘‘Aztlan’’ has galvanized a generation of Mexican Americans to examine their indigenous roots (Garcia, 1997). Aztlan is regarded by many Chicana=o scholars as the ancestral homeland of the Aztecs prior to their migration to Tenochitlan (Mexico City). For example, the Disturnell Map used to demarcate territory ceded to the United States in the Treaty of Guadalupe Hidalgo notes that the ancestral homeland of the Aztecs was in present day Utah (Rodriguez & Gonzales, 2004). This claim, supported by archival evidence, more than implies that Mexican Americans, Mexicans, and Chicana=os believe their ancestors lived within the United States. It also implies a deeply-rooted connection to the land and a sense of commonality with American Indians in the Southwest.
LIMITATIONS There are measurement and conceptual limitations of historical trauma theory itself as well as its potential application to Mexican-origin people residing in the southwestern United States. One of the problems with the concept of historical trauma is how it is measured. There are few quantitative measures that capture the concept directly (Whitbeck, Adams, Hoyt, & Chen, 2004). A related issue is specificity, that is, what are the specific causes and effects of historical trauma. Public health views causes as multi-factorial— there are few specific causes and specific effects related to psychosocial stressors. And, as with post-traumatic stress disorder, is the concept of historical trauma differentiating between recency and latency effects in a temporal sense? These limitations are important to rectify to increase the veracity of historical trauma theory and its application to physical and psychological disorders.
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The application of historical trauma theory to Mexican-origin people may also have limitations. For example, some have argued that the Mexican government dispossessed land from indigenous populations throughout Mexico, including what is now California, Arizona, New Mexico, Nevada, and Texas. How can a people (Mexicans) dispossess one group (Indians) and feel dispossessed themselves when another government (the United States) takes over through conquest? These issues should be closely examined from both a historical and contemporary perspective. Governmental policies regarding indigenous populations in Mexico should be coupled with an examination of social and political interactions between the affected groups. For example, during the Spanish colonial period and the period of Mexican rule, mestizos and those Indians who adopted Spanish customs and values oppressed and exploited other Indians in the southwest. Additionally, some concerns over misappropriation of Native American philosophy, culture, and symbolism have been expressed by some North American Indians (Hernandez-Avila, 2004). Some have described the application of historical trauma theory to Mexican Americans as inappropriate based on the groups’ mestizo origins, claiming that they have relinquished their indigeniety in favor of Spanish language and culture (Hernandez-Avila & Perez, 2004). Alternatively, proponents of historical trauma theory and its application to Mexican Americans argue that most seek their indigenous cultural roots among the tribes of Mexico, including the Maya, Aztec, Tarahumara, Yaqui, and Zapotec (Anzaldua, 1987; Chavez-Leyva, 2004). There are also many Mexican Americans with cultural, linguistic, and biological ties to American Indian tribes of the southwest, including the Navajo, Apache, Kickapoo, Chumash, Comanche, and Hopi. Linguists have long known that Nahuatl, the language spoken by the Aztecs and still spoken in many parts of Mexico today, is similar to other Uto-Aztecan dialects spoken in the southwestern American and Mexico (Steele, 1979). Much more research needs to be conducted on the application of historical trauma theory to Mexicans and Mexican Americans residing in the southwest. This article has highlighted several social and historical events that theoretically could have a cumulative effect on the health and mental health status of Mexicans and Mexican Americans. Clearly, the notion of cumulative causation effects from historical and social events should not be discounted.
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