Racial Discrimination and Racial Identity Attitudes in Relation to Self-Rated Health and Physical Pain and Impairment Among Two-Spirit American Indians/Alaska Natives

Research on lesbian, gay, bisexual, and other sexual-minority (two-spirit) American Indians/Alaska Natives is sparse. Existing epidemiologic data, however, indicate that the general American Indian/Alaska Native (AIAN) population is at disproportionately greater risk for poorer general health and physical pain and impairment. According to the National Center for Health Statistics, in 2004 American Indians/Alaska Natives had the highest prevalence of respondent-rated fair or poor health (16.5%) of the racial/ethnic groups surveyed. According to the National Center for Health Statistics, in 2004 American Indians/Alaska Natives had the highest prevalence of respondent-rated fair or poor health (16.5%) of the racial/ethnic groups surveyed. Moreover, American Indians/Alaska Natives had the highest prevalence of past-month severe headache or migraine (19.1%), low back pain (35.3%), neck pain (18.8%), and joint pain (39.6%). American Indians/Alaska Natives were most likely to experience limitations in daily activities caused by chronic conditions than were other racial/ethnic groups (17.1%). Two-spirit American Indians/Alaska Natives may also face serious public health problems. For example, research focused on two-spirit AIAN communities suggests a high prevalence of HIV infection and substance use. Moreover, studies on two-spirit American Indians/Alaska Natives indicate high levels of exposure to social hazards, including experiences of homophobia in mainstream and AIAN heteronormative contexts as well as racism within gay communities.