The Long Term Effects of Colonialism: Treating Historical Trauma in Omaha

By: Leandra Warren, Maria Resendiz, and Echohawk Lefthand


European colonization led to the genocide of Native Americans. Genocide is the idea to exterminate a group or the function of a group, intentional or not. While committing this act, colonizers enslaved Native Americans and forced them to give up their religious and cultural practices. This loss of heritage and identity has led to a massive group trauma experienced by Native Americans, which could lead to Native Americans resorting to unhealthy coping mechanisms learned through historical trauma. By restoring and empowering Native people and reclaiming traditional knowledge this should lead to healthy, vital and vibrant communities, unencumbered by depression, overwhelming grief, substance abuse and traumatic responses, by striving to transcend the collective traumatic past (Brave Heart).

There are many symptoms of Historical Trauma within Native American communities. Poverty, substance abuse, and suicide have been documented in many articles and studies. Our group is interested in prevention and intervention strategies specifically addressing those mentioned above. We searched for Native American programs in the Omaha area specifically geared towards Native Americans. We will correlate these strategies to the articles we have collected as a group.


According to our interests we were grouped into a team of three and given the topic of historical trauma in Native Americans. In this team we discussed what we felt the definition of trauma was and wrote a topic paragraph around historical trauma. From there, we met in Criss library to gather four peer-reviewed research articles per person on Historical trauma issues related to our topic paragraph. Next, we created annotated bibliographies for each of the articles we had found and discussed our articles to create a strategy for collecting data. We then collected and organized our data to create an orientating memo. From analyzing our memo we coded and came up with six themes we decided were most important to our research. From these themes we began to put our research paper together. After some editing and review we finalized our paper below.


Cultural Preservation

In the context of historical trauma, cultural preservation is key. It helps to link the present to the past by instilling traditional values and raising cultural awareness and promotion of overall well-being through the reconnection of community, family, and spirit in a healthy way. In each of the organizations we researched, there is prevention and/or intervention services and all had some type of cultural preservation program. These programs include tribal elders providing their knowledge or the youth being engaged in activities and programs which had cultural traditions and values within them.


In the article “Understanding and Healing Historical Trauma: The Perspectives of Native American Elders” there were four themes which were recommended for healing. They were (1) focus on the positive; (2) awareness and education; (3) return to cultural and spiritual ways of life, and (4) language learning. Each of these organizations we researched, provided prevention and intervention services with some type of awareness of cultural and spiritual ways of life into their respective services. Through the inclusion of cultural teachings and methodologies, participants can heal within the context of their respective cultural identities.


The organizations we researched in the Omaha, Winnebago, and Macy areas all provided local transportation. This service is reserved for clients who need transportation because their access to travel is limited or they have no other means of accessing healthcare near them. Some limitations on the transportation provided were – it must be related to healthcare services. In some organizations, they provided transportation for both rural and urban Native Americans.


To look at the need for transportation and the causes for the need of transportation we feel we must look at poverty. Limited access to transportation means there is no vehicle available or funds to pay for other means of transportation are little to non-existent. More than one-quarter of the American Indian and Alaska Native population is living in poverty, a rate that is more than double that of the general population and one that is even greater for certain tribal groups (e.g., approaching 40%) (Sarche). With this rate, it is easy to see how Native people would need transportation services in both rural and urban areas.

Crisis Services

At the Ponca Tribe of Nebraska, the Domestic Violence Program provides crisis and emergency services for victims of sexual assault, stalking, and domestic violence. The staff holds several prevention and awareness activities for community members about issues surrounding domestic violence. Ideas are exchanged on how to increase awareness of the issue and the devastating effects in the local communities we reside in. Social services such as the Domestic Violence Program; offers support that is necessary to improve family functioning, preservation and outreach services, keep children safe, promote healthy families and to improve social, spiritual, physical and emotional needs. They do this through working or referring to the Ponca Tribal offices or accessing other resources available within the local community.


The process of assimilation seems to follow a pattern. These groups of people endure multiple degrees of prejudice, discrimination, and racism while trying to find a new homeland unfamiliar to them. Assimilation is hard and could lead to harsh cases of historical trauma of which one symptom is domestic violence. “Violence against Indigenous women in the United States is higher than for any other racial group and has been characterized as an urgent public health and safety issue, but less is understood about violence experienced by Indigenous peoples than by any other racial group. This lack of understanding limits practitioners’ ability to address and treat this injustice. The present study focused on understanding Indigenous families affected by violence; families are highly salient for Indigenous communities, and Indigenous women who have experienced violence overwhelmingly rely on families for support and recovery (Burnette).” This is important to understand the outlook women have due to historical trauma. It’s not always just women, but women are more vulnerable to men and usually have the tendency of being abused.

Health education, diabetes, and disease prevention

Being well educated about health is important to cultural preservation. Ways of preventing diseases and other health problems include controlling it through interventions, health education, and advocacy programs. The Ponca Tribe of Nebraska operates the Fred LeRoy Health & Wellness Center in Omaha and the Ponca Hills Health & Wellness Center in Norfolk. The mission of these clinics is to provide holistic, caring, family-centered, and culturally sensitive services through a quality clinical and educational approach to health care. Both clinics offer medical, dental, and pharmaceutical services. When it comes to diabetes, you must have your proof of diagnosis before any further treatment at this specific local clinic. After proving a diagnosis, there are plenty of supplies at the clinic used to test oneself regularly including alcohol swabs, insulin syringes, and log books to document treatment.

Diabetes relates back to another topic of health care. It does so depending on your coverage. The costs of diabetes treatments are paid only after the client’s Medicare, Medicaid, and/or private insurance have paid their allowable costs. This may cause some issues or may be costly as well if you do not have any form of insurance. Preventing the cause of diabetes is a better path. The clinic provides a registered dietitian for nutrition consultations for individuals with diabetes and others who are at risk for developing diabetes. The Community Health Representatives are in Lincoln, Niobrara, Norfolk, and Omaha, and serve as liaisons between the healthcare provider and client. CHRs provide outreach, health education and promotion, and disease prevention to the Native communities residing in the PTN Service Delivery Areas. This serves as a health advocate for community members by assisting with healthcare needs and coordinating services with internal and external programs. Having such culturally sensitive programs and clinics in the area can help make treatment of indigenous people a lot easier today in hopes of avoiding such traumas toward Native American People’s caused by forced assimilation.


Native Americans continue to be disproportionately affected by health disparities in the United States and suffer devastating consequences such as cardiovascular disease, diabetes, alcohol related diseases, and mental health issues, including depression and post-traumatic stress disorder. “Historical traumatic events have contributed to disparities related to social and behavioral factors. In many pre-colonial tribal communities, Native American women held significant positions as keepers and teachers of health and wellness practices (Brown).”


  AI/AN Rate 2007-2009 U.S. All Races Rate – 2008 Ratio: AI/AN to U.S. All Races
ALL CAUSES 943.0 774.9 1.2
Diseases of the heart 182.4 192.1 0.9
Malignant neoplasm 170.8 176.4 1.0
Unintentional injuries* 94.5 39.2 2.4
Chronic lower respiratory diseases 43.2 44.7 1.0
Diabetes mellitus 61.0 22.0 2.8
Chronic liver disease and cirrhosis 43.1 9.2 4.7
Cerebrovascular diseases 39.1 42.1 0.9
Influenza and pneumonia 24.1 17.8 1.4
Nephritis, nephrotic syndrome 22.1 15.1 1.5
Intentional self-harm (suicide) 18.5 11.6 1.6
Septicemia 16.5 11.3 1.5
Alzheimer’s disease 14.6 24.4 0.6
Assault (homicide) 11.0 5.9 1.9
Essential hypertension and hypertensive renal disease 12.8 13.9 0.9
Parkinson’s disease 5.1 6.6 0.8
* Unintentional injuries include motor vehicle crashes.

NOTE: Rates are adjusted to compensate for misreporting of American Indian and Alaska Native race on state death certificates. American Indian and Alaska Native age-adjusted death rate columns present data for the 3-year period specified. U.S. All Races columns present data for a one-year period. ICD-10 codes were introduced in 1999; therefore, comparability ratios were applied to deaths for years prior to 1999. Rates are based on American Indian and Alaska Native alone; 2000 census with bridged-race categories.

Substance Abuse

Although the percentage of Native Americans with substance abuse problems is about as high to any other race, there have been multiple studies that have shown that there is a higher percentage of deaths that are alcohol related compared to the general population in Native Americans (Szlemko). There have been records that show 26.5% of death among Native American men were alcohol related and among Native American women, 13.2% were alcohol related (Szlemko). Substance abuse became a coping mechanism for the unique history among Native Americans. Many organizations provide programs that help maintain sobriety by placing them in a safe, therapeutic living environment. For example, The American Indian Human Resource Center provides support for member and their families with outpatient treatment like aftercare counseling, sessions, and educating them on ways to prevent. Being able to address this issue the proper way, due to its cause, is an important aspect of the person treating a patient with historical trauma. There is a different history behind each abuse and counseling the person to understand the specific cause that may help them understand the other symptoms caused by the issue. Knowing this would help in a sociological perspective on how certain treatments help different tribes and how the different programs that are provided benefit them.


The holistic way of coping is through the usage of self-help, empowerment, and building a healthy community throughout the treatment and recovery process. Treatments includes mental health, substance abuse, medical care, family services, and traditional American Indian medicine (Nebelkopf). The Center for Mental Health Services developed a system of care for Native American children and their families in the San Francisco Bay Area. An accumulative series of studies includes research on 490 adult substance abusers, women and men, who received treatment from 2003-2008 and completed both a baseline and six month follow-up questionnaire, regardless of whether or not they completed the prescribed course of treatment given to them from the start. The Friendship House provided outpatient and residential substance abuse services (Nebelkopf). There is plenty of statistical data to back our research. The data analysis is as follows: out of 490 participants, 71% were women and 29% were men; 24% reported using alcohol or drugs in the prior 30 days at baseline, with a decline to 5% only six months later. Experiences of stress, emotion, or activities resulting from substance use in the prior 30 days also showed a decrease from 47% to 23% (Nebelkopf). Urban trails were a children’s mental health project funded by the federal Center for Mental Health Services aimed to improve the mental health of youth and their families, focusing on severely emotionally disturbed children between the ages of 0 to 21. A comparison of all tribal youth served through the CMHS System of Care program with the Oakland youth included these findings: 79% of Oakland youth reported using at least one substance prior to intake. A larger than expected number of Oakland youth used prescription painkillers (30.8%). Other substances used by a large percentage of the youth included alcohol (75%), cigarettes (65%), marijuana/hashish (60%), cocaine (39%), hallucinogens (35%), and ecstasy (35%) (Nebelkopf). Substance abuse seemed to be a very highly used go-to when dealing with historical trauma issues. Alcohol misuse has been associated with the reservation system of colonialism, where a policy that led to Indigenous peoples’ loss of control over their land, culture, and way of life, in turn, was associated with a response of internalized aggression and substance use (Nutton). All of this is important to the research project because it shows numbers and statistics towards all ages of Native American people and just how widely used drugs and alcohol are. It also lists many different places found across the United States for these Indigenous People to seek help.

Health Care

In our research over Historical Trauma in Native Americans, we’ve noticed issues in health care. Many of the issues fall under accessibility, types of care provided, and lack of resources. There are many health programs for Native Americans provided by organization. But the real issue is that a lot of Native Americans can’t access them. Not having access to check-ups or emergency visits due to not being able to afford it or not having transportation. There are health insurances that cover the cost for health care visits but many insurance companies require a copay fee. The Winnebago Tribe of Nebraska provides health benefits and insurance for members and access to multiple health programs, as well as transportation to hospitals. There are health care facilities that provide Outpatient care and a few who provide outpatient and inpatient care. This is due to a limitation on resources and size of facility. This becomes an issue when Omaha tribes can’t receive inpatient care locally and must travel to farther locations, like Winnebago. Another issue with the health care provided to Native American is that many local general hospital many not respect their tribe traditions.

There are many similar issues with health care in many other ethnicities. A lot of these issues revolve around the social classes and the lower it is the harder it is to access health care. Finding a way to provide facilities with enough resources to treat inpatients so they can stay local with their families would be a benefit.


Although, there are similar issues with health care/problems in many other ethnicities, the deaths related to diabetes, cancer, and infant mortality are much higher in Native Americans (Warne). Such statistics are related to the social class. Being able to afford transportation to a clinic and can pay for such visits raise their life expectancy. Native Americans have the highest poverty level than any other ethnicity (Denny, Holtzman, Goins, & Croft).


European colonization has caused many unhealthy coping mechanisms within Native American groups across North America. As many of their customs and traditions have been taken or lost due to assimilation and genocide efforts of the colonizers. As our initial research and secondary research has shown using these customs and traditions in programs and services has been proven to help Native Americans heal from traumas of the past, so they can become healthy empowered productive citizens of the future.




Brave Heart, Maria Yellow Horse, et al. “Historical Trauma among Indigenous Peoples of the Americas: Concepts, Research, and Clinical Considerations.” Journal of Psychoactive Drugs, vol. 43, no. 4, Oct-Dec2011, pp. 282-290. EBSCOhost, doi:10.1080/02791072.2011.628913.

Brown, Danica Love. “Daughters of the Drum.” Alternative: An International Journal of Indigenous Peoples, vol. 12, no. 2, Mar. 2016, pp. 109-123. EBSCOhost, doi:10.20507/AlterNative.2016.12.2.1.

Burnette, Catherine E. “Historical Oppression and Indigenous Families: Uncovering Potential Risk Factors for Indigenous Families Touched by Violence.” Family Relations, vol. 65, no. 2, Apr. 2016, pp. 354-368. EBSCOhost, doi:10.1111/fare.12191.

Coyhis, Don and Richard Simonelli. “The Native American Healing Experience.” Substance Use & Misuse, vol. 43, no. 12/13, Oct. 2008, pp. 1927-1949. EBSCOhost, doi:10.1080/10826080802292584.

Garrett, M. T., Parrish, M., Williams, C., Grayshield, L., Portman, T. A., Agahe, . . . Maynard, E. (2014). Invited commentary: Fostering resilience among native american youth through therapeutic intervention. Journal of Youth and Adolescence, 43(3), 470-90. doi:

Grayshield, Lisa, et al. “Understanding and Healing Historical Trauma: The Perspectives of Native American Elders.” Journal of Mental Health Counseling, vol. 37, no. 4, 2015, pp. 295-307, Social Science Premium Collection (graphic)

Maria Yellow Horse, B. H., & Deschenie, T. (2006). Historical trauma and post-colonial stress in american indian populations. Tribal College, 17(3), 24-27.

Maria Yellow Horse, Brave H. 2003. “The Historical Trauma Response among Natives and its Relationship with Substance Abuse: A Lakota Illustration.” Journal of Psychoactive Drugs 35(1):7-13 (

Nebelkopf, Ethan and Serena Wright. “Holistic System of Care: A Ten-Year Perspective.” Journal of Psychoactive Drugs, vol. 43, no. 4, Oct-Dec2011, pp. 302-308. EBSCOhost, doi:10.1080/02791072.2011.628922.

Nicolai, Shanley S., and Merete Saus. “Acknowledging the Past while Looking to the Future: Conceptualizing Indigenous Child Trauma.” Child welfare, vol. 92, no. 4, 2013, pp. 55-74, Social Science Premium Collection,

Nutton, Jennifer and Elizabeth Fast. “Historical Trauma, Substance Use, and Indigenous Peoples: Seven Generations of Harm from a ‘Big Event’.” Substance Use & Misuse, vol. 50, no. 7, June 2015, pp. 839-847. EBSCOhost, doi:10.3109/10826084.2015.1018755.

Sarche, M. and Spicer, P. (2008), Poverty and Health Disparities for American Indian and Alaska Native Children. Annals of the New York Academy of Sciences, 1136: 126–136. doi:10.1196/annals.1425.017

Szlemko, W. J., Wood, J. W., & Pamela, J. T. (2006). Native americans and alcohol: Past, present, and future. The Journal of General Psychology, 133(4), 435-51. Retrieved from

West, A. E., Williams, E., Suzukovich, E., Strangeman, K., & Novins, D. (2012). A mental health needs assessment of urban american indian youth and families. American Journal of Community Psychology, 49(3-4), 441-53. doi:

Wiechelt, S. A., Gryczynski, J., Johnson, J. L., & Caldwell, D. (2012). Historical trauma among urban american indians: Impact on substance abuse and family cohesion. Journal of Loss and Trauma, 17(4), 319-336. Retrieved from