Degree Name

PhD (Doctor of Philosophy)



Date of Award


Committee Chair or Co-Chairs

Joy Wachs

Committee Members

Charles A. Stuart, Linda Garrett, Sadie Hutson


Since European settlers arrived to the United States (U.S.), American Indians (AI) have been separate and unequal members of society. After a long history of discrimination, ethnocide, genocide, and distrust, the AI have become a population with severe disparities, having the highest rates of diabetes, depression, suicide, tuberculosis, and alcoholism than any other minority or majority population in the U.S. The author's purpose for conducting this study was to explore a possible relationship between depression or psychological distress and diabetes in AI women.

AI women are the most under studied group in the country; therefore, a secondary analysis of the large established California Health Interview Survey (CHIS) was done. The sample used 1,110 self-identified AI women's data. Even though the literature shows that the AI have the highest rates of diabetes and depression of any population, this analysis revealed no statistically significant relationship between the two diseases. It did reveal many limitations and implications associated with the use of such large databases for the AI woman.

Among the limitations were the survey itself, its administration to the AI population, guidelines for self-identifying as AI, and the researcher's limited access to the data. The implications of this study are significant. Large databases provide the basis for social and political decisions such as allocation of federal dollars for health care. Healthcare and health care services are designed according to the health burden of specific populations. If these databases are in error, or not representative of the true population, healthcare decisions will not reflect the true health care needs of the population. The inadequacies of large databases results in less funding, leading to less quality health care, and an increase in AI health disparities. Further research is needed to determine the actual health burden depression and diabetes place on the AI woman.

Document Type

Dissertation - Open Access


Copyright by the authors.