This article uses the culturally grounded Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to examine the experiences and impacts of hurricanes on indigenous (i.e., Native American) family members in the Gulf Coast and to identify how experiencing hurricanes and natural disasters, family and community support, adverse childhood experiences (ACE), discrimination, and intimate partner violence (IPV) may be related to post-traumatic stress disorder (PTSD) among two Southeastern tribes. Results were drawn from a convergent mixed-methodology design, which incorporates ethnographic qualitative data and a culturally grounded quantitative follow-up survey. Thematic analysis of qualitative data with 208 participants from a coastal indigenous community revealed several emergent themes, namely (a) the impact of federal recognition on hurricane affected communities; (b) rapidly changing landscape, lives, and communities; and (c) family and personal effects of hurricane experiences. Descriptive and hierarchical regression analysis of 127 participants across two Southeastern tribes indicate that many participants frequently thought of losses from hurricanes and disasters, and that over one third of the sample met the criteria for clinically significant PTSD. Regression results affirmed the independent effects of hurricane experiences, ACE, community and family support as they relate to PTSD; yet IPV and discrimination were the strongest predictors of PTSD. Results reveal the extensive repercussions of hurricanes on indigenous families of the Southeast, which are inseparable from and exacerbated by insidious historical oppression, including discrimination, already experienced by these groups.

Key Take Away Points

    • Like other ethnic minorities, Indigenous peoples of the Gulf South have been affected by hurricanes in specific ways that differ from other groups/ We utilize the Indigenous-based Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to situate this inquiry and understand how a context of historical oppression has set the stage for living on the margins, both in terms of geography and vulnerability to natural disasters, along with access to the resources, privileges, and quality of life that are afforded to those with greater economic, social, and political power.
    • Thematic analysis of qualitative data with 208 participants from a coastal Indigenous community revealed several emergent themes, namely (a) the Impact of Federal Recognition on Hurricane Affected Communities; (b) Rapidly Changing Landscape, Lives, and Communities; and (C) Family and Personal Effects of Hurricane Experiences.
    • Qualitative findings reveal several themes that illustrate how Indigenous families in the Coastal Tribe have experienced, coped with, and navigated their recovery from the impacts of multiple hurricanes affecting their communities. From the perspective of Coastal tribal members, the context of historical oppression that pushes Indigenous families to the margins significantly impedes their ability to successfully recover from hurricanes in a timely and holistic manner, which has important implications for policy and programs that might promote equitable disaster relief for ethnic minority groups in vulnerable social and geographic locations.
    • Descriptive and hierarchical regression analysis of 127 participants across two Southeastern tribes indicate that many participants frequently thought of losses from hurricanes and disasters and that over one-third of the sample met the criteria for clinically significant PTSD.
    • Regression results affirmed the independent effects of hurricane experiences, ACE, community and family support as they relate to PTSD; yet IPV and discrimination were the strongest predictors of PTSD. The cumulative effects of historical oppression –both through contemporary and historical losses – were apparent through the quantitative results.
    • Participants thought about the effects of disasters regularly, with almost one-third being cognizant of losses daily or weekly.
    • Results reveal the extensive repercussions of hurricanes on Indigenous families of the Southeast, which are inseparable from and exacerbated by the insidious historical oppression, including discrimination, already experienced by these groups.

Author Biography

Dr. Burnette was drawn to health disparities research related to Indigenous Peoples (e.g. Native American, American Indian, Alaska Native, and/or Native Hawaiian in the U.S.) due to many of the distinct strengths demonstrated by these peoples as well as the high disparities related to violence, mental, and physical health. After conducting research on “how to conduct culturally sensitive research” she began working with tribes of the Southeast to address disparities in violence, mental health, substance abuse and health. Her work now extends cross-nationally. Given there has been a lack of culturally relevant frameworks to explain disparities, she has worked in collaboration with tribes to develop the ecological “Framework of Historical Oppression, Resilience, and Transcendence”, which identifies and organizes culturally relevant risk and protective factors across community, family, and individual levels to understand how, despite experiencing centuries of historical oppression and trauma, Indigenous peoples recover from, demonstrate resilience in response to, and transcend oppression and other forms of adversity. Since coming to Tulane in 2013, she has published over 40 peer-reviewed journal articles, and presented at almost 60 national and international conferences on such topics. She is a recipient of the National Institutes of Health loan repayment program and has been involved in federally-funded research to address violence and health disparities using culturally relevant intervention approaches. After completing extensive grant-funded cross-tribal research to identify culturally relevant risk and protective factors related to violence and health disparities, Dr. Burnette now works to develop a culturally adapted evidenced-based program (EBP) to prevent substance abuse and violence among Indigenous peoples using a family resilience and culturally grounded intervention program. She hopes to evaluate the effectiveness of this program, providing culturally grounded EBPs for Indigenous peoples. She also works to identify social and cultural determinants of health related to the health disparities of diabetes and related disorders (e.g., cardiovascular disease), cancer, in addition to mental health and substance abuse. Dr. Burnette approaches this work using a wellness approach, incorporating mental, physical, social, and spiritual aspects of health. By focusing on risk and protective factors across societal/community, familial, and individual levels, a holistic understanding will be gained. Finally, by developing an intervention model of family resilience, this research aligns with the centrality of family in Indigenous support systems, and builds upon existing strengths within this underserved population. Jenn Miller Scarnato is a doctoral student in the interdisciplinary City, Culture, and Community program at Tulane University in New Orleans, Louisiana. Jenn is also a fellow in the inaugural cohort of the Mellon Program for Community-Engaged Scholarship at Tulane, and a research assistant with the Traumatology Institute. Jenn earned a Master’s degree in Women’s Studies & Gender Studies and a Master of Social Work degree with a focus on immigration and migration from Loyola University Chicago, and an interdisciplinary Bachelor’s Degree in Liberal Arts from the University of Central Florida. Both within and outside of academia, Jenn’s work has focused on storytelling for social justice within immigrant and indigenous communities in the U.S. and Latin America. Before joining the CCC program, Jenn worked in the non-profit arena for 10 years developing culturally sensitive programs and policies with marginalized populations. Jenn’s professional experiences include community organizing, program administration, and policy analysis with the Illinois Coalition for Immigrant and Refugee Rights in Chicago, Illinois, providing direct services to at-risk youth in Orlando, Florida, and fostering cultural resilience and leadership through participatory filmmaking with indigenous youth in Guatemala. Throughout her career, Jenn has been guided by resilience- and strengths-based approaches to engaging members of groups who have experienced oppression, with a commitment to working toward social transformation and collective empowerment. As a doctoral student, Jenn is interested in critical and anti-oppressive approaches to social work research and practice, public scholarship, and digital methods. Her current research focuses on narrative therapy, digital media production practices, and testimonio methodologies. She works with immigrant young people in the New Orleans area to promote individual and collective resilience through creating and sharing digital testimonios as part of a youth organizing initiative. Jenn’s planned dissertation research will focus on developing and evaluating digital testimonio as a therapeutic intervention and research methodology. During her time at Tulane University, Jenn has published articles in several peer-reviewed publications, including Qualitative Social Work, Family Process, and the Journal of Technology in Human Services. She is currently working on a manuscript focused on the resilience of immigrant young people facing social isolation in schools. Jessica Liddell is a Doctoral Candidate in the City, Culture and Community inter-disciplinary PhD program at Tulane University in New Orleans, Louisiana. Jessica received an undergraduate degree in Psychology at Reed College, in Portland, Oregon and attended graduate school at Tulane University where she completed a Master in Public Health degree, with a focus on program design and implementation, and a Master in Social Work degree, with a focus on disaster mental health. Throughout her career, her work and research has focused on the empowerment of women, beginning with her introduction to gender studies as an undergraduate, and subsequent work at a domestic violence shelter, up to her current studies as a PhD student conducting research on the unique experiences Native American women have in accessing healthcare. Her previous work reflects her dedication to underserved populations and to gender empowerment. In particular, her experiences working in Mexico with Indigenous women accessing reproductive services, in Ethiopia with HIV-positive women and children, and with female injection drug users in Louisiana, have instilled in her a belief that it is only through working directly with communities, and including their voices in health interventions and initiatives, that we can achieve change that is truly sustainable and effective. Jessica believes strongly in working across disciplines and using multiple approaches to address complex problems, which has been fostered by her training in an interdisciplinary Ph.D. program. Her current research interests include making health services more responsive to community needs and input, in addition to general interests in sexual and reproductive health, reproductive justice, and harm reduction service models. Jessica’s dissertation research explores reproductive justice topics among Native American tribes in the Southeastern region of the United States. While in graduate school, Jessica has published 12 peer-reviewed articles, presented in 14 oral sessions at conferences, presented posters at 15 conferences, and presented her work at 5 symposiums. Her goal is to continue working with vulnerable women in the United States and internationally after she completes her Ph.D. She will be pursuing an academic position that facilitates her ability to continue participating in meaningful community-engaged research, and where she will be able to teach and instill a passion for social justice among emerging students. Hannah Knipp is a Licensed Master of Social Work employed as the Social Emotional Learning (SEL) Coordinator and SEL Specialist at Communities in Schools (CIS) Gulf South. Hannah received her undergraduate degree in Social Work from Texas Christian University. During this time, Hannah worked with survivors of sexual assault as a volunteer Rape Crisis Interventionist as well as with people living with HIV/AIDS through a housing program in the Dallas Fort Worth metroplex. After receiving her undergraduate degree, Hannah spent four years as a Pre-Kindergarten teacher in New Orleans in a public charter school servicing exclusively students qualifying for free lunch programs. She later returned to her social work roots by completing a Masters program in Social Work at Louisiana State University. During her course of study, Hannah worked with children and adolescents through an in-patient hospitalization program for those with a high level of risk related to suicide or homicide. In 2016, Hannah began her current role as the SEL Coordinator and Specialist with Communities in Schools. In this position, Hannah has worked with elementary age students in the development of social and emotional skills through whole class, small group, and individualized interventions at a public charter school in New Orleans. During this time, Hannah successfully implemented the first comprehensive sexual health program for elementary age students in Louisiana. She has been accepted to present on topics related to SEL learning and sexual health at conferences including the American Council of School Social Work, Communities in Schools Leadership Town Hall, and the Social Emotional Learning Conference. Within her roles, Hannah has worked extensively with adults, children, and families in the school, medical, and housing systems who have experienced trauma, survived natural disasters, and lived within systems of discrimination and oppression. Her interest in this research was sparked by years of working directly with clients to navigate discriminatory systems as well as cope with and recover from traumatic experiences. While her roles have been diverse, Hannah has consistently worked in partnership with people vulnerable to systemic oppression and exploitation. Hannah is a prospective PhD student and hopes to study the utilization of comprehensive and inclusive sexual health education in the prevention of sexual assault and sexual violence. Shanondora Billiot (United Houma Nation) is an Assistant Professor at the University of Illinois. She earned a Ph.D. in Social Work from Washington University in St. Louis. Prior to assuming this role in 2017, she was a Henry Roe Cloud Fellow at Yale University. She holds a Master’s of Social Work from the University of Michigan and both Bachelor of Arts and Bachelor of Science degrees from Louisiana State University. As a master’s of social work student, Dr. Billiot led an epidemiological study in a small Ecuadorian parish to discover the incidence rates of persons living with disabilities who were exposed to volcanic ash. Shanondora had over 10 years of social work experience before entering a doctoral program as active duty military personnel and working in the health and mental health field from the grassroots level to implementing and analyzing federal and international health and mental health policies. At both the U.S. Department of Veterans Affairs and U.S. Department of Health and Human Service she analyzed programs that address health and mental health issues of veterans and victims of armed conflict. Her work was recognized by the Secretary of Veterans Affairs for developing the “Greening VA” strategic plan. Building on these experiences, her current research uses mixed methods to explore gaps in knowledge of how chronic health issues, non-communicable diseases, and mental illness disproportionately burden indigenous peoples. Experiences of historical trauma, discrimination, poverty, violence, repeated disasters, and chronic environmental changes have been shown to exacerbate the onset and severity of health conditions among indigenous peoples. Her contribution to indigenous health disparities science is through three levels of influence factors: physical environment, sociocultural, and historical. As an indigenous woman who has experienced repeated disasters and loss of “home” through environmental changes, she is committed to highlighting and addressing the social impacts of global environmental changes, especially among vulnerable populations.


The authors thank the dedicated work and participation of the tribes who contributed to this work. This work was supported by the Fahs-Beck Fund for Research and Experimentation Faculty Grant Program [grant number #552745]; The Silberman Fund Faculty Grant Program [grant #552781]; the Newcomb College Institute Faculty Grant at Tulane University, University Senate Committee on Research Grant Program at Tulane University, the Global South Research Grant through the New Orleans Center for the Gulf South at Tulane University, The Center for Public Service at Tulane University, and the Carol Lavin Bernick Research Grant at Tulane University. This work was supported, in part, by Award K12HD043451 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (Krousel-Wood-PI; Catherine Burnette-Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) Scholar). Supported in part by U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.