Project Summary/Abstract
The life expectancy for American Indians (AIs) living on the Blackfeet reservation in Northwest Montana
is 13 years shorter than the life expectancy of non-Hispanic Whites living in the same county, in part because
of disproportionately high incidence of chronic diseases including diabetes, depression, and cardiovascular
disease. While social connectedness has been shown to associate with health and disease-risk in other racial
groups, in AI populations, the prospective role of social connectedness in health disparities is unknown. This
has left a critical gap in knowledge regarding a potential factor which may offset enduring AI health disparities.
Our previous cross-sectional work in the Blackfeet community indicates relationships between low social
connectedness and health-risk factors including high levels of inflammatory cytokines, high resting blood
pressure, high levels of symptoms of depression and anxiety, and poor sleep quality. Each of these outcomes
is implicated in the onset and progression of the chronic diseases which disproportionately affect Blackfeet AI
adults. Based on these observed relationships, it is possible that social connectedness may act as resilience
factor which promotes good health in this at-risk community.
To address this critical research gap, Blackfeet AI adults (n=280) will participate in a longitudinal study
over 2 years in order to capture meaningful long-term changes in mental and physical health and social
connectedness. With three measurements spaced evenly across the 2 years, we will track long-term
trajectories of social connectedness, mental health, sleep quality, and biomarkers related to risk for
inflammatory and cardiometabolic diseases, and investigate the correspondence between these trajectories
(Aim 1). During Year 1, over a 14-day monitoring period, we will use an ecological momentary assessment app
to deliver questions to participants’ mobile phones to investigate short-term dynamic relationships between
social interactions, social connectedness, sleep quality and indices of mental health (i.e. symptoms of
depression and anxiety) (Aim 2). In all of our models, we will consider cultural factors, experiences, and health-
risk factors which we have been found to be relevant in our previous work with the community including
childhood and historical trauma, recent trauma, perceived discrimination, alcohol use, smoking status, and
medication use. The overarching goal of the proposed work is to understand prospective relationships
between social connectedness and health in BF AI adults. This will be the first comprehensive, longitudinal
study to investigate relationships between social connectedness and health risk factors in AIs. This knowledge
could be applicable to other AI communities with similar cultural values and health disparities. Successful
demonstration of associations between social connectedness and health-relevant outcomes will enable us to
develop future interventions to improve social connectedness and thereby health in this vulnerable population.
