Historical Trauma and Alcohol Use Among Indigenous Peoples in Taiwan: The Protective Role of Traditional Practices

Background: Evidence show alarming health disparities among indigenous communities in Taiwan. The prevalence of indigenous alcohol use is two times higher than the national average. Alcohol-involved illness is now the leading cause of death among Taiwanese indigenous people. Many studies have focused on socioeconomic status and biological factors as determinants of Taiwanese indigenous alcohol use. However, few studies have explored the influence of historical context on indigenous peoples’ use of alcohol. This study uses a historical trauma framework to investigate historical determinants of Taiwanese indigenous people’s alcohol use, with a special attention on Truku tribal people. Historical trauma theory emphasizes that contemporary indigenous health outcomes (e.g., substance abuse) are the long reaching effects of historically traumatic events.

Methods:

Data & Sample: This study used a community-engagement approach that involves collaborating with Truku tribe. Similar to many global and Taiwanese indigenous communities, Truku people have experienced a history of colonial oppression, such as forced relocation and prohibition of traditional and cultural practices. Analysis drew on qualitative data from 30 Truku tribal members (20-83 years) who live in a rural locale in the East Taiwan.

Analysis: We used semi-structured interviews to explore the influence of historically traumatic events on Truku people’s alcohol use. Transcripts were analyzed using inductive thematic analysis approach, which involved both within- and cross-case analysis to identify major themes.

Findings: Data analysis reveals that “drinking heavily is not allowed” in Truku’s tradition, but the frequency of Truku people’s alcohol use increased following the colonization of Taiwan. Three major themes related to historical determinants of alcohol use emerged: 1) cumulative stress of historically traumatic events; 2) alcohol use as stress coping strategy; and 3) the role of traditional practices in alleviating alcohol use. Participants mentioned that government policies spurred historically traumatic events such as:  loss of lands, culture and traditional practices that subsequently influenced Truku people’s relationship with alcohol. Participants also reported that excessive drinking is used to cope with cumulative stress, relating from historical traumatic events. Furthermore, participants emphasized that traditional practices (e.g., hunting and returning to traditional lands), help address some of the root causes of excessive drinking among Truku people.

Implications: Findings support historical trauma framework and demonstrate that historically traumatic events are one of the major causes of the change in indigenous Truku people’s drinking behaviors in Taiwan. Additionally, the study underscores the importance of traditional practices as protective factors to mitigate the negative influence of historically traumatic events on Truku people’s alcohol use. Future intervention should explore the role traditional cultural practices can play in ameliorating historical trauma and alleviating negative drinking behaviors among Indigenous peoples.