Early-life origins of disparities in chronic diseases among Indigenous youth: pathways to recovering health disparities from intergenerational trauma

Phillips-Beck, W.; Sinclair, S.; Campbell, R.; Star, L.; Cidro, J.; Wicklow, B.; Guillemette, L.; Morris, M. I.; McGavock, J. M.

doi:10.1017/s2040174418000661

Cited by 44Indigenous Health, Education, and RightsIndigenous Health and EducationBirth, Development, and Health

Early-life origins of disparities in chronic diseases among Indigenous youth: pathways to recovering health disparities from intergenerational trauma

Phillips-Beck, W., Sinclair, S., Campbell, R., Star, L., Cidro, J., Wicklow, B., Guillemette, L., Morris, M. I. +1 more·2019·Journal of Developmental Origins of Health and Disease

DOI 10.1017/s2040174418000661

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Abstract

Indigenous women and children experience some of the most profound health disparities globally. These disparities are grounded in historical and contemporary trauma secondary to colonial atrocities perpetuated by settler society. The health disparities that exist for chronic diseases may have their origins in early-life exposures that Indigenous women and children face. Mechanistically, there is evidence that these adverse exposures epigenetically modify genes associated with cardiometabolic disease risk. Interventions designed to support a resilient pregnancy and first 1000 days of life should abrogate disparities in early-life socioeconomic status. Breastfeeding, prenatal care and early child education are key targets for governments and health care providers to start addressing current health disparities in cardiometabolic diseases among Indigenous youth. Programmes grounded in cultural safety and co-developed with communities have successfully reduced health disparities. More works of this kind are needed to reduce inequities in cardiometabolic diseases among Indigenous women and children worldwide.

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After forced relocation, consigning Aboriginal children to residential schools deepened poverty, unemployment, and health disparities such as tuberculosis, substance use, obesity, and early mortality in Aboriginal communities.
“For instance, after requiring Aboriginal groups to endure forced relocation, many Western nations consigned surviving children to residential schools to be “civilized” into Western institutions (e.g., family, religious, health systems); deepening poverty, unemployment, and ensuing health disparities such as tuberculosis, substance use, obesity, and early mortality in Aboriginal communities (H”
From Cultural trauma as a fundamental cause of health disparities (2022) · cites this paper as Phillips-Beck et al., 2019

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Type 2 diabetes in Indigenous Australian children and adolescents
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How Early Experience Matters in Intellectual Development in the Case of Poverty
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Low rates of predominant breastfeeding in hospital after gestational diabetes, particularly among Indigenous women in Australia
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Cross-tissue comparisons of leptin and adiponectin
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Breast feeding practices as cultural interventions for early childhood caries in Cree communities
Cidro, J., Zahayko, L., Lawrence, H. P., Folster, S., McGregor, M., & McKay, K. (2015) · BMC Oral Health · doi:10.1186/s12903-015-0027-5 · Cited by 30 · see citing works
Perceptions of barriers, facilitators and motivators related to use of prenatal care: A qualitative descriptive study of inner-city women in Winnipeg, Canada
Heaman, M. I., Sword, W. A., Elliott, L. J., MOFFATT, M. E. K., Helewa, M. E., Morris, H. M., Tjaden, L., Gregory, P., & Cook, C. (2015) · SAGE Open Medicine · doi:10.1177/2050312115621314 · Cited by 30 · see citing works
Prevalence of metabolic syndrome and diabetes mellitus in Sami and Norwegian populations. The SAMINOR—a cross-sectional study
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Prenatal, Obstetric and Perinatal Factors Associated With the Development of Childhood-Onset Type 2 Diabetes
Halipchuk, J., Temple, B., Dart, A. B., Martin, D., & Sellers, E. A. C. (2017) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.04.003 · Cited by 28 · see citing works
Nistawatsiman1: Rethinking Assessment of Aboriginal Parents for Child Welfare Following the Truth and Reconciliation Commission
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Primary birthing attendants and birth outcomes in remote Inuit communities—a natural “experiment” in Nunavik, Canada
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Calls to action
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Factors Associated with Effective Nutrition Interventions for Pregnant Indigenous Women: A Systematic Review
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Cultural trauma as a fundamental cause of health disparities
Subica, A. M., & Link, B. G. (2022) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114574 · Cited by 123 · see citing works
“, family, religious, health systems); deepening poverty, unemployment, and ensuing health disparities such as tuberculosis, substance use, obesity, and early mortality in Aboriginal communities (Haskell and Randall, 2009; MacDonald and Steenbeek, 2015; Phillips-Beck et al., 2019; Walls and Whitbeck, 2012).”
Background
Resilience: Safety in the Aftermath of Traumatic Stressor Experiences
Matheson, K., Asokumar, A., & Anisman, H. (2020) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2020.596919 · Cited by 63 · see citing works
The Perinatal Mental Health of Indigenous Women: A Systematic Review and Meta-Analysis
Owais, S., Faltyn, M., Johnson, A., Gabel, C., Downey, B., Kates, N., & Lieshout, R. J. V. (2019) · The Canadian Journal of Psychiatry · doi:10.1177/0706743719877029 · Cited by 57 · see citing works
Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review
Okpalauwaekwe, U., Ballantyne, C., Tunison, S., & Ramsden, V. R. (2022) · BMC Public Health · doi:10.1186/s12889-022-14047-2 · Cited by 36 · see citing works
The influence of intergenerational trauma on epigenetics and obesity in Indigenous populations - a scoping review
Schafte, K., & Bruna, S. P. (2023) · Epigenetics · doi:10.1080/15592294.2023.2260218 · Cited by 16 · see citing works
The burden of atopic dermatitis and bacterial skin infections among urban‐living Indigenous children and young people in high‐income countries: A systematic review
Ricciardo, B. M., Kessaris, H., Kumarasinghe, P., Carapetis, J. R., & Bowen, A. C. (2022) · Pediatric Dermatology · doi:10.1111/pde.15153 · Cited by 15 · see citing works
Changes in health indicator gaps between First Nations and other residents of Manitoba
Katz, A., Urquia, M. L., Star, L., Lavoie, J. G., Taylor, C. R., Chateau, D. G., Enns, J. E., Tait, M. J., & Burchill, C. A. (2021) · Canadian Medical Association Journal · doi:10.1503/cmaj.210201 · Cited by 14 · see citing works
Studying Vulnerable Populations Through an Epigenetics Lens: Proceed with Caution
Saulnier, K. M., Berner, A., Liosi, S., Earp, B. D., Berrios, C., Dyke, S. O. M., Dupras, C., & Joly, Y. (2022) · Canadian Journal of Bioethics · doi:10.7202/1087205ar · Cited by 13 · see citing works
Multi-methods process evaluation of the SToP (See, Treat, Prevent) trial: a cluster randomised, stepped wedge trial to support healthy skin
Thomas, H. M. M., Mullane, M. J., Enkel, S. L., McRae, T., Amgarth‐Duff, I., Carapetis, J. R., Coffin, J., Christophers, R., Famlonga, R., Jacky, J., et al. (2024) · EClinicalMedicine · doi:10.1016/j.eclinm.2024.102793 · Cited by 10 · see citing works
Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project
Ricciardo, B. M., Kessaris, H., Nannup, N., Tilbrook, D., Farrant, B. M., Michie, C., Hansen, L., Douglas, R., Walton, J., Poore, A., et al. (2024) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01428-6 · Cited by 9 · see citing works
The association between four neighborhood disadvantage indices and child chronic health classifications
Jawad, K. S., Feygin, Y. B., Stevenson, M. D., Wattles, B. A., Porter, J., Jones, V. F., & Davis, D. W. (2025) · Pediatric Research · doi:10.1038/s41390-025-04143-5 · Cited by 9 · see citing works
Racial disparities in suicide-related mortality in the US: Examining trends before, during, and after the COVID-19 pandemic using the CDC WONDER database
Akhtar, M., Mughees, M., Faisal, N., Aamir, J., Rehman, K. A., Raza, M. S., Afridi, M. K., Waqas, S. A., & Maleki, N. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116885 · Cited by 5 · see citing works
Systematic review of the evidence for treatment and management of common skin conditions in resource‐limited settings: An update
Amgarth‐Duff, I., Thomas, H. M. M., Ricciardo, B. M., Anderson, L., Stephens, M., Currie, B. J., Steer, A. C., Tong, S. Y. C., Crooks, K., Hempenstall, A., et al. (2024) · Tropical Medicine & International Health · doi:10.1111/tmi.14047 · Cited by 5 · see citing works
The Koolungar Moorditj Healthy Skin Project: Elder and Community Led Resources Strengthen Aboriginal Voice for Skin Health
Ricciardo, B. M., Walton, J., Nannup, N., Tilbrook, D., Kessaris, H., Michie, C., Farrant, B. M., Forrest, R., Garlett, A., Hill, J., et al. (2024) · Journal of the Australian Indigenous HealthInfoNet · doi:10.14221/2653-3219.1034 · Cited by 5 · see citing works
Intergenerational Trauma
Keaney, J., Byrne, H., Warin, M. J., & Kowal, E. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009201704.016 · Cited by 5 · see citing works
Skin health of Aboriginal children living in urban communities
Ricciardo, B. M., Kessaris, H., Nannup, N., Tilbrook, D., Rind, N., Douglas, R., Ingrey, J., Walton, J., Michie, C., Farrant, B. M., et al. (2024) · Australasian Journal of Dermatology · doi:10.1111/ajd.14363 · Cited by 3 · see citing works
The impact of a stress management intervention including cultural components on stress biomarker levels and mental health indicators among indigenous women
Aker, A. M., Serghides, L., Cotnam, J., Jackson, R., Robinson, M., Gauvin, H., Mushquash, C. J., Gesink, D., Amirault, M., & Benoit, A. C. (2023) · Journal of Behavioral Medicine · doi:10.1007/s10865-023-00391-0 · Cited by 6 · see citing works
The Mental Health of First Nations Children in Manitoba: A Population-Based Retrospective Cohort Study Using Linked Administrative Data: La santé mentale des enfants des Premières Nations au Manitoba : une étude de cohorte rétrospective dans la population, à l’aide de données administratives liées
Chartier, M., Brownell, M. D., Star, L., Murdock, N., Campbell, R., Phillips-Beck, W., Horton, M., Meade, C., Au, W., Schultz, J., et al. (2024) · The Canadian Journal of Psychiatry · doi:10.1177/07067437241226998 · Cited by 3 · see citing works
Epigenetic science and Indigenous health: key issues and considerations for future research
Keaney, J., Byrne, H., Warin, M. J., Kowal, E., Meloni, M., Gilbert, S., Craig, J. M., Rae, K. M., Wenitong, M., & Brown, A. D. H. (2024) · International Indigenous Policy Journal · doi:10.18584/iipj.2023.14.3.14820 · Cited by 4 · see citing works
Foundations of Canadian Indigenous Medicine (Part III): Treatment Approaches for Common Dermatological Conditions
Dababneh, N. E., Dababneh, S., Barakat, S., Cox, J., Chiskamish, W., Kelly, A., Pootoo, S., Ilisituk, P., Sala, M., Kitishimik, P., et al. (2025) · Journal of Cutaneous Medicine and Surgery · doi:10.1177/12034754251341852 · Cited by 2 · see citing works
Health disturbances stemming from overcrowding and inadequate housing among indigenous peoples within Canada
Anisman, H., Bombay, A., & Matheson, K. (2025) · Frontiers in Environmental Health · doi:10.3389/fenvh.2025.1720326 · Cited by 4 · see citing works
An environmental scan of impacts and interventions for women with methamphetamine use in pregnancy and their children
Ackerman, M., Madampage, C. A., Epp, L. J., Gartner, K., & King, A. (2021) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13851 · Cited by 2 · see citing works
A Canadian perspective on the developmental origins of health and disease: understanding the past as a way forward
Connor, K. L., Bourque, S. L., & Weaver, I. C. G. (2019) · Journal of Developmental Origins of Health and Disease · doi:10.1017/s2040174419000011 · Cited by 2 · see citing works
Evaluating Facilitators’ Experience Delivering a Stress-Reducing Intervention for Indigenous Women with and without HIV
Quelch, J., Jackson, R., Toombs, E., Robinson, M., Serghides, L., Aker, A. M., Gauvin, H., Sinoway, C., Barkman, L., Mushquash, C. J., et al. (2023) · Health & Social Care in the Community · doi:10.1155/2023/9219287 · Cited by 1 · see citing works
Seeing Our Native Patients: A Case-based Learning Module on Intergenerational Trauma in American Indian/Alaska Native People
Wilson, K. T., Esposito, M. L., MacColl, C. D., Hammock, R., Pennewell, T., Dionne, A., & Garcia, A. N. (2025) · MedEdPORTAL · doi:10.15766/mep_2374-8265.11528 · Cited by 1 · see citing works
Wáts'iyus Harvest Basket Model: turning to ancestral plant knowledge to develop Indigenized strategies towards decolonial ethnobotanical research in Sḵwxwú7mesh (Squamish) BC
Joseph, L., Mathews, D. L., Cuerrier, A., & Boulos, L. (2025) · Botany · doi:10.1139/cjb-2025-0032 · Cited by 1 · see citing works
The Context
Morris, G. J., Ungunmerr-Baumann, M.-R., Atkinson, J., & Schuberg, E. L. (2023) · Springer eBooks · doi:10.1007/978-981-99-6159-7_1 · Cited by 1 · see citing works
A descriptive overview of healthy relationship programs for Indigenous youth in Canada: an integrated environmental scan
Melro, C. M., Kakish, I., D’souza, N. A., Brass, G. M., Ballantyne, C., Boksa, P., Mushquash, C. J., & Iyer, S. N. (2024) · Discover Public Health · doi:10.1186/s12982-024-00248-0 · Cited by 1 · see citing works
Multi-Methods Evaluation of the Stop (See, Treat, Prevent) Trial: A Cluster Randomised, Stepped Wedge Trial to Support Healthy SkinPreprint
Thomas, H. M. M., Amgarth‐Duff, I., Carapetis, J. R., Coffin, J., Christophers, R., Enkel, S. L., Famlonga, R., Jacky, J., Jones, M., Marsh, J. A., et al. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4831853
A model of care for Aboriginal and Torres Strait Islander prisoner health and wellbeing in South Australia
Sivak, L., Cantley, L., Reilly, R. E., Kelly, J., Hawke, K., Stewart, H., Mott, K., McKivett, A., Rankine, S., Miller, W., et al. (2024) · International Journal of Prison Health · doi:10.1108/ijoph-06-2023-0035
Special Issue “Molecular Insights into the Developmental Origins of Health and Disease”
Tappia, P. S., & Ramjiawan, B. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262311579
Additional file 3 of Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review
Okpalauwaekwe, U., Ballantyne, C., Tunison, S., & Ramsden, V. R. (2022) · Figshare · doi:10.6084/m9.figshare.20727649
Additional file 1 of Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project
Ricciardo, B. M., Kessaris, H.-L., Nannup, N., Tilbrook, D., Farrant, B. M., Michie, C., Hansen, L., Douglas, R., Walton, J., Poore, A., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26666338
Additional file 1 of Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review
Okpalauwaekwe, U., Ballantyne, C., Tunison, S., & Ramsden, V. R. (2022) · Figshare · doi:10.6084/m9.figshare.20727643
Additional file 2 of Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project
Ricciardo, B. M., Kessaris, H.-L., Nannup, N., Tilbrook, D., Farrant, B. M., Michie, C., Hansen, L., Douglas, R., Walton, J., Poore, A., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26666341
Additional file 6 of Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project
Ricciardo, B. M., Kessaris, H.-L., Nannup, N., Tilbrook, D., Farrant, B. M., Michie, C., Hansen, L., Douglas, R., Walton, J., Poore, A., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26666353
Additional file 4 of Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project
Ricciardo, B. M., Kessaris, H.-L., Nannup, N., Tilbrook, D., Farrant, B. M., Michie, C., Hansen, L., Douglas, R., Walton, J., Poore, A., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26666347
Additional file 7 of Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project
Ricciardo, B. M., Kessaris, H.-L., Nannup, N., Tilbrook, D., Farrant, B. M., Michie, C., Hansen, L., Douglas, R., Walton, J., Poore, A., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26666356
Additional file 2 of Enhancing health and wellness by, for and with Indigenous youth in Canada: a scoping review
Okpalauwaekwe, U., Ballantyne, C., Tunison, S., & Ramsden, V. R. (2022) · Figshare · doi:10.6084/m9.figshare.20727646
Additional file 3 of Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project
Ricciardo, B. M., Kessaris, H.-L., Nannup, N., Tilbrook, D., Farrant, B. M., Michie, C., Hansen, L., Douglas, R., Walton, J., Poore, A., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26666344
Additional file 5 of Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project
Ricciardo, B. M., Kessaris, H.-L., Nannup, N., Tilbrook, D., Farrant, B. M., Michie, C., Hansen, L., Douglas, R., Walton, J., Poore, A., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26666350
Sex as a predictor and moderator of psychosocial determinants of cardiometabolic risks for Métis People in Canada
Johnson, S. R., Moore, S., Fatima, M. A., McInnes, A., & Foulds, H. J. A. (2026) · Frontiers in Stroke · doi:10.3389/fstro.2026.1736530
Testing the effectiveness of Family Spirit Strengths (FSS) – a culturally informed intervention designed to prevent mental health and substance misuse for indigenous families through home visiting
Nelson, L., Lopez, L. M., Archuleta, S., Skavenski, S. V. W., Kushman, E., Martin, L., Mitchell, K., Leffler, E., Werwie, T. R., Kemp, C. G., et al. (2026) · BMC Public Health · doi:10.1186/s12889-026-26593-0
Informing Equity-Oriented Approaches to Postpartum Care Following Severe Maternal Morbidity Events: A Qualitative Descriptive Study Protocol
Jack, S. M., Atkinson, D. J., Hicks, A., Deol, R., D’Souza, R., Frey, B. N., Green, S., Ramos-Lima, L. F., Anderson, L. N., Darling, E. K., et al. (2026) · Global Qualitative Nursing Research · doi:10.1177/23333936261448865

Health Disparities Among Indigenous Peoples: Exploring the Roles of Evolutionary and Developmental Mismatch on Cardiometabolic Health
Gurven, M., Sarrieddine, A., & Lea, A. J. (2024) · Annual Review of Anthropology · doi:10.1146/annurev-anthro-041222-101445 · Cited by 5 · see citing works
DOHaD in Indigenous populations: DOHaD, epigenetics, equity and race
Singh, G., Morrison, J. L., & Hoy, W. E. (2019) · Journal of Developmental Origins of Health and Disease · doi:10.1017/s2040174419000023 · Cited by 15 · see citing works
Inequities in Canadian maternal-child healthcare are perpetuating the intergenerational effects of colonization for indigenous women and children
Weckman, A. M., & Farrugia, P. (2025) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2025.1513145 · Cited by 7 · see citing works
Maternal health issues and cardio-metabolic outcomes in the offspring: A focus on Indigenous populations
Wicklow, B. A., & Sellers, E. A. C. (2014) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2014.04.017 · Cited by 11 · see citing works
Histories, Bodies, Stories, Hungers: The Colonial Origins of Diabetes as a Health Disparity among Indigenous Peoples in Canada
Dawson, L. (2018) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r3bn9xj7n · Cited by 1 · see citing works

Authors: Phillips-Beck, W., Sinclair, S., Campbell, R., Star, L., Cidro, J., Wicklow, B., Guillemette, L., Morris, M. I., & McGavock, J. M.
Affiliations: First Nations Health and Social Secretariat of Manitoba (CA)
The University of Winnipeg (CA)
Children's Hospital Research Institute of Manitoba (CA)
ORCID: Phillips-Beck, W.
Sinclair, S.
Cidro, J.
Wicklow, B.
Guillemette, L.
Morris, M. I.
McGavock, J. M.
Venue: Journal of Developmental Origins of Health and Disease
Publisher: Cambridge University Press (CUP)
Published: 2018-09-18
Volume: 10
Issue: 1
Pages: 115-122
ISSN: 2040-1744 (ISSN-L)
2040-1752
DOI: 10.1017/s2040174418000661
OpenAlex: W2892063495
Cited by: 44
References: 114
Citations by year: 2026: 3 · 2025: 7 · 2024: 18 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 1 · 2019: 2
FWCI: 0.25
Type: journal article
Language: en
Open access: closed
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Journal of Developmental Origins of Health and Disease (publishedVersion)
PubMed (publishedVersion)
Funders: Canadian Institutes of Health Research
Topics: Social Sciences › Health › Indigenous Health, Education, and Rights
Health Sciences › Health Professions › General Health Professions › Indigenous Health and Education
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords: health disparities, Indigenous youth, chronic disease, intergenerational trauma, early life exposure, cardiometabolic disease, epigenetics, first 1000 days, breastfeeding, prenatal care, socioeconomic status, cultural safety, colonial trauma
MeSH terms: Health Equity, Indigenous Peoples, Chronic Disease, Female, Health Services Accessibility, Humans, Maternal Health Services, Pregnancy, Prenatal Exposure Delayed Effects, Socioeconomic Factors

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Early-life origins of disparities in chronic diseases among Indigenous youth: pathways to recovering health disparities from intergenerational trauma

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