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Abstract Over ten million Native Americans live in the USA today, but their experiences are often obscured in empirical research. While the rise in despair, or chronic distress, among White Americans is much discussed, what is not discussed is what has happened for the first Americans. We demonstrate that levels of consistently poor mental health were higher among Native peoples than among White or Black Americans in every year between 1993 and 2020, and these levels have been rising. We find this pattern among those over the age of 30 but less so for the young. Chronic distress seems to be lowest among Native peoples living in the seven states with the largest proportion of Native Americans as a fraction of their population: Alaska, Arizona, Montana, New Mexico, North Dakota, Oklahoma and South Dakota. In our judgment, these facts are important and not widely known. This stands in stark contrast to the enormous scholarly and media interest in declining physiological well-being among White Americans.