Multi-generational perspectives on health, cancer, and biomedicine: Northeastern Native American perspectives shaped by mistrust.

Cancer is the second leading cause of death among Native Americans, who have-some of the poorest cancer survival rates of any race/ethnicity nationwide. Considering the cancer burden experienced by Native Americans and the lack of research exploring Northeastern tribal communities' cancer experiences, a qualitative investigation of Native Americans' cancer coping strategies and health education needs was undertaken. Data were collected through group (74) and individual (17) interviews with 91 Native Americans from the Northeast. Relationships between intergenerational mistrust, individual mistrust, and utilization of biomedical health care systems for Northeastern Native Americans are presented. Trust is central to the provider-patient relationship and the foundation for developing and maintaining connections to Native American communities. Intergenerational mistrust, shaped by historical and contemporary issues of prejudice and miscommunication, affect cancer health experiences and views. Approaches for reducing mistrust and building relationships between health care providers and Native communities are highlighted.