Unwellness Empire: Part II – Scars of Oppression
How do the wounds of imperial violence live on in the mind and body? Colonialism is more than kinetic warfare—it reconfigures memory, fractures identity, and alters the body’s biology. The damage lives on through families, communities, and political systems, shaping lives long after the initial act of violence.
The term “colonialism” should be understood herein to be interchangeable with “neocolonialism” and the broader spectrum of past and present capitalist violence. This includes imperialism (military and economic violence from the “core” outwards) and fascism (colonial violence turned inwards.) Whether discussing racialized class warfare against communities in the US, or genocidal violence perpetrated by Western empires across the global South, the actors, motivations, and methodologies are all deeply intertwined.
The wounds of the Unwellness Empire fester through the mechanisms of colonial mentality and cultural hegemony. Colonial mentality is the internalized belief of the colonized in their own inferiority—a psychological architecture built by centuries of dehumanization, where the language, values, and even the bodies of the colonizer are upheld as the supreme standard.
This is not a passive inheritance but an active conditioning, sustained by the cultural hegemony that naturalizes the dominance of the oppressor’s worldview. It renders the colonizers violence a matter of historical fact rather than ongoing political choice. It is the process by which the oppressed come to police themselves, viewing their own cultures as backward, their pain as personal failing, and liberation as assimilation into the very systems that engineered their suffering. This hegemony ensures that the empire’s most insidious damage lives on in the mind, turning resistance into self-doubt and collective trauma into an individual pathology to be managed, rather than a political and economic injury to be remedied.
To understand how these harms persist, three complementary frameworks offer insight. Historical Trauma Theory (HTT) traces the transmission of collective grief and cultural disruption across generations, Race-Based Traumatic Stress Injury (RBTS) explains how ongoing systemic racism and structural violence inflict repeated psychological injury, and Intergenerational Colonial Trauma Syndrome (ICTS) brings these dynamics together, emphasizing that colonial violence is not only remembered but actively sustained. Each reveals how oppression is etched into cultural memory and biological processes such as stress regulation and gene expression.
For the Lakota Nation, the history of loss runs from the Wounded Knee Massacre to the theft of the Black Hills to the forced removal of children into settler-run boarding schools. The goal was cultural erasure; the effect was a psychic wound that still bleeds today. Lakota scholar Maria Yellow Horse Brave Heart’s work on HTT has documented the fallout: depression rates in some Lakota communities reach over 50%, alcohol and substance use disorders far exceed national averages, and suicide rates among Native youth are more than twice that of their white peers.
In fact, suicide is the second leading cause of death for Native youth aged 10–24, a statistic Brave Heart links directly to the unresolved grief of colonization—a grief transmitted not only through memory, but through patterns of disrupted parenting, community disintegration, and chronic stress that ICTS predicts will persist without structural repair. The sustained discrimination faced by Native people in housing, healthcare, and education fits the RBTS model: each new encounter with systemic racism reactivates the historical wound. These are not isolated “lifestyle” problems, they are symptoms of a social and historical injury. Healing in this context must be collective, rooted in cultural revival, land reclamation, and dismantling the very structures that caused the harm.
For African Americans, the legacy of slavery is an ongoing determinant of health and survival. Enslavement was followed by Jim Crow, redlining, mass incarceration, and police violence, creating a continuous thread of structural oppression. The CDC reports that African Americans have a life expectancy four years shorter than white Americans, with higher rates of hypertension, maternal mortality, and chronic disease. Research on “weathering” shows that persistent racial discrimination accelerates biological aging, echoing ICTS’s argument that structural violence embeds inequality in the body.
Black women are three to four times more likely to die from pregnancy-related causes than white women, a disparity unchanged even when controlling for income and education. Adverse childhood experience studies show that Black children are more than twice as likely as white children to face chronic harm—a key pathway for long-term trauma identified in HTT. Furthermore, the criminal justice system functions as a modern extension of slavery’s control: incarceration rates, police violence, and discriminatory sentencing create ongoing psychological injury consistent with RBTS, with effects reverberating through families for decades. Exposure to police violence—even indirectly through media—is associated with higher rates of PTSD, depression, and anxiety.
Epigenetic studies show that the chronic stress of racism can alter gene expression related to immune function and inflammation, suggesting that slavery’s trauma is not only cultural but biological. These are not “community problems”—they are the direct biological, psychological, and sociological consequences of centuries of racial oppression—a violence that continues to shorten lives and limit futures long after formal emancipation.
In Palestine, generational trauma is not a theory or an ailment, it’s daily life. The Nakba of 1948, which displaced over 750,000 Palestinians, was not a one-time event but the opening chapter of an unbroken continuum of dispossession and oppressive military occupation. Families who lost their homes 80 years ago are now experiencing continued bombings, blockades, and the erasure of their homeland.
Since the genocide escalated in October of 2023, Gaza has endured destruction so relentless it is reshaping the population’s biology. More than 20,000 babies were born under siege in the first year, with 15% facing severe birth complications. Low-weight births have surged nearly one-third compared to pre-siege levels, driven by maternal malnutrition, displacement, and relentless stress. Miscarriage rates have spiked, and doctors have reported birth defects linked to munitions toxins. Even before the current escalation, over 53% of Gaza’s children already showed signs of PTSD, and Save The Children reported that 80% were living with chronic emotional distress as a baseline condition.
Research from war zones shows that extreme maternal stress can disrupt fetal brain development and alter gene expression in ways that affect stress responses for life. In the Palestinian context, where siege, displacement, and militarized violence are chronic rather than episodic, the biological imprint of trauma is compounded across generations. This means the Nakba is not just a memory, it is a biological inheritance, carried in cortisol dysregulation, immune system changes, and altered neural pathways in both those who directly endured it and those born decades later.
Colonialism’s violence in South Asia was not only in its overt political domination but also in the orchestrated starvation that accompanied imperial extraction. The Bengal Famine of 1943, in which an estimated 3 million Bengalis died, was not a natural disaster but the outcome of British wartime policies that diverted grain exports and dismantled local food security systems. This famine was one in a series—from the Madras famine of 1876–78 to the Bombay famine of 1899–1900—that functioned as both population control and a method of resource extraction.
Biomedical research shows that survivors and descendants of such famines carry physiological imprints of starvation. Studies in populations from famine-exposed adults in India reveal that early-life undernutrition alters pancreatic β-cell function and insulin sensitivity, predisposing individuals to type 2 diabetes decades later. In these cohorts, prenatal and early childhood famine exposure has been linked to a “thrifty phenotype,” an adaptive metabolic programming for scarcity that becomes maladaptive in today’s calorie-rich environments, leading to high rates of metabolic syndrome, insulin resistance, and cardiovascular disease.
These findings help explain why Indian and Bengali populations, even at lower BMI thresholds, have disproportionately higher risks of diabetes compared to other ethnic groups. The health burden is compounded by the persistence of food insecurity, structural poverty, and nutritional coloniality—where cash crops and export-oriented agriculture still displace diverse, nutrient-rich local diets. The legacy of famine is not confined to historical memory; it persists in the body’s hormonal pathways, shaping the destinies of entire communities.
Lakota, African-American, Palestinian, Bengali—different histories, different geographies, but the same underlying processes. Military aggression and colonial exploitation don’t just dismantle economies and governments; they dismantle entire peoples. They fragment identity, corrode mental health, and leave scars that outlast treaties and ceasefires. The colonial mentality imparted by this violence is propagated and sustained through Western cultural hegemony. Whether this manifests as imperialism or fascism matters little—the architecture remains the same, the results, inevitable.
When governments and agencies treat these scars as a “mental health crisis” divorced from its full context, they miss the point. The wound is political and economic. The cure must be as well.
Until the structures of occupation, dispossession, and economic domination are dismantled, there will be no clean break from the past, only the inheritance of injury. And as long as that inheritance continues, the war goes on.
Stay tuned for Part III: Imperialist’s Burden, where we delve into what Aimé Césaire referred to as the “decivilizing” of those perpetrating colonial violence.
