"Nobody Knew . . . What Was Gonna Happen": Indigenous Loss and Grief During the COVID-19 Pandemic.

Indigenous peoples have experienced higher rates of loss and death compared to the general population, partly due to historical loss. This qualitative inquiry focused on understanding Indigenous women's experiences of loss, grief, and death during the COVID-19 pandemic, involving 31 head-of-household Native American women from a southeastern US tribe. Reconstructive analysis of data from a community-based critical ethnography identified the following themes spanning the ecological levels of the FHORT: (a) loss of finances, (b) loss of structure and loss of self, (c) death due to COVID-19, (d) disrupted mourning and burial rituals, and (e) grief and extensive losses. Results indicate that the pandemic not only exacerbated historical loss, but interventions and models for working through grief and loss should not only be culturally tailored and promote healing across all ecological domains and include physical, mental, emotional, and spiritual aspects, but should also address historical trauma, collectivist values, and traditional ways.