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However, a history of mistreatment that led to those vulnerabilities also built resilience, said Spero M. Manson, director of the Centers for American Indian & Alaska Native Health at the Colorado School of Public Health. "This is not our first experience with pandemics and epidemics. We recognize that these kinds of chronic stresses and strains have been present in the lives of Native Americans for generations," he said. "For us, it's a matter of survival."