A Brief Review of Sickle-Cell Haemoglobin, β-Thalassaemia and G-6-PD Deficiency Genes among Tribals of Scheduled Area of Rajasthan, India: Focus on Tribal Health

Rajasthan, situated at the north-western part of India is the biggest state in the country of India and has total of 33 districts. By merging eight tribal dominating districts namely, Banswara, Chittourgarh, Dungarpur, Pali, Pratapgarh, Rajasamand, Sirohi, and Udaipur of these, the government has created a special area called the ‘schedule area” in which >70% of the people are tribal. This area is mostly backward and underdeveloped where malaria is also hyperendemic. In this area, Bhil, Damor, Meena, Garasiya, Kathudia and Sahariya are the most dominating and major endogamous tribes. Besides the several communicable and non-communicable diseases in this area, certain erythrocyte genetic disorders, Sickle-Cell Haemoglobin (Hb-S), β-thalassaemia and G-6-PD deficiency (Gd) are also deteriorating the tribal health and causing morbidity and mortality in them. Genes of these red cell genetic disorders are more prevalent and widely distributed among tribal people. The maximum prevalence of these blood genetic disorders in tribes was found as 31.14%, 9.00% and 22.00%, respectively. Since the groundwater of this tribal area contains a high amount of Fluoride (F), drinking it poses a high risk of premature death of tribal people who already have homozygous state of sickle-cell and β-thalassaemic genes. In present communication, besides the focus on tribal health, the status of genes of sickle-cell haemoglobin, β-thalassaemia and G-6-PD deficiency in different tribal ethnic groups of scheduled area, the correlation of these blood genetic disorders with malaria, impact of F intoxication in tribal subjects possessing red cell genetic disorders and the prevention and control of these erythrocyte genetic disorders in tribal people have been critically reviewed. The results of this review are significant and advantageous in making and execution of prevention and control programme of these blood genetic disorders in tribals of scheduled area of Rajasthan, India. Moreover, in this review, research gaps are also highlighted for further research work.

“I Hope to Hell Nothing Goes Back to The Way It Was Before”: COVID-19, Marginalization, and Native Nations

We draw on new and original data to examine both partisan and systemic inequities that have fueled the spread of COVID-19 in Native America. We show how continued political marginalization of Native Americans has compounded longstanding inequalities and endangered the lives of Native peoples. Native nations have experienced disproportionate effects from prior health epidemics and pandemics, and in 2020, Native communities have seen greater rates of infection, hospitalization, and death from COVID-19. We find that Native nations have more COVID-19 cases if they are located in states with a higher ratio of Trump supporters and reside in states with Republican governors. Where there is longstanding marginalization, measured by lack of clean water on tribal lands and health information in Native languages, we find more COVID-19 cases. Federal law enables non-members to flout tribal health regulations while on tribal lands, and correspondingly, we find that COVID-19 cases rise when non-members travel onto tribal lands. Our findings engage the literatures on Native American politics, health policy within U.S. federalism, and structural health inequalities, and should be of interest to both scholars and practitioners interested in understanding COVID-19 outcomes across Tribes in the United States.

Diminishing traditional methods and inaccessible modern healthcare: the dilemma of tribal health in India

PurposeThis paper critically examines the state of tribal health in India by analyzing the accessibility and availability of traditional medicine and modern healthcare.Design/methodology/approachThis essay is the product of an extensive review of the literature and authors' personal experience in working with the tribal communities.FindingsThe traditional medicinal practices once very prevalent among the tribal communities are diminishing due to various socio-economic, environmental and political factors. Modern healthcare in India's tribal region is characterized by a lack of availability, accessibility and affordability. As a result of the diminishing traditional practices and inaccessible modern healthcare provisions, tribal communities depend on quacks and magico-religious practices.Originality/valueThis essay advocates for urgent policy interventions to integrate traditional medicine and modern healthcare practices to address critical tribal health issues. Preservation of traditional medicinal knowledge-base and improving research in the field have the potential to address the health of tribal communities and of others. The accessibility and availability of modern healthcare facilities in tribal regions should be improved to ensure better health outcomes.

Commercial Tobacco Retailing in Tribal Jurisdictions: A Field Study

Objectives: Our objective was to provide data contrasting commercial tobacco retailing in Tribal versus non-Tribal jurisdictions, in 3 states. These data may be relevant for US Food and Drug Administration regulation of Tribal retailing. Methods: With Tribal permission, observations were made on commercial tobacco advertising, product variety, pricing, and retail concept for stores within and just outside Tribal jurisdictions in areas of Arizona (AZ), California (CA), and Oklahoma (OK). Results: A total of 87 Tribal (20 AZ, 53 CA, 14 OK) and 67 (10, 43, 14) non-Tribal retailer visits were completed. There was substantial variation across tribes, with sales in AZ and most CA Tribal jurisdictions handled at convenience stores, whereas OK Tribal retailing was done mostly in specialized tobacco-specialty shops. Electronic cigarettes were ubiquitous across Tribal and non-Tribal outlets. Advertising and breadth of cigarette offerings was most extensive in the tobacco specialty retailers of Tribal OK. Surprisingly, Tribally manufactured cigarettes were found only at some CA Tribal retailers. Conclusions: Some Tribal commercial tobacco outlets actually price above their non-Tribal competitors and there is substantial variation in retailing strategy across Tribal jurisdictions. Tribal governments can continue to evaluate and reform commercial tobacco retailing so as to improve Tribal health.