Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona

Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment.

Environmental and occupational health on the Navajo Nation: a scoping review

A scoping review was performed to answer: what environmental health concerns have been associated with adverse health outcomes in the Navajo Nation? The review focused on occupational and ambient environmental exposures associated with human industrial activities. The search strategy was implemented in PubMed, and two investigators screened the retrieved literature. Thirteen studies were included for review. Data were extracted using the matrix method. Six studies described associations between work in uranium mining and cancer. Six studies focused on environmental exposures to uranium mine waste and other metals, with outcomes that included biological markers, kidney disease, diabetes and hypertension, and adverse birth outcomes. One study explored occupational exposure to Sin Nombre Virus and infection. Most research has focused on the health effects of uranium, where occupational exposures occurred among miners and environmental exposures are a legacy of uranium mining and milling. Gaps exist with respect to health outcomes associated with current occupations and the psychosocial impact of environmental hazards. Other environmental exposures and hazards are known to exist on the Navajo Nation, which may warrant epidemiologic research.

Incidence of SARs-CoV-2 (Dikos-Ntsaaigii-19) Among Navajo Nation Children

On March 17, 2020 the SARs-CoV-2 virus was first reported on the Navajo Reservation. Today, the Navajo Nation has a 147% higher infection rate and a 450% higher death rate than the national average. Despite this tragedy, a glaring question remains, what is happening among the Navajo children. The study found that Navajo children had an infection rate 220% higher than the general population and a death rate from COVID 1,400% greater than non-Navajo in the United States. This occurs even though of Navajo children having a much higher vaccination rate of 68% compared to about 25% of children Nationwide. The introduction of SARs-CoV variants such as the alpha and omicron variants did not seem to play a role in these findings. The higher infection rates suggest a genetic predisposition among the Navajo to SARs-CoV-2 via the ACE-2 receptor and signal transduction pathway while the increased death rates may also suggest inferior care provided by the Bureau of Indian Affairs Hospitals.

Environmental control: charting a course for the Navajo reservation through road construction, 1945–1978

This article examines the history of road planning in the decades following the Second World War on the Navajo Nation. Federal highway planners and Navajo residents had conflicting ideas about the role of roads in the Nation's postwar development. The planners’ support for highways near uranium mines undermined efforts towards Navajo self-development and modernization. Federally planned and subsidized highways granted extractive industries control over large portions of the Nation. Those highways locked in a regime of environmental exploitation that caused severe and debilitating public health consequences for Navajo communities.

Perspectives on Genetic Research: Results From a Survey of Navajo Community Members

The Navajo Nation placed a moratorium on genetic research studies in 2002, in part due to concerns about historical distrust, exploitation, limited expertise and resources, and the lack of a genetics policy. Navajo tribal leaders, scientists, and policy experts are exploring the possibility of lifting the moratorium, developing a genetic research policy, and discussing its potential health implications. This study aimed to identify the key concerns, needs, and desires of Navajo people regarding genetic research. We conducted a survey of Navajo individuals to assess knowledge of the moratorium and research, gauge interest in genetic research, and quantify appropriate genetic research topics to understand broad views and concerns. We performed descriptive statistics and tested associations between relevant categorical variables using Chi-square tests. We hypothesized that individuals with more knowledge about the moratorium and health research increased the likelihood of supporting and participating in genetic research. A total of 690 surveys from Navajo respondents were analyzed. Of these, 63% of respondents reported being unaware of the Navajo Nation’s moratorium on genetic research. There were positive associations between those who knew about the moratorium and willingness to donate biospecimens for research under certain conditions, such as community involvement, review and approval by community leaders, research on diseases affecting the community, and support for lifting the moratorium (p-values < 0.001). We found no significant differences between age, gender, religious/spiritual beliefs, or agency affiliation with knowledge levels of genetics and related topics, participation in relation to beliefs, and donation of biospecimens. Interestingly, respondents who resided off the Navajo Nation were positively associated with having knowledge of the moratorium, having heard of discussions of genetics on the Navajo Nation, and the lawsuit filed by the Havasupai Tribe. Most respondents agreed that it was very important to develop a policy that incorporates cultural knowledge (56%), is beneficial (56%), and has data sharing protections (59%) before allowing genetic research on the Navajo Nation. Overall, a large proportion of respondents (46%) were unsure about lifting the moratorium and instead wanted more genetics education to assess its potential implications. The study results can inform the direction of future guidelines and policies.

CARING FOR OUR PEOPLE: INDIGENOUS RESPONSES TO COVID-19 ERA INFORMATIC COLONIALISM

Based on qualitative and quantitative analyses, activist work and HCI approaches, these papers show how organizations formed partnerships to curate information resources, and deploy community Wi-Fi and Internet infrastructure across southwest US Indigenous communities during the most challenging months of the 2020 COVID-19 pandemic. For Native Americans this means ideating while navigating colonial inequality. Through an investigation of sociotechnical interdependencies across a broadband network cooperative, tribes, and university labs, an HCI team reflects on how relational stability sustains fragile Internet ecologies stretched to capacity by the needs of users deeply affected by COVID-19 in New Mexico and Arizona. Through an autoethnography of community-centered digital solutions for Navajo Nation, a member of the Nation considers how the role of K’é informs a system of infrastructural care in a nation struggling with high rates of infection and systemic lack of adequate infrastructure. Through an advocacy-oriented analysis of social media content, a Diné and Lakota social media scholar discerns the relationship between community enforcement of social distancing, the loss of interpersonal interaction, mutual aid, and the impact of public health memes for the Navajo Nation. Through radical librarianship practices, a Tohono O’odham librarian and artist counteracts the values of ‘information neutrality’ shaping whiteness-centering American librarianship by generating a community-curated solution to actionable information about COVID-19 for Indigenous communities. This panel models decolonial liberation rooted in responsiveness across mediated layers of Indigenous belonging. The authors express Indigenous interpretations of collective autonomy vis-a-vis strategic Internet assemblages, and particularly, how an Indigenous ethics of care intersects with the dream of an Internet for social good.

Beautiful Ruin: Creating Healthfields

Multiple programs promote redevelopment of land reuse sites, which are environmentally impacted or potentially contaminated sites. Historically, such programs have focused primarily on economic development. However, public health is an important consideration to address not only sustainable redevelopment but also health inequity and disparities. The Agency for Toxic Substances and Disease Registry’s (ATSDR) Land Reuse Health Program is a special program to promote broad public health improvements through safe land reuse and redevelopment. Land reuse sites are virtually in every community in the U.S. and are a global problem. Brownfields are the greatest number of land reuse sites. With estimates of over 450,000 land reuse sites across the U.S., most communities suffer the burden of blight and contamination associated with these sites. ATSDR promotes and practices Healthfields Redevelopment: The safe reuse of environmentally distressed land to reduce exposures to contaminants and to improve overall health in the community. In this chapter, I highlight Navajo Nation Healthfields activities using ATSDR’s 5-step Land Reuse Strategy to Safely Reuse Land and Improve Health (5-step Land Reuse Model) and describe some of ATSDR’s Healthfields projects and related tools and resources for communities to create their own Healthfields practice.