Climate change and COVID-19: Assessing the vulnerability and resilience of U.S. Indigenous communities to syndemic crises.

The rapid emergence of the COVID-19 pandemic and the insidiously evolving climate crisis represent two of the most pressing public health threats to Indigenous Peoples in the United States. Understanding the ways in which these syndemics uniquely impact Indigenous Peoples, given the existing health disparities for such communities, is essential if we are to address modifiable root causes of health vulnerability and devise effective and equitable strategies to protect and improve health in the evolving climate landscape. We explore the compounding burden of the COVID-19 pandemic and climate change on Indigenous Peoples' health, and present several case studies which outline novel Indigenous approaches and perspectives that address climate change, COVID-19 and future health threats.

Conservation aquaculture as a tool for imperiled marine species: Evaluation of opportunities and risks for Olympia oysters, Ostrea lurida.

Conservation aquaculture is becoming an important tool to support the recovery of declining marine species and meet human needs. However, this tool comes with risks as well as rewards, which must be assessed to guide aquaculture activities and recovery efforts. Olympia oysters (Ostrea lurida) provide key ecosystem functions and services along the west coast of North America, but populations have declined to the point of local extinction in some estuaries. Here, we present a species-level, range-wide approach to strategically planning the use of aquaculture to promote recovery of Olympia oysters. We identified 12 benefits of culturing Olympia oysters, including identifying climate-resilient phenotypes that add diversity to growers' portfolios. We also identified 11 key risks, including potential negative ecological and genetic consequences associated with the transfer of hatchery-raised oysters into wild populations. Informed by these trade-offs, we identified ten priority estuaries where aquaculture is most likely to benefit Olympia oyster recovery. The two highest scoring estuaries have isolated populations with extreme recruitment limitation-issues that can be addressed via aquaculture if hatchery capacity is expanded in priority areas. By integrating social criteria, we evaluated which project types would likely meet the goals of local stakeholders in each estuary. Community restoration was most broadly suited to the priority areas, with limited commercial aquaculture and no current community harvest of the species, although this is a future stakeholder goal. The framework we developed to evaluate aquaculture as a tool to support species recovery is transferable to other systems and species globally; we provide a guide to prioritizing local knowledge and developing recommendations for implementation by using transparent criteria. Our collaborative process engaging diverse stakeholders including managers, scientists, Indigenous Tribal representatives, and shellfish growers can be used elsewhere to seek win-win opportunities to expand conservation aquaculture where benefits are maximized for both people and imperiled species.

How Indigenous Communities Are Adapting To Climate Change: Insights From The Climate-Ready Tribes Initiative.

Climate change directly threatens human health, with substantial impacts on Indigenous peoples, who are uniquely vulnerable as climate-related events affect their practices, lifeways, self-determination, and physical and cultural health. At the same time, Indigenous communities are leading the way in innovative health-related climate change adaptation work, using traditional knowledges and novel approaches. In 2016 the Centers for Disease Control and Prevention and the National Indian Health Board created the Climate-Ready Tribes Initiative to support these efforts. The initiative has funded tribes, shared information nationally, and supported a learning cohort, resulting in pioneering work to protect health from climate hazards. We describe how two tribes-the Pala Band of Mission Indians and the Swinomish Indian Tribal Community-implemented their Climate-Ready Tribes Initiative projects, and we provide recommendations for making climate and health policy more effective for tribes. Lessons learned from the Climate-Ready Tribes Initiative can inform climate and health policy and practice nationwide.

Climate Change and Health: Local Solutions to Local Challenges.

PURPOSE OF REVIEW: Climate change has direct impacts on human health, but those impacts vary widely by location. Local health impacts depend on a large number of factors including specific regional climate impacts, demographics and human vulnerabilities, and existing local adaptation capacity. There is a need to incorporate local data and concerns into climate adaptation plans and evaluate different approaches. RECENT FINDINGS: The Centers for Disease Control and Prevention (CDC) has provided funding, technical assistance, and an adaptation framework to assist localities with climate planning and activities. The differing processes with which states, cities, and tribes develop and implement adaptation plans have been observed. We outline examples of the implementation of CDC's framework and activities for local adaptation, with a focus on case studies at differing jurisdictional levels (a state, a city, and a sovereign tribe). The use of local considerations and data are important to inform climate adaptation. The adaptable implementation of CDC's framework is helping communities protect health.

Impact of local and regional sources of PAHs on tribal reservation air quality in the U.S. Pacific Northwest.

Atmospheric fine particulate matter (PM2.5) transports polycyclic aromatic hydrocarbons (PAHs) regionally and globally, influencing the air quality of communities around the planet. Concentrations of 130 PAHs extracted from PM2.5, collected on a Native American Tribal Reservation in the Northern Puget Sound region of the American Pacific Northwest, were used to assess the air quality impacts of regional and local PAH sources, atmospheric transport, and human health implications. Wind coming from the southeast of the sampling locations increased the overall PAH concentration of the PM2.5, while winds from the southwest decreased the PAH concentration. Concentrations of PAH subclasses increased or decreased independently at the two sampling locations with different changes in wind patterns, changing the excess lifetime cancer risk significantly. No long-range transport was measured, but emissions from local and regional PAH sources were measured. Samples collected during regional wildfires showed increased PAH concentrations. Samples collected during predicted weather inversions resulted in the highest PAH concentrations, and up to a ten-fold increase in excess lifetime cancer risk over the normal days.

A Case Study Describing a Community-Engaged Approach for Evaluating Polycyclic Aromatic Hydrocarbon Exposure in a Native American Community.

In 2015, the Swinomish Indian Tribal Community (SITC) was impacted by an air toxic release from one of two nearby oil refineries. This experience motivated SITC members to learn more about their exposure to air toxics. On the invitation of SITC, this community-based study measured personal exposure to polycyclic aromatic hydrocarbons (PAHs) and conducted interviews with the volunteers to evaluate perceptions of the data and experience of participating. Non-smoking SITC members were recruited in March 2016 (N = 10) and January 2017 (N = 22) with seven volunteers participating both times. Volunteers wore a wristband passive sampler for 7 days and completed daily activity diaries. Wristbands were analyzed for 62 PAHs using gas chromatography mass spectrometry. Wilcoxon exact tests determined if the sum total PAHs (ΣPAH) differed by activity, proximity to the refineries, and time. Aggregated results were shared during community meetings, and volunteers received individual reports. Volunteers (N = 9) participated in individual interviews. All volunteers were exposed to different amounts and types of PAHs. Burning candles or using a wood stove and/or propane heating were associated with higher ΣPAH exposures. While ΣPAH was similar in both sampling periods, the composition of PAHs differed. More priority listed PAHs were detected in January (N = 17) versus March (N = 10). Among volunteers who participated in both sampling events, exposure to four PAHs significantly differed between seasons. Overall, volunteers reported that the study made them more aware of air pollution sources in their community. They also commented that the chemical nomenclature was difficult to understand, but appreciated the individual reports that allowed them to visually compare their data to the distribution of data collected in their community. For volunteers with lower exposures, these comparisons gave them relief. However, volunteers with higher exposures reported concern and several changed their behaviors to reduce their exposure to known PAH sources. This study provided an opportunity for SITC members to learn about their personal exposure to a class of air toxics within the context of their community. While the limitations of the study hindered the ability to identify sources of air toxics in the community, this activity appeared to raise awareness about ambient and indoor air pollution among the volunteers.

Developing Responsive Indicators of Indigenous Community Health.

How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is "at risk" is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations.

Evaluating Threats in Multinational Marine Ecosystems: A Coast Salish First Nations and Tribal Perspective.

Despite the merit of managing natural resources on the scale of ecosystems, evaluating threats and managing risk in ecosystems that span multiple countries or jurisdictions can be challenging. This requires each government involved to consider actions in concert with actions being taken in other countries by co-managing entities. Multiple proposed fossil fuel-related and port development projects in the Salish Sea, a 16,925 km2 inland sea shared by Washington State (USA), British Columbia (Canada), and Indigenous Coast Salish governments, have the potential to increase marine vessel traffic and negatively impact natural resources. There is no legal mandate or management mechanism requiring a comprehensive review of the potential cumulative impacts of these development activities throughout the Salish Sea and across the international border. This project identifies ongoing and proposed energy-related development projects that will increase marine vessel traffic in the Salish Sea and evaluates the threats each project poses to natural resources important to the Coast Salish. While recognizing that Coast Salish traditions identify all species as important and connected, we used expert elicitation to identify 50 species upon which we could evaluate impact. These species were chosen because Coast Salish depend upon them heavily for harvest revenue or as a staple food source, they were particularly culturally or spiritually significant, or they were historically part of Coast Salish lifeways. We identified six development projects, each of which had three potential impacts (pressures) associated with increased marine vessel traffic: oil spill, vessel noise and vessel strike. Projects varied in their potential for localized impacts (pressures) including shoreline development, harbor oil spill, pipeline spill, coal dust accumulation and nearshore LNG explosion. Based on available published data, impact for each pressure/species interaction was rated as likely, possible or unlikely. Impacts are likely to occur in 23 to 28% of the possible pressure/species scenarios and are possible in another 15 to 28% additional pressure/species interactions. While it is not clear which impacts will be additive, synergistic, or potentially antagonistic, studies that manipulate multiple stressors in marine ecosystems suggest that threats associated with these six projects are likely to have an overall additive or even synergistic interaction and therefore impact species of major cultural importance to the Coast Salish, an important concept that would be lost by merely evaluating each project independently. Failure to address multiple impacts will affect the Coast Salish and the 7 million other people that also depend on this ecosystem. These findings show the value of evaluating multiple threats, and ultimately conducting risk assessments at the scale of ecosystems and highlight the serious need for managers of multinational ecosystems to actively collaborate on evaluating threats, assessing risk, and managing resources.

Community-based research as a mechanism to reduce environmental health disparities in american Indian and alaska native communities.

Racial and ethnic minority communities, including American Indian and Alaska Natives, have been disproportionately impacted by environmental pollution and contamination. This includes siting and location of point sources of pollution, legacies of contamination of drinking and recreational water, and mining, military and agricultural impacts. As a result, both quantity and quality of culturally important subsistence resources are diminished, contributing to poor nutrition and obesity, and overall reductions in quality of life and life expectancy. Climate change is adding to these impacts on Native American communities, variably causing drought, increased flooding and forced relocation affecting tribal water resources, traditional foods, forests and forest resources, and tribal health. This article will highlight several extramural research projects supported by the United States Environmental Protection Agency (USEPA) Science to Achieve Results (STAR) tribal environmental research grants as a mechanism to address the environmental health inequities and disparities faced by tribal communities. The tribal research portfolio has focused on addressing tribal environmental health risks through community based participatory research. Specifically, the STAR research program was developed under the premise that tribal populations may be at an increased risk for environmentally-induced diseases as a result of unique subsistence and traditional practices of the tribes and Alaska Native villages, community activities, occupations and customs, and/or environmental releases that significantly and disproportionately impact tribal lands. Through a series of case studies, this article will demonstrate how grantees-tribal community leaders and members and academic collaborators-have been addressing these complex environmental concerns by developing capacity, expertise and tools through community-engaged research.

Conducting research with tribal communities: sovereignty, ethics, and data-sharing issues.

BACKGROUND: When conducting research with American Indian tribes, informed consent beyond conventional institutional review board (IRB) review is needed because of the potential for adverse consequences at a community or governmental level that are unrecognized by academic researchers. OBJECTIVES: In this article, we review sovereignty, research ethics, and data-sharing considerations when doing community-based participatory health-related or natural-resource-related research with American Indian nations and present a model material and data-sharing agreement that meets tribal and university requirements. DISCUSSION: Only tribal nations themselves can identify potential adverse outcomes, and they can do this only if they understand the assumptions and methods of the proposed research. Tribes must be truly equal partners in study design, data collection, interpretation, and publication. Advances in protection of intellectual property rights (IPR) are also applicable to IRB reviews, as are principles of sovereignty and indigenous rights, all of which affect data ownership and control. CONCLUSIONS: Academic researchers engaged in tribal projects should become familiar with all three areas: sovereignty, ethics and informed consent, and IPR. We recommend developing an agreement with tribal partners that reflects both health-related IRB and natural-resource-related IPR considerations.

Issues in evaluating fish consumption rates for Native American tribes.

The environmental health goals of many Native American tribes are to restore natural resources and ensure that they are safe to harvest and consume in traditional subsistence quantities. Therefore, it is important to tribes to accurately estimate risks incurred through the consumption of subsistence foods. This article explores problems in conventional fish consumption survey methods used in widely cited tribal fish consumption reports. The problems arise because of the following: (1) widely cited reports do not clearly state what they intend to do with the data supporting these reports, (2) data collection methods are incongruent with community norms and protocols, (3) data analysis methods omit or obscure the highest consumer subset of the population, (4) lack of understanding or recognition of tribal health co-risk factors, and (5) restrictive policies that do not allow inclusion of tribal values within state or federal actions. In particular, the data collection and analysis methods in current tribal fish consumption surveys result in the misunderstanding that tribal members are satisfied with eating lower contemporary amounts of fish and shellfish, rather than the subsistence amounts that their cultural heritage and aboriginal rights indicate. A community-based interview method developed in collaboration with and used by the Swinomish Tribe is suggested as a way to gather more accurate information on contemporary consumption rates. For traditional subsistence rates, a multidisciplinary reconstruction method is recommended.

Framing scientific analyses for risk management of environmental hazards by communities: case studies with seafood safety issues.

Risk management provides a context for addressing environmental health hazards. Critical to this approach is the identification of key opportunities for participation. We applied a framework based on the National Research Council's (NRC) analytic-deliberative risk management dialogue model that illustrates two main iterative processes: informing and framing. The informing process involves conveying information from analyses of risk issues, often scientific, to all parties so they can participate in deliberation. In the framing process, ideas and concerns from stakeholder deliberations help determine what and how scientific analyses will be carried out. There are few activities through which affected parties can convey their ideas from deliberative processes for framing scientific analyses. The absence of participation results in one-way communication. The analytic-deliberative dialogue, as envisioned by the NRC and promoted by the National Institute of Environmental Health Sciences (NIEHS), underscores the importance of two-way communication. In this article we present case studies of three groups--an Asian and Pacific Islander community coalition and two Native American Tribes--active in framing scientific analyses of health risks related to contaminated seafood. Contacts with these organizations were established or enhanced through a regional NIEHS town meeting. The reasons for concern, participation, approaches, and funding sources were different for each group. Benefits from their activities include increased community involvement and ownership, better focusing of analytical processes, and improved accuracy and appropriateness of risk management. These examples present a spectrum of options for increasing community involvement in framing analyses and highlight the need for increased support of such activities.