ADVANCEMENT OF THE PRACTICE
Open Access
SPECIAL REPORT
Health Equity, Environmental Justice, and American Indian and Alaska Native Communities: A Short Report
Maya Dizack, ScM Johns Hopkins University Bloomberg School of Public Health Jesse Bliss, MPH Gina Bare, RN National Environmental Health Association David T. Dyjack, DrPH, CIH National Environmental Health Association nal mortality rates have been reduced by 19% since 1972. More recently, a report published by the Centers for Disease Control and Pre- vention (CDC, 2023) in the wake of the COVID-19 pandemic found that compared with all other U.S. Census race and ethnicity groupings, AI/AN people “had the greatest increase in life expectancy from 65.6 in 2021 to 67.9 in 2022, regaining 2.3 years of their 6.2-year life expectancy loss between 2019 and 2021.” Also, many tribal communities are implementing progressive health policies that enable culturally tailored health initia- tives such as the integration of Traditional Indian Medicine (Warne & Frizzell, 2014). Despite these strides for AI/AN public health in evolving health policy and public health initiatives, access to healthcare and disparate health outcomes are a continual challenge within Indian Country. The e¡ects of environmental health chal- lenges are compounded by systematic barriers to health equity for AI/AN people. According to the National Center for Health Statistics, approximately 40% of the AI/AN population resides in rural areas (Villarroel et al., 2020). The lack of healthcare infrastructure increases travel time to an average of 17 min from the nearest hospital compared with 12 min and 10 min for suburban and urban residents, respec- tively (Lam et al., 2018). Additional barriers to healthcare access other than travel time to IHS facilities include long wait times, a lack of or limited access to transportation, and the lack of availability of culturally or linguistically appropriate healthcare professionals (Adakai et al., 2018). Furthermore, AI/AN people are under- represented in public health professions
Abstract Environmental public health hazards present unique challenges for American Indian and Alaska Native (AI/AN) communities due to their close cultural, physical, and spiritual associations with the environment. To raise visibility of these challenges among environmental public health professionals, this report summarizes findings from studies, news articles, and case studies. We categorized five major environmental public health challenges that aect AI/AN communities: climate change, environmental health hazards, air quality, water quality, and environmental prenatal exposures. A general explanation of each environmental health issue is articulated with contextual history, statistics, and reports. Discussion of these categories is followed by case studies of AI/AN communities aected by these environmental health challenges. Lastly, we point to eorts by Indigenous communities and allies who are working to improve AI/AN environmental public health within the U.S. Keywords: American Indian communities, Alaska Native communities, environmental health risks, environmental public health challenges
Background and Needs Statement
world is integral to AI/AN communities and Indigenous identities. The state of the natu- ral world is directly connected to Indigenous mental, physical, and emotional well-being. Climate change and environmental degrada- tion have threatened ways of being for AI/AN communities. Multiple systemic factors have exacerbated this situation, such as a lack of funding, poor access to technical resources, legacies of colonialism, and discrimination (ITEP, 2021). Despite these challenges, over the past few decades there have been major health suc- cesses within Indian Country. According to the Indian Health Service (IHS, 2014), mater-
The U.S. government identifies 574 feder- ally recognized Indian Nations in 36 states, including 220 nations in Alaska (U.S. Census Bureau, 2022). According to the U.S. Cen- sus Bureau (2022), the population of Native Americans was 6.79 million, which is approx- imately 2% of the U.S. population. American Indian and Alaska Native (AI/AN) people have been marginalized throughout history, punctuated by the recent emphasis on health equity and environmental justice (Insti- tute for Tribal Environmental Professionals [ITEP], 2021). Connection to the natural
26
Volume 87 • Number 10
https://doi.org/10.70387/001c.140442
Powered by FlippingBook