Environmental Prenatal Exposures
The Navajo Birth Cohort Study is a col- laborative research partnership of the Navajo Nation, researchers at the University of New Mexico, and the Agency for Toxic Substances and Disease Registry within CDC (Hunter et al., 2015). Navajo female individuals who were concerned about their reproduc- tive health from uranium pollution were the impetus behind this cohort project, which is the first prospective cohort study to exam- ine the association between heavy metal levels and birth outcomes in a population that has been exposed to uranium. Ongoing eorts of tribal, academic, and government partnerships aim to inform tribal policy and empower tribally driven public health initia- tives. Furthermore, the Navajo Birth Cohort Study strives to create linguistically and cul- turally appropriate questionnaires informed and approved by the Navajo Nation Human Research Review Board. These research eorts are exemplary of interagency research partnerships that bring tribal direction and input to the forefront. Limitations This report is limited to focusing only on the environmental public health hazards found to have significant and documented eects on AI/AN communities. Therefore, we might have underrepresented the array of envi- ronmental public health hazards associated with environmental health, health equity, or environmental injustices in these communi- ties. This report is also limited to the health impacts related to environmental health. While we made eorts to thoroughly search the literature for connections between envi- ronmental public health and AI/AN commu- nities, publications might have been missed, and additional environmental public health impacts might exist beyond the connections included in this report. It is also noteworthy that many environmen- tal health professionals in tribal jurisdictions focus on public health practice rather than research-based approaches. For several impor- tant environmental health topics, research and statistics were either missing or very limited. Thus, environmental health themes were determined by the availability of data and nar- rowed down for conciseness here. Addition- ally, the referenced case studies show only one person’s or one community’s perspective. It is important to note that other individuals and
communities might have dierent viewpoints, perceptions, or experiences. Conclusion The disproportionate burden of exposures shouldered by AI/AN communities repre- sents serious, persistent health and envi- ronmental problems. These challenges war- rant a corrective action plan that reflects our nation’s commitment to optimal health, safety, and financial security for its resi- dents. The intimate traditional ecological knowledge that these communities pos- sess represents an important insight into local environments and natural ecosystems. Incorporating regionally specific, traditional ecological knowledge should be considered a tool to use in future climate change adapta- tion, mitigation planning, and resolution of related environmental health concerns. Another critical step the environmental health community can take to address long- standing disparities is to expand eorts to cultivate and support the next generation of AI/AN professionals in this field. Increas- ing the representation of AI/AN individuals in environmental public health is essential to ensuring that tribal communities are not only included but also positioned to lead in the research, management, and decision- making processes that directly impact their health and environments. Investing in edu- cation, training, and career development opportunities tailored to AI/AN popula- tions will help build a more equitable and eective environmental health workforce. We recommend that future environmental health research and management continue to celebrate and model these strength-based approaches (O’Keefe et al., 2023). Climate change is an escalating global cri- sis with profound eects not only on the envi- ronment but also on human health, including mental health (Walinski et al., 2023). Stud- ies have documented various mental health issues arising from climate change such as increased suicide rates due to rising tempera- tures, post-traumatic stress disorder (PTSD) from severe storms, and acculturation stress linked to climate-induced relocation (Padhy et al., 2015). This intersection between mental health and environmental health is a burgeoning area of study, and Indigenous communities worldwide have begun to lead research initiatives that validate their lived
Exposure to environmental contaminants is concerning, particularly to adults of reproduc- tive age, pregnant individuals, and children. Exposure to contaminants can negatively aect fertility, development in utero, pregnancy out- comes, and child health (Sunyach et al., 2018). The environments where pregnant individuals live, work, and spend time can influence both their health and the health of their unborn children. AI/AN people have almost twice the infant mortality rate as non-Hispanic White people and are 50% more likely to die from complications related to low birthweight (Oce of Minority Health [OMH)], 2021). In this study, the AI/AN infant mortality rate was 8.2 per 1,000 live births and 4.6 per 1,000 live births for people who self-identified as White (OMH, 2021). With regard to environmental contaminants, AI/AN female individuals have a higher risk for medical conditions, includ- ing reproductive cancer and miscarriage, as well as a higher risk of giving birth to babies with birth defects and intellectual function impairments (Gilio-Whitaker, 2019). In 2008, the U.S. Department of Health and Human Services reported that AI/AN infant mortality was 44% higher than in the previous decade (Gilio-Whitaker, 2019). Lakota female individuals have experi- enced high rates of miscarriage and repro- ductive cancers due to the eects of ura- nium contamination (Hoover et al., 2012). Uranium mining contamination has aected the Oglala Lakota, and studies have reported radiation in groundwater and surface water sources in the Pine Ridge Indian Reservation, an Oglala Lakota reservation in South Dakota (Hoover et al., 2012). In 1986, PCB contamination in the St. Lawrence River resulted in an advisory for the Mohawk Nation at Akwesasne to stop eat- ing local fish (Hoover et al., 2012). Although PCB levels have since declined among the local population, levels are still elevated when compared with the general U.S. popula- tion. Significantly higher levels of PCBs were found among Mohawk Nation adolescents who were breastfed as infants. Compared with girls of similar age in the general U.S. population, Mohawk Nation girls were more likely to have reached puberty at 12 years of age, which could be from the estrogenic eects of PCBs (Hoover et al., 2012).
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June 2025 • Journal of Environmental Health
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