Office of Tribal Affairs Addresses Environmental Health in Native American Communities

November is National Native American Heritage Month. Learn about the work of the NCEH/ATSDR Office of Tribal Affairs among American Indian/Alaskan Native Tribes.

For many Native Americans, culture and the natural environment are closely connected. Together, they provide American Indians/Alaskan Natives (AI/AN) a unique identity and contribute to their physical, mental, and spiritual health. In fact, some Native Americans still rely on their natural environments to practice subsistence fishing, hunting, and farming. And some tribes use environmental resources for traditional ceremonies and celebrations.

Because of their deep environmental connections and the wealth of natural resources found on tribal lands, AI/AN populations are confronting a number of environmental threats to their health. Other issues common to Native American populations, such as economic adversity and lack of access to adequate health care, increase possibilities for harmful health effects.

Recognizing these health threats to AI/AN populations, the National Center for Environmental Health (NCEH) and the Agency for Toxic Substances and Disease Registry (ATSDR) established the Office of Tribal Affairs (OTA). The OTA works closely with AI/AN populations to identify and evaluate environmental health concerns and empower individual Tribes to make informed decisions that benefit their people and their communities.

Although NCEH/ATSDR first established OTA in 1999, in 2012 OTA became a stand-alone office. This action demonstrates the NCEH/ATSDR commitment to work with Indian Tribes as unique governments. It also allows OTA to work directly with center and agency programs that benefit AI/AN populations.

Environmental Challenges to AI/AN health

The 566 federally-recognized Tribes in the United States make up approximately 1.8% of the entire U.S. population. Yet this small percentage faces a disproportionate number of significant health disparities.

• 12% of AI/AN households in the United States do not have access to safe drinking water.
• 11.7% of residents of Native American lands do not have complete plumbing systems.
• Around 25% of Native American children and 20% of Native American adults are diagnosed with asthma during their lifetimes.
• 100% of U.S. government uranium mining is conducted on Native American reservations.
• Four out of the ten largest coal strip mines in the United States are located on reservations.

Culture as Prevention

In 2011, OTA invited 12 Tribal professionals with diverse backgrounds and experience in environmental health to participate in the National Tribal Environmental Health (NTEH) Think Tank. The think tank’s main purpose that first year was to help OTA develop a 3-5 year strategic plan. As the think tank continues, the members will work together to create a foundation for future Tribal partnerships and collaborations.

The think tank has already provided valuable input by making Tribal environmental health issues more visible, defining the priority issues in Tribal communities, determining which NCEH/ATSDR divisions are best suited to address these issues, and highlighting successful ways to collaborate with Tribes.

OTA activities

OTA’s mission to advance environmental health among the AI/AN population includes outreach and communication activities as well as training and education opportunities. Below are recent programs in which OTA participated.

• Since 2011, OTA has been offering a training course twice a year: Working Effectively with Tribal Government (WETG). What began as an in-person course for NCEH/ATSDR staff has expanded to two additional courses offered to all CDC/ATSDR staff with more possibilities to come. Annabelle Allison, Associate Director of the Office of Tribal Affairs facilitates the course.(Read more about Annabelle)
• In August 2012, OTA participated in the NCEH/ATSDR Science Seminar, Drought: When Every Drop Counts that focused on the impacts of drought on AI/AN populations. This course quickly expanded into a four-part webinar series, to which OTA and three Tribal professionals contributed.
• In October 2012, OTA and three Tribal professionals led the fourth webinar The Public Health Implications of Drought in Tribal Communities that focused on extreme weather and educational outreach.

Throughout ATSDR’s history, the Agency and its partners have conducted environmental health investigations on Tribal lands, for example the Spokane, Fort Peck, Pine Ridge, and Hope Indian, and Umatilla Nation Reservations and the Santa Clara Pueblo. In late 2009, Congress appropriated funds for ATSDR to conduct a prospective birth cohort study in the Navajo Nation.

From 2010-2012, ATSDR awarded funds to the University of New Mexico, the Indian Health Service and the Navajo Division of Health to conduct the study and recruit participants (beginning in February 2013). The study will assess Navajo mothers for uranium/heavy metal exposure at key developmental milestones during their pregnancies. Team members will then follow their children after birth to evaluate any associated birth defects or developmental delays.

Other OTA ongoing activities include coordinating with NCEH/ATSDR environmental justice outreach and collaborating with ATSDR on Tribal petitions for health assessments, as well as providing guidance for Tribal collaborations.

The OTA continues to refine its processes for addressing the environmental health needs of AI/AN communities and Tribal members. In 2014, the NTEH Think Tank will expand to 15 Tribal environmental health professionals. Their unique perspective and input provide the OTA valuable guidance to empower tribes to build safe, healthy, and sustainable communities.