Promoting Environmental Health
 in Native American Communities:
 A Webinar Series Addressing the Environmental
Health and Exposure Concerns of North American
        Native Subsistence Populations
      4>EPA
United States
Environmental Protection
Agency
                  Sponsored by the
EPA's STAR Research Grants Program and the National EPA-Tribal Science Council
   with additional support from EPA Office of Children's Health Protection and
     Environmental Education and the Human Health Research Program

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                   United States
                   Environmental Protection
                   Agency
                            Executive  Summary
The Environmental Protection Agency's (EPA) STAR
Research Grants Program, in partnership with the National
EPA-Tribal Science Council, conducted a webinar series
designed to translate and disseminate recent findings of
previous and current STAR-funded research addressing
the environmental health and exposure concerns of North
American Native subsistence populations. Additional
support for the project was provided by the EPA Office of
Children's Health Protection and Environmental Education
and the Human Health Research Program.

The series highlighted research goals and preliminary
findings of newly awarded projects focused on cumulative
risk and climate change. These projects may particularly
appeal to those interested in novel risk assessment methods
or the potential direct and indirect impacts of global
warming on the health outcomes to Alaska Natives. The
results discussed in these webinars may be of particular
interest to Agency risk assessors, Tribal environmental
managers, and Tribal health care practitioners.

The series consisted of four webinars conducted from
June 30, 2009 to December 10, 2009:
              "Eco-social Cultural Mapping: Tribal
              Lifestyles and Environmental Risks,"
              June 30, 2009.
              "Alaska Tribal Berry Resources and
              Human Health Under the Cloud of
              Climate Change," October 14, 2009.

              "Community-Based Risk Assessment
              of Exposure to Contaminants via Water
              Sources on the Crow Reservation in
              Montana," November 18, 2009.

              "Climate Change and Contaminants
              in Subsistence Foods: A Tribal Program
              to Monitor the Health of Alaska
              Yupik Women and Children,"
              December 10, 2009.
Overview of the Research
Many traditional North American Native Tribal Populations
maintain intricate and ecologically interdependent
relationships with the natural environment. Though many
of these relationships developed over centuries, with
knowledge and skills accumulated and passed across scores
of generations, the rapid emergence of industrial chemical
pollution; the availability of refined, processed foods; and
social and political isolation have severely threatened the
health, wellness, and way of life of individuals and entire
Tribal communities in the United States.

Recently, there has been increased emphasis on
encouraging traditional diets, religious practices, and
customs to restore and protect the health and knowledge
base of Tribal communities, while concomitantly
addressing issues of environmental pollution, social
justice, and sovereignty. This seminar series featured
Tribal communities and their research partners conducting
dietary exposure, cumulative risk, climate change health
effects, and risk reduction research that aimed to quantify
and reduce environmental risks and to encourage or restore
traditional, healthy ways of life for American Native
communities.

Specific objectives of the Webinar Series included:
1.  Understanding and reviewing research findings.

2.  Exploring new strategies, methods, and tools for
   assessing environmental health exposure among
   Tribal populations.

3.  Identifying research opportunities for advancing
   health protection and maintaining traditional
   Tribal ways of life.

The following pages provide one-page summaries of
each webinar. To read a complete summary or to view the
webinars, visit http://www.epa.gov/osp/tribes/events.htm.

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   &EPA
United States
Environmental Protection
Agency
                                        Webinar Series
        Promoting  Environmental  Health  in
              Native  American  Communities
                Eco-social Cultural Mapping: Tribal Lifestyles and Environmental Risks —
          Regional Tribal Exposure Scenarios Based on Ecological Zones and Traditional Lifeways
           Barbara Harper,1'2 Anna Harding,1 Therese Waterhous,1 Anthony Wilcox,1 and Stuart Harris2
                                            June 30, 2009
                   This project systematically described
                   how Tribal people interact with
                   the environment and how they
                   might be exposed to environmental
                   contaminants. The initial driver was
                   the lack of exposure scenarios and
                   exposure factors for use in Superfund
                   risk assessments where Tribes and
                   Tribal resources are affected.
Tribal communities engage in active, outdoor lifestyles in
all climates, with greater environmental contact rates in
comparison to members of the suburban community. Diets
of each Tribe are based on the natural resources present and
the unique cultural uses. Consequently, most Tribal exposure
factors are higher than EPA default rates.

Exposures occur through food and medicine intake as well
as through cultural, ceremonial, and occupational practices
of Tribal members. Data were taken in consideration of the
whole-life scenario—that is, data from full-time residents, not
those with recreational status—and analyses were conducted
assuming nutritionally complete diets for accurate statistical
plotting.

Researchers operated under the basic concepts of ecology,
cultural quality of life, a broader definition of health,
contemporary suppression of resource use, and reconstruction
of traditional lifeways. Researchers considered the
biodiversity, landscapes, critical habitat, and human use of
the local environment to determine food chain concentrations
and socio-cultural exposures for evaluating eco-risk to the
population.

The researchers recognized that contemporary suppression
of resource use would have to be considered when collecting
data. Local fish advisories, contaminated sites, and rights
of access issues could restrict use and consumption and
associated exposures, so real-time subsistence lifestyles and
diets were measured for risk assessment. The outcomes would
help target restoration efforts of the natural resources.
                                  To reconstruct traditional lifeways and natural resources,
                                  researchers conducted culturally competent interviews and
                                  reviewed anthropological literature that included traditional
                                  ecological knowledge, physiology, culture, ecology, ethno-
                                  botany, language and oral tradition, and exposure science.
                                  Major food groups were used to categorize caloric intake,
                                  and consumption and exposure rates were estimated based
                                  on cultural activities. This holistic overview approach to data
                                  collection was used, versus simple food consumption surveys
                                  to attain precise and accurate study results, and these multiple
                                  lines of evidence were peer-reviewed for a more robust and
                                  confident conclusion.

                                  This research was conducted solely for the benefit of the
                                  Tribe, so it was critical to ensure their willing participation.
                                  An advisory board consisting of Tribal and technical members
                                  ensured that the communities were involved, informed
                                  (informed consent) and in control of the data (intellectual
                                  property). True informed consent was obtained after members
                                  were apprised of how the data would be used and potential
                                  misuse of the data was explained fully.
                                  1 Oregon State University
                                  2 Confederated Tribes of the Umatilla Indian Reservation

                                  To read a complete summary or to
                                  view and/or listen to the webinar, visit
                                  http://www.epa.gov/osp/tribes/events.htm.
 Sponsored by the EPA's STAR Research Grants Program and the National EPA-Tribal Science Council with additional support
  from EPA Office of Children's Health Protection and Environmental Education and the Human Health Research Program

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   &EPA
United States
Environmental Protection
Agency
                                        Webinar Series
        Promoting Environmental  Health  in
              Native American  Communities
          Alaska Tribal Berry Resources and Human Health Under the Cloud of Climate Change
                   Mary Ann Lila, Ph.D.,1 Courtney G. Flint, Ph.D.,2 Gary Ferguson, N.D.3
                                          October 14, 2009
                  This project investigated the potential
                  health and medical benefits of
                  wild berries to Alaska Natives in
                  three coastal communities. Wild
                  Alaska Berries (salmonberries, bog
                  blueberries, blue huckleberries, and
                  blackberries/crowberries/mossberries)
                  are a rich part of many Alaska Native
                  people's Tribal resources, and they
produce beneficial biological compounds in response to the
stresses they undergo during growth in the harsh climate. The
research team worked with students and community members
to look at the role berries play in the lives, lifestyle, and
culture of Native Americans in each community.

The participating communities—Seldova, Akutan, and Point
Hope—are located along three distinctive coastal areas of
Alaska. Each one has a complement of berries keyed to the
                                 Field screening of the berries was conducted under the
                                 Screens-to-Nature (STN) program to measure health benefits
                                 and help students and elders learn first-hand how the
                                 chemistry of wild berries makes them healthy for humans.
                                 The STN technology tested for amylases and amylase
                                 inhibitors; proteases and protease inhibitors; and antioxidants.
                                 Scientific analyses of the berries  indicated that the amylase-
                                 inhibiting activity of berries slows down the process of
                                 turning starch into sugar (i.e., it has an important impact
                                 on diabetes); berries contain varying levels of antioxidants;
                                 and protease inhibitors in berries may help fight HIV/AIDS,
                                 parasitic diseases, and metabolic disorders.

                                 Alaska Natives were engaged to  assess their overall opinions
                                 and perspectives on their communities, including the risks
                                 and challenges they face from climate change, environmental
                                 contamination, threats to subsistence resources, as well as
                                 their concerns about their health  and the vitality of their local
health and economic benefits of the community. Berries are
important for food, physical activity, sharing with family
and friends, and keeping traditions alive. They are eaten in a
variety of ways and stored for winter. Berries generally are
considered healthy, but specific benefits are not very well
known in the communities. Berries produced under stress
offer enhanced health benefits to humans.

The project was conducted within a Community Based
Participatory Research (CBPR) framework. CBPR involves
collaboration that equitably includes community members,
organizational representatives, and researchers in the project.
The research team combined biological and social sciences,
community participation, and integrated inquiry.
                                 economies. Each community has concerns about diabetes,
                                 cancer, and unhealthy diets.
                                 In all three communities, Tribal health issues were linked to
                                 the loss of a traditional way of life and a decreased emphasis
                                 on subsistence resources and foods. Many factors prevent
                                 the subsistence lifestyle. The influence of Western culture on
                                 Alaska Native youth and the high cost of fuel are also altering
                                 the cultural landscape.
                                  1 North Carolina State University
                                  2 University of Illinois
                                  3 Alaska Native Tribal Health Consortium

                                  To read a complete summary or to
                                  view and/or listen to the webinar, visit
                                  http://www.epa.gov/osp/tribes/events.htm.
 Sponsored by the EPA's STAR Research Grants Program and the National EPA-Tribal Science Council with additional support
  from EPA Office of Children's Health Protection and Environmental Education and the Human Health Research Program

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                  United States
                  Environmental Protection
                  Agency
                                        Webinar Series
        Promoting Environmental  Health  in
              Native American  Communities
                    Community Based Risk Assessment of Exposure to Contaminants
                         via Water Sources on the Crow Reservation in Montana
                        Crescentia Cummins,1'2 Timothy Ford, Ph.D.,3 John Doyle,2'4'5
                        Larry Kindness,1'2'4 Urban Bear Don't Walk,2'4'6 Mari Eggers1'7
                                         November 18, 2009
                  This research project developed a risk
                  assessment program focusing on the
                  contamination of water sources on
                  the Crow Reservation in Montana.
                  Water, wastewater, and aquatic
                  subsistence foods were collected and
                  analyzed, and contamination from
                  toxic substances in drinking water
and surface water sources were evaluated. These data are
being combined with an investigation into contemporary and
traditional uses of water in the Crow community.

LifeLine Tribal risk assessment modeling software will
be used to assess the overall risks to the community from
contaminated water sources. Potential outcomes from this
research include a better understanding of the environmental
risks of water sources associated with a subsistence-based
lifestyle of Tribal populations. Also, through community-
based participation, this research may help improve Tribal
capacity to manage and protect environment and health
through health education and other risk communication
measures.

The Crow Indian Reservation, located in south-central
Montana, encompasses 2.8 million acres and has a
population of about 8,000 people. Although much of the
Reservation is rangeland, it does include a significant
amount of agricultural land.

Water has  always been a treasured resource in the Crow
community, and traditions and history surrounding water
are still honored and practiced today. Rivers and springs
continue to be used in many ceremonial practices and
recreational purposes, including in the Native American
Church, the Sun Dance, and Sweat Lodge ceremonies.
However,  water quality on the Reservation has deteriorated
over the past 50 years, and, today, degradation of water
quality is the community's top environmental health
concern.
This research project employed a Community-Based
Participatory Research (CBPR) model, which is defined
as "[a] collaborative approach to research that equitably
involves, for example, community members, organizational
representatives, and researchers in all aspects of the research
process."

The data from this project has helped the Apsaalooke Water
and Wastewater Authority move into the next phase of its
work, replacing wastewater lagoons and repairing water lines.
The Authority is in the process of raising funds for Phase 3,
which will include funds for drilling new drinking water wells
and expansion of Little Big Horn College's health education
facility.
1 Little Big Horn College
2 Crow Tribal member
3 University of New England
4 Apsaalooke Water and Waste water Authority; Crow Environmental Health
 Steering Committee
5 Big Horn County Commissioner; Big Horn County Health Board
6 Legal counsel for the Crow Indian Nation
7 Montana State University

To read a complete summary or to view and/or listen to the
webinar, visit http: //www. epa. gov/osp/tribe s/e vents .htm.
 Sponsored by the EPA's STAR Research Grants Program and the National EPA-Tribal Science Council with additional support
  from EPA Office of Children's Health Protection and Environmental Education and the Human Health Research Program
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   &EPA
United States
Environmental Protection
Agency
                                       Webinar Series
        Promoting Environmental  Health  in
             Native American Communities
              Climate Change and Contaminants in Subsistence Foods: A Tribal Program to
                       Monitor the Health of Alaska Yupik Women and Children
                                       James E. Berner, M.D.1
                                        December 10, 2009
                  Dr. James E. Berner directs the
                  Alaska Native Traditional Food Safety
                  Monitoring Program, which assesses
                  contaminant and micronutrient levels
                  in pregnant Alaska Native women and
                  evaluates health effects in mothers
                  and newborn infants. In this webinar,
                  Dr. Berner describes the climate
                  changes taking place in Alaska and
the contaminants these changes are bringing to Alaska. He
discusses the impacts climate change and contaminants are
having on the health of pregnant Alaska Yupik women and on
subsistence food safety.

Health impact mechanisms on the Native Alaska people
because of climate change and contaminants in the Arctic
include:
• The effect of contaminant transport on subsistence foods.
• The spread of zoonotic disease (diseases animals can give
  to people).
• Damage to permafrost-dependent infrastructure.
• Unintentional injury.
• Extreme weather events.

Subsistence food safety is essential to the Alaska Native
population in the following ways:
• Rural Alaska Natives are the most subsistence dependent
  population in the United States.
• Accumulation of organic contaminants in the food web
  biomagnifies and bioaccumulates, and the developing fetus
  and pregnant women are most sensitive to the toxicologic
  effects of contaminants and heavy metals.
• Traditional food has public health and culture benefits.
• Transport of contaminants by ocean, river, and atmospheric
  mechanisms may be increased by a warming climate.

Food safety issues surrounding contaminants include
persistent organic pollutants and heavy metals that are
present and threaten food safety, including mercury, lead,
arsenic, and cadmium.
                                 This research attempted to discover the human toxicological
                                 effects of climate change and contaminants in the Arctic on
                                 subsistence food safety, including negative effects on Native
                                 people in terms of growth, neurologic development; endocrine
                                 disruption; immunologic effects; and adult chronic disease,
                                 which might turn out to be the most common effect of all.

                                 In a comparison of women in the Yukon-Kuskokwim Delta to
                                 other populations along the Arctic coast, the blood levels of
                                 persistent organic compounds in circumpolar pregnant women
                                 were less than or about average for the group. However, the
                                Yupik population had substantially higher omega-3 fatty acid
                                levels than any other pregnant Inupiat women on Alaska's
                                Arctic Ocean coast, and future studies will consider the risk
                                and balance of these levels of fatty
                                acids in the diet of pregnant women.
                                 1 Division of Community Health Services, Alaska
                                 Native Tribal Health Consortium, Anchorage, AK
                                 To read a complete summary or to view
                                 the webinar, visit http://www.epa.gov/osp/tribes/events.htm.
 Sponsored by the EPA's STAR Research Grants Program and the National EPA-Tribal Science Council with additional support
  from EPA Office of Children's Health Protection and Environmental Education and the Human Health Research Program

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