NEHA November 2022 Journal of Environmental Health

32 Volume 85 • Number 4 A D VANC EME N T O F T H E PRACTICE Alyssa Wooden, MHS Gina Bare, RN Jesse C. Bliss, MPH David T. Dyjack, DrPH, CIH National Environmental Health Association Introduction American Indian/Alaska Native (AI/ AN) populations experience widespread health disparities, including lower life expectancies and higher rates of chronic diseases than the U.S. population (Indian Health Service, 2019). Because AI/AN communities are often located in rural areas, they can encounter di‚culties accessing medical care or public health services (Boccuti et al., 2014). Tribal communities are especially vulnerable to environmental hazards such as exposure to toxic substances and disasters including wildfires, heat waves, and droughts. In addition, many tribal communities are in the southern and western U.S., where the adverse impacts of climate change are strongest (NortonSmith et al., 2016). Despite limited funding and awareness, many tribal health agencies have implemented environmental health programs and services to address these issues. In 2022, the National Environmental Health Association, (NEHA), in partnership with the Centers for Disease Control and Prevention (CDC) and Agency for Toxic Substances and Disease Registry (ATSDR), hosted the American Indian/Alaska Native Environmental Health Recognition Awards to elevate and raise awareness of these e‘orts. The awards sought to recognize tribal agencies or tribal colleges or universities that had developed a unique environmental health program, strategy, or initiative. Award submissions were solicited during April and May 2022 and were evaluated based on how well the program addressed health equity gaps, enhanced capacity of the environmental health workforce, and incorporated indigenous ways of knowing, among other criteria. Ultimately, three award submissions were selected for the Gold, Silver, and Bronze Awards. In addition to sharing their stories with NEHA, each winner also participated in a panel discussion at the NEHA 2022 Annual Educational Conference & Exhibition. The panel was moderated by Dr. Patrick Breysse, director of the National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry (NCEH/ATSDR) within CDC. “NCEH/ATSDR is committed to addressing environmental health concerns within the American Indian/Alaska Native communities,” Breysse said. “Our hope is that all communities across America that are disproportionately bearing the brunt of environmental hazards and injustices have equal opportunity to thrive in healthy environments.” Gold Award Winner Northwest Portland Area Indian Health Board The Northwest Portland Area Indian Health Board (NPAIHB) provides public health services to the 43 federally-recognized tribes in Oregon, Idaho, and Washington. In 2020, NPAIHB entered into a Public Law 93-638 Title I contract with the Portland Area Indian Health Service (IHS) to assume the responsibility and funding for delivering the Environmental Public Health (EPH) Program. This program aims to assess environmental conditions and implement interventions to prevent environmentally caused disease or injury. In addition to the annual IHS contract funding, the program receives funding from CDC, the U.S. Environmental Protection Agency, and the Oregon Health Authority. To identify the areas of greatest need within the tribal communities served by NPAIHB, EPH Program sta‘ gathered data via community environmental health assessments (CEHAs). Holly Thompson Du‘y, environmental health science manager of the EPH Program, described the variety of indicators collected in the CEHAs. “We have social factors [such as] socioeconomic status...household composition, housing, and transportation,” she said. “And then we have di‘erent kinds of ecosystem threats and pressures like toxic emissions, issues with food and water, outdoor air quality indicators, indoor air quality indicators, drinking water indicators, stream water quality ones.” Additionally, the CEHAs facilitate the collection of data on health outcomes such as gastrointestinal issues, vectorborne diseases, childhood lead poisoning, asthma, and cancer, as well as tribal public health policies and programs. EPH Program sta‘ plan to conduct these assessments every 5 years and evaluate trends over time. The EPH Program also works to incorporate tribal traditional ecological knowledge into programs and services. Celeste Davis, director of the EPH Program, explained the process of collecting this knowledge. “It starts with talking with each of the tribes and asking them to identify traditional knowledge keepers. Once those individuals in the tribal community are identified, then we set up interviews with them,” Davis said. “Ultimately, we would like to create a code book around traditional ecological knowledge, and we want to use it to inform our practices.” Davis added that EPH Program sta‘ typically identify around 10 traditional knowledge keepers in each community and provide each participant with an honorarium or gift card. Conducting CEHAs and collecting traditional ecological knowledge has allowed American Indian/Alaska Native Environmental Health Programs and Strategies  F E AT U R E S T O RY