NEHA November 2022 Journal of Environmental Health

November 2022 • Journal of Environmental Health 33 EPH Program sta to prioritize activities and ensure that services are culturally appropriate. Over the past 2 years, EPH Program services have included COVID-19 response, emergency management, occupational health, housing and septic system remediation, energy sovereignty, and more. Davis is pursuing funding to implement a climate and health program in the near future. “The Indian Health Service does not fund climate change and it’s not part of what they consider their environmental health services. But that doesn’t stop us from looking at it as the existential crisis of our lifetime,” she said. “We have done some key informant interviews of Oregon and Idaho tribes to understand what their environmental health priorities are, and climate change obviously came out as one of those issues.” Du y has been developing a 4-year work plan for a future climate and health program. She explained that for the first couple of years, the EPH Program will be doing an assessment of the work that tribal communities are currently doing regarding climate and what their needs are. “The goal is to shift into identifying indicators of climate and health for tribal health departments and to work with clinics to determine these indicators of climate change that can be tracked and managed and assessed over time,” she stated. “And then there’s a component of incorporating traditional ecological knowledge into those indicators.” In addition to climate services, the EPH Program also plans to expand its home visit programs to address elevated blood lead levels and asthma and provide sampling services for private wells. NPAIHB Institutional Environmental Health Manager Matthew Ellis will work to address environmental health and infection prevention in the healthcare sector, as well as occupational hazards for tribal workers in other industries. Davis explained that because there are so few resources for tribal environmental health, it is di‘cult to maintain an adequate tribal health workforce. “There’s quite a bit of turnover,” she said. “Most [tribal agencies] want to hire professional people with credentials, but trying to hire someone with an REHS [Registered Environmental Health Specialist] in a rural place—whether you’re a county or a tribe—is challenging. Tribes often hire someone who came from a county health department. But sometimes it’s not the right fit. For whatever reason, working in a tribal community just doesn’t work.” To address this workforce shortage, EPH Program sta hope to identify individuals in the community who are interested in becoming tribal environmental health specialists. “What we’re trying to do right now is just talk about the basic skill sets [we] want for someone and then see if we can help mentor and work with them,” Du y explained. Davis added that although it has been difficult at times to communicate the importance of environmental health services to tribal communities, the EPH Program has ultimately succeeded in building trust and providing services that have not been previously accessible. “I do feel that because of our work in COVID-19, we have gained trust,” she stated. “It’s taken a while to get everybody on board. It’s challenging to build a program from the ground up. We are just barely 2 years into it as a program, so as far as I’m concerned, I think we’re doing fantastic.” For tribal communities that are interested in implementing their own environmental health programs, Davis recommends looking to CDC, IHS, and other nations that have established environmental health programs for guidance and resources. Tribal communities can also reach out directly to Davis. Davis stressed that while collaboration with nontribal organizations or agencies on environmental health programs is appreciated, it is important for these organizations to receive cultural sensitivity training and to respect tribal sovereignty. Du y noted that every tribal community is unique and outside organizations should be sensitive to these di erences when working with them. She also highlighted the importance of identifying advocates for environmental health. “It’s all about finding champions within the communities: who can really take what you’re saying and advocate for it within the community. And you rarely get that in the first person that you talk to and so that persistence—but being polite and respectful in following up—is critical as well,” she said. Ultimately, Davis and her colleagues believe that the EPH Program has been largely successful because it is a tribal-run program, and thus has a unique understanding of the environmental health needs of the community. In the future, EPH Program sta plan to focus on bringing together public health professionals across NPAIHB to build a community of practice and mobilize collective action. By incorporating empirical data, community participation, and tribal ecological knowledge, the EPH Program aims to eliminate environmental hazards and health inequities and ensure the health, sustainability, and sovereignty of tribal communities in the Portland area. This section was based on an interview with NPAIHB sta Celeste Davis, Holly Thompson Du y, Matthew Ellis, and Melino Gianotti. Other NPAIHB sta involved in the EPH Program include Senior Environmental Health Specialist Shawn Blackshear, Environmental Health Scientist Ryan Sealy, Environmental Health Specialist Antoinette Ruiz, Environmental Health Informatics Specialist Nicole Smith, and Environmental Health Specialist Lela Rainey Brown. Silver Award Winner Albuquerque Area Southwest Tribal Epidemiology Center The Albuquerque Area Southwest Tribal Epidemiology Center (AASTEC), founded in 2006, serves 27 nations in the IHS Albuquerque Area. In 2016, AASTEC established the Tribal Healthy Homes Project (THHP) that aims to identify and survey tribal homes for indoor air quality exposures, chronic health conditions, and potential injury risk factors. Dr. Sheldwin Yazzie, deputy director of AASTEC, explained that THHP arose out of an interest among AASTEC sta to expand environmental health work with tribal communities. An environmental health survey disseminated by AASTEC in 2017 to tribal community partners in the IHS Albuquerque Area identified home radon exposure as a concern, which led to the development of THHP. The project has received funding from IHS, the University of New Mexico Center for Native Environmental Health Equity Research, and CDC. AASTEC sta used a community-based participatory approach to design the project, which involved identifying key stakeholders in each tribal community to design and implement a customized home assessment tool. Dr. Joseph Hoover, a faculty member in the Department of Environmental Science, faculty associate with the Indigenous Resilience

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