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A Systematic Review of Environmental Health Outcomes in Selected American Indian and Alaska Native Populations

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Background

Economic and social marginalization among American Indians and Alaska Natives (AI/ANs) results in higher chronic disease prevalence. Potential causal associations between toxic environmental exposures and adverse health outcomes within AI/AN communities are not well understood.

Objectives

This review examines epidemiological literature on exposure to toxicants and associated adverse health outcomes among AI/AN populations.

Methods

PubMed, Embase, Cochrane, Environment Complete, Web of Science Plus, DART, and ToxLine were searched for English-language articles. The following data were extracted: lead author’s last name, publication year, cohort name, study location, AI/AN tribe, study initiation and conclusion, sample size, primary characteristic, environmental exposure, health outcomes, risk estimates, and covariates.

Results

About 31 articles on three types of environmental exposures met inclusion criteria: persistent organic pollutants (POPs), heavy metals, and open dumpsites. Of these, 17 addressed exposure to POPs, 10 heavy metal exposure, 2 exposure to both POPs and heavy metals, and 2 exposure to open dumpsites. Studies on the Mohawk Nation at Akwesasne; Yupik on St. Lawrence Island, Alaska; Navajo Nation; Gila River Indian Community; Cheyenne River Sioux; 197 Alaska Native villages; and 13 tribes in Arizona, Oklahoma, North Dakota, and South Dakota that participated in the Strong Heart Study support associations between toxicant exposure and various chronic conditions including cardiovascular conditions, reproductive abnormalities, cancer, autoimmune disorders, neurological deficits, and diabetes.

Discussion

The complex interplay of environmental and social factors in disease etiology among AI/ANs is a product of externally imposed environmental exposures, systemic discrimination, and modifiable risk behaviors. The connection between environmental health disparities and adverse health outcomes indicates a need for further study.

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Authors and Affiliations

  1. Department of Social and Behavioral Sciences, New York University School of Global Public Health, 715/719 Broadway, New York, NY, 10003, USA

    Gabriella Y. Meltzer

  2. Department of Epidemiology, New York University School of Global Public Health, 715/719 Broadway, New York, NY, 10003, USA

    Beverly-Xaviera Watkins

  3. Health Sciences Library, New York University School of Medicine, 550 First Avenue, New York, NY, 10016, USA

    Dorice Vieira

  4. Department of Environmental Medicine, New York University School of Medicine, 341 East 25th Street, New York, NY, 10010, USA

    Judith T. Zelikoff

  5. Department of Population Health, University of California Irvine, 653 East Peltason Drive, Irvine, CA, 92697, USA

    Bernadette Boden-Albala

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GYM conceptualized the study, performed the literature search, conducted the analysis, and drafted the manuscript. BXW also conceptualized the study and performed the systematic search. JTZ, DV, and BBA added points of importance and critically revised the work.

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Meltzer, G.Y., Watkins, BX., Vieira, D. et al. A Systematic Review of Environmental Health Outcomes in Selected American Indian and Alaska Native Populations. J. Racial and Ethnic Health Disparities 7, 698–739 (2020). https://doi.org/10.1007/s40615-020-00700-2

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