Historical Environmental Racism, Structural Inequalities, and Dik’os Ntsaaígíí-19 (COVID-19) on Navajo Nation

The Navajo Nation has been disproportionately affected by Dik’os Ntsaaígíí-19 (COVID-19), with the highest per capita COVID-19 rate in the United States. While some media attention has focused on the importance of structural inequalities in understanding the heightened experiences of COVID-19 for Navajo people, we draw from Indigenous knowledge and Indigenous research paradigm to bring the need to consider the lasting legacy of historical environmental racism on Indigenous land to the current public health discourse. Specifically, we explore the potential lasting health implications of the historical environmental racism on Navajo people at the ecological level by describing the associations between abandoned uranium mines, structural inequalities (as measured by lack of grocery stores and hospitals) and COVID-19 confirmed cases on the Navajo Nation by compiling unique dataset from the Navajo Department of Health, 2014-2018 American Community Survey 5-years estimates, and the Uranium Mines and Mills Location Database from the U.S. Environmental Protection Agency. We found that population and housing characteristics do not fully explain the different COVID-19 cases among 11 counties on Diné Bikéyah, and suggest that there is a need for the holistic approach is guided by Hózhó wisdom of Navajo people that emphasize the importance of interconnectedness and whole-system in understanding the impacts of Dik’os Ntsaaígíí-19

Differential Influence of the Great Recession on Political Participation among Race and Ethnic Groups

Our study seeks to understand the role of perceived economic stress of the Great Recession on political participation among blacks, whites and Latinos. Methods. We use the 2012 Collaborative Multi-Racial Political Study and negative binomial regression to examine the impact of financial hardship on black, Hispanic, and white political participation. Results. We find that political participation among whites is unaffected by the Great Recession and is largely motivated by political interest. Blacks are mobilized by financial hardship even after controlling for political enthusiasm and linked fate. Hispanics have the lowest level of political participation. Conclusion. Overall, we conclude that the Great Recession did affect political behavior but differently across race and ethnic groups; specifically, Hispanics were least likely to politically engage if they experienced negative consequences of the Great Recession

Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders

Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.Peer reviewe

Why the federal government needs to change how it collects data on Native Americans

This January, the White House released proposals for reclassifying racial data collection in the 2030 census. Most notably, the proposals include combining race and ethnicity into a single question, as well as creating a new racial category for Middle Eastern and North African people.While these changes are welcome and will go a long way toward helping create a more accurate picture of demographic identity in the U.S., they don't improve data representation for a group that has long been misrepresented: American Indians and Alaska Natives (here collectively referred to as "Native Americans"). In particular, the way the U.S. government currently collects, aggregates, and publishes race and ethnicity data can lead to the exclusion of more than three-quarters of Native Americans from some official data sets. These practices may bias research, contribute to negative policy impacts, and perpetuate long-standing misunderstandings about Native American populations

Differential Influence of the Great Recession on Political Participation among Race and Ethnic Groups

Our study seeks to understand the role of perceived economic stress of the Great Recession on political participation among blacks, whites and Latinos. Methods. We use the 2012 Collaborative Multi-Racial Political Study and negative binomial regression to examine the impact of financial hardship on black, Hispanic, and white political participation. Results. We find that political participation among whites is unaffected by the Great Recession and is largely motivated by political interest. Blacks are mobilized by financial hardship even after controlling for political enthusiasm and linked fate. Hispanics have the lowest level of political participation. Conclusion. Overall, we conclude that the Great Recession did affect political behavior but differently across race and ethnic groups; specifically, Hispanics were least likely to politically engage if they experienced negative consequences of the Great Recession

Sex Differences in Diabetes Prevalence, Comorbidities, and Health Care Utilization among American Indians Living in the Northern Plains

Background The American Indian (AI) population experiences significant diet-related health disparities including diabetes and cardiovascular disease (CVD). Owing to the relatively small sample size of AIs, the population is rarely included in large national surveys such as the NHANES. This exclusion hinders efforts to characterize potentially important differences between AI men and women, track the costs of these disparities, and effectively treat and prevent these conditions. Objective We examined the sex differences in diabetes prevalence, comorbidity experience, health care utilization, and treatment costs among AIs within a Northern Plains Indian Health Service (IHS) service unit. Methods We assessed data from a sample of 11,144 persons using an IHS service unit in the Northern Plains region of the United States. Detailed analyses were conducted for adults (n = 7299) on prevalence of diabetes by age and sex. We described sex differences in comorbidities, health care utilization, and treatment costs among the adults with diabetes. Results In our sample, adult men and women had a similar prevalence of diabetes (10.0% and 11.0%, respectively). The prevalence of CVD among men and women with diabetes was 45.7% and 34.0%, respectively. Among adults with diabetes, men had a statistically higher prevalence of hypertension and substance use disorders than women. The men were statistically less likely to have a non–substance use mental health disorder. Although men had higher utilization and costs for hospital inpatient services than women, the differences were not statistically significant. Conclusions In this AI population, there were differences in comorbidity profiles between adult men and women with diabetes, which have differential mortality and cost consequences. Appropriate diabetes management addressing gender-specific comorbidities, such as substance use disorders for men and non–substance use mental health disorders for women, may help reduce additional comorbidities or complications to diabetes

Understanding the Associations among Social Vulnerabilities, Indigenous Peoples, and COVID-19 Cases within Canadian Health Regions

Indigenous Peoples are at an increased risk for infectious disease, including COVID-19, due to the historically embedded deleterious social determinants of health. Furthermore, structural limitations in Canadian federal government data contribute to the lack of comparative rates of COVID-19 between Indigenous and non-Indigenous people. To make visible Indigenous Peoples’ experiences in the public health discourse in the midst of COVID-19, this paper aims to answer the following interrelated research questions: (1) What are the associations of key social determinants of health and COVID-19 cases among Canadian health regions? and (2) How do these relationships relate to Indigenous communities? As both proximal and distal social determinants of health conjointly contribute to COVID-19 impacts on Indigenous health, this study used a unique dataset assembled from multiple sources to examine the associations among key social determinants of health characteristics and health with a focus on Indigenous Peoples. We highlight key social vulnerabilities that stem from systemic racism and that place Indigenous populations at increased risk for COVID-19. Many Indigenous health issues are rooted in the historical impacts of colonization, and partially invisible due to systemic federal underfunding in Indigenous communities. The Canadian government must invest in collecting accurate, reliable, and disaggregated data on COVID-19 case counts for Indigenous Peoples, as well as in improving Indigenous community infrastructure and services

Social determinants of obesity in American Indian and Alaska Native peoples aged ≥ 50 years.

ObjectiveAmerican Indian and Alaska Native peoples (AI/ANs) have a disproportionately high rate of obesity, but little is known about the social determinants of obesity among older AI/ANs. Thus, our study assessed social determinants of obesity in AI/ANs aged ≥ 50 years.DesignWe conducted a cross-sectional analysis using multivariate generalized linear mixed models to identify social determinants associated with the risk of being classified as obese (BMI ≥ 30.0 kg/m2). Analyses were conducted for the total study population and stratified by median county poverty level.SettingIndian Health Service (IHS) data for AI/ANs who used IHS services in FY2013.Participants27,696 AI/ANs aged ≥ 50 years without diabetes.ResultsMean BMI was 29.8 ± 6.6 with 43% classified as obese. Women were more likely to be obese than men, and younger ages were associated with higher obesity risk. While having Medicaid coverage was associated with lower odds of obesity, private health insurance was associated with higher odds. Living in areas with lower rates of educational attainment and longer drive times to primary care services were associated with higher odds of obesity. Those who lived in a county where a larger percentage of people had low access to a grocery store were significantly less likely to be obese.ConclusionsOur findings contribute to the understanding of social determinants of obesity among older AI/ANs and highlight the need to investigate AI/AN obesity, including longitudinal studies with a life course perspective to further examine social determinants of obesity in older AI/ANs

American Indian Alaska Native (AIAN) adolescents and obesity: the influence of social determinants of health, mental health, and substance use

ObjectiveTo explore the prevalence of obesity among American Indian and Alaska Native (AIAN) adolescents aged 12-19 years in association with social determinants of health (SDOH), and mental health and substance use disorders.MethodsGuided by the World Health Organization's Social Determinants of Health Framework, we examined data from the Indian Health Service (IHS) Improving Health Care Delivery Data Project from Fiscal Year 2013, supplemented by county-level data from the U.S. Census and USDA. Our sample included 26,226 AIAN adolescents ages 12-19 years. We described obesity prevalence in relationship to SDOH and adolescents' mental health and substance use disorder status. We then fit a multivariable logit generalized linear mixed model to estimate the relationships after adjusting for other individual and county level characteristics.ResultsWe observed a prevalence of 32.5% for obesity, 13.8% for mental health disorders, and 5.5% for substance use disorders. Females had lower odds of obesity than males (OR = 0.76, p < 0.001), which decreased with age. Having Medicaid coverage (OR = 1.09, p < 0.01), residing in a county with lower education attainment (OR = 1.17, p < 0.05), and residing in a county with higher rates of poverty (OR = 1.51, p < 0.001) were each associated with higher odds of obesity. Residing in a county with high access to a grocery store (OR = 0.73, p < 0.001) and residing in a county with a higher proportion of AIANs (OR = 0.83, p < 0.01) were each associated with lower odds of obesity. Those with mental health disorders had higher odds of obesity (OR = 1.26, p < 0.001); substance use disorders were associated with decreased odds of obesity (OR = 0.73, p < 0.001).ConclusionsOur findings inform future obesity prevention and treatment programs among AIAN youth; in particular, the need to consider mental health, substance use, and SDOH