Margaret J. Eggers

American Indian communities may be at increased risk of water-related PFAS exposure. However, communicating the health risks of PFAS exposure requires attention to concepts of health literacy and aligning educational messages with the community’s understanding of health. The purpose of this study was to determine the health literacy demand of PFAS educational materials, with specific attention to their appropriateness for American Indian communities. Publicly available PFAS educational materials were evaluated using the Simple Measure of Gobbledygook (SMOG), the Patient Education Material Assessment Tool (PEMAT), and a cultural appropriateness tool. The mean reading level of the materials was above 12th grade. The PEMAT scores for the 33 print materials were 62% (understandability), 34% (actionability), and 61% (cultural appropriateness). For the videos, the scores were 62% (understandability), 53% (actionability), and 68% (cultural appropriateness). Neither the print nor the video materials met acceptable health literacy standards, meaning the materials are not well-designed for a variety of health literacy levels. There was a lack of actionable directives that should be addressed in future PFAS educational materials. This study highlights the importance of working closely with community partners to develop education materials that match the skills and preferences of the intended audience.

We assessed potential exposures to a broad suite of contaminants (inorganic, organic and microbial) in culturally important surface waters from three watersheds in a northern plains Native American community (Apsáalooke [Crow Tribe of Montana]) in south-central Montana, United States, with water insecurity concerns. Inorganic (37), organic (435) and microbial (3) constituents were assessed in 12 surface water sites from the Pryor Creek (n = 2), Bighorn River (n = 2) and Little Bighorn River (n = 8) valleys. Twenty-six organics, 33 inorganics and Escherichia coli were detected. Despite relatively low concentrations in surface waters within the Crow Reservation, mixture toxicity indicated prevalent chronic ecological effects and human-health secondary contact (recreation) effects at multiple sites. Further, to address Tribal concerns over the prevalence and corresponding risks of per- and polyfluoroalkyl substances (PFAS), we sampled water, sediment, biofilms and fish at a limited number of locations in the Little Bighorn River. Results indicated that PFAS were prevalent in fish tissues, including whole blood and filets, and to a lesser extent in biofilms, despite few detections in water and sediment samples. This is the first attempt to document environmental PFAS contamination within the reservation and the potential human-health concerns for the general population from consumption of recreational/subsistence fish. Overall, this effort provided preliminary information on the contaminant mixtures present and their potential health implications, which can support the protection of community health and culturally meaningful resources across the Crow Reservation.

The authors provide an example of how an Environmental Health Literacy framework can be used to understand the movement of communities from identifying environmental health risks through addressing environmental health inequities. The Guardians of the Living Water program, an Indigenous-­led research partnership, used such a framework, complemented by a community-­based participatory approach to address local water-­related environmental health inequities. The authors highlight three recommendations for promoting equitable environmental health education and research. First, community–academic partnerships can support the development of clear, culturally appropriate environmental education and research efforts. Second, engaging youth in environmental research and education can be an effective way to reach the broader community. And third, using a strengths-­based approach to environmental education and research provides equitable opportunities for Indigenous youth to see themselves as scientists engaging in locally relevant STEM education. Community engagement was central to the success of the ongoing efforts in the Apsáalooke community, including the Guardians program.

Title First Author Type Visibility 3 days ago New approach to assessing cumulative human health risk from consuming home well water, using public data - Montana case study - Data and Code

Affordable access to safe drinking water is essential to community health, yet there is limited understanding of water insecurity among Native Americans. Therefore, the focus of this paper is to describe Apsáalooke (Crow Indian) tribal members’ experiences with water insecurity. For Apsáalooke people, local rivers and springs are still vitally important for traditional cultural activities. We interviewed 30 Native American adults living on the Crow Reservation in Southeastern Montana. Participants answered six open-ended interview questions about their water access, costs of obtaining water and changes in their domestic and traditional water uses. Participants emphasized how the use of water has changed over time and described the complex challenges associated with addressing water insecurity in their community, including the importance of considering the spiritual and cultural impacts of water insecurity on health. Water insecurity is a growing global problem and more attention and efforts are needed to find appropriate and affordable solutions.

It is well established that climate change is already causing a wide variety of human health impacts in the United States and globally, and that for many reasons Native Americans are particularly vulnerable. Tribal water security is particularly threatened; the ways in which climate changes are damaging community health and well‐being through impacts on water resources have been addressed more thoroughly for Tribes in coastal, arid, and sub‐arctic/arctic regions of the United States. In this article, Crow Tribal members from the Northern Plains describe the impacts of climate and environmental change on local water resources and ecosystems, and thereby on Tribal community health and well‐being. Formal, qualitative research methodology was employed drawing on interviews with 26 Crow Tribal Elders. Multiple determinants of health are addressed, including cultural, social, economic, and environmental factors. The sense of environmental‐cultural‐health loss and despair at the inability to address the root causes of climate change are widespread. Yet the co‐authors and many other Tribal members are actively prioritizing, addressing, and coping with some of the local impacts of these changes, and are carrying on Apsáalooke [Crow] lifeways and values.

The Little Bighorn River is the primary source of water for water treatment plants serving the local Crow Agency population, and has special significance in the spiritual and ceremonial life of the Crow tribe. Unfortunately, the watershed suffers from impaired water quality, with high counts of fecal coliform bacteria routinely measured during run-off events. A metagenomic analysis was carried out to identify potential pathogens in the river water. The Oxford Nanopore MinION platform was used to sequence DNA in near real time to identify both uncultured and a coliform-enriched culture of microbes collected from a popular summer swimming area of the Little Bighorn River. Sequences were analyzed using CosmosID bioinformatics and, in agreement with previous studies, enterohemorrhagic and enteropathogenic Escherichia coli and other E. coli pathotypes were identified. Noteworthy was detection and identification of enteroaggregative E. coli O104:H4 and Vibrio cholerae serotype O1 El Tor, however, cholera toxin genes were not identified. Other pathogenic microbes, as well as virulence genes and antimicrobial resistance markers, were also identified and characterized by metagenomic analyses. It is concluded that metagenomics provides a useful and potentially routine tool for identifying in an in-depth manner microbial contamination of waterways and, thereby, protecting public health.