Tribal Environmental Public Health Indicators

EPA Grant Number: R834791
Title: Tribal Environmental Public Health Indicators
Investigators: Donatuto, Jamie
Current Investigators: Donatuto, Jamie , Campbell, Larry
Institution: Swinomish Indian Tribal Community
EPA Project Officer: Nolt-Helms, Cynthia
Project Period: July 1, 2011 through June 30, 2013 (Extended to June 30, 2014)
Project Amount: $235,517
RFA: Exploring Linkages Between Health Outcomes and Environmental Hazards, Exposures, and Interventions for Public Health Tracking and Risk Management (2009) RFA Text |  Recipients Lists
Research Category: Human Health , Health


The overarching goals of the proposed research plan are to create and test environmental public health indicators (EPHIs) specific to Native American tribal communities in the Puget Sound/ Salish Sea region of the Pacific Northwest. The hypothesis being tested is that the public health of Native American communities is more accurately evaluated when the health indicators employed reflect Native American definitions of health. The objectives of the proposed research are:

(1) to establish a set of environmental public health indicators for Coast Salish communities in the Puget Sound region that reflect the communities’ meanings and prioritizations of health;

(2) to test the tribal–specific indicator set by employing it to assess the health status of the tribal communities; and,

(3) to evaluate the efficacy of the tribal-specific indicator set by reviewing the health status results with tribes.


Representatives of Puget Sound area tribes will elucidate the key tribal-specific public health indicators using existing data garnered from: initial work in developing tribal health indicators; published literature on the key aspects of Native American health as stated by tribes and experts across the country; ethnographic records; and, past interviews with tribal experts and elders. The qualitative data will be coded, which allows for difficult-to-quantify, often intangible information to be grouped together and compared with descriptive scales in a comprehensible manner (e.g., low to high) in order to determine the primary indicators. The indicators will then be ranked using a swing weighting method. Once the indicators and their rankings have been properly weighted, the results will be presented to the tribal councils of the participating tribes for review.

Expected Results:

Tribal-specific EPHIs are necessary because current U.S. government public health regulations and policies are based on a position that views risks and impacts as objective measures of dose-response assessments and physiological morbidity or mortality outcomes but does not otherwise connect them to social or cultural beliefs and values integral to Native American definitions of health. For many Native American communities, the issue of how health is defined and assessed in policies and regulations is a high priority because of the considerable environmental public health risks they face from the contamination of their territories and natural resources. By constructing a more complex, narrative set of indicators beyond the physiological for tribal communities, a more accurate picture of health status is gained with which to better evaluate and manage tribal public health risks and impacts.

Publications and Presentations:

Publications have been submitted on this project: View all 3 publications for this project

Journal Articles:

Journal Articles have been submitted on this project: View all 3 journal articles for this project

Supplemental Keywords:

risk assessment, risk management, seafood, fish consumption,

Progress and Final Reports:

  • 2011 Progress Report
  • 2012 Progress Report
  • 2013 Progress Report
  • Final Report