Grantee Research Project Results

Final Report: New Mexico Center for Advancement of Research, Engagement, & Science on Health Disparities (NM CARES HD) - Environmental Health Core

EPA Grant Number: NIMHD009
Title: New Mexico Center for Advancement of Research, Engagement, & Science on Health Disparities (NM CARES HD) - Environmental Health Core
Investigators: Williams, Robert L , Gonzales, Melissa , Lewis, Johnnye Lynn , Scott, Amy Anixter , Page-Reeves, Janet , Moffett, Mark , Apodaca, Veronica D , Hudson, Laurie , Liu, Jim
Institution: University of New Mexico
EPA Project Officer: Hahn, Intaek
Project Period: August 1, 2011 through July 31, 2014
Project Amount: $528,500
RFA: Transdisciplinary Networks of Excellence on the Environment and Health Disparities (2012) RFA Text |  Recipients Lists
Research Category: Environmental Justice , Human Health

Objective:

The objective of the Environmental Health Core (EHC) was to establish a research focus in the science of intervention on environmental health (EH) disparities based at UNM HSC. This effort was based on sound research practices, informed by community needs, and focused on filling information gaps to inform policy and clinical care. The EHC initiated a vigorous, self-sustaining, research core to advance the scientific base of knowledge about interventions and solutions to socioeconomic, natural, chemical, and built environment issues contributing to the health disparities faced by Native Americans and Hispanic communities in NM, and actively work to ensure these results are used to inform policy, clinical, social and behavioral interventions to reduce disparities.

Summary/Accomplishments (Outputs/Outcomes):

The aims of the main EHC are to:

(1) Expand existing relationships between communities, researchers, health practitioners and policy makers to identify and address gaps in our understanding of EH disparities, and to inform interventions. Create unique training programs for constituents including clinicians, researchers and communities, to develop multi-directional communication and research capacity in EH disparities;

(2) Mentor minority trainees to develop and expand EH disparities research. In all core activities, as well as in research projects associated with the core, mentor and involve community EH scholars, and trainees representing our partner communities.

Aim 1: Expand our ongoing relationships between communities, researchers, practitioners and policy makers to address gaps in understanding EH disparities and inform interventions

In collaboration with the Community Engagement Core of the NM CARES Health Disparites Center, the EHC identified environmental health disparities concerns of communities in four regions of New Mexico. This led to several intra-Center collaborations including Dr. Gonzales’

• Participation in two intercultural dialogues hosted by Northern New Mexico College initiating partnerships with 4 community groups, 3 community foundations, and a national foundation;
• Organizing a multi-stakeholder team to work on children’s asthma and second-hand smoke exposure as a significant health disparity indicator for the state of New Mexico.

Advancing these collaborations, the EHC identified and initiated partnerships with the New Mexico Coalition on Asthma, American Lung Association (local chapter), American Thoracic Association, New Mexico Thoracic Society, UNM Pulmonary and Fierce Pride. The issue of pediatric exposure to environmental tobacco smoke (ETS) in vehicles is of concern.

Outputs:

• Two tobacco-themed posters presented at the 2013 Annual Conference
• Dr. Gonzales’ collaboration in the American Lung Association in New Mexico Community Transformation Grant for Smoke-Free Public Housing
• The introduction of HB 148 to the New Mexico State Legislature entitled "Restricting smoking in vehicles with minors present" (sponsor Rep. Steinborn)

Through expansion of our existing relationships, the EHC identified the following gaps to inform policy, research and practice, the following outcomes and outputs were achieved:

• A need for input into research plan and technical support for Colonia Water Quality programs in southern New Mexico
• A research/policy concern for air pollution and respiratory health in southeastern NM and the Four-Corners Region resulting from coal-fired power generating facilities and natural gas production, and initiating a collaboration with concerned community members/partners (American Lung Association, NM DOH, UNM Pulmonary) with emphasis on exposure assessment and policy. Dr. Gonzales collaborated on the development of research proposals (unfunded).
• A field-tested protocol for metals detected in in-home dust samples for Dine project (collaboration with Project 2); Dr. Gonzales provided exposure assessment expertise.
• Submitted two NIH intervention grants to reduce lower respiratory tract infections resulting from wood smoke exposures in collaboration with University of Montana and the University of Alaska. These involve three tribal and one rural community—rural Montana, Nez Perce, Navajo, and Alaska Native Yupik communities.
  • Output: RO1ES022649 NIH/NIEHS (Ward, U Montana, PI; Lewis, UNM Subaward PI) Wood stove interventions and child respiratory infections in rural communities. Compares the effectiveness of two intervention strategies and a control in reducing frequency and severity of lower respiratory tract infections in children up to 5 years of age in Alaska Native, Navajo, and rural Montana communities. Navajo children will be participants in the birth cohort study.
• Dr. Lewis was invited by Rep. James Clyburn to participate with the Congressional Black Caucus in developing an environmental justice agenda for the next U.S. Congress.  This will specifically address the impact of disparities in community infrastructure on health.
• New Mexico Public Health Association/NM CARES Health Disparities Joint 2013 Conference
  Sent email invitations to our extended list of community partners from across the state of NM to attend and submit abstracts related to Environmental Health in New Mexico for poster/oral presentations at the 2013
  NMPHA/NM CARES conference.
  Output :   9 partners presented posters, 5 panel presentations including 20 community members and EH Core members.
• We identified a need to address the pervasive environmental health disparities related to exposures from mining wastes, with primary biomedical and environmental research and Native-focused community engagement.

  Output: University of New Mexico’s Center for Native American Environmental Health Equity Research, or “Native EH Equity” (1P50ES026102-01, Lewis and Gonzales Co-PIs).

  The Center’s Cores (Community Engagement, Facilities and Services and Administrative) were developed based on the expansion of partnerships derived from the supplemental funding from this core. The research project in the new Center (Research Project 1- Metals and metal mixtures in DNA damage and repair) is a direct output of the work conducted in the community partnership-based Zinc Project (see Project 2 below).

  The Center is timely in the face of the recent Gold-King Mine spill where the questions from communities and local and federal government mimic those asked by the Center.

  A Facility Core was incorporated in the Center, which works with tribal staff and students hand in hand on data analysis and interpretation to build capacity in tribes to help reduce disparities long term. This model and the focus on abandoned mine waste are essential to resolving long-term exposure and health from such disasters, and critical in decisions/choices to prevent future crises and improve responses, and effectively prioritize clean-ups.

Hosted Visit and Tour for Dr. Linda Birnbaum, Director, NIEHS. Raising awareness of abandoned mine contamination issues in tribal and rural southwestern communities.

Dr. Lewis hosted a visit by Dr. Linda Birnbaum to introduce her to uranium mine and mill tailings waste and its impact on tribal and rural communities in the Southwest. The tour included first-hand 2-day observation of abandoned mine waste sites in NM and AZ paired with in-home visits and discussions with community members at Laguna Pueblo, Navajo Nation, and the rural community of Milan, NM, as well as a meeting with Navajo Vice-President and Navajo Chief Medical Officer. The discussions were focused on research needs of the communities to understand health outcomes. The final day of the visit concluded with a series of briefings on ongoing research at UNM in which both Drs. Gonzales and Lewis participated, as well as a discussion with graduate students.

Mentoring and Training

• Supported the attendance of community members Veronica Apodaca (Project 1) and Ranalda Tsosie (Project 2) from the two EHC Projects (Aim 2) at a week-long course in Community-Based Participatory Research offered in May 2012 by the UNM Masters in Public Health Program.
• Partnered with the Research Education Core to work with two undergraduates through the UNM Undergraduate Pipeline Network (see Project 2 and Aim 3 for details). Supported travel for two Undergraduate Pipeline Network (UPN) students to attend training sessions at clinical sites and Navajo IRB for Project 2.
• Mentorship of postdoctoral fellow: Salina Torres, PhD, MPH (represented EH Core during NM CARES Team meetings and during the planning of the 2013 annual conference, organized meetings with potential community collaborators, measured and demonstrated success of the core using PEHP metrics, generated manuscript based on evaluation of the core); Predoctoral fellow: Gwendolyn Saul, ABD Cultural Anthropology – Environmental Health and Health Equity.
• Providing training on environmental health research and health disparities to Navajo Nation CHRs pursuing public health certificates. Through the Navajo Birth Cohort Study, Dr. Lewis’ team has been mentoring staff of the Navajo Division of Health in research methods appropriate to address environmental health disparities. Several of these staff are pursuing certificates in public health through the tribal college.
• Dr. Gonzales incorporated disparities issues in exposure analysis, policy and clinical care into: General Preventive Medicine and Public Health Residency Program didactics and seminars in Environmental Health for which she was the instructor of record.
• Based on her prior expertise with native jewelry makers, Dr. Gonzales produced an informational page for environmental hazards related to jewelry making exposures. She also was invited to present this educational material at 1) American Indian Arts and Crafts Association AIACA Trade Show in Albuquerque and 2) Eight Northern Indian Pueblos Council, Office of Environmental Technical Assistance at Sandia Pueblo.
• See additional mentoring in relation to our two community partnership-based research projects below.

B.  Community Partnership-based Research Project 1: FIESTAS Project

Description and Objective of Project
FIESTAS was a 2-year research project that started in September 2011. FIESTAS involved researchers from the Office for Community Health at UNM in collaboration with the Santa Barbara/Martineztown (SB/MT) Community Learning Center and women who are residents of the community. FIESTAS focused on improving food security in SB/MT. We attempted to understand women’s everyday experience in relation to food, and to create opportunities for women to develop supportive social relationships with other women, to obtain useful information about available food and health resources, and to envision strategies that could improve nutrition and strengthen social networks in the neighborhood. The design of the project involved unique ways to engage women from the community in the research. Project activities include: Community Board Meetings, Household Food Security Survey of 49 households (149 individuals), Neighborhood Food Environment Assessment, 50 Interviews  with 25 women and 3 men conducted in four phases, 5 FIESTA events involving 18 women + the 5 members of the Community Board & 13 Evaluation Interviews, and Social Network Analysis.

Change in Investigators during the funding period. Dr. Amy Scott left the University of New Mexico in 2012 and stepped down as PI for the FIESTAS Project. The Co-PI, Dr. Janet Page-Reeves became the lead PI on FIESTAS. Because of their close collaboration and Dr. Page-Reeves’ extensive community-engagement during the initial phase of the study, the transition was smooth, and resulted in no delays or changes to the study as planned.

Outputs/Outcomes

• Community Board Process.  Members of the community board and the research team met (twice a month December 2011 - May 2013 and once a month from May 2013 to February 2014) to prepare and share a meal; identify and discuss community issues related to food and health; discuss and decide upon interview questions; discuss and interpret findings; plan and implement “FIESTA” events; and conceptualize and develop community-level strategies to improve food access, food security and nutrition in SB/MT.
• Household Food Security Survey 31% of households with children in SB/MT fall below the federal poverty level (U.S. Census); compared to the 1-in-6 families who struggle to buy food in the rest of the Unites States, 1-in-3 families in SB/MT have trouble feeding their families; and the food insecurity rate in SB/MT was twice the state average.
• Table 1

  Food Security Status	NM	SB/MT
  Low (adults miss meals but children do not)	16.5%	32.7%
  Very low (adults and children have to skip meals)	6.3%	12.2%

• Neighborhood Food Environment Assessment Results: SB/MT is an urban food desert; access to affordable, healthy food is low; 71% of households surveyed reported that they have to leave the neighborhood to buy food; comparing food at grocery stores near the neighborhood with grocery stores in a wealthier neighborhood:
  Availability of food near SB/MT is lower; quality of food near SB/MT is lower; food prices near SB/MT are higher.
• Interviews  Food insecurity generated by economic forces outside of SB/MT intersects with everyday experience for women in their homes and kitchens. Women struggle with the experience of food insecurity in a variety of physically and emotionally challenging ways. Women we spoke with connect shame, fear, stress, family conflict, the potential for child abuse, feelings of failure, having to sell beloved family pets, the risk of becoming homeless, not knowing where to turn for help, and actual physical distress with food insecurity.
  • Struggles: Women try to: buffer the experience of hunger for family, friends and for themselves; hide scarcity from husbands, children, family and friends; try to cope with emotional distress by themselves; blame themselves for their situation rather than connecting their experience with what is happening in the kitchens of other households in SB/MT.
  • Strategies: Women nurture and activate social networks for support and food sharing; access safety net sources like Food Stamps/SNAP and the school meals programs; creatively stretch food through thrifty shopping and cooking techniques.
• Social Network Analysis
  FIESTAS participants were asked to complete a short survey to assess whether the project increased the participants’ social networks and awareness of resources discussed at the FIESTAS events. The survey results then were entered into a software program that analyzes social networks. The analysis (as shown in the following tables) found that: 1) FIESTAS participants did increase their social networks: of the 20 participants who completed the survey, 16 said they would call upon more of the other participants after having participated in the project than they would have before the project; 2) participants also said they were more likely to access the resources discussed at FIESTAS events – local farmers' markets, food stamps/SNAP, the SB/MT Community Learning Center (SB/MT CLC) and the Neighborhood Association – after having participated in FIESTAS.

Local Impact and Benefit Outcomes

• A grant was written and funded for fruit trees to plant at the SB/MT Community Learning Center.
• At least six households in SB/MT applied for and received Food Stamps/SNAP as a result of information and support provided through FIESTA events likely totaling more than $1,000 a month in an ongoing way.
• Through networks created through this project, $140 was raised by individuals from outside of SB/MT to support a family in crisis because of a house fire; a team formed to participate in the Susan G. Komen breast cancer walk. The group obtained sponsorship from Susan G. Komen.
• The Graduate Assistant from the community received mentoring and support for a career in academic research in addition to salary and tuition assistance.
• Information was generated about the community that can be used for advocacy.
• Women who participated in FIESTAS report increased social ties/relationships with other women; increased knowledge of local resources; and learned that they are not alone in their struggles. This has been a huge revelation, allowing women to think about themselves differently and to see their relationship to each other in a new way.
• The monthly FIESTAS Bulk Buying Club functioned from November 2014 to July 2015, saving women who participated up to 50% on household and food items. In Albuquerque, it would not be possible for a group of neighborhood women to work with wholesale distributors because of requirements for insurance, minimum purchase and delivery fees. In Fall 2014, we were selected to support two Congressional Hunger Fellows from the National Congressional Hunger Center. The fellows worked with women in the community to develop the FIESTAS Bulk-Buying Club that operated from November 2014 to July 2015. Women who participated saved up to 50% on monthly purchases of basic food staples and household products. A Bulk Buying Club Toolkit and a Facilitators Guide to Community Cooking Classes were produced by the Hunger Fellows. Cooper, Elizabeth. Just Eats: Community Cooking Program: A Facilitator’s Guide to Developing, Organizing, and Implementing Community Cooking Classes. Emerson National Hunger Fellow in collaboration with women from the FIESTAS project. Congressional Hunger Center. Malow, Leila. Bulk Buying Club Toolkit: A Guide to Starting a Neighborhood Bulk Buying Club. Emerson National Hunger Fellow in collaboration with women from the FIESTAS project. Congressional Hunger Center.

Community Partnership-based Research Project 2: Zinc Reversal of Uranium Toxicity

Aims: (1) To test a mechanism-based intervention to reverse the effects of uranium through use of zinc supplements in a prenatal cohort; (2) initiate a population study linked to the Navajo Birth Cohort Study (NBCS).

The radiologic carcinogenicity of U is established, but U also may act as a metal through zinc finger proteins (ZnFP). Several studies report that U leads to DNA repair deficiency in exposed populations, suggesting that U may interact with ZnFP that control DNA repair. Although these experiments are suggestive, they did not investigate the impact of U on a relevant target protein.

Zinc Aim 1:  Mechanistic Studies. We will test a mechanism-based intervention to reverse the effects of uranium through use of zinc supplements in a prenatal cohort.

The radiologic carcinogenicity of U is established, but U also may act as a metal through zinc finger proteins (ZnFP). Several studies report that U leads to DNA repair deficiency in exposed populations, suggesting that U may interact with ZnFP that control DNA repair. Although these experiments are suggestive, they did not investigate the impact of U on a relevant target protein.

Achievements

• Our work with arsenic has demonstrated that very low levels of arsenic exposure at or near the drinking water standard of 10 ppb leads to Zn depletion from target proteins in cells and this concentration is nearly two orders of magnitude less than that necessary to interfere with purified protein. If, as suggested, U disrupts ZnFP function in a similar manner, Zn supplementation would offset U toxicity by this mechanism, leading to a sound basis for an over-the-counter, readily implemented Zn intervention to protect against toxicity. Increased Zn has been shown to increase DNA repair at levels associated with dietary supplementation in humans.
• First, we established that pre-incubation of cells with uranyl acetate (U) before a DNA damaging exposure of ultraviolet radiation (UV) caused retention of UV-induced DNA damage at 6h, similar to what is observed with arsenic (Fig. 1). This finding strongly suggests that U inhibits DNA repair processes. A key ZnFP in DNA repair is poly (ADP-ribose) polymerase (PARP)-1.
• The activity of PARP-1 is strongly dependent on the coordination of zinc in the zinc finger domain. We established previously that treatment of cells with arsenic caused loss of zinc from PARP-1. As shown in Fig. 2, incubation of HEK cells with U for 24h leads to loss of zinc from PARP-1 immunoprecipitated from U treated cells. A significant decrease in zinc content was evident at 1 uM U exposure. Although our preliminary studies using mass spectrometry have not established whether U interacts directly with a PARP-1 zinc finger peptide, this finding indicates that cell exposure to U can disrupt zinc binding to the PARP-1 zinc finger domains. Ongoing studies will investigate the mechanism responsible for this observation.

  

  Fig. 1. Uranyl acetate inhibits DNA repair. HEK cells were treated with 2 uM arsenite or 10 uM uranyl acetate for 24h before exposure to 3 kJ solar simulated UVR to stimulate DNA damage. UV-induced DNA damage was measured at 1h and 6h post exposure using immune-histochemical approaches. Retention of DNA damage at 6h post-exposure by arsenic and uranyl acetate is illustrated by the bracket.

  

  Fig. 2. Uranyl acetate causes zinc depletion in the DNA repair protein PARP-1. HEK cells were treated with the indicated concentrations of U for 24h, then PARP-1 was immune-precipitated from cell lysates. The isolated protein was treated with hydrogen peroxide to release bound zinc and zinc content was measured using a zinc sensor.

• Loss of zinc from the zinc finger domain is predicted to inhibit PARP-1 activity as we have reported previously for arsenic. Pretreatment of cells with either arsenic or U led to a decrease in UV-stimulated PARP activity as detected by a decrease in PARP enzyme product poly (ADP-ribose) (Fig. 3.). Collectively, the experiments illustrated in Figures 1-3 represent the first evidence that U can inhibit PARP-1 activity and DNA repair, at least in part through a mechanism involving disruption of zinc finger function.
• Our studies on arsenic have demonstrated that zinc can reverse the effects of arsenic on PARP-1 activity and DNA damage in human cells and in mouse models. We tested whether U-dependent inhibition of DNA repair, as detected by enhancement of UV-induced DNA damage, could be reversed by co-incubation of U and zinc. The results in Fig. 4 illustrate that preincubation of cells with U augments UV-induced DNA damage using an independent marker of DNA damage to confirm the results obtained in Fig. 1. This is shown by the U-dependent increase (red bars) above the no-metal control (blue bars) at the 1h and 6h time points post-UV exposure. The DNA damage is resolved at 6h in the no-metal control cells and the continued elevation of DNA damage in the U treated cells indicates inhibition of DNA repair. However, when cells were co-treated with U and zinc, the augmentation of DNA damage is eliminated and DNA repair occurs (Fig. 4, compare green bars with red bars). These findings suggest that zinc adequacy can offset the deleterious effects of U on DNA damage repair and provide the scientific support for the natural history intervention proposed with the Navajo Birth Cohort Study.

  

  Fig. 3. Uranyl acetate inhibits PARP-1 activity.  HEK cells were treated with arsenic (1 uM) or U (10 uM) for 24h, then PARP-1 was immuno-precipitated from cell lysates. Cells then were exposed to UV to activate PARP. PARP activity is detected using antibodies directed against its product poly (ADP-ribose). Note the decrease in fluorescent intensity in the arsenic and uranium pretreated samples.

  

  Fig. 4. Zinc offsets the effects of U in DNA repair. HEK cells were treated with 10 uM U with or without 2 uM zinc for 24h before exposure to 3 kJ solar simulated UVR to stimulate DNA damage. UV-induced DNA damage was measured at 1h and 6h post exposure using immunohistochemical approaches. The red bars illustrate augmentation of DNA damage by U over the no-metal control (blue bars). The green bars represent cell response when U and Zn are both present.

Zinc Aim 2: Population Study

The Population Study aim of the Zinc Project was a component of the Navajo Birth Cohort Study conducted in partnership with a tribal nation (Navajo) and two federal agencies (CDC/ATSDR, IHS), Dr. Lewis (PI).

• Due to delays at the federal level (e.g., OMB approval), the Navajo Birth Cohort Study enrollment was delayed, but training and enrollment have been ongoing. Recruitment and enrollment began in early 2013 at the first of six hospitals, and the fifth site is being certified as this report is being written. Completion of Aim 2 of Project 2 is predicated on sufficient enrollment to conduct data analysis. Blood samples that will support the analyses of DNA damage now have been obtained from the first four parent participants. An additional five have been enrolled this week and are awaiting their blood draws. Sample analysis will begin after the first 10 samples are collected.

Project 2 Outcomes and Outputs
Project 2 results also have been incorporated into a submission of a 5-year continuation proposal to CDC. The submission was in response to a sole-source RFP and will provide funding to expand the number of analyses in the zinc intervention study by 150 participants.

• Trainined clinical and laboratory staff at the participating IHS hospitals, and due to the readiness in the laboratories, we will be able to work at not one, but three hospitals to identify women for this NMCARES pilot project. We, therefore, made up for lost time by increasing the catchment area.
• The IRB approvals are in place to look at these responses across all three facilities, and the laboratory protocols for sample collection to confirm not only U but also Zn and As exposure through biomonitoring in urine (U, As) and serum (Zn) are complete, with training of laboratory staff in each hospital either complete or in progress.
• Pilot walk-throughs were conducted at all facilities prior to the initiation of enrollment.
• The capacity to analyze population samples also has been increased through incorporation of two additional students, a predoctoral student from Dr. Lewis’s program, as well as a Navajo undergraduate biochemistry student who worked on the project with Dr. Lewis this summer and will continue doing independent research projects through the next two terms as described below. Both of these students are interested in the translational aspects of bench science to communities and will be assisting in Dr. Hudson’s laboratory to ensure the population sample analysis moves forward, as well as participating in the broader aspects of the community studies.
• Project 2 was presented in panel presentations at the 2013 NMPHA/NMCARES Disparities to Equity conference.
• Project 2 also was incorporated into a mechanism of uranium toxicity presentation and update at an EPA-sponsored Navajo Uranium Stakeholder’s meeting, which involved six federal agencies, Navajo agencies, and communities. The meeting will form the basis of development of a reauthorization of a new 5-year plan to address uranium contamination legacy on Navajo Nation.
• Follow-up analyses in human samples replicated laboratory work described above and published in Cooper, et al. Our results show that arsenic and uranium increased the number of cells with DNA damage in young adults (p=0.0007 interaction synergistic with DNA damage) and the effect is significantly reduced in the presence of Zn (p = 0.0006). Taking zinc-containing prenatal vitamins – prior to but not during pregnancy – significantly reduced DNA damage caused by arsenic and uranium.

Project 2 Mentoring and Training

• Tele-Education Presentation to Dine College 11/28/2012 – Four-part series on environmental health, uranium exposure history and legacy, community-based studies, and laboratory mechanistic studies. Presentations broadcast through UNM Center for Native American Health to Dine College campuses in Tuba City, Tsaile, Shiprock, Window Rock, Crownpoint, and Chinle (Dr. Lewis’ team).
• Ranalda Tsosie (Navajo undergraduate student) completed laboratory studies on the effects of uranium on kidney cell viability and DNA damage. Ms. Tsosie presented at the NMPHA/NMCARES 2013 Conference (with Project 2). She entered an environmental chemistry Ph.D. program at the University of Montana in Fall 2013 (with Project 2).
• Charlton Lindsay (Navajo undergraduate student) completed laboratory studies on the effects of uranium on Jurkat cell (T-lymphocyte line). He completed his honor’s thesis in biochemistry and entered UNM School of Medicine July 2013. Mr. Lindsay presented a poster at the NMPHA/NMCARES 2013 Conference (with Project 2).
• Reviewed applicants for summer placements of students from Navajo tribal college (Dine College). The students are distributed throughout Navajo Nation and placement will depend on capacity of field staff to manage additional activities in combination with the start-up of enrollment. However, we have made a commitment to take students from the Dine college program next summer and will look at options to continue to strengthen those collaborations. Their program has since inception focused on Diabetes and Cancer. This will be the first time they branch out to incorporate environmental health!
• Dr. Lewis has begun to mentor a Masters level psychologist hired by one of the participating hospitals in research methodology and career choices for completing a Ph.D. once the birth cohort work is complete. Options to build on this research experience in completing her degree are being evaluated.

Conclusions:

FIESTAS: The women we worked with learned about dimensions of the community they had not previously considered systematically (e.g., health disparities, food environment, and built environment) and to think about the community in a new way.  The vision emerging from our work is contributing to a new sense of possibility for the community and for women individually in their own lives. Women who participated in this project reported that they felt personally empowered by the experience. Women who participated in the project became involved in their community and a group of them were elected to the board of the SB/MT Neighborhood Association in 2015. They have begun to make changes in their community. Through the operation of FIESTAS, the women involved in the Community Board and the FIESTAS events learned about factors that influence the health and wellbeing of people in SB/MT. This experience has helped them begin to formulate and apply strategies to improve food security and nutrition for themselves and the families in their community, including 1) a women’s supper club, 2) a bulk-buying initiative, 3) a walking group, 4) a multidimensional grocery store pilot, 5) a community kitchen, and 6) a community garden.

Zinc Intervention: If, as suggested, U disrupts ZnFP function in a similar manner, Zn supplementation would offset U toxicity by this mechanism, leading to a sound basis for an over-the-counter, readily implemented Zn intervention to protect against toxicity. Increased Zn has been shown to increase DNA repair at levels associated with dietary supplementation in humans.

Overall:  Because of their reliance on natural resources to maintain traditional diets, lifestyles, customs and languages, Native American communities in the Western United States have direct and frequent contact with metal mixtures from unremediated abandoned uranium and other hardrock mine sites. Exacerbating these exposures are disparities in infrastructure, especially drinking water supplies and unique social determinants of health from poverty in rural and isolated locations. Addressing these pervasive environmental health disparities with primary biomedical and environmental research and Native-focused community engagement is the focus of the University of New Mexico’s Center for Native American Environmental Health Equity Research, or “Native EH Equity” (1P50ES026102-01, Lewis and Gonzales Co-PIs, See Output/Outcomes of the Main Core [Aim 1] for details).

Journal Articles on this Report : 5 Displayed | Download in RIS Format

Publications Views

Other project views:	All 50 publications	16 publications in selected types	All 11 journal articles

Publications

Type	Citation	Project	Document Sources
Journal Article	Cooper KL, Dashner EJ, Tsosie R, Cho YM, Lewis J, Hudson LG. Inhibition of poly(ADP-ribose)polymerase-1 and DNA repair by uranium. Toxicology and Applied Pharmacology 2016;291:13-20.	NIMHD009 (Final)	Abstract from PubMed Full-text: ScienceDirect-Full Text HTML Exit Other: ScienceDirect-Full Text PDF Exit
Journal Article	Lewis J, Gonzales M, Burnette C, Benally N, Seanez P, Shuey C, Nez H, Nez C, Nez S. Environmental exposures to metals in Native communities and implications for child development: basis for the Navajo Birth Cohort Study. Journal of Social Work in Disability and Rehabilitation 2015;14(3-4):245-269.	NIMHD009 (Final)	Abstract from PubMed Full-text: Taylor & Francis-Full Text HTML Exit Abstract: Taylor & Francis-Abstract Exit Other: Taylor & Francis-Full Text PDF Exit
Journal Article	Page-Reeves J, Mishra SI, Niforatos J, Regino L, Bulten R. An integrated approach to diabetes prevention: anthropology, public health, and community engagement. Qualitative Report 2013;18:1-22.	NIMHD009 (Final)	Full-text from PubMed Abstract from PubMed Associated PubMed link
Journal Article	Page-Reeves J, Niforatos J, Mishra S, Regino L, Gingrich A, Bulten R. Health disparity and structural violence: how fear undermines health among immigrants at risk for diabetes. Journal of Health Disparities Research and Practice 2013;6(2):30-47.	NIMHD009 (2012) NIMHD009 (Final)	Full-text from PubMed Abstract from PubMed Associated PubMed link Full-text: Journal of Health Disparities Research and Practice-Full Text PDF Exit Abstract: Journal of Health Disparities Research and Practice-Abstract Exit
Journal Article	Page-Reeves J, Scott AA, Moffett M, Apodaca V, Apodaca V. “It is always that sense of wanting...never really being satisfied”: women’s quotidian struggles with food insecurity in a Hispanic community in New Mexico. Journal of Hunger & Environmental Nutrition 2014:9(2):183-209.	NIMHD009 (Final)	Full-text: Taylor&Francis-Full Text HTML Exit Abstract: Taylor&Francis-Abstract Exit Other: Taylor&Francis-Full Text PDF Exit

Supplemental Keywords:

drinking water, exposure, health effects, food security, heavy metals, sustainable development, public policy, decision making, community-based, survey, socioeconomic epidemiology, environmental toxicology, southwest, New Mexico, Native American, tribal communities, health disparities;

Relevant Websites:

New Mexico Cares: UNM Health Sciences Center Exit
Healthy Voices Radio and Environmental Health Information Exit

Progress and Final Reports:

Original Abstract

2012 Progress Report

2013 Progress Report