Diné Network for Environmental Health: Working Together to Understand Kidney Disease and Environmental Exposures

The Eastern Agency of the Navajo Nation contains substantial deposits of uranium. Historical mining operations have left a legacy of environmental and occupational exposures. In addition, the natural occurrence of uranium in the region combined with possible legacy contaminants from unremediated mines and mills has raised concerns that significant exposures may be occurring through the use of unregulated drinking water. The Eastern Navajo Health Board initiated the development of a collaborative to begin documenting exposures and examining the relationships between exposure and kidney health. The prevalence of kidney disease in the region is substantially greater than nationally and occurs in younger members of the community than expected nationally or in other indigenous communities with high diabetes prevalence. The Diné Network for Environmental Health (DiNEH) has worked to develop the community capacity to conduct research and understand environmental health issues through extensive outreach and education. This work has formed the basis for an extensive community-based participatory epidemiologic study involving community members, the health board, clinicians, university researchers, tribal policy makers, and representatives of Navajo, state, and federal agencies in a comprehensive evaluation of this issue. The results are being used to inform communities and reduce exposures, to inform policy, and to inform clinical care in the community. The presentation will discuss and highlight the strategies that have made this Tribal-University parntership so successful. It will also address the many positive outcomes related to this project specifically and for the partnership in general. (Supported by NIEHS R25, R01, & P30 funding.)