Tribal/public health care provider initiative: Recognition and prevention of fetal/infant exposure to environmental toxins

Overview and Rationale for the Session: Infants and children are uniquely vulnerable to environmental toxins and tribal children may be at increased risk of exposures that could result in excess illness, injury, or death (Tribal Nations Children's Environmental Health Summit, 2007). In Montana, infant mortality rates are almost two times higher for Native American infants (11.3 deaths per 1,000 births) compared to white infants (6.0/1,000). Out of 12 service units across the United States, Billings had the fourth highest infant mortality rate. The top three causes of death, sudden infant death syndrome (three times higher among Native American infants), congenital anomalies, and prematurity may in part be due to toxic environmental exposures (US DHHS IHS, 2008). Tribal and community health nurses and other healthcare providers represent frontline community members uniquely positioned to assess and implement protective environmental health assessments and interventions. However, a recent study of Montana's public health nurse workforce identified the need for additional education in order for nurses to address environmental health practice issues (Hill, Butterfield, & Kuntz, 2010). This session will describe a community-academic research partnership designed to (1) provide pediatric environmental health continuing education to tribal/public health care providers; (2) engage healthcare providers and other members of the community in focus groups to identify and prioritize potential hazards to decrease fetal/infant/child mortality and morbidity on one northwest reservation; and (3) introduce a community-based participatory research approach and model for conducting research in Native American communities. An overview and presenter introductions (5 minutes) will launch this 90 minute session followed by five abstract presentations (14 minutes each); audience questions and discussion will take place during the last 15 minutes of the session.