Federal Statutes and Environmental Justice in the Navajo Nation: The Case of Fracking in the Greater Chaco Region

Arguing for the importance of robust public participation and meaningful Tribal consultation to address the cumulative impacts of federal projects, we bridge interdisciplinary perspectives across law, public health, and Indigenous studies. We focus on openings in existing federal law to involve Tribes and publics more meaningfully in resource management planning, while recognizing the limits of this involvement when only the federal government dictates the terms of participation and analysis. We first discuss challenges and opportunities for addressing cumulative impacts and environmental justice through 2 US federal statutes: the National Environmental Policy Act and the National Historic Preservation Act. Focusing on a major federal planning process involving fracking in the Greater Chaco region of northwestern New Mexico, we examine how the Department of the Interior attempted Tribal consultation during the COVID-19 pandemic. We also highlight local efforts to monitor Diné health and well-being. For Diné people, human health is inseparable from the health of the land. But in applying the primary legal tools for analyzing the effects of extraction across the Greater Chaco region, federal agencies fragment categories of impact that Diné people view holistically. (Am J Public Health. 2022;112(1):116-123. https://doi.org/10.2105/AJPH.2021.306562).

Associations between ethnic identity, regional history, and genomic ancestry in New Mexicans of Spanish-speaking descent

This study examines associations between ethnic identity, regional history, and genomic ancestry in New Mexicans of Spanish-speaking descent (NMS). In structured interviews, we asked 507 NMS to select from a list of eight ethnic identity terms identified in previous research. We estimated genomic ancestry for each individual from 291,917 single nucleotide polymorphisms (SNPs) and compared genomic ancestry, age, and birthplace between groups of individuals who identified using each ethnic identity term. Eighty-eight per cent of NMS who identified as "Hispanic," "Nuevomexicano/a," and "Spanish," on average, were born in New Mexico, as were the vast majority of their parents and grandparents. Thirty-three per cent of NMS who identified as "Mexican" and "Mexican American" were born in Mexico, as were 59 per cent of their parents and 67 per cent of their grandparents. Average Native American and African ancestry proportions in "Hispanic" (0.26, 0.02, respectively), "Spanish" (0.25, 0.01), and "Nuevomexicano/a" (0.24, 0.01) NMS were significantly lower than in "Mexican American" (0.37, 0.04) NMS. Significant age differences between older "Spanish" and younger "Nuevomexicano/a" individuals, combined with widespread use of the term "Hispanic," may reflect ongoing nomenclature changes. Patterns of correspondence between ethnic identity, ethnic nomenclatures, and genomic ancestry reflect historical patterns of migration, colonization, and cultural change.

The Association Between Positive Relationships with Adults and Suicide-Attempt Resilience in American Indian Youth in New Mexico

This study examined the 2013 New Mexico Youth Risk and Resiliency Survey (NM-YRRS) to determine whether cultural connectedness and positive relationships with adults protected against suicide attempts among American Indian and Alaska Native (AI/AN) youth and whether these relationships differed by gender. The sample included 2,794 AI/AN students in grades 9 to 12 who answered the question about past-year suicide attempts. Protective factor variables tested included relationships with adults at home, school, and the community. The language spoken at home was used as a proxy measure for cultural connectedness. Positive relationships with adults were negatively associated with the prevalence of past-year suicide attempts in bivariate analysis. However, language spoken at home was not associated with the prevalence of suicide attempts. Multivariate analysis showed that among girls, relationships with adults at home, at school, and in the community were independently associated with lower suicide-attempt prevalence. Among boys, only relationships with adults at home showed such an association. These results have important implications for the direction of future research about protective factors associated with AI/AN youth suicide risk as well as in the design of suicide intervention and prevention programs.

Social Identity in New Mexicans of Spanish-Speaking Descent Highlights Limitations of Using Standardized Ethnic Terminology in Research

In this study, we evaluated the extent to which regional history has shaped the social identity nomenclature in New Mexicans of Spanish-speaking descent (NMSD). We asked 507 NMSD to list the social-identity terms they used to describe themselves and their parents, and we examined the correspondence between these choices and family ties to the region, birthplace, and continental ancestry. NMSD frequently identified using the regional terms "Nuevomexicano/a" (15%) and "Spanish" (12%). These individuals reported family ties to the region that predate New Mexican statehood. They and their parents were frequently born in New Mexico, frequently chose the other of the two terms as a secondary descriptor, and frequently ascribed one of the two terms to their parents. About 10% of NMSD identified as "Mexican American" and "Mexican." About 25% of these individuals, and more than half of their parents, were born in Mexico. They also frequently chose the other of the two terms as a secondary descriptor and frequently ascribed one of the two terms to their parents. Compared to NMSD who identified as "Mexican" and "Mexican American," individuals who identified as "Nuevomexicano/a" and "Spanish" had higher European ancestry and lower Native American and African ancestry. Our results also suggest that the term "Hispanic," frequently chosen as both a primary and secondary social identity term by NMSD, may, as it continues to rise in prominence, mask more deeply rooted and potential socially relevant aspects of social identity in New Mexico. More broadly, these results indicate that regional history influences social identity nomenclatures in ways that are potentially incompatible with US Office of Management and Budget standards. This incompatibility may adversely affect the ability of researchers in the social sciences to assess the causes of social inequality and health disparities in individuals of Spanish-speaking descent in different regions of the United States. We argue that future studies would benefit from more fine-grained, region-specific analyses of social identity.

PERFORMANCE OF A1C VERSUS OGTT FOR THE DIAGNOSIS OF PREDIABETES IN A COMMUNITY-BASED SCREENING

OBJECTIVE

Reliable identification of individuals at risk for developing diabetes is critical to instituting preventative strategies. Studies suggest that the accuracy of using hemoglobin A1c as a sole diagnostic criterion for diabetes may be variable across different ethnic groups. We postulate that there will be lack of concordance between A1c and the oral glucose tolerance test (OGTT) for diagnosing prediabetes across Hispanic and non-Hispanic white (NHW) populations.

METHODS

A total of 218 asymptomatic adults at risk for type 2 diabetes (T2D) were assessed with A1c and OGTT for the diagnosis of prediabetes. Glucose homeostasis status was assigned as no diabetes (A1c <5.7% [39 mmol/mol]), prediabetes (A1c 5.7 to 6.4% [46 mmol/mol]), and T2D (A1c >6.4% [46 mmol/mol]). Inclusion criteria were age >18 years and at least one of the following: a family history of diabetes, a history of gestational diabetes, Hispanic ethnicity, non-Caucasian race, or obesity. Subjects received a fasting 75-g OGTT and A1c on the same day. Bowker's test of symmetry was employed to determine agreement between the tests.

RESULTS

Data from 99 Hispanic patients and 79 NHW patients were analyzed. There was no concordance between A1c and OGTT for Hispanic (P = .002) or NHW individuals (P = .003) with prediabetes.

CONCLUSION

A1c is discordant with OGTT among Hispanic and NHW subjects for the diagnosis of prediabetes. Sole use of A1c to designate glycemic status will result in a greater prevalence of prediabetes among Hispanic and NHW New Mexicans.

ABBREVIATIONS

A1c = hemoglobin A1c BMI = body mass index CDC = Centers for Disease Control CI = confidence interval FPG = fasting plasma glucose NHW = non-Hispanic white OGTT = oral glucose tolerance test T2D = type 2 diabetes WHO = World Health Organization.

Binge Drinking and Perceived Neighborhood Characteristics Among Mexican Americans Residing on the U.S.-Mexico Border

BACKGROUND

This study examines the association between perceived neighborhood violence, perceived neighborhood collective efficacy, and binge drinking among Mexican Americans residing on the U.S.-Mexico border.

METHODS

Data were collected from a multistage cluster sample of adult Mexican Americans residing in the U.S.-Mexico border areas of California, Arizona, New Mexico, and Texas (N = 1,307). The survey weighted response rate was 67%. Face-to-face interviews lasting approximately 1 hour were conducted in respondents' homes in English or Spanish. Path analysis was used to test whether collective efficacy mediated the impact of perceived neighborhood violence on binge drinking.

RESULTS

Among 30+-year-old women, perceived neighborhood collective efficacy mediated the effects of perceived neighborhood violence on binge drinking in a theoretically predicted way: Lower perceptions of violence predicted an increased perception of collective efficacy, which in turn, predicted less binge drinking. Direct effects of violence perceptions on binge were nonsignificant. Younger 18- to 29-year-old women showed a similar (but nonsignificant) pattern of effects. Perceived collective efficacy also mediated the effects of perceived violence on binge drinking among men, but in opposite ways for older and younger men. Older men showed the same mediating effect as older women, but the effect reversed among younger men due to a strong, positive relation between collective efficacy and binge drinking. There were also age differences in the direct effect of violence perceptions on binge drinking: Perceptions of violence predicted more binge drinking among young men, but less among older men.

CONCLUSIONS

These results highlight the complexity of people's responses to neighborhood characteristics in regard to their drinking. Young men in particular seem to react very differently to perceptions of collective efficacy than other groups. However, among both men and women, collective efficacy may come to play an increasingly important protective role in health outcomes with age.

Decomposing associations between acculturation and drinking in Mexican Americans

BACKGROUND

Acculturation to life in the United States is a known predictor of Hispanic drinking behavior. We compare the ability of 2 theoretical models of this effect-sociocultural theory and general stress theory-to account for associations between acculturation and drinking in a sample of Mexican Americans. Limitations of previous evaluations of these theoretical models are addressed using a broader range of hypothesized cognitive mediators and a more direct measure of acculturative stress. In addition, we explore nonlinearities as possible underpinnings of attenuated acculturation effects among men.

METHODS

Respondents (N = 2,595, current drinker N = 1,351) were interviewed as part of 2 recent multistage probability samples in a study of drinking behavior among Mexican Americans in the United States. The ability of norms, drinking motives, alcohol expectancies, and acculturation stress to account for relations between acculturation and drinking outcomes (volume and heavy drinking days) were assessed with a hierarchical linear regression strategy. Nonlinear trends were assessed by modeling quadratic effects of acculturation and acculturation stress on cognitive mediators and drinking outcomes.

RESULTS

Consistent with previous findings, acculturation effects on drinking outcomes were stronger for women than men. Among women, only drinking motives explained acculturation associations with volume or heavy drinking days. Among men, acculturation was linked to increases in norms, and norms were positive predictors of drinking outcomes. However, adjusted effects of acculturation were nonexistent or trending in a negative direction, which counteracted this indirect normative influence. Acculturation stress did not explain the positive associations between acculturation and drinking.

CONCLUSIONS

Stress and alcohol outcome expectancies play little role in the positive linear association between acculturation and drinking outcomes, but drinking motives appear to at least partially account for this effect. Consistent with recent reports, these results challenge stress models of linear acculturation effects on drinking outcomes and provide (partial) support for sociocultural models. Inconsistent mediation patterns-rather than nonlinearities-represented a more plausible statistical description of why acculturation-drinking associations are weakened among men.

Assessing health-related quality of life in Northern Plains American Indians: prominence of physical activity as a health behavior

Associations of behavioral health risks and healthy behaviors with self-reported health-related quality of life measures were investigated in a Northern Plains American Indian sample. Participants were surveyed in person using the Behavioral Risk Factor Surveillance Survey. The results showed that regular physical activity was significantly associated with better self-reported overall health, fewer mentally unhealthy and activity limitation days in the past 30 days, and with a greater number of good health days.

Estimating genetic ancestry proportions from faces

Ethnicity can be a means by which people identify themselves and others. This type of identification mediates many kinds of social interactions and may reflect adaptations to a long history of group living in humans. Recent admixture in the US between groups from different continents, and the historically strong emphasis on phenotypic differences between members of these groups, presents an opportunity to examine the degree of concordance between estimates of group membership based on genetic markers and on visually-based estimates of facial features. We first measured the degree of Native American, European, African and East Asian genetic admixture in a sample of 14 self-identified Hispanic individuals, chosen to cover a broad range of Native American and European genetic admixture proportions. We showed frontal and side-view photographs of the 14 individuals to 241 subjects living in New Mexico, and asked them to estimate the degree of NA admixture for each individual. We assess the overall concordance for each observer based on an aggregated measure of the difference between the observer and the genetic estimates. We find that observers reach a significantly higher degree of concordance than expected by chance, and that the degree of concordance as well as the direction of the discrepancy in estimates differs based on the ethnicity of the observer, but not on the observers' age or sex. This study highlights the potentially high degree of discordance between physical appearance and genetic measures of ethnicity, as well as how perceptions of ethnic affiliation are context-specific. We compare our findings to those of previous studies and discuss their implications.

The relation of social isolation, loneliness, and social support to disease outcomes among the elderly

OBJECTIVE

This study examined relations between social isolation, loneliness, and social support to health outcomes in a sample of New Mexico seniors.

METHOD

We used random-digit dialing to obtain a random sample of 755 southern New Mexico seniors. Participants answered questions pertaining to demographics, social isolation and loneliness, social support, and disease diagnosis including diabetes, hypertension, heart disease, liver disease, arthritis, emphysema, tuberculosis, kidney disease, cancer, asthma, and stroke. The sample allowed for comparison of Caucasian and Hispanic participants.

RESULTS

Correlational and logistic analyses indicated that belongingness support related most consistently to health outcomes. Ethnic subgroup analysis revealed similarities and differences in the pattern of associations among the predictor and outcome variables.

DISCUSSION

The results demonstrate the importance of social variables for predicting disease outcomes in the elderly and across ethnic groups.

Utilization and purchase of medical care services in Mexico by residents in the United States of America, 1998-1999

OBJECTIVES

We assessed self-reported frequency of purchase of medications and medical care services in Mexico by southern New Mexico (United States, [U.S.]) residents in relation to their medical insurance coverage.

METHODS

We analyzed data obtained in 1998 and 1999 from a health interview survey of residents in a six-county region of southern New Mexico, using prevalence and logistic regression methods for complex survey data.

RESULTS

About 22% of southern New Mexico residents had purchased medications and 11% had sought medical care in Mexico at least once during the year preceding the survey. When we adjusted for the effects of other variables, persons able to pay for services out of pocket and those who were uninsured were more likely than persons who were fully covered to purchase medications or medical care in Mexico.

CONCLUSIONS

Large numbers of people residing near the border in New Mexico traveled south to Mexico to purchase medications and medical care. Lack of medical insurance was associated with higher frequencies of these purchases. There seems to be a need to establish relationships between U.S. private and public care plans and Mexican medical care providers to identify appropriate mechanisms for U.S. residents to purchase medical care in Mexico.

Physical activity and the metabolic syndrome in a tri-ethnic sample of women

OBJECTIVE

To determine the association of moderate-intensity physical activity (PA), vigorous-intensity PA, and maximal treadmill duration with the metabolic syndrome among African-American (n = 49), Native-American (n = 46), and white (n = 51) women (ages, 40 to 83 years), enrolled in the Cross-Cultural Activity Participation Study.

RESEARCH METHODS AND PROCEDURES

The metabolic syndrome was defined as three or more of the following risk factors: waist circumference >88 cm, blood pressure > or =130/85 mm Hg, fasting glucose > or =110 mg/dL, hypertriglyceridemia (> or =150 mg/dL), and high-density lipoprotein-cholesterol <50 mg/dL. PA was determined from detailed PA records that included all PA performed during two consecutive 4-day periods. Maximal treadmill duration was determined from a graded exercise test. Women were categorized into quartiles of moderate-intensity PA, vigorous-intensity PA, and maximal treadmill duration. Multiple logistic regression was used to estimate odds ratios of the metabolic syndrome as a function of the four PA categories, adjusted for age, ethnicity, study site, menopausal status, and use of hormone-replacement therapy.

RESULTS

The adjusted odds ratio for the metabolic syndrome was 0.18 (95% confidence interval, 0.33 to 0.90) for women in the highest category of moderate-intensity PA compared with women in the lowest category (p = 0.01 for trend). Similar associations were observed for the metabolic syndrome with vigorous-intensity PA (p = 0.01 for trend) and maximal treadmill duration (p = 0.0004 for trend).

DISCUSSION

Higher levels of moderate and vigorous-intensity PA and greater maximal treadmill duration were inversely associated with the metabolic syndrome among an ethnically diverse sample of women.

Developing a community-specific health-related quality of life (HRQOL) questionnaire for asthma: the Asthma-Specific Quality of Life Questionnaire for Native American Adults (AQLQ-NAA)

The Asthma Quality of Life Questionnaire for Native American Adults (AQLQ-NAA) was developed by modifying the Asthma Quality of Life Questionnaire-Marks (AQLQ-M) using the focus group technique. The 19-item AQLQ-NAA has emphasis on restrictions in social, community, and cultural activities. Higher scores indicate a better quality of life. The modified questionnaire was administered to a sample of 51 Native American adults with asthma at the Albuquerque USPHS Indian Hospital and its affiliated field clinics. Principal components analysis identified three domains with eigenvalues greater than 1.00: Community and Social Restrictions (CSR), Psychological Impact (PIM), and Symptoms (SYM). Cronbach's coefficient alpha for the AQLQ-NAA was 0.95 and ranged from 0.82 to 0.93 for the individual domains, indicating good internal consistency. The AQLQ-NAA score correlated negatively and significantly to urgent care visits, physician visits, and total number of medications taken for asthma in the past 6 and 12 months (p < 0.05). Additionally, the AQLQ-NAA score was correlated positively and significantly to medication adherence in the past 6 and 12 months (p < 0.05). Similar patterns of correlations were found with all three domain scores. These results indicated that there is evidence for the construct validity of the AQLQ-NAA and its domains. The AQLQ-NAA should provide a useful measure of HRQOL in asthma-specific medical interventions for the population in which it was developed.

Victim impact panels: who is sentenced to attend? Does attendance affect recidivism of first-time DWI offenders?

BACKGROUND

Victim Impact Panels (VIPs) have been implemented widely in the United States by judges as a deterrent to drinking and driving, but there is little evidence of their utility in preventing recidivism.

OBJECTIVES

The objectives of this study were to examine judges' referral patterns to the VIPs among a multiethnic population of convicted first-time driving while impaired (DWI) offenders and to compare 5-year recidivism rates of those mandated and not mandated to attend the VIP.

METHODS

Study participants included 5,238 convicted first-time DWI offenders who were referred to a screening program in Bernalillo County, New Mexico, and who completed a personal interview with a master's-level counselor between April 1989 and October 1995. Logistic regression analysis was used to evaluate judges' preferences in mandating offenders to attend a VIP. The percent of subjects reoffending in the 5 years following their referral for screening was calculated by standard life-table analyses. Cox proportional hazards analysis was used to test the effects of known independent predictors for recidivism. Separate models were developed for the entire population, non-Hispanic offenders, and Hispanic/Mexican national subgroups.

RESULTS

Female judges who regularly adjudicated DWI offenders were more likely to refer offenders to a VIP. Judges were less likely to refer men and offenders with less than 12 years of education and an unknown arrest blood alcohol concentration (BAC), and of Hispanic/Mexican national or other race/ ethnicity. Judges were more likely to refer unmarried offenders to a VIP. After controlling for multiple risk factors, referral to VIP was not a strong predictor of recidivism in Hispanic and non-Hispanic ethnic groups, with 95% confidence limits ranging from 0.8 to 1.0, compared to those not referred.

CONCLUSIONS

Female judges were more likely than male judges to refer offenders to a VIP, and referral patterns varied by offender characteristics. The VIP referral did not increase rearrest rates but lowered them marginally to not at all. This study should be followed up with a randomized design to control for referral patterns and to further define the impact of mandating offenders to the VIP.

Increased serum levels of N-telopeptides (NTx) of bone collagen in postmenopausal Nigerian women

Serum levels of cross-linked N-telopeptides (NTx) of bone collagen, alkaline phosphatase (ALP), and intact parathyroid hormone (PTH) were determined in 64 premenopausal (PRM) and 86 postmenopausal (PSM) women living in northern Nigeria. Serum NTx values were correlated with ALP activity (r = 0.31-0.58, P < 0.01) and PTH (0. 32-0.35, P < 0.01)) in all of the subjects studied, and were also related to age (-0.47, P < 0.001) and body mass index (-0.45, P < 0. 001) in PRM women. Menopause had the effect of increasing the circulating concentrations of NTx and ALP activity by 15% (P = 0. 001) and 11% (P = 0.02), respectively; however, serum levels of PTH were not different between these two groups of women. Compared with Caucasian counterparts matched for age and body mass index, PSM Nigerian women had significantly increased circulating concentrations of NTx (21.7 versus 16.2 nmol BCE/liter, P = 0.01) and demonstrated a trend towards higher ALP activities and PTH levels. These results indicate that (1) discrete reference intervals should be defined for biochemical markers of bone metabolism in African populations, (2) Nigerian women have relatively higher rates of bone turnover, and (3) further investigation of the implications of increased serum NTx should be undertaken using physical methods such as dual X-ray absorptiometry (DXA) and bone ultrasound attenuation.

Determination of cystic fibrosis carrier frequency for Zuni native Americans of New Mexico

The Zuni native Americans of the Southwest have an incidence of cystic fibrosis of approximately one in 333 or seven and one-half times that found for Caucasians. Earlier studies indicated that dF508 was not among the cystic fibrosis mutations causing this disease. Through a collaborative study the R1162X mutation was found on 12 out of 12 cystic fibrosis chromosomes from six Zuni patients. Because of the relative high incidence of cystic fibrosis, we undertook a study to determine the carrier frequency of the R1162X mutation among randomly sampled individuals. We found the carrier frequency in the general population for the R1162X to be 6.7%, a very significant number when compared with the carrier frequency for all cystic fibrosis mutations in the Caucasian population of approximately 4%.

Changing trends in mortality among New Mexico's American Indians, 1958-1987

Health care availability and living conditions have improved substantially for American Indians in New Mexico over the past quarter century. To investigate the impact of these changes on health statistics, we examined mortality data collected from 1958 to 1987 for American Indians in the state. We analysed the data for all causes of death combined and for specific causes, and compared these data with figures for nonHispanic whites in the state. Age-adjusted mortality rates were calculated for 5-year periods for each ethnic-gender group, using denominators from US Census reports. Mortality rates for all causes combined did not improve significantly for American Indian males from 1958 to 1987, although the rates for American Indian females showed an 8% decline. Infectious disease-related mortality rates for American Indians decreased dramatically over the 30-year study period; however, mortality rates for cancer and diabetes increased over the 30-year period. Mortality rates for injuries and alcoholism among American Indians increased greatly from 1958 to 1977 and then declined later in the study period, but they were consistently higher than rates for whites. The study indicates that several chronic diseases remain of major public health importance for New Mexico's American Indian population.

Response of the New Mexico Disaster Medical Assistance Team in St. Croix after Hurricane Hugo

Our DMAT pulled together with the energy, flexibility, and adaptability necessary to make things work. Sally Coan expressed it best, saying, "I was with a group of people who would do anything [that was] needed." Dedication and trust within the DMAT helped create lasting friendships. The islanders were appreciative and we formed attachments to them that made them too dear to leave without sadness. The DMAT did leave, but we left in place an established medical system that the island would not otherwise have had a standard of care of which we felt proud.

Symmetrical osteoporosis (spongy hyperostosis) in a prehistoric skull from New Mexico

Fragments of an Anasazi skull (Pueblo II-III) from New Mexico are described. Lesions of symmetrical osteoporosis were found and their anatomical and roentgenographic characteristics are discussed. The term symmetrical osteoporosis has led to confusion with the unrelated disease osteoporosis and should be replaced by the designation spongy hyperostosis.