Search Results (312)

Since 1992, we have promoted the use of descriptions from ethnographic data, including ancient, surviving oral traditions, to aid in explaining the iconography portrayed in pictographs and petroglyphs found in Missouri, particularly those at Picture Cave. The literature to which we refer is from American Indian groups related linguistically and connected to the pre-Columbian inhabitants of Missouri. In addition, we have had on-going conversations with many elder tribal members of the Dhegiha Sioux language group (including the Osage, Quapaw, and Kansa (the Ponca and Omaha are also part of this cognate linguistic group)). With the copious collections of southern Siouan ethnographic accounts, we have been able to explain salient features in the iconography of several of the detailed rock art motifs and vignettes, and propose interpretations. This Midwest region is part of the Cahokia interaction sphere, an area that displays western Mississippian symbolism associated with that found in Missouri rock art as well as on pottery, shell, and copper. Full article

Background/Objectives: Sexual health research involving young adolescents remains scarce despite rising rates of early sexual debut, pregnancies, and sexually transmitted infections (STIs) in this population. We explored community stakeholders’ perspectives on engaging young adolescents in sexual health research in Western New York to inform strategies for engaging young adolescents in sexual health research. Methods: This qualitative descriptive study was conducted from April 2022 to June 2023. Seventeen community stakeholders, including health education teachers, youth counselors, and adolescent health providers, participated in semi-structured in-depth interviews. Data were analyzed using conventional content analysis, managed by MAXQDA 2020. The rigor and trustworthiness of the data were ensured through triangulation with observations, peer debriefing, team analysis, and respondent validation. Results: Participants were predominantly female (94.1%), 52.9% Black/African American, 41.2% White, and 5.9% Caucasian–Indian American, and aged 23–59 years. Four themes emerged: perspectives on conducting sexual health research with young adolescents, recruitment strategies, sexual health questions appropriate for young adolescents, and building readiness for participation in sexual health research. Participants reported the need for sexual health research with young adolescents and recommended building a trusting relationship and involving schools, parents, and trusted community organizations in the research process. Suggested research questions included those related to awareness of sex, STIs, available resources, experiences with sexual education, and desired support. The findings also revealed the need to initiate sexual health conversations early when children start asking questions, as a foundation for meaningful participation in sexual health research. Conclusions: The findings suggest that sexual health research with young adolescents is feasible and necessary, with implications for the design of developmentally appropriate sexual health research and interventions grounded in trust and community collaboration. Future research should explore the perspectives of caregivers and young adolescents to inform studies and programs that are attuned to young adolescents’ developmental needs. Full article

Background: Cardiac arrest remains a significant public health challenge with variable mortality trends across different demographics and regions, affecting healthcare planning and intervention strategies. We conducted this study to analyze cardiac arrest-related mortality trends from 1999 to 2023 and predict future trends up to 2035. Methods: This study analyzed data from 1999 to 2023, focusing on cardiac arrest as the primary cause of death (ICD-10: I46). Age-adjusted mortality rates (AAMRs) were standardized according to the 2000 U.S. Census. Joinpoint regression was utilized to calculate annual percentage change (APC), and an ARIMA model with Python 3.10 was used for mortality predictions. Results: A total of 365,608 cardiac arrest-related deaths were recorded in the USA from 1999 to 2023. There was a sharp decline in mortality rate until 2001 (APC: −10.35, p < 0.05), followed by a slowed decline until 2013 (APC: −2.91, p < 0.05), and then a gradual uptrend. Males exhibited a higher AAMR (5.8, 95% CI: 5.8–5.9) compared to females (4.2, 95% CI: 4.1–4.2). African Americans had the highest AAMR (8.9, 95% CI: 8.9–9), followed by Caucasians (4.8, 95% CI: 4.8–4.9) and American Indians (3.5, 95% CI: 3.3–3.7). The South region of the US had the highest AAMR, followed by the Northeast, Midwest, and West. Alabama exhibited the highest AAMR, followed by Nevada and Hawaii. Predictive analysis suggests a potential stable slow downtrend in mortality rates by 2035 (AAMR: 4.28, 95% CI: −1.8–10.4). Conclusions: The observed trends and future predictions underscore the importance of targeted public health interventions and healthcare planning to address cardiac arrest mortality. Full article

The North American Great Lakes offer a dynamic case study of inundated cultural landscapes. These bodies of water and the life around them have never been static. While submerged lands offer avenues for archaeological research, it is essential to first understand that these cultural landscapes have also been flooded with invasive power dynamics through settler colonialism. For example, the land and water systems in Anishinaabe Akiing (the northern Great Lakes) have fundamentally shifted from flourishing life systems to poisoned areas and now struggle to deal with invasive species. When seeking to learn from or otherwise engage Indigenous knowledge, it is essential to work from a perspective that takes all these changes into consideration. There are Indigenous communities who are interested in these inundated landscapes, and in this research, but a pause, naandamo, is needed to ethically consider the ongoing process of settler colonialism and Indigenous perspectives. Here we address ethical considerations for researchers participating in, or interested in participating in, submerged site research. By incorporating settler colonialism as a methodology of understanding, we will provide an ethical starting place for working with Indigenous communities and inundated landscapes. Full article

Background: Ovarian cancer remains the deadliest and leading cause of gynecological cancer-associated mortality in the US. The aim of this study was to characterize the trends in the incidence of ovarian cancer between premenopausal and postmenopausal women to inform future targeted interventions. Methods: This population-based cross-sectional study analyzed data from the US Cancer Statistics (USCS) database, which covered the whole of the US population between 2001 and 2021. Joinpoint regression was used to compute the average annual percentage change (APC) with 95% confidence interval (CI) and age-standardized incidence rates per 1,000,000 population. Results: The results showed that the IR of ovarian cancer declined between 2001 and 2021. Postmenopausal women had greater decreases in the IR of ovarian cancer compared to premenopausal women who showed a small decline. When stratified by race/ethnicity, non-Hispanic American Indian/Alaska Native women aged 20–49 years experienced an increase in the IR of ovarian cancer (APC = 2.4; 95% CI 0.9 to 4.1) compared to other racial/ethnic groups which showed a decline. Joinpoint trend analyses identified one inflection point in localized ovarian cancer incidence trends among all three age groups: an initial decline from 2001 to 2011 among women 20–49 years old and 65+ years old, and from 2001 to 2012 among women 50–64 years old, followed by an upward trend thereafter to 2021. Similarly, there was one inflection point in the IR of ovarian cancer for the clear cell and endometrioid types among women aged 20–49 years old. Conclusions: The IR of ovarian cancer in the US declined significantly among postmenopausal compared to premenopausal women, for whom the IR of ovarian cancer decreased only slightly. Although encouraging, these findings show a need for continued efforts to improve early detection and prevention strategies to mitigate the burden of this deadly disease. Full article

Coccidioidomycosis (Valley fever), caused by Coccidioides spp., is a fungal infection endemic to semi-arid regions of the Americas. Despite 80 years of disease recognition in New Mexico, there is limited disease awareness. We incorporated clinical, epidemiological, and ecological datasets to summarize the knowledge of Valley fever in New Mexico. We analyzed 1541 human cases from 2006 to 2023. On average, 86 cases were reported each year (4.1 cases per 100,000 population per year). The highest levels of incidence were in southwestern New Mexico. American Indian or Alaska Natives in New Mexico had a 1.9 times higher incidence rate of coccidioidomycosis than White people, and among age groups, older populations in New Mexico had the highest incidence rates. We analyzed 300 soil samples near Las Cruces, New Mexico, for the presence of Coccidioides and reported the first known positive soil samples collected from the state, the majority of which were from grassland-dominated sites and from animal burrows. Sequence analyses in clinical specimens, wild animals, and soil samples confirmed that Coccidioides posadasii is the main causative species of coccidioidomycosis in New Mexico. Environmental surveillance validated that locally acquired infections could occur in, but are not limited to, Catron, Doña Ana, Sierra, and Socorro Counties. Full article

Objectives—Health screening data were collected from participants at Native American community and celebratory events to evaluate their health status and identify common health concerns. These results will form the basis for developing community-based health care interventions to address health inequalities. Design—A descriptive, observational design was used to gather data in line with STROBE guidelines. Results—The screening data revealed that this population was largely obese, had low bone mass, and were in various states of dehydration. These characteristics can lead to major health risks and morbidities including diabetes, hypertension, cancer, hormone and neurotransmitter imbalances, bone fractures, and psychological disorders such as depression and anxiety. Conclusions—Professional and community efforts are essential to meet the health care needs of this population and avoid the repercussions of obesity, low bone mass, and dehydration. By incorporating collaborative input from the Native American community, we intend to develop partnerships for goals of promoting effective, culturally appropriate interventions to meet these health inequalities and promote good health and well-being. Full article

Background: The disparities observed in COVID-19 vaccine access at the early stages of vaccine distribution highlight the need for vaccine distribution plans that consider equitable access. Strategies to identify areas with low access to vaccines that use a single pre-specified distance or time as a threshold to define accessibility may not represent reality. We propose a novel mobility data-driven (MDD) definition to identify areas that have low access to the COVID-19 vaccine. Methods: We collected geospatial mobility data for our MDD approach to determine areas of low access. We identified census tracts in Oregon with low access to the COVID-19 vaccine through two approaches—(1) an adapted United States Department of Agriculture (USDA) food desert definition and (2) our proposed MDD framework. Ten spatial and social measures of access were utilized to compare these two approaches. Results: Compered with USDA, low-access census tracts identified by the MDD definition have a lower spatial accessibility; higher rates of poverty, unemployment, uninsured individuals, and a population without high school diplomas; and a low per capita income. Moreover, we found that the proportion of older populations, as well as American Indian and Alaskan Native populations, as identified in the MDD low-access census tracts, is higher than that in the USDA definition. Conclusions: We believe that the new proposed framework using mobility data can identify more representative areas that have low access to COVID-19 vaccines. Our proposed framework provides a starting point for achieving the goal of the equitable distribution of resources. Full article

Background: The burden of liver cirrhosis correlated with diabetes mellitus (DM) poses a significant public health challenge in the United States. Both conditions independently contribute to high morbidity and mortality rates. While extensive individual analyses have been conducted, US trends in comorbid liver cirrhosis-DM-related mortality remain unexplored. This study seeks to investigate mortality trends associated with the simultaneous occurrence of liver cirrhosis and DM among U.S. adults over the period from 1999 to 2020. Methods: We conducted a descriptive analysis using publicly available mortality data from the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) database. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated using the 2000 U.S. standard population. Trends were stratified by year, age, sex, race/ethnicity, urbanization, region, and state. Joinpoint regression analysis was employed to determine annual percentage changes (APCs) and assess statistical significance (p < 0.05). Results: A total of 90,418 deaths were recorded among adults with both cirrhosis and DM between 1999 and 2020. The overall AAMR increased from 1.02/100,000 in 1999 to 1.78/100,000 in 2020, reflecting a significant upward trend in mortality. The highest mortality rates were observed in non-metropolitan regions, in the South, and among males, older adults (65+), and NH American Indian or Alaska Native and Hispanic populations. All demographic groups exhibited a pronounced mortality surge between 2018 and 2020. A state-level analysis revealed notable disparities, with Oklahoma and Texas presenting the highest AAMRs. Conclusions: Liver cirrhosis and diabetes-related mortality have been steadily increasing over the past two decades, with notable disparities in demographics and regions. These findings underscore the urgent necessity for targeted prevention, early intervention, and policy-level strategies specifically designed for high-risk populations to reduce future mortality rates in the US and ultimately, globally. Full article

Beer is one of the most widely consumed alcoholic beverages and is rich in nutrients. Meanwhile, bread waste is a major contributor to global food waste. This study investigated substituting up to 50% of malt with whole wheat bread in American lager, Indian pale ale, and Bavarian weiss ale to reduce bread waste and enhance beer’s nutritional profile. The study assessed physicochemical properties, bioactive compounds, and volatile profiles of bread-based beers versus traditional malt-based brews. Results showed that bread beers maintained key properties while increasing bioactive compounds, especially in Bavarian weiss, which had higher total polyphenol content (1.04 mg GAE mL⁻¹ compared to 0.507 mg GAE mL⁻¹). Antioxidant activity in weiss beer also increased (2.007–2.057 μMol DPPH mL⁻¹ relative to 0.68–1.75 μMol DPPH mL ⁻¹ in 100% malt weiss). PCA analysis highlighted a distinct bioactive profile in bread beers, with elevated phenylethyl alcohol and ethyl octanoate. Substituting malt with bread was feasible, producing beers of comparable quality and potential health benefits. These findings support bread as a sustainable, cost-effective malt alternative, reducing waste and enhancing beer within a circular economy framework. Full article

Queer, trans, and Two Spirit Native youth are rarely represented in research, with extant evidence continuously pointing out health disparities and pathologizing individual characteristics rather than accounting for the structural aspects of colonial society. Global Indigenous scholars have put forth a holistic conception of social and emotional wellbeing that integrates Indigenous sovereignty, strengths, and cultures, positing that Indigenous health is a culturally bound phenomenon. To move beyond these deficit-based framings and collate available scholarship, the present work presents the results of a scoping review surrounding the social and emotional wellbeing of queer, trans, and Two Spirit Native youth. Informed by the Indigiqueer ecological medicine wheel, the present work includes a breadth of health and wellbeing concepts for QT2S Native youth across micro and macro domains. A total of 27 articles met the criteria and were reviewed to (a) illuminate current experiences of QT2S Native youth, (b) provide recommendations for health providers to better support QT2S Native youth clients, and (c) suggest future research and data recommendations to build towards a holistic understanding of social and emotional wellbeing for queer, trans, and Two Spirit Native youth. Full article

In Ten Little Indians, Sherman Alexie presents nine poignant and emotionally resonant stories about Native Americans’ struggle with alienation and stereotypes. Instead of focusing merely on the ethnic identity of American Indians, Alexie writes about a particular group of people sharing similar circumstances and addresses their common humanity, namely their search for love and respect in urban spaces. Alexie questions the authenticity of Indian identity and asserts that a “mental reservation” exists in the minds of Indian people which significantly influences their perceptions of self and community. Race, as a medium of seeing “the other” permeates U.S. society, especially in the wake of terrorist attacks. However, racial profiling has proven to be an ineffective means of detecting criminals and criminal activities, and has obstructed social relationships, bringing emotions of fear, loneliness and grief to urban Indians. In response to the modernity crisis, Alexie explores the American Indian cosmopolitanism in Ten Little Indians, and envisions a human social community based on reciprocity and mutual respect. His concerns regarding ordinary people’s life experiences and their ways of forming healthy relationships exhibit his considerable hope for “the triumph of the ordinary”. Full article

Purpose: Because of shared mechanisms such as decreased access to health care, rurality and poverty may act synergistically to decrease colorectal cancer (CRC) survival. Methods: We conducted a retrospective cohort analysis of SEER data (22 registries) with census tract-level measures of poverty/rurality for the period 2006–2015. Multivariable Cox proportional hazard regressions were applied to examine the independent and intersectional associations of persistent poverty and rurality on 5-year cause-specific CRC survival across five racial/ethnic groups. Results: Among 532,868 CRC patients, non-Hispanic Blacks (NHB) demonstrated lower 5-year survival probability (64.2% vs. 68.3% in non-Hispanic Whites [NHW], 66.5% in American Indian/Alaska Natives [AI/AN], 72.1% in Asian/Pacific Islanders, and 68.7% in Hispanic groups) (p-value < 0.001). In adjusted analysis, CRC patients living in rural areas with poverty were at a 1.2–1.6-fold increased risk of CRC death than those who did not live in these areas in five racial/ethnic groups. In particular, AI/AN patients living in rural areas with poverty were 66% more likely to die from CRC (95% CI, 1.32, 2.08). Conclusions: CRC patients who live in rural or poverty areas in SEER areas in the U.S. have a poorer survival compared with those who do not live in such areas regardless of race/ethnicity. Significantly greater risk of CRC death was observed in AI/ANs. Impact: Patient navigators, community education or screening, and other health care system interventions may be helpful to address these disparities by socioeconomic status, race, and geographic residence. Multi-level interventions aimed at institutional racism and medical mistrust may also be helpful. Full article

Syndromic surveillance has evolved into a vital public health tool, providing near real-time data to detect and respond to health threats. While states administer syndromic surveillance systems, Tribal Epidemiology Centers (TECs) serve American Indian and Alaska Native (AIAN) communities across multistate regions, often encountering significant barriers to data access and utilization. This manuscript explores how TECs access and use syndromic surveillance data to address health disparities in AIAN populations, highlighting successes, innovations, and ongoing challenges. The Alaska Native Epidemiology Center (ANEC), Great Plains Tribal Epidemiology Center (GPTEC), and Northwest Tribal Epidemiology Center (NWTEC) provide insights into their syndromic surveillance practices. This includes data access methods, the creation of dashboards and reports, technical assistance for Tribal Health Organizations (THOs), and strategies for overcoming jurisdictional and data-sharing barriers. TECs have successfully leveraged syndromic surveillance to monitor critical health issues, including respiratory illnesses, substance misuse, behavioral health, and maternal care. Collaborative efforts have addressed race misclassification and data gaps, enabling targeted interventions such as air purifier distribution and improving health care delivery for tribal veterans. However, TECs can face restrictive data use agreements, jurisdictional misalignments, and limited access to granular data, hindering their ability to serve AIAN communities comprehensively. Syndromic surveillance offers transformative potential for improving public health in AIAN communities. To fully realize this potential, systemic changes are needed to streamline data-sharing agreements and improve data accuracy. These efforts, along with strong collaborations between TECs and state health departments, are critical to advancing health equity, respecting tribal sovereignty, and ensuring timely, actionable insights for AIAN populations. Full article

Background/Objectives: Early-onset cancer is an emerging global health concern, including in the United States. However, data on early-onset liver and intrahepatic bile duct cancer remain limited. This study aims to fill this gap by analyzing trends in early-onset liver and intrahepatic bile duct cancer in the United States over the past two decades. Methods: This study used National Childhood Cancer Registry data to examine temporal trends in early-onset liver and intrahepatic bile duct cancer in the United States. The analysis involved estimating age-adjusted incidence rates of early-onset liver and intrahepatic bile duct cancer, stratified by histological type, ethnicity, and sex. Results: In 2021, the age-adjusted incidence rate of early-onset liver and intrahepatic bile duct cancer was estimated at 0.53 per 100,000 population (95% Confidence Interval [CI]: 0.48–0.59). From 2001 to 2021, the age-adjusted incidence rate showed a significant annual percent change (APC) of 1.35% (95% CI: 0.87–1.83%). When stratified by sex, the age-adjusted incidence rate in females increased significantly (APC: 3.07%, 95% CI: 2.26–3.87%) while remaining stable in males. Among racial and ethnic groups, non-Hispanic American Indian and Alaska Native (AIAN) individuals had the highest age-adjusted incidence rate, recorded at 2.67 per 100,000 population (95% CI: 0.95–5.85). By histological type, hepatic carcinoma had the highest age-adjusted incidence rate, significantly increasing over time (APC: 1.47%, 95% CI: 0.96–1.99%). In contrast, the incidence rates for hepatoblastoma and unspecified hepatic tumors remained stable between 2001 and 2021. Conclusions: Our study identified an increasing incidence of early-onset liver and intrahepatic bile duct cancer in the United States, primarily driven by cases in females and hepatic carcinoma. Full article