Strong Heart Study
Native communities bear a disproportionate share of risk from environmental exposures. The Strong Heart Study (SHS) is an ongoing population-based prospective cohort study of American Indian (AI) adults and their family members from 13 tribal communities in Arizona, Oklahoma and North and South Dakota that emphasizes environmental health. Working in partnership with the SHS investigators and communities, we have recently shown that arsenic and cadmium exposure levels were disproportionately higher in the SHS participants than in the general U.S. population. Moreover, arsenic and cadmium exposures were related to increased cardiovascular disease (CVD) incidence and mortality, type 2 diabetes, and/or cancer mortality. These findings underscore a pressing need to conduct rigorous, relevant research to elucidate the links of environmental health disparities with chronic conditions that are highly prevalent in the SHS and other Native communities.
Chronic Health Effects of Arsenic and Other Metals
Our research investigates clinical and subclinical health effects of arsenic and other metals, including cardiovascular disease, diabetes, kidney disease, and cancer mortality. By elucidating the contribution of metals in chronic diseases, our research informs and impacts environmental health policies and interventions.
We investigate the interaction of genetic markers in the development of chronic diseases, particularly diabetes, obesity and the metabolic syndrome with arsenic exposure and arsenic metabolism in American Indian communities. Our goal is to identify population-groups that are most susceptible to the health effects of arsenic and other environmental exposures.
Evidence from our study and others indicates a role for metals as independent risk factors for cardiovascular disease and other chronic diseases. To characterize and understand these health effects, we are evaluating the role of epigenetic modifications, in particular DNA methylation, as potential mediators of health effects of exposure to metals, as well as the interplay between genetics, epigenetics and environment in environmental health disparities.
Drinking Water Intervention
Effective interventions are urgently needed to mitigate arsenic exposure in the Strong Heart Study communities, especially in areas of North and South Dakota that cannot be connected to community drinking water systems. Through substantial community engagement, we are planning a study that will develop, pilot, and evaluate the effectiveness of a multi-level participatory intervention to prevent arsenic exposure in rural communities.