Investigating linkages between arsenic exposure, diabetes, and COVID-19 infections and risks on the Navajo Nation

项目摘要 严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）大流行引起了恐惧， 随着COVID-19病例和死亡病例在地球仪蔓延，不确定性日益增加。部落土地上的COVID-19感染率 是美国全国平均水平的四倍多，而且还在继续增长。在美国，最高的COVID-19 纳瓦霍族是联邦政府承认的第二大部落。COVID-19 纳瓦霍民族的病例和死亡人数继续上升，因为COVID-19病例在一些 最初受打击最严重的国家。迪内人（纳瓦霍人）感染新冠病毒的风险较高的原因有很多- 19例感染、并发症和死亡，包括但不限于食物、能源和水不安全， 基础疾病（合并症）的患病率和环境健康因素。但我们 没有直接的证据表明缺乏健康食品，糖尿病的高患病率， 金属污染的水是纳瓦霍族COVID-19感染增加的原因。有 迫切需要确定与COVID-19感染相关的环境和个人风险因素 纳瓦霍族居民的死亡率和死亡率，为缓解当前疫情的新战略和政策提供信息 防止COVID-19的传播，并防止未来爆发。我们的长期目标是减缓COVID-19的传播 以及其他纳瓦霍部落爆发的疾病我们的研究目标是识别个体和环境 纳瓦霍族居民中COVID-19感染和死亡的风险因素。我们假设个体 合并症（例如，糖尿病），在低社会经济状况下（例如，没有室内管道的家庭）， 和/或生活在有无机污染物的水源中将有更高的COVID-19风险 感染和死亡。拟议研究的理由是，一旦COVID-19的特定风险因素 感染和死亡是众所周知的纳瓦霍民族，它将有可能发展有用的社区教育 战略，公共卫生信息和干预措施，可能有利于这些高风险社区。目标1： 按章节（地区）确定COVID-19感染和死亡的环境和个人风险因素， 纳瓦霍族在6个月内。目标2：确定社区教育机制，公共卫生信息 以及减轻纳瓦霍族COVID-19感染和死亡风险因素的干预措施。目标3： 确定关于公共卫生知识的社区教育和公共卫生信息的有效性 防止纳瓦霍族感染COVID-19和死亡的做法（如水源、分配） 居民纳瓦霍族正在积极应对COVID-19，纳瓦霍族需要获得数据驱动的 决策分析。我们选择将重点放在初步项目活动的二手数据上， 有很多原因。

Project Summary The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has generated fear and uncertainty as COVID-19 cases and fatalities spread across the globe. COVID-19 infection rates on tribal lands are more than four times the US national average and are still increasing. In the US, the highest COVID-19 infection rate per capita is on the Navajo Nation, the second largest federally recognized tribe. COVID-19 cases and deaths for the Navajo Nation continue to rise as COVID-19 cases have begun to decline in some of the initially hardest hit states. There are many reasons that Diné people (Navajo) are at higher risk for COVID- 19 infections, complications, and death including, but not limited to food, energy and water-insecurities, high prevalence of underlying medical conditions (comorbidities), and environmental health factors. However, we do not have direct evidence that the lack of access to healthy foods, high prevalence of diabetes, and heavy metal-contaminated water are responsible for increased COVID-19 infections on the Navajo Nation. There is an urgent need to identify the environmental and individual risk factors associated with COVID-19 infection rates and deaths among Navajo Nation residents to inform new strategies and policies to mitigate the current spread of COVID-19 and prevent future outbreaks. Our long-term goal is to mitigate the spread of COVID-19 and other outbreaks on the Navajo Nation. Our research objective is to identify individual and environmental risk factors for COVID-19 infection and death among Navajo Nation residents. We hypothesize that individuals with comorbidities (e.g., diabetes), in low socioeconomic situations (e.g., households without indoor plumbing), and/or living with access to water sources with inorganic contaminants will have a higher risk of COVID-19 infection and death. The rationale for the proposed research is that, once the specific risk factors for COVID-19 infection and death are known on the Navajo Nation, it will be possible to develop useful community education strategies, public health messaging and interventions that may benefit these high-risk communities. AIM 1: Identify environmental and individual risk factors for COVID-19 infection and death by Chapter (regions) on the Navajo Nation within 6 months. AIM 2: Identify community education mechanisms, public health messaging and interventions to mitigate risk factors for COVID-19 infection and death in Navajo Nation. AIM 3: Determine effectiveness of community education and public health messaging on knowledge of public health practices (e.g. water sources, distribution) to prevent COVID-19 infection and death among Navajo Nation residents. The Navajo Nation is actively addressing COVID-19, the Navajo Nation needs access to data-driven analyses for decision-making. We have chosen to focus on secondary data for the initial project activities for multiple reasons.