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

项目摘要 严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)大流行引发了人们的恐惧和 随着新冠肺炎病例和死亡人数在全球蔓延，疫情存在不确定性。部落土地上新冠肺炎的感染率 是美国全国平均水平的四倍多，而且还在增加。在美国，最高的新冠肺炎 人均感染率在纳瓦霍民族上，这是联邦承认的第二大部落。新冠肺炎 纳瓦霍民族的病例和死亡人数继续上升，因为在一些国家，新冠肺炎的病例已经开始下降 最初受灾最严重的州。迪内人(纳瓦霍人)患新城疫的风险更高，原因有很多。 19感染、并发症和死亡，包括但不限于食物、能源和水的不安全、高 潜在医疗条件(合并症)和环境健康因素的患病率。然而，我们有 没有直接证据表明，缺乏健康食品，糖尿病患病率高， 被金属污染的水是纳瓦霍民族新冠肺炎感染增加的原因。的确有 迫切需要确定与新冠肺炎感染相关的环境和个人风险因素 纳瓦霍民族居民死亡率和死亡率，以提供新的战略和政策，以缓解当前的 传播新冠肺炎，防止未来疫情暴发。我们的长期目标是缓解新冠肺炎的传播 以及纳瓦霍民族的其他疫情。我们的研究目标是确定个人和环境 纳瓦霍族居民新冠肺炎感染和死亡的危险因素我们假设每个人 患有合并症(如糖尿病)、社会经济状况较差(如没有室内管道的家庭)、 和/或生活在可获得无机污染物的水源的人患新冠肺炎的风险更高 感染和死亡。拟议研究的基本原理是，一旦新冠肺炎的特定风险因素 感染和死亡在纳瓦霍民族是已知的，它将有可能发展有用的社区教育 可能使这些高危社区受益的战略、公共卫生宣传和干预措施。目标1： 按章节(地区)确定新冠肺炎感染和死亡的环境和个人风险因素 纳瓦霍民族在6个月内。目标2：确定社区教育机制、公共卫生宣传 和干预措施，以减轻纳瓦霍民族新冠肺炎感染和死亡的风险因素。目标3： 确定社区教育和公共卫生宣传对公共卫生知识的有效性 在纳瓦霍民族中预防新冠肺炎感染和死亡的做法(如水源、分配) 居民。纳瓦霍民族正在积极应对新冠肺炎，纳瓦霍民族需要获得数据驱动 决策分析。我们选择将重点放在以下项目活动的初始项目活动的次要数据上 原因有很多。

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.