finding 15.2 : key-message-15-2

Indigenous health is based on interconnected social and ecological systems that are being disrupted by a changing climate (high confidence). As these changes continue, the health of individuals and communities will be uniquely challenged by climate impacts to lands, waters, foods, and other plant and animal species (likely, high confidence). These impacts threaten sites, practices, and relationships with cultural, spiritual, or ceremonial importance that are foundational to Indigenous peoples’ cultural heritages, identities, and physical and mental health (high confidence).

This finding is from chapter 15 of Impacts, Risks, and Adaptation in the United States: The Fourth National Climate Assessment, Volume II.

Process for developing key messages:

The report authors developed this chapter through technical discussions of relevant evidence and expert deliberation via several meetings, teleconferences, and email exchanges between the spring of 2016 and June 2017. The authors considered inputs and comments submitted by the public in response to the U.S. Global Change Research Program’s (USGCRP) Federal Register Notices, as well as public input provided through regional engagement workshops and engagement webinars. The author team also considered comments provided by experts within federal agencies through a formal interagency review process.

Additional efforts to solicit input for the chapter were undertaken in 2016–2017. The Bureau of Indian Affairs (BIA) worked with partners, the College of Menominee Nation, and the Salish Kootenai College to develop and execute an outreach plan for the chapter. This included awarding mini-grants for community meetings in the fall of 2016 and attending and presenting at tribally focused meetings such as the American Indian Higher Education Consortium 2016 Student Conference (March 2016), the Annual National Conference of the Native American Fish and Wildlife Society (May 2016), the National Tribal Forum on Air Quality (May 2016), the workshops of Rising Voices (2016, 2017), the Native Waters on Arid Lands Tribal Summit (November 2017), the BIA Tribal Providers Conference in Alaska (November 2017), and the Tribes & First Nations Summit (December 2017), among others. Additionally, through these tribal partners, the BIA provided 28 travel scholarships to interested tribal partners to attend and comment on the initial draft content of all regional chapters at the USGCRP’s regional engagement workshops. Additional avenues to communicate during these formal open-comment periods included multiple webinars, website notices on the BIA Tribal Resilience Program page, and email notices through BIA and partner email lists. In particular, the BIA solicited comments from multiple tribal partners on the completeness of the online interactive version of the map in Figure 15.1. Chapter authors and collaborators also presented at interactive forums with tribal representatives, such as the National Adaptation Forum (2017), and in various webinars to extend awareness of formal requests for comment opportunities through the USGCRP and partners, such as the Pacific Northwest Tribal Climate Change Network. The feedback and reports from these activities were used to ensure that the Key Messages and supporting text included the most prominent topics and themes.

Description of evidence base:

Multiple epidemiological studies provide consistent and high-quality evidence that Indigenous peoples face health disparities according to conventional Western science approaches to assessing health risk; in general, Indigenous peoples have disproportionately higher rates of asthma,5a3ba94b-e83c-4f01-8156-d4b018006d0c cardiovascular disease,f5751fe0-05cf-47eb-8e47-3d84a1949c76,5328f11a-77d7-4f6c-88cc-5ca990872aad,3497dde6-91ae-47d4-8d37-e97f0d71e1bb,31eb5126-1705-4113-b686-f81617332d97 Alzheimer’s disease or dementia,ca4f6c75-7028-4bab-bc3c-c7b72ec1fa6c,46555650-d3fb-4b36-b9e0-912e75dcab03 diabetes,112e9785-ce7c-499c-9155-f7196017a0f5 and obesity.3497dde6-91ae-47d4-8d37-e97f0d71e1bb There is also robust qualitative evidence that various social determinants of health affect Indigenous health disparities, including historical trauma,162dba04-6e69-43e0-8450-60e2279679f3,e9137b2c-1fbd-4e41-8493-6394a4b6f1cc institutional racism, living and working circumstances that increase exposure to health threats, and limited access to healthcare services.c76d7935-9da3-4c4b-9186-86dc658bcc74,e9137b2c-1fbd-4e41-8493-6394a4b6f1cc A recent peer-reviewed scientific assessment of health concluded that these health disparities have direct linkages to increased vulnerability to climate change impacts from changes in the pollen season and allergenicity, air quality, and extreme weather events.f1e633d5-070a-4a7d-935b-a2281a0c9cb6

Additionally, a number of qualitative studies consistently find that Indigenous health, adaptive capacity, and health disparities/environmental justice issues typically do not capture many of the key elements of health and resilience that are important to Indigenous populations, which include concepts related to community connection, natural resources security, cultural use, education and knowledge, self-determination, and autonomy.98957f73-e40a-4a1e-b48d-01108d939123,719ba05e-ba19-43e4-ba3f-83d111809b59,b9a63264-fd0b-4b7e-a658-3c4d602b69c7,171d2a1b-b2d1-46ee-b1c2-2e2999637552,123baf63-1521-424b-9c14-f2827ad7ce18,25a6aed4-2794-45bc-8211-03d093ddc35b Available qualitative evidence consistently identifies Indigenous peoples as having a unique and interconnected relationship with the natural environment and wildlife that is integral to their place-based social, cultural, and spiritual identity; intangible cultural heritage (traditions or living expressions transmitted and inherited through generations); and subsistence practices and livelihoods that foster intra- and intergenerational knowledge sharing and relationships.6848eec2-534b-4629-967c-53d8530089a3,22ee4fef-966e-4fdd-ac3b-7503c4450956,5eff7771-5f15-43c7-8a4c-4383cac47316,98957f73-e40a-4a1e-b48d-01108d939123,719ba05e-ba19-43e4-ba3f-83d111809b59,25a6aed4-2794-45bc-8211-03d093ddc35b,c76d7935-9da3-4c4b-9186-86dc658bcc74,2ae3020a-26d0-41c8-a079-f5d129f2e183,be534331-f6a0-4d55-97ee-7d164dd653b2,b8c76481-c90d-422c-a96e-c9a8995f4860,add63799-e9cd-410d-87df-803f9e9b35ea,ea0d9e2a-65cb-4752-9d83-418c38efa380,eac03a8d-a422-4973-bfcf-b4e04916cb81 Climate impacts to lands, waters, foods, and other plant and animal species undermine these relationships, affect place-based cultural heritages and identities (including through damage to cultural heritage sites), may worsen historical trauma still experienced by many Indigenous peoples, and ultimately result in adverse mental health impacts.25a6aed4-2794-45bc-8211-03d093ddc35b,b8c76481-c90d-422c-a96e-c9a8995f4860,add63799-e9cd-410d-87df-803f9e9b35ea,f1601533-28d5-409b-83c4-2ff390596e71 There is robust documentation of observed adverse climate change related impacts on culture and food security,22ee4fef-966e-4fdd-ac3b-7503c4450956,5eff7771-5f15-43c7-8a4c-4383cac47316,2ae3020a-26d0-41c8-a079-f5d129f2e183,ea0d9e2a-65cb-4752-9d83-418c38efa380 physical health,f1e633d5-070a-4a7d-935b-a2281a0c9cb6 and mental health.c1162288-6379-4b60-b573-d0f8482d8fa0,b8c76481-c90d-422c-a96e-c9a8995f4860,add63799-e9cd-410d-87df-803f9e9b35ea,6b22a163-b918-48bf-993f-32e61712a455,f66b946f-c672-4a4b-8f71-1b05738e029e

The studies consistently conclude that these adverse impacts to culture,5eff7771-5f15-43c7-8a4c-4383cac47316,d642fb15-2aff-47da-9e99-355077803288 food security,5eff7771-5f15-43c7-8a4c-4383cac47316,2ae3020a-26d0-41c8-a079-f5d129f2e183 and overall human healthf1e633d5-070a-4a7d-935b-a2281a0c9cb6,2ae3020a-26d0-41c8-a079-f5d129f2e183,b8c76481-c90d-422c-a96e-c9a8995f4860,add63799-e9cd-410d-87df-803f9e9b35ea will continue under future projections of climate change, though methods for making these determinations vary, and there are limited quantitative or modeling results that are specific to Indigenous peoples in the United States.

There is consistent evidence from behavioral and public health research showing that responses to extreme heat serve as examples of climate change adaptation.99ab656c-36e4-4410-b5b3-7a6a360e6fa0,749bdc28-1eb2-4833-b7a3-09ec2afa6907,3a0fc24d-c88b-45b7-a805-1c722bfed64b,b942f09b-749a-47f0-8a95-afb35ccb9f15 There are also multiple examples of tribal health vulnerability assessments that acknowledge the role of traditional subsistence species, or First Foods, as an essential aspect of health and tribal resilience.0648fd9b-f6d4-474b-a6a6-7a8db5f1e5ac,dcd99b11-6940-4ea4-9696-427c994262a0 One example from the Republic of the Marshall Islands illustrates a community-led planning process that incorporates traditional knowledge, facilitates local self-determination, and supports climate adaptation, natural resource management, and community health goals.123baf63-1521-424b-9c14-f2827ad7ce18

New information and remaining uncertainties:

The literature currently lacks national-scale studies that quantify and/or monetize climate impacts on Indigenous health, either through traditional Western science health metrics or Indigenous values-based metrics and indicators of health. There are quantitative studies of specific health-relevant topics, such as climate impacts to air quality (Ch. 13: Air Quality) or extreme heat (Ch. 29: Mitigation), but health impact models have not to date been used to model Indigenous population-specific climate impacts. Quantitative national studies of climate impacts may have general applicability to Indigenous peoples, but their overall utility in quantifying impacts to Indigenous peoples may be limited, because there is uncertainty regarding the extent to which appropriate extrapolations can be made between Indigenous and non-Indigenous contexts. In addition, none of the studies explicitly modeled the effects of climate adaptation actions and the extent to which such actions may reduce Indigenous vulnerabilities or projected future impacts.

Other uncertainties include characterizing future impacts and vulnerabilities in a shifting policy landscape, in which vulnerabilities can be either exacerbated or alleviated in part by policy or programmatic changes, such as a recognition of the non-physiological aspects of Indigenous health.

Assessment of confidence based on evidence:

Based on available evidence, the authors have high confidence that Indigenous health is based on interconnected social and ecological systems that are being disrupted by a changing climate. The authors have high confidence in the available evidence indicating that it is likely that future climate change will increase impacts to lands, waters, foods, and other plant and animal species and that Indigenous health will be uniquely challenged by these impacts. The authors have high confidence, based on the quality of available evidence, that the lands, waters, foods, and other natural resources and species are foundational to Indigenous peoples’ cultural heritages, identities, and physical and mental health due to their essential role in maintaining Indigenous peoples’ sites, practices, and relationships with cultural, spiritual, or ceremonial importance.

References :

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