Culture counts

The University of Arizona is on the land and territories of Indigenous Peoples, and today, Arizona is home to 22 federally recognized tribes, with Tucson being home to the O'odham and the Yaqui.

There is a disproportionate burden of contaminant exposure in underserved populations like Native Americans, and because their culture and traditions are closely woven with the environment, special strategies must be used to study and help these groups. Dr. Paloma Beamer, professor of public health, research scientist in the Asthma and Airway Disease Research Center, and director of the Community Engagement Core at the Southwest Environmental Health Sciences Center, shares how she takes a culturally-informed approach to conducting research with and devising interventions for Indigenous Peoples.

Tell us a little bit about your research.

I am most interested in understanding how people are exposed to contaminants. This can be chemicals or even viruses like COVID. Parts of our daily lives bring us into contact with contaminants - in our drinking water, the air we breathe, the consumer products we choose to buy and bring into our homes. I use my background in engineering to come up with interventions to reduce those exposures.

I came to this from engineering because I was really struggling to understand how we develop interventions without knowing where the main exposures are occurring. If you think about in the last year, the pandemic, we were so focused on droplets and surfaces when in reality, our field knew the air was always the predominant exposure route. Now that we've shifted that paradigm, it changes how we deal with things.

What has always interested me is understanding these exposures in communities that have been less served and understanding their disproportionate burden of these exposures.

Why are you interested in studying underserved populations, and what makes their exposures or experiences unique?

If I were to go back and look at my own life, it comes from growing up binational and bicultural between Mexico and the U.S., and really looking at my grandmothers’ homes because they were so different from one another. One lived in suburban California, and the other lived in Mexico in a cinderblock home with a corrugated roof. I could tell from a very young age how different their exposures were and how that impacted health.

Then, growing up in Bay Area and seeing the different regions that were impacted by the environment in different ways stimulated my interest in understanding how could I help serve or work in those communities that may not have as much access to the resources they need to protect themselves and to explain things in different culturally relevant ways so that people could understand how to protect themselves.

Over the years I’ve learned that how we're exposed really differs based upon some of our social and cultural practices, like what type of water we choose to drink. If we treat everybody as the same, we're not understanding how they are actually exposed to things.

You mentioned you must tailor your messaging to the group you're talking to. Can you speak a bit to that - why that's important and how you approach talking to different groups about their exposures and risks and how they can protect themselves?

One of the things that I’ve really learned over the last few years is that you really need to understand the community you're working with - every community is different. This varies from some rural, predominantly white communities in Arizona, to some of the Native American communities, to some of the ones that I’ve worked with along the U.S.-Mexico border.

With each community, the first step when we're working with them on an environmental health problem is to sit down and think, “What is the concern, and why is that a concern?” Then, “How are they exposed to these contaminants - what are all the differences?”

In particular with the Gold King Mine Spill and my work in the Navajo Nation, we found a lot of pathways that may not have occurred to more conventional researchers that were really important to the community, like how they interact with the river. We ended up doing an assessment where we ran focus groups and asked questions about how they used the river. We found 42 different activities where people were using either the water, the sediment from the river, or plants or animals that grew along the river.

They could have been exposed to contaminants that were in the river, and that hadn't been incorporated when EPA originally did the risk assessment, when they reopened the river, because they didn’t ask those questions.

How do you think your findings can change the way we assess what's going on and help these groups moving forward?

The first step if you're looking at a risk assessment to determine if something is potentially hazardous to the health is to identify all the ways people are exposed and to look at the frequency and intensity. We do this every day with COVID – when we go somewhere, we think about whether it will be indoors or outdoors, whether people will wear masks, and if people are vaccinated.

It's the same idea, except here, we were looking at lead and arsenic in the river. After the spill, we found a huge decline in their interactions with the river, which had much bigger implications than I think most of us can understand. We just don’t understand what it is like for an Indigenous community to not be able to pass on some of their traditional practices due to fear of contamination - that's a priceless shift in their way of life that maybe not something that they can recover from to maintain those cultural practices.

We hope to build a framework for taking culture and community practices into account when doing these sort of assessments in the future. 

You recently became the Community Engagement Core Director at The Southwest Environmental Health Sciences Center. That core has a long history of working with tribes, so can you tell us a little bit about the Center and what you do as Community Engagement Core Director?

The Center is funded by the National Institutes of Health, and it aims to bring together researchers to work on environmental health issues along with the translational research framework that goes all the way from bench science through policy change.

Within the Center, I run the Human Population Exposure Resource, and that's a core function that tries to get researchers engaged more in environmental health studies, as well as to get the community involved. It provides resources to researchers to help them with study design and execution, and it also helps to get the results back to the community to answer their questions. 
This resource works closely with the Community Engagement Core that I direct, and the idea behind being in both those roles is to bring together both perspectives - we're addressing the concerns the community has about environmental health, and we're also letting them know the findings from the researchers that they can use to protect their environmental health.

We are working on ways to improve communication about environmental health and better address risk perceptions people might have about something as simple as tap water versus bottled water.

We're also working towards sustainability. We know that here in Arizona, as well as across the U.S., that certain communities are impacted a lot more by environmental health, but the people that grew up in those communities are less represented in science. We’re working a lot on training the next generation so that we can build sustainability. We operated five summer programs this year from middle school, all the way through tribal Community College students.

We really want to give them a sense of belonging on campus - we want them to feel like they belong before they enroll because as we know, for underrepresented students that's one of the most important facets for success. 

What aspects of these roles have you found to be most challenging?

A big part of the work we do right now in public health is that you're constantly dealing with unexpected fires every day, like the mine spill or the pandemic. It’s also hard trying to maintain good, authentic relationships, making sure that we are responsive but are also addressing community concerns.

You are a master of three very different disciplines – public health, engineering, and Native American studies. Your multidisciplinary approach really aligns well with what we're all about here at BIO5. How has your interdisciplinary background benefited your research?

I've always felt really at home at BIO5 since I do cross so many disciplines. My graduate degrees are in engineering, but I when I came to Uof A and started in public health, I recognized that I needed to have more training in clinical and translational research and epidemiology. I was really fortunate at that time to get a career development award from NIH and to partner with the Asthma and Airway Disease Research Center to get more training in those areas, which has allowed me to develop a lot of skill sets including working with large data sets. 

I have now come to this point where I can sit at the nexus of all those areas and work with junior investigators that are interested in learning those areas to kind of increase the number of multi-disciplinary studies we can do on these topics here in Arizona.

What are some of your upcoming projects?

We have a study about dust exposure and children. It may sound a little bit esoteric and boring, but it does really matter how much dust children ingest because it has so many implications for their lifelong health. I have a three-year-old and an 11-year-old, and they highlight how important this route of exposure. They are exposed at a much higher rate per body weight than adults, and their bodies are still developing, so any kind of interference can actually have much longer lasting effects.

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LAND ACKNOWLEDGEMENT We respectfully acknowledge the University of Arizona is on the land and territories of Indigenous peoples. Today, Arizona is home to 22 federally recognized tribes, with Tucson being home to the O’odham and the Yaqui. Committed to diversity and inclusion, the University strives to build sustainable relationships with sovereign Native Nations and Indigenous communities through education offerings, partnerships, and community service.