Biodiversity conservation efforts have been criticized for generating inequitable socio‐economic outcomes. These equity challenges are largely analyzed as place‐based problems affecting local communities directly impacted by conservation programs. The conservation of migratory species extends this problem geographically since people in one place may benefit while those in another bear the costs of conservation. The
COVID‐19 has highlighted a brutal reality known for decades, that Black, Indigenous, and People of Color bear a disproportionate burden of US annual sepsis cases. While plentiful research funds have been spent investigating genetic reasons for racial disparities in sepsis, an abundance of research shows that sepsis incidence and mortality maps to indicators of colonial practices including residential segregation, economic and marginalization sepsis, and denial of care. Here we argue that sepsis risk is an immunological embodiment of racism in colonial states, that the factors contributing to sepsis disparities are insidious and systemic. We show that regardless of causative pathogen, or host ancestry, racialized people get and die of sepsis most frequently in a pattern repeatedly reiterated worldwide. Lastly, we argue that while alleviation of sepsis disparities requires radical, multiscale intervention, biological anthropologists have a responsibility in this crisis. While some of us can harness our expertise to take on the ground action in sepsis prevention, all of us can leverage our positions as the first point of contact for in depth human biology instruction on most college campuses. As a leading cause of death worldwide, and a syndrome that exhibits the interplay between human physiology, race and environment, sepsis is at the nexus of major themes in biological anthropology and is a natural fit for the field's curriculum. In adopting a discussion of race and sepsis in our courses, we not only develop new research areas but increase public awareness of both sepsis and the factors contributing to uneven sepsis burden.
more » « less- Award ID(s):
- 1750675
- NSF-PAR ID:
- 10374692
- Publisher / Repository:
- Wiley Blackwell (John Wiley & Sons)
- Date Published:
- Journal Name:
- American Journal of Biological Anthropology
- Volume:
- 178
- Issue:
- S74
- ISSN:
- 2692-7691
- Format(s):
- Medium: X Size: p. 230-255
- Size(s):
- ["p. 230-255"]
- Sponsoring Org:
- National Science Foundation
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Abstract spatial subsidies approach offers an effective tool for analyzing such relationships between places connected by migratory species. Designed to quantify ecosystem services provided and received in specific locations across a migratory species’ range—and the disparities between them—the spatial subsidies approach highlights three axes of inequity: between indigenous and settler colonial societies, between urban and rural populations, and between the Global North and Global South. Recognizing these relationships is critical to achieving two mutually reinforcing policy goals: avoiding inequitable conservation outcomes in efforts to conserve migratory species, and ensuring effective long‐term conservation of migratory species. In demonstrating how the spatial subsidies approach enables the identification and quantification of inequities involving three migratory species (northern pintail ducks, monarch butterflies, and Mexican free‐tailed bats), we argue that a spatial subsidies approach could apply to migratory species conservation efforts worldwide under the context of “payments for ecosystem services.” -
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Background Despite significant global progress in reducing neonatal mortality, bacterial sepsis remains a major cause of neonatal deaths.
Klebsiella pneumoniae (K .pneumoniae ) is the leading pathogen globally underlying cases of neonatal sepsis and is frequently resistant to antibiotic treatment regimens recommended by the World Health Organization (WHO), including first-line therapy with ampicillin and gentamicin, second-line therapy with amikacin and ceftazidime, and meropenem. Maternal vaccination to prevent neonatal infection could reduce the burden ofK .pneumoniae neonatal sepsis in low- and middle-income countries (LMICs), but the potential impact of vaccination remains poorly quantified. We estimated the potential impact of such vaccination on cases and deaths ofK .pneumoniae neonatal sepsis and project the global effects of routine immunization of pregnant women with theK .pneumoniae vaccine as antimicrobial resistance (AMR) increases.Methods and findings We developed a Bayesian mixture-modeling framework to estimate the effects of a hypothetical
K .pneumoniae maternal vaccine with 70% efficacy administered with coverage equivalent to that of the maternal tetanus vaccine on neonatal sepsis infections and mortality. To parameterize our model, we used data from 3 global studies of neonatal sepsis and/or mortality—with 2,330 neonates who died with sepsis surveilled from 2016 to 2020 undertaken in 18 mainly LMICs across all WHO regions (Ethiopia, Kenya, Mali, Mozambique, Nigeria, Rwanda, Sierra Leone, South Africa, Uganda, Brazil, Italy, Greece, Pakistan, Bangladesh, India, Thailand, China, and Vietnam). Within these studies, 26.95% of fatal neonatal sepsis cases were culture-positive forK .pneumoniae . We analyzed 9,070K .pneumoniae genomes from human isolates gathered globally from 2001 to 2020 to quantify the temporal rate of acquisition of AMR genes inK .pneumoniae isolates to predict the future number of drug-resistant cases and deaths that could be averted by vaccination.Resistance rates to carbapenems are increasing most rapidly and 22.43% [95th percentile Bayesian credible interval (CrI): 5.24 to 41.42] of neonatal sepsis deaths are caused by meropenem-resistant
K .pneumoniae . Globally, we estimate that maternal vaccination could avert 80,258 [CrI: 18,084 to 189,040] neonatal deaths and 399,015 [CrI: 334,523 to 485,442] neonatal sepsis cases yearly worldwide, accounting for more than 3.40% [CrI: 0.75 to 8.01] of all neonatal deaths. The largest relative benefits are in Africa (Sierra Leone, Mali, Niger) and South-East Asia (Bangladesh) where vaccination could avert over 6% of all neonatal deaths. Nevertheless, our modeling only considers country-level trends inK .pneumoniae neonatal sepsis deaths and is unable to consider within-country variability in bacterial prevalence that may impact the projected burden of sepsis.Conclusions A
K .pneumoniae maternal vaccine could have widespread, sustained global benefits as AMR inK .pneumoniae continues to increase. -
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Abstract Though safe drinking water for all is a global public health goal, disparities in access persist worldwide. We present a critical review of primary‐data based environmental justice (EJ) studies on drinking water. We examine their findings in relation to the broader EJ and drinking water literatures. Using pre‐specified protocols to screen 2423 records, we identified 33 studies for inclusion. We organized our results using the following questions: (1) what sampling and data collection methods are used; (2) how is (un)just access to water defined and measured; (3) what forms of environmental injustice are discussed; (4) how are affected communities resisting or coping; and (5) what, if any, mechanisms of redress are advocated? We find that while many studies analyze the causes and persistence of environmental injustices, most primary‐data studies on drinking water are cross‐sectional in design. Many such studies are motivated by health impacts but few measure drinking water exposures or associated health outcomes. We find that, while distinct types of injustice exist, multiple types are either co‐produced or exacerbate one another. Recognitional injustice is emerging as an undergirding injustice upon which others (distributional or procedural) can take hold. Tensions remain regarding the role of the state; redress for inequitable water access is often presumed to be the state's responsibility, but many EJ scholars argue that the state itself perpetuates inequitable conditions. The accountability for redress under different forms of water governance remains an important area for future research.
This article is categorized under:
Human Water > Methods
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Objective: Mortality-trends from alcoholic liver disease (ALD) have recently increased and they differ by various factors in the U.S. However, these trends have only been analyzed using univariate models and in reality they may be influenced by various factors. We thus examined trends in age-standardized mortality from ALD among U.S. adults for 1999-2017, using multivariable piecewise log-linear models. Methods: We collected mortality-data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database, using the Underlying Cause of Death. Results: We identified 296,194 deaths from ALD and 346,386 deaths indirectly attributable to ALD during the period from 1999-2017. The multivariable-adjusted, age-standardized ALD mortality was stable during 1999-2006 (annual percentage change [APC]=-2.24, P=0.24), and increased during 2006-2017 (APC=3.18, P<0.006). Their trends did not differ by sex, race, age or urbanization. Subgroup analyses revealed upward multivariable-adjusted, age-standardized mortality-trends in alcoholic fatty liver (APC=4.64, P<0.001), alcoholic hepatitis (APC=4.38, P<0.001), and alcoholic cirrhosis (APC=5.33, P<0.001), but downward mortality-trends in alcoholic hepatic failure (APC=-1.63, P=0.006) and unspecified ALD (APC=-0.86, P=0.013). Strikingly, non-alcoholic cirrhosis also had an upward multivariable-adjusted, age-standardized mortality-trend (APC=0.69, P=0.046). By contrast, recent mortality-trends were stable for all cause of deaths (APC=-0.39, P=0.379) and downward for malignant neoplasms excluding liver cancer (APC=-2.82, P<0.001), infections (APC=-2.60, P<0.001), cardiovascular disease (APC=-0.69, P=0.044) and respiratory disease (APC=-0.56, P=0.002). The adjusted mortality with ALD as a contributing cause of death also had an upward trend during 2000-2017 (APC=5.47, P<0.001). Strikingly, common comorbidities of ALD, including hepatocellular carcinoma, cerebrovascular and ischemic heart cardiovascular diseases and sepsis, had upward trends during the past 14 to 16 years. Conclusions: ALD had an upward multivariable-adjusted, age-standardized mortality-trend among U.S. adults, without significant differences by sex, race, age or urbanization. Three ALD subtypes (alcoholic fatty liver, alcoholic hepatitis and alcoholic cirrhosis) and non-alcoholic cirrhosis had upward morality-trends, while other ALD subtypes and other causes of death did not.more » « less
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Abstract Background Historical trauma experienced by Indigenous peoples of North America is correlated with health disparities and is hypothesized to be associated with DNA methylation. Massive group traumas such as genocide, loss of land and foodways, and forced conversion to Western lifeways may be embodied and affect individuals, families, communities, cultures, and health. This study approaches research with Alaska Native people using a community-engaged approach designed to create mutually-beneficial partnerships, including intentional relationship development, capacity building, and sample and data care.
Methods A total of 117 Alaska Native individuals from two regions of Alaska joined the research study. Participants completed surveys on cultural identification, historical trauma (historical loss scale and historical loss associated symptoms scale), and general wellbeing. Participants provided a blood sample which was used to assess DNA methylation with the Illumina Infinium MethylationEPIC array.
Results We report an association between historical loss associated symptoms and DNA methylation at five CpG sites, evidencing the embodiment of historical trauma. We further report an association between cultural identification and general wellbeing, complementing evidence from oral narratives and additional studies that multiple aspects of cultural connection may buffer the effects of and/or aid in the healing process from historical trauma.
Conclusion A community-engaged approach emphasizes balanced partnerships between communities and researchers. Here, this approach helps better understand embodiment of historical trauma in Alaska Native peoples. This analysis reveals links between the historical trauma response and DNA methylation. Indigenous communities have been stigmatized for public health issues instead caused by systemic inequalities, social disparities, and discrimination, and we argue that the social determinants of health model in Alaska Native peoples must include the vast impact of historical trauma and ongoing colonial violence.
