Bringing Wastewater Tracking to Tribal Lands to Protect Families and Elders

Indigenous Americans, who make up two percent of the total U.S. population, were particularly vulnerable to poor outcomes from Covid-19, in part due to the high burden of chronic disease in the community.

For instance, 23.5 percent of the Indigenous population have diabetes compared to 8 percent of white, non-Hispanic people. They are also at a much higher risk for coronary heart disease, being 50 percent more likely to be diagnosed with this condition. While access to health care has improved, it remains inadequate, plagued by underfunding and healthcare worker shortages.

This is compounded by decades of systemic racism that has led to persistent health disparities and unmet need, resulting in a life expectancy that is 5.5 years lower than the combined U.S. population.

The high incidence of Covid-19 cases among Indigenous Americans is not news to Dr. Otakuye Conroy-Ben, Assistant Professor in ASU’s School of Sustainable Engineering and the Built Environment, who is helping oversee the PPI-supported along with Dr. Rolf Halden, Director of the Biodesign Center for Environmental Health Engineering and an ASU professor.

“Everyone in my family has gotten sick from Covid—some of them twice,” says Conroy-Ben, who grew up in Porcupine, S.D. on the Pine Ridge Indian Reservation. The same is true of her husband’s family, from the Navajo Tribe, and she lost her mother-in-law to the virus.

Wastewater monitoring gained renewed attention with the arrival of Covid-19, in part because it provided quick insights into communities as testing declined and vaccination plateaued. In the U.S., the Centers for Disease Control and Prevention launched a National Wastewater Surveillance Program and hundreds of wastewater programs have sprung up globally.

Halden’s own interest in the field shows its broad potential. He began studying wastewater surveillance after a grad student of his lost two friends to prescription drug addiction. He became convinced that wastewater could provide insights into a community’s health and potential risks, including when those most at risk were unlikely or unable to seek medical help. He began working with the city of Tempe in 2018.

The neighboring city of Tempe is an example. “We embraced wastewater surveillance when we realized we could combat opioid addictions with compassion, services and science,” said Rosa Inchausti, Deputy City Manager who has worked with the city for 29 years.

With the start of the Covid-19 outbreak, the city shifted its wastewater efforts to detect the virus, and recently expanded their geographic reach into Guadalupe, an underserved community of 6,700 sandwiched between Tempe and Phoenix, half of whose residents identify as members of the Yaqui tribe.

“Our work there exemplified and amplified our commitment to equity and inclusion,” Inchausti said. “We overlaid everything with our equity map, identified the most vulnerable, and set up wastewater testing at no cost to them. It allowed our larger community to understand where to put resources, where to send educational material.

“Rich data and trust,” she says. “That’s the power of local governments. That’s the future, period.”