“The decline in health is the inevitable outcome of the collapse of place”[1].

Tribes are disproportionately impacted by poor indoor air quality resulting from substandard housing, over-crowding, poor ventilation, unsafe cooking and heating practices, indoor smoking, and poor outdoor air quality.  Poor ventilation can cause moisture and mold problems and elevated radon levels, as well as high concentrations of air toxics related to household cleaning products and use of personal care products.  Other sources of air pollution can quickly degrade the indoor air, including combustion pollutants from wood stoves from cooking and heating or unvented gas appliances.  Since people spend a majority of their time indoors, specifically in their homes, poor indoor air quality can impact health and wellbeing of residents.

Native American children, older adults, and individuals with preexisting conditions are more vulnerable to the adverse health impacts of indoor air pollution.  Older adults are more likely to have chronic obstructive pulmonary disease (COPD) and asthma; younger children are more likely to have asthma and other lower respiratory tract infections (Singleton et al. 2005).  Indoor air pollution can exacerbate asthma and COPD (IOM 2000, Liu 2008).  Brim et al. (2008) reports that 13% of American Indian/Alaska Native (AI/AN) children has asthma compared with 9.6% of the general U.S. population of children.  Recent research by Singleton et al. (2012) reports that lower-respiratory-tract-infection (LRTI)-associated hospitalization rate for AI/AN children aged <5-y was 32% lower in 2006-2008 than the 1998-1999 rate, indicating some progress in improving child health (some of this is due to vaccines). But it was still 1.6 times higher than the general U.S. children rate.  Additionally a great disparity was seen for AI/AN infants for pneumonia hospitalization, with a 3-fold higher rate in AI/AN infants compared to the U.S. general infant population.  Singleton et al. states that closing this disparity gap “will require addressing housing and sanitation inequities and ensuring high immunization rates and access to care.”  Increased risks of hospitalization for pneumonia, respiratory syncytial virus (RSV), LRTI, and invasive pneumococcal disease have been associated with household crowding and woodstove use (Bulkow et al. 2002, Robin et al. 1996).  It is reported that these higher rates contribute to a high burden of chronic supportive lung disease (Redding et al. 2009).

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