# Water for Health: Strengthening Tribal Action for Cancer Prevention

> **NIH NIH U19** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2024 · $785,499

## Abstract

PROJECT 2: WATER FOR HEALTH: PROJECT SUMMARY
For decades, the Strong Heart Study (SHS) has collaborated with American Indian/Alaska Native (AI/AN)
communities in the Northern Plains, Southern Plains, and Southwest to improve cardiovascular health through
various multi-level interventions and state-of-the-art epidemiologic research. AI/AN communities experience
significantly elevated drinking water arsenic and uranium exposures in both private wells and regulated public
drinking water systems. However, the contribution of these modifiable drinking water exposures to AI/AN
disparities in arsenic and uranium-associated cancer incidence mortality remains poorly characterized.
Arsenic- and uranium- associated cancers are of increasing concern for SHS communities and AI/AN
communities nationwide, as AI/AN communities experience increasing disparities in incidence for these
cancers (lung, bladder, kidney, pancreas, prostate). The objective of the proposed project is to support multi-
level interventions to reduce water arsenic and uranium for AI/AN communities, with the ultimate goal of
reducing arsenic and uranium associated cancers for AI/AN communities. The proposed project is grounded in
a conceptual model linking local social-ecological frameworks for health disparities and disparities in water
arsenic exposures with Indigenous frameworks weaving mainstream science with Indigenous Knowledge. In
Aim 1, we will comprehensively characterize exposure to arsenic and uranium in unregulated well and public
water systems across all SHS communities and disseminate individualized dashboards to tribal communities.
In addition to leveraging available resources that have not been compiled for stakeholder use, we will extend
process-based models for estimating groundwater arsenic and geospatial models of arsenic/uranium in
regulated public water to all SHS communities. In Aim 2, we will conduct state-of-the-art epidemiologic
analyses to evaluate the association between water arsenic and uranium with incident and fatal cancers of the
lung, bladder, kidney, pancreas, and prostate in the SHS, with a focus on estimating the impacts of potential
interventions on cancer rates. These data are critical because AI/AN populations remain unrepresented in
epidemiologic science driving federal drinking water standards. In Aim 3, we will conduct formative research
with eight SHS communities and comprehensively review successful multi-level intervention plans with
community priorities, needs, strengths, and challenges, with the ultimate goal of supporting communities to
develop culturally relevant and individualized intervention plans to reduce water arsenic and uranium. Our
proposal brings together a multi-disciplinary, multi-site team, and leverages decades of collaboration and
community engagement with SHS communities across all three SHS study sites. The proposed study
responds directly to the NIMHD-identified need for community-driven prevention strategies to reduce the
i...

## Key facts

- **NIH application ID:** 11161060
- **Project number:** 1U19MD020537-01
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Anne E Nigra
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $785,499
- **Award type:** 1
- **Project period:** 2024-09-17 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11161060

## Citation

> US National Institutes of Health, RePORTER application 11161060, Water for Health: Strengthening Tribal Action for Cancer Prevention (1U19MD020537-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/11161060. Licensed CC0.

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