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Equity in health care is a basic human right, yet disparities in health and wellness exist across racial lines. Despite the fact that disparities in Indigenous People's health are particularly dramatic, they are less well understood. This volume focuses on the American Indian, in whom disparities in health are particularly severe. In a disease-specific format, health disparities in the American Indian are identified and discussed, with an emphasis on causes and solutions. Edited by experts in healthcare disparities, one of whom is a member of the Oglala Lakota Tribe, this book focuses attention on the historically overlooked and underappreciated problem of inadequate healthcare for the American Indian and has relevance for Indigenous People's health around the world. Of interest to all concerned with equity and inclusiveness in healthcare, it will be essential reading for physicians, public health workers, academics, and Indigenous People worldwide.

\"In this gutsy, eye-opening examination of the lives of workers in the New South, Vanesa Ribas, working alongside mostly Latino/a and native-born African American laborers for sixteen months, takes us inside the contemporary American slaughterhouse. Ribas, a native Spanish speaker, occupies an insider/outsider status there, enabling her to capture vividly the oppressive exploitation experienced by her fellow workers. She showcases the particular vulnerabilities faced by immigrant workers--a constant looming threat of deportation, reluctance to seek medical attention, and family separation--as she also illuminates how workers find connection and moments of pleasure during their grueling shifts. Bringing to the fore the words, ideas, and struggles of the workers themselves, On The Line underlines how deep racial tensions permeate the factory, as an overwhelmingly minority workforce is subject to white dominance. Compulsively readable, this extraordinary ethnography makes a powerful case for greater labor protection, especially for our nation's most vulnerable workers\"--Provided by publisher.

Draft genomes of two south-central Siberian individuals dating to 24,000 and 17,000 years ago show that they are genetically closely related to modern-day western Eurasians and Native Americans but not to east Asians; the results have implications for our understanding of the origins of Native Americans. Intertwining roots of the First Americans Where did the First Americans come from, and who were they? On both counts the interpretation of the genetic and archaeological evidence causes controversy. The publication of the draft genome of a 24,000-year-old human specimen from Mal'ta in south-central Siberia — the earliest modern human genome sequence reported to date — may help to clarify matters. Eske Willerslev and colleagues find that the Mal'ta individual is genetically closely related to modern-day Native Americans and basal to modern-day western Eurasians, but has no close affinity to east Asians. This implies that populations related to modern-day western Eurasians had a more northeasterly distribution in the past than commonly thought. The authors estimate that between 14 and 38% of Native American ancestry originates from this ancient Mal'ta group and is therefore not of east Asian but rather of western Eurasian ancestry, which may explain why several First American crania have been reported as bearing non-east Asian features. The origins of the First Americans remain contentious. Although Native Americans seem to be genetically most closely related to east Asians 1 , 2 , 3 , there is no consensus with regard to which specific Old World populations they are closest to 4 , 5 , 6 , 7 , 8 . Here we sequence the draft genome of an approximately 24,000-year-old individual (MA-1), from Mal’ta in south-central Siberia 9 , to an average depth of 1×. To our knowledge this is the oldest anatomically modern human genome reported to date. The MA-1 mitochondrial genome belongs to haplogroup U, which has also been found at high frequency among Upper Palaeolithic and Mesolithic European hunter-gatherers 10 , 11 , 12 , and the Y chromosome of MA-1 is basal to modern-day western Eurasians and near the root of most Native American lineages 5 . Similarly, we find autosomal evidence that MA-1 is basal to modern-day western Eurasians and genetically closely related to modern-day Native Americans, with no close affinity to east Asians. This suggests that populations related to contemporary western Eurasians had a more north-easterly distribution 24,000 years ago than commonly thought. Furthermore, we estimate that 14 to 38% of Native American ancestry may originate through gene flow from this ancient population. This is likely to have occurred after the divergence of Native American ancestors from east Asian ancestors, but before the diversification of Native American populations in the New World. Gene flow from the MA-1 lineage into Native American ancestors could explain why several crania from the First Americans have been reported as bearing morphological characteristics that do not resemble those of east Asians 2 , 13 . Sequencing of another south-central Siberian, Afontova Gora-2 dating to approximately 17,000 years ago 14 , revealed similar autosomal genetic signatures as MA-1, suggesting that the region was continuously occupied by humans throughout the Last Glacial Maximum. Our findings reveal that western Eurasian genetic signatures in modern-day Native Americans derive not only from post-Columbian admixture, as commonly thought, but also from a mixed ancestry of the First Americans.

This innovative ethnographic study animates the racial politics that underlie genomic research into type 2 diabetes, one of the most widespread chronic diseases and one that affects ethnic groups disproportionately. Michael J. Montoya follows blood donations from \"Mexican-American\" donors to laboratories that are searching out genetic contributions to diabetes. His analysis lays bare the politics and ethics of the research process, addressing the implicit contradiction of undertaking genetic research that reinscribes race's importance even as it is being demonstrated to have little scientific validity. In placing DNA sampling, processing, data set sharing, and carefully crafted science into a broader social context, Making the Mexican Diabetic underscores the implications of geneticizing disease while illuminating the significance of type 2 diabetes research in American life.

In the United States, non-Hispanic Black (NHB), Hispanic, and non-Hispanic American Indian/Alaska Native (NHAIAN) populations experience excess COVID-19 mortality, compared to the non-Hispanic White (NHW) population, but racial/ethnic differences in age at death are not known. The release of national COVID-19 death data by racial/ethnic group now permits analysis of age-specific mortality rates for these groups and the non-Hispanic Asian or Pacific Islander (NHAPI) population. Our objectives were to examine variation in age-specific COVID-19 mortality rates by racial/ethnicity and to calculate the impact of this mortality using years of potential life lost (YPLL). This cross-sectional study used the recently publicly available data on US COVID-19 deaths with reported race/ethnicity, for the time period February 1, 2020, to July 22, 2020. Population data were drawn from the US Census. As of July 22, 2020, the number of COVID-19 deaths equaled 68,377 for NHW, 29,476 for NHB, 23,256 for Hispanic, 1,143 for NHAIAN, and 6,468 for NHAPI populations; the corresponding population sizes were 186.4 million, 40.6 million, 2.6 million, 19.5 million, and 57.7 million. Age-standardized rate ratios relative to NHW were 3.6 (95% CI 3.5, 3.8; p < 0.001) for NHB, 2.8 (95% CI 2.7, 3.0; p < 0.001) for Hispanic, 2.2 (95% CI 1.8, 2.6; p < 0.001) for NHAIAN, and 1.6 (95% CI 1.4, 1.7; p < 0.001) for NHAP populations. By contrast, NHB rate ratios relative to NHW were 7.1 (95% CI 5.8, 8.7; p < 0.001) for persons aged 25-34 years, 9.0 (95% CI 7.9, 10.2; p < 0.001) for persons aged 35-44 years, and 7.4 (95% CI 6.9, 7.9; p < 0.001) for persons aged 45-54 years. Even at older ages, NHB rate ratios were between 2.0 and 5.7. Similarly, rate ratios for the Hispanic versus NHW population were 7.0 (95% CI 5.8, 8.7; p < 0.001), 8.8 (95% CI 7.8, 9.9; p < 0.001), and 7.0 (95% CI 6.6, 7.5; p < 0.001) for the corresponding age strata above, with remaining rate ratios ranging from 1.4 to 5.0. Rate ratios for NHAIAN were similarly high through age 74 years. Among NHAPI persons, rate ratios ranged from 2.0 to 2.8 for persons aged 25-74 years and were 1.6 and 1.2 for persons aged 75-84 and 85+ years, respectively. As a consequence, more YPLL before age 65 were experienced by the NHB and Hispanic populations than the NHW population-despite the fact that the NHW population is larger-with a ratio of 4.6:1 and 3.2:1, respectively, for NHB and Hispanic persons. Study limitations include likely lag time in receipt of completed death certificates received by the Centers for Disease Control and Prevention for transmission to NCHS, with consequent lag in capturing the total number of deaths compared to data reported on state dashboards. In this study, we observed racial variation in age-specific mortality rates not fully captured with examination of age-standardized rates alone. These findings suggest the importance of examining age-specific mortality rates and underscores how age standardization can obscure extreme variations within age strata. To avoid overlooking such variation, data that permit age-specific analyses should be routinely publicly available.

Northeastern Siberia has been inhabited by humans for more than 40,000 years but its deep population history remains poorly understood. Here we investigate the late Pleistocene population history of northeastern Siberia through analyses of 34 newly recovered ancient genomes that date to between 31,000 and 600 years ago. We document complex population dynamics during this period, including at least three major migration events: an initial peopling by a previously unknown Palaeolithic population of ‘Ancient North Siberians’ who are distantly related to early West Eurasian hunter-gatherers; the arrival of East Asian-related peoples, which gave rise to ‘Ancient Palaeo-Siberians’ who are closely related to contemporary communities from far-northeastern Siberia (such as the Koryaks), as well as Native Americans; and a Holocene migration of other East Asian-related peoples, who we name ‘Neo-Siberians’, and from whom many contemporary Siberians are descended. Each of these population expansions largely replaced the earlier inhabitants, and ultimately generated the mosaic genetic make-up of contemporary peoples who inhabit a vast area across northern Eurasia and the Americas. Analyses of 34 ancient genomes from northeastern Siberia, dating to between 31,000 and 600 years ago, reveal at least three major migration events in the late Pleistocene population history of the region.