Radon mitigation in Native communities: A partnership between a tribal health clinic and University of Wisconsin Carbone Cancer Center.

44 Background: Radon is the second leading cause of lung cancer in the United States, and the Native communities in Wisconsin bear an outsized burden of lung cancer. Radon testing is attainable for these communities, but the cost of one-time mitigation is high and out of reach for many. The University of Wisconsin Carbone Cancer Center (UWCCC) partnered with the Stockbridge-Munsee Band of the Mohican Nation (S-M) Health Center to test homes for radon levels and mitigate (repair) those structures when levels were high to mitigate a structural barrier of health. Prior tests had suggested 10% of homes across Wisconsin test “high” for radon (above 4 pCi/L). The mean radon level among tested homes in Wisconsin is 5.7 pCi/L (American Lung Association, Radon Testing Disparities: Wisconsin, 2022). Methods: The project was co-developed with the UW and S-M. A key partner was the Wisconsin Radon Program, housed at the Wisconsin Department of Health Services. We aimed to educate, test for radon, and mitigate all homes that tested high for radon. Education, promotion of the program and testing were done in collaboration between state, university, and tribal officials. The environmental health and community health coordinators at S-M was the key person for distributing and ensuring the return of kits. Mitigation was performed by a private certified contractor over the project. We used descriptive statistics to evaluate the percentage of Wisconsin homes that tested high for radon in our sample. We also surveyed community members about their satisfaction with the mitigation contractor. Results: This project was done from April 2023 to April 2024. Staff reported educational sessions were successful in improving their knowledge of radon and testing and mitigation procedures. The S-M had 1822 enrolled tribal members at the start of the study. A total of 85 kits were distributed, with 64 returned (75.3% return rate). Of those, 42 of 64 tested positive for high radon in the home (65.6%), much higher than the expected 10% positive rate. The mean radon level among all homes was 14.1 pCi/L (0-111.6pCi/L) and 18.7 pCi/L among homes that tested positive. All homes testing high have completed radon mitigation. All reported their homes could not have been mitigated without this collaboration. The community was satisfied with the services of the certified contractor. Conclusions: Radon levels were much higher than anticipated in Native lands in Wisconsin and may explain higher rates of lung cancer. Cancer centers are key partners in addressing high radon levels and mitigating structural determinants of health among Native communities, such as with housing quality.