Covid-19 in Native America

Abstract

According to CDC data, American Indians, and Alaskan Natives (AI/AN) have insofar experienced the highest rates of COVID-19 cases, hospitalizations, and deaths among any ethnic group in the U.S., despite the highest rate of vaccinations among any ethnic group. AI/AN peoples suffer 1.7x cases, 3.5x hospitalizations, and 2.4x deaths when compared to White, Non-Hispanic persons. In June 2020 in particular, the Navajo Nation reported a 3.4% COVID-19 infection rate, higher than any U.S. state. The prevalence of COVID-19 cases may be attributed to generational inequities in access to healthcare, health insurance, healthy foods, preventative health education, and public funding in indigenous communities. There is also a significantly higher rate of comorbidities in indigenous populations placing them at higher risk of COVID-19 infection and case severity. In addition, cases of indigenous populations with COVID-19 may be significantly underreported due to provider assumptions of race/ethnicity of AI/AN peoples, and limited options for race/ethnic data that may exclude AI/AN self-identification. The implications of these findings are greater awareness, advocacy, and funding for health prevention programs, access to basic resources such as power and clean water, access to recreation centers and grocery stores, and funding for tribal liaisons and community access members in indigenous communities for better health system relations with indigenous populations. The disproportionate mortality experienced by AI/AN populations is similar to that of the 2009 Influenza A pandemic, suggesting that similar trends may be seen in vulnerable AI/AN communities in the future without urgent funding for preventative health measures in AI/AN-predominant communities.