COVID kills Native Americans at much higher rates than other groups, study finds

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COVID-19 killed Native Americans at a rate 2.8 times higher than that among white people last year before vaccines became widely available, according to a new study. The mortality rate for the disease among the group was also “considerably higher” than that of Black and Latino populations.

The study found Native Americans living in rural reservations faced greater risks of dying from COVID-19, likely because of poor living conditions and inadequate access to health care, researchers said in their paper published Nov. 17 in the journal Demographic Research.

Meantime, limited data suggests Native Americans have the highest vaccination rates in the country, which could prevent further COVID-19 infections and deaths in the group, especially as more coronavirus variants emerge.

The findings add to a relatively scant pool of data on the group — comprising people who self-identify as American Indian or Alaska Native — which has long been disproportionately affected by poverty, food insecurity and poor health outcomes from several diseases such as heart and kidney disease.

“A lack of reliable data” still prevents the world from knowing the true extent of the risks Native Americans face during the COVID-19 pandemic, researchers say.

“The overall set of factors associated with high COVID-19 deaths are largely the same as those that have been identified to increase vulnerability of Native Americans to a host of diseases through generations,” study author Noreen Goldman, a professor of demography and public affairs at Princeton University in New Jersey, said in a news release. “Elevated COVID-19 death rates among Native Americans serve as a stark reminder of the legacies of historical mistreatment and the continued failure of governments to meet basic needs of this population.”

The team analyzed 2020 data from the Centers for Disease Control and Prevention, Census and national surveys from Alaska, Arizona, California, Colorado, Florida, Michigan, Minnesota, Montana, New Mexico, New York, North Carolina, Oklahoma, South Dakota, Texas, Washington and Wisconsin — the states with the largest Native American populations.

They also measured COVID-19 risk factors such as poverty, health insurance coverage, frontline worker status, prevalence of health conditions, smoking status and housing conditions.

Native Americans disproportionately affected in many areas

Overall, Native Americans are more likely to face socioeconomic and health-related risk factors for COVID-19 than Black, Latino and white Americans, researchers say.

For example, many Native Americans live in crowded, multigenerational households that facilitate coronavirus spread. Some tribes still live in reservations, too, many of which are in remote areas far from health care services such as COVID-19 tests and treatments.

Many advocacy groups, including the National Congress of American Indians, have voiced their concerns over such struggles and mistreatment. In October 2020, the NCAI said it was “extremely troubled to learn” that coronavirus-infected tribal members of Cheyenne River Sioux in South Dakota were required to travel over seven hours to Minnesota to “access appropriate hospital care” when the state was claiming to have enough beds.

Since the 1950s, nearly 80% of Native Americans have moved out of reservations either voluntarily or by coercion, according to the study. But the proportion varies depending on location. In South Dakota and Montana, over 60% of Native Americans live on reservations, compared to less than 5% in Texas, Alaska, Florida and Colorado.

Many Native Americans also don’t have access to health insurance other than the Indian Health Service (IHS), “a chronically underfunded health system for nationally recognized tribes that is part of the U.S. Public Health Service,” the researchers note. The group is underrepresented among Medicaid users, and it “frequently face[s] discrimination and language barriers in non-IHS and nontribal health facilities.”

Poverty rates among Native Americans exceed those of the general population, too, reaching 40% for some, the study says.

The Navajo Nation — the largest reservation in the U.S. that was one of the worst hit populations at the beginning of the pandemic — is home to about 40% of families without running water, “a serious concern for quality of life in general but a particularly critical risk factor for the spread of infectious diseases like COVID-19,” researchers said.

Native Americans also have the “poorest health profile in terms of COVID-19 susceptibility,” they said, with the highest prevalence of heart disease, cancer, diabetes, smoking and kidney disease compared to Black, Latino and white populations.

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