American Indian and Alaska Native (AI/AN) people had rates of COVID-19 infection three times higher than whites, CDC data from 23 states found.
Among 340,059 confirmed COVID-19 cases reported to the agency from January 22 to July 3, the rate of infection was 3.5 times higher for the AI/AN population than it was for whites (95% CI 1.2-10.1), and more so affected younger people in this population (median age 40 vs 51 years in whites), reported Sarah M. Hatcher, PhD, of the CDC COVID-19 Response Team, and colleagues.
Incidence varied greatly across states, with New Mexico reporting the highest disproportionate rate among AI/AN people, at 14.9-fold higher than white people, the researchers wrote in the agency’s Morbidity and Mortality Weekly Report.
Arizona, in which more than one-third of COVID-19 cases among AI/AN people have been documented, was excluded from the analysis due to a paucity of data, as were other states with fewer than 70% complete data on race/ethnicity, the team added.
“Historical trauma and persisting racial inequity have contributed to disparities in health and socioeconomic factors between AI/AN and white populations that have adversely affected AI/AN communities,” Hatcher and co-authors wrote. “[T]hese factors likely contribute to the observed elevated incidence of COVID-19 among the AI/AN population.”
A disproportionate rate of COVID-19 infection has been documented among AI/AN persons. On the Navajo reservation, the infection rate per capita exceeded that of any U.S. state, and deaths were also exceedingly high, in part due to a lack of resources, as well as a chronically underfunded and understaffed Indian Health Service.
Poor infrastructure on reservations leaves many families living in multigenerational housing without running water and also likely contributes to an elevated infection rate.
Because reporting to the CDC is voluntary, federal data paint an incomplete picture of the prevalence of COVID-19 infection among the AI/AN population. The CDC was delayed in reporting data on COVID-19 and race/ethnicity, and the New York Times, using data it obtained after suing the CDC, estimated that the rate of infection among AI/AN individuals was 1.7-fold higher than in white people.
In the current study, data on underlying health conditions was included in just 8.4% of cases involving AI/AN people, compared with 27.3% of cases in white people. Similarly, a lower proportion of AI/AN versus white people had data on symptoms (11% vs 28.2%), hospitalization status (24.2% vs 78.9%), admission to the intensive care unit (9.4% vs 26.7%), and vital status (22.5% vs 74.4%), the researchers reported.
“The excessive absence of data among AI/AN persons represents an important gap in public health data for AI/AN persons and suggests a need for additional resources to support case investigation and reporting infrastructure in AI/AN communities,” the authors wrote.
Congress has provided $165 million to tribal communities through the Coronavirus Preparedness and Response Supplemental Appropriation Act and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Other funding, including $142 million through the Supporting Tribal Public Health Capacity in Coronavirus Preparedness and Response, is available to tribes as well, according to a press release from CDC.
“Funding is only one step in addressing the impact of COVID-19 on tribal communities,” José T. Montero, MD, director of CDC’s Center for State, Tribal, Local, and Territorial Support, said in a statement. “CDC is continuing to work on coordinated outreach to tribal nations through our Office of Tribal Affairs and Strategic Alliances and new Tribal Support Section to provide remote- and field-based support to our hardest hit tribal communities.”
Disclosures
Hatcher and co-authors did not report any disclosures.
Source: MedicalNewsToday.com
