COVID-19 has disproportionate impact on American Indian, Alaska Native populations
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American Indian and Alaska Native people living in Alaska are at an increased risk for COVID-19 illness, hospitalization and death compared with white people living in the same area, researchers reported in MMWR.
“American Indian or Alaska Native (AI/AN) persons across the United States face substantial health disparities, including a disproportionately higher incidence of COVID-19," Lowrie A. Ward, MPH, an epidemiologist at the Alaska Native Tribal Health Consortium Epidemiology Center, and colleagues wrote.
“AI/AN persons living in Alaska also face serious health and health care challenges, including access to care because 90% of the state’s land area is inaccessible by road, and approximately one-half of the state’s AI/AN population (AI/AN race alone or in combination with another race) live in remote rural areas,” they wrote.
To examine the extent of COVID-19-associated disparities among AI/AN persons living in Alaska, Ward and colleagues conducted a retrospective analysis of 159,043 COVID-19 cases reported to the Alaska Department of Health and Social Services between March 12, 2020, and Dec. 31, 2021. They excluded 5,717 cases that occurred among nonresidents and 1,064 that occurred among residents who were out of state.
AI/AN people, white people and persons of other races accounted for 39,338 (25.8%), 55,415 (36.4%) and 19,615 (12.9%) persons with COVID-19, respectively. According to the study, among 3,295 hospitalized patients with COVID-19, 823 were AI/AN persons, 1,438 were white, and 675 were people of other races.
Among the 1,020 people who died, 289 were AI/AN people, 521 were white, 159 were people from other races. Race was not recorded or was still under investigation for the remaining 51 people.
Ward and colleagues calculated that among AI/AN people, the age-adjusted COVID-19 incidence was 26,583 per 100,000 standard population, or approximately twice the incidence among white people living in Alaska (RR = 2.23). Additionally, the age-adjusted COVID-19-associated hospitalization rate among AI/AN people was 742 per 100,000, nearly three times the rate among white people (RR = 2.72), and the age-adjusted COVID-19-related mortality rate among AI/AN persons was 297 per 100,000, approximately three times that among white persons (RR = 2.86).
“Culturally competent public health efforts that are designed in collaboration with AI/AN persons and communities, including support for vaccination and other proven COVID-19 prevention or treatment strategies, are critical to reducing COVID-19-associated disparities among AI/AN persons in Alaska,” the authors concluded.
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