Home > Health Sciences > JHDRP > Vol. 16 (2023) > Iss. 3
Keywords
Epidemiology; COVID-19; American Indian/Alaska Native; Surveillance; Tribal Epidemiology
Disciplines
Community Health and Preventive Medicine | Epidemiology | Public Health | Respiratory Tract Diseases | Virus Diseases
Abstract
Objective: To compare rates and risk factors of severe COVID-19-related outcomes between American Indian/Alaska Native (AI/AN) and non-Hispanic White people (NHW).
Methods: Aggregate Social Vulnerability Index (SVI), COVID-19-related risk factor, hospitalization, and mortality data were obtained from 16 states for January 1, 2020-March 31, 2021. Generalized estimating equation Poisson regression models calculated age-adjusted cumulative incidences, incidence ratios (IR), and 95% confidence intervals (CI) comparing AI/AN and NHW persons by age, sex, and county-level SVI status.
Results: Race data were missing for 42.7% of COVID-19 cases, 24.7% of hospitalizations, and 10.1% of deaths. Risk of AI/AN COVID-19 mortality was 2.6 times that of NHW persons (IR 2.6, 95% CI: 1.7 – 3.4); risk of COVID-19-related hospitalization among AI/AN persons was 3.5 times that of NHW (IR: 3.5, 95% CI: 2.7 – 4.3). Severe COVID-19 outcomes were significantly higher for AI/AN persons compared to NHW persons across all age and sex groups. There was no statistically significant difference in COVID-19 outcomes by SVI status. Associations between severe COVID-19 outcomes and co-morbid risk factors were inconsistent.
Conclusions: Results describe increased risk of severe COVID-19 outcomes for AI/AN persons compared to NHW persons despite quality issues in public health surveillance data. Data linkages and improved ascertainment reduce race/ethnicity misclassification and improve data quality. COVID-19-related health burdens among AI/AN persons warrant improved access for AI/AN communities to medical countermeasures and healthcare resources.
Recommended Citation
Arrazola, Jessica; Erickson, Scott; Lan, Chiao Wen; Dominguez, Adrian; Joshi, Sujata; Apostolou, Andria; Busacker, Ashley; Casey, David; Coyle, Christiana; Helfrich, Kathryn; Kraszewski, Jennifer; Kim, Thomas; Lamont, Genelle; Leman, Richard; LeMaster, Pamela; Lehnertz, Nick; Mannell, Mike; Matson, Dakota; Merrill, Alex; Miller, Tracy; Schram, Benjamin; Naqvi, Ozair; Rice, Samantha; Hyde-Rolland, Samantha; Rowell, Alyssa; Seneca, Dean; Warren-Mears, Victoria; and Williamson, Laura
(2023)
"COVID-19 Severity Among American Indians and Alaska Natives in 16 States - January 1, 2020, to March 31, 2021,"
Journal of Health Disparities Research and Practice: Vol. 16:
Iss.
3, Article 4.
Available at:
https://digitalscholarship.unlv.edu/jhdrp/vol16/iss3/4
Included in
Community Health and Preventive Medicine Commons, Epidemiology Commons, Respiratory Tract Diseases Commons, Virus Diseases Commons