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Stark Disparities Evident in COVID-19 Pandemic Among American Indian and Alaska Native Communities


According to some studies, Native Americans have a 50% chance of being listed as the wrong race on medical records. A 2015 study of Oregon hospital discharge records found that over half of Native American patients had been miscategorized in their file, the majority as white. Many organizations have not been including Native Americans in their COVID-19 demographic breakdowns — categorizing them under “other” — making it difficult to examine the impact of the coronavirus pandemic on these populations. Even so, Comagine Health’s analyses show COVID-19 is having a disproportionate effect on communities with higher proportions of American Indian and Alaska Native (AI/AN) residents.

By synthesizing and analyzing data from multiple sources, including the U.S. Census Bureau, USAFacts, Definitive Healthcare and the Indian Health Service, we’ve found that communities with higher concentrations of AI/AN individuals have:

  • Higher COVID-19 case and death rates
  • Faster increase in COVID-19 case and death rates

On June 4 — 77 days into the epidemic — the infection rate in McKinley County, New Mexico, where 8 in every 10 residents are Native American, was a staggering 3,516 cases per 100,000. That’s more than six times the national rate of 566 cases per 100,000.

Also as of June 4, San Juan County, New Mexico, where more than 40% of residents are Native American, was experiencing a sharp increase in death rate (103 per 100,000 residents) eclipsing the U.S. average (32 per 100,000).



To tackle the COVID-19 pandemic, it is paramount that health systems are able to handle the increase in infection-related hospitalizations. The Indian Health System (IHS), the major health care provider for Native Americans, is likely to struggle to keep up with the need for hospital beds and critical care. IHS hospitals have on average just 33.7 staffed beds compared to 128.2 in other health systems as well as fewer ICU beds — 6.5 versus 14.1.



These analyses reveal only a fragment of the inequities Indigenous people in the U.S. experience. At Comagine Health we are charged with exposing disparities in health associated with socioeconomic status, race/ethnicity, gender, rurality and more. As we’re able to access more and better data about the spread of the coronavirus, we’ll be able to uncover more patterns and identify ways to reduce its impact on American Indians and Alaska Natives and other populations experiencing inequities.

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