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COVID-19 risk factors and mortality among Native Americans

Author

Listed:
  • Katherine Leggat-Barr

    (Princeton University)

  • Fumiya Uchikoshi

    (Princeton University)

  • Noreen Goldman

    (Princeton University)

Abstract

Background: Academic research on the disproportionate impact of COVID-19 among Native Americans has largely been restricted to particular indigenous groups or reservations. Objective: We estimate COVID-19 mortality for Native Americans relative to other racial/ethnic groups and explore how state-level mortality is associated with known risk factors. Methods: We use the standardized mortality ratio (SMR), adjusted for age, to estimate COVID-19 mortality by racial/ethnic groups for the United States and 16 selected states that account for three-quarters of the Native American population. The prevalence of risk factors is derived from the American Community Survey and the Behavioral Risk Factor Surveillance System. Results: The SMR for Native Americans greatly exceeds those for Black and Latino populations and varies enormously across states. There is a strong positive correlation across states between the share of Native Americans living on a reservation and the SMR. The SMR for Native Americans is highly correlated with the income-poverty ratio, the prevalence of multigenerational families, and health insurance (excluding the Indian Health Service). Risk factors associated with socioeconomic status and comorbidities are generally more prevalent for Native Americans living on homelands, a proxy for reservation status, than for those living elsewhere. Conclusions: Most risk factors for COVID-19 are disproportionately high among Native Americans. Reservation life appears to increase the risk of COVID-19 mortality. Contribution: We assemble and analyze a broader set of COVID-19-related risk factors for Native Americans than previous studies, a critical step toward understanding the exceptionally high COVID-19 death rates in this population.

Suggested Citation

  • Katherine Leggat-Barr & Fumiya Uchikoshi & Noreen Goldman, 2021. "COVID-19 risk factors and mortality among Native Americans," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 45(39), pages 1185-1218.
    • Handle: RePEc:dem:demres:v:45:y:2021:i:39
    DOI: 10.4054/DemRes.2021.45.39
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    1. Noreen Goldman & Theresa Andrasfay, 2022. "Life expectancy loss among Native Americans during the COVID-19 pandemic," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 47(9), pages 233-246.
    2. Noreen Goldman & Anne R Pebley & Keunbok Lee & Theresa Andrasfay & Boriana Pratt, 2021. "Racial and ethnic differentials in COVID-19-related job exposures by occupational standing in the US," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-17, September.

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    More about this item

    Keywords

    COVID-19; risk; Native Americans; American Indian; mortality; homelands; United States of America;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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