Volume 45 - Article 39 | Pages 1185–1218
COVID-19 risk factors and mortality among Native Americans
By Katherine Leggat-Barr, Fumiya Uchikoshi, Noreen Goldman
demographic-research.45-39 (zip file, 127 MB)
readme.45-39 (text file, 8 kB)
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.
Author's Affiliation
- Katherine Leggat-Barr - Princeton University, United States of America EMAIL
- Fumiya Uchikoshi - Princeton University, United States of America EMAIL
- Noreen Goldman - Princeton University, United States of America EMAIL
Other articles by the same author/authors in Demographic Research
Life expectancy loss among Native Americans during the COVID-19 pandemic
Volume 47 - Article 9
Marriage intentions, desires, and pathways to later and less marriage in Japan
Volume 44 - Article 3
Calloused hands, shorter life? Occupation and older-age survival in Mexico
Volume 42 - Article 32
Order matters: The effect of premarital pregnancy on second childbearing in Japan
Volume 39 - Article 48
Self-Reported Versus Performance-Based Measures of Physical Function: Prognostic Value for Survival
Volume 30 - Article 7
Most recent similar articles in Demographic Research
Lessons from the pandemic: Gender inequality in childcare and the emergence of a gender mental health gap among parents in Germany
Volume 51 - Article 3
| Keywords:
COVID-19,
division of childcare,
exhaustion,
gender role attitudes,
loneliness,
mental health,
pandemic,
stress
Two-dimensional contour decomposition: Decomposing mortality differences into initial difference and trend components by age and cause of death
Volume 50 - Article 41
| Keywords:
decomposition methods,
mortality
Decomposition analysis of disparities in infant mortality rates across 27 US states
Volume 50 - Article 40
| Keywords:
decomposition,
health disparities,
infant mortality,
United States of America
International completeness of death registration
Volume 50 - Article 38
| Keywords:
data collection,
death,
mortality,
statistics,
sustainable development goals,
vital registration
Incorporating subjective survival information in mortality and change in health status
predictions: A Bayesian approach
Volume 50 - Article 36
| Keywords:
Bayesian demography,
health,
mortality,
self report,
subjective mortality probabilities
Cited References: 70
Download to Citation Manager
PubMed
Google Scholar