The COVID-19 pandemic has severely impacted minority communities that were already chronically neglected by the healthcare system. The disproportionate impact on Alaska Native and American Indian (AN/AI) communities exemplifies all too well the consequences of indigenous erasure on pandemic resiliency and recovery.
Alaska Natives and American Indians are 3.5 times more likely to contract COVID-19 than their White counterparts—and nearly twice as likely to die from COVID infection. The Center for Disease Control (CDC) released this staggering statistic in their COVID-19 morality report for the first stretch of the pandemic (January- June 2020).
A CDC report from Montana found that AN/AI people in that state had twice the risk of COVID infection and were dying at a rate almost four times that of Whites. A year’s worth of quarantining and safety measures had done little to protect Indigenous communities.
A deeper look into that arduous year revealed that health disparities persisted for Native Hawaiian and Pacific Islanders, Alaska Natives, and American Indians long after other disparities affecting other ethnic groups had declined. Interestingly, this was true only for individuals under age 25. The previous CDC report found higher mortality rates for Indigenous people in all age groups except the oldest (80+). These findings suggest selective inequity for AN/AI communities within the larger community that puts them at greater health risk.
Data from past pandemics shows that health disparities for Indigenous communities have existed for more than a century. For example, in 1918, 80% of Alaska’s deaths from the Spanish Flu occurred within their indigenous population. While healthcare mechanisms are in place for AN/AI peoples, like the Indian Health Service, these organizations receive significantly less funding than other government health programs. Apathy and ignorance towards indigenous health occurs at the most basic levels— collecting patient information.
Public health researchers and legislators use data on patient age, sex, ethnicity, and other factors to organize health programs. The Urban Indian Health Institute analyzed COVID-19 data from all 50 states and graded them on reporting racial information. Unfortunately, just over half of the states included an AN/ AI option, despite CDC data clearly outlining Indigenous people as an at-risk population. Rolling out an appropriate and effective pandemic response is impossible when healthcare bodies neglect to obtain crucial information for public health.
Several hurdles stand in the way of AN/AI individuals being able to universally and consistently access quality healthcare. For instance, many Indigenous people live in rural communities and have to drive several hours to reach a hospital. Lack of healthcare access together with impoverished living conditions depletes the quality of life for these communities. Indigenous people suffer diabetes, obesity, heart disease, and health complications from smoking at higher rates than White people. Even with remote doctor visits, too many are unable to access this basic human need.
Some AN/AI individuals reside in urban areas, while others may live in multigenerational households that may lack common resources like running water and electricity. Tight living quarters and poor conditions are major contributors to the rapid spread of viruses, leading to a significant loss of tribal elders throughout indigenous communities. The pandemic also resulted in devastating losses to businesses like casinos, operated by more than 40% of tribes. Between the mounting financial hardships and emotional losses, COVID-19 shone a bright light on the inequities leveled against indigenous communities.
Of the 1,134 indigenous deaths reported in the initial 2020 CDC report, over half were men. Conditions like diabetes and heart disease that plague indigenous peoples also occur more often in men than women. Both sex and race impact a person’s health, and research suggests this does not play in favor of male minorities. In truth, if men live sicker lives, indigenous men live chronically ill. These men are more vulnerable to COVID-19 because they are fighting with a handicap hundreds of years in the making, with scarcely any resources to overcome it.
The CDC also showed that higher mortality rates occur in younger AN/AI individuals (<60 years old) compared to Whites. The highest disparity in mortality appeared between the ages of 20-49—prime working age. These are individuals going out into the community, where they are more exposed to infection risk than housebound elders. Similarly, aged members of some other ethnic groups (Whites and Asians, for example) were more likely to be able to support their families by working at home, where they had a lower risk of contracting COVID. This left AN/AI communities comparatively more vulnerable to the worst of the virus.
Indigenous men and their families need access to culturally competent health resources. Diligent collection of patient data and development of intuitive public health programs are crucial to protecting the health of at-risk communities.
Photo by Andrew James on Unsplash