American Indians and COVID-19

Morbidity and Mortality Disparities among Indigenous Populations in the Rural South

  • Leslie Musshafen University of Mississippi Medical Center https://orcid.org/0000-0001-8844-2935
  • Thomas E. Dobbs Mississippi State Department of Health, University of Mississippi Medical Center
  • Aaron Robinson
  • Thomas Wyatt
  • Michael Puskarich
  • Richard Summers
  • Seth Lirette
  • Caroline Compretta
Keywords: American Indian, COVID-19, rural, in-hospital mortality, health disparities

Abstract

Background The COVID-19 pandemic has highlighted health inequities among indigenous populations, with those in rural settings facing compounded barriers.

Purpose To investigate morbidity and mortality experiences among hospitalized, COVID-19+ American Indian adults from rural and urban settings.

Methods The described cross-sectional study used retrospective discharge data from the University of Mississippi Medical Center and Hennepin County Medical Center. Adults (≥ age 18) admitted from January 1, 2020 to August 8, 2021with a COVID-19 diagnosis and known race were included.

Results A total of 3,659 inpatients met inclusion criteria. Among adults hospitalized with COVID-19 at the University of Mississippi Medical Center, American Indians (n=73) had the highest mean comorbidity risk score (11.2, SD 8.1) and unadjusted mortality rate (42%) among all races. Among adults hospitalized with COVID-19 at Hennepin County Medical Center, American Indians (n=62) had the second lowest comorbidity risk score (6.1, SD 10.7) and the lowest unadjusted mortality rate (6%). American Indian mortality disparities persisted after controlling for age, sex, and comorbidity risk.

Conclusion Hospitalized American Indians from predominantly rural settings experienced significant morbidity and COVID-19 mortality disparities when compared to native persons in predominantly urban environments, or Blacks and Whites in either setting. Compounded disparities faced by rural, indigenous populations must be addressed.  

Published
2022-09-21