COVID-19 Cases, Hospitalizations, and Deaths Among American Indian or Alaska Native Persons — Alaska, 2020–2021
Lowrie A. Ward, Kelsey P. Black, Carla Britton, Megan L. Tompkins, Ellen Provost
Abstract
American Indian or Alaska Native (AI/AN) persons across the United States face substantial health disparities, including a disproportionately higher incidence of AI/AN persons living in Alaska also face serious health and health care challenges, including access to care because 90% of the state's land area is inaccessible by road (3), and approximately one half of the state's AI/AN population (AI/AN race alone or in combination with another race) live in remote rural areas (4). To examine the extent of COVID-19-associated disparities among AI/AN persons living in Alaska, a retrospective analysis of COVID-19 cases reported to the Alaska Department of Health and Social Services (AKDHSS) during March 12, 2020-December 31, 2021, was conducted. The age-adjusted COVID-19 incidence among AI/AN persons was 26,583 per 100,000 standard population, approximately twice the rate among White persons living in Alaska (11,935). The ageadjusted COVID-19-associated hospitalization rate among AI/AN persons was 742 per 100,000, nearly three times the rate among White persons (273) (rate ratio [RR] = 2.72). The age-adjusted COVID-19-related mortality rate among AI/AN persons was 297 per 100,000, approximately three times that among White persons (104; RR = 2.86). Culturally competent public health efforts that are designed in collaboration with AI/AN persons and communities, including support for vaccination and other proven COVID-19 prevention strategies, are critical to reducing COVID-19-associated disparities among AI/AN persons in Alaska. A retrospective analysis was conducted of COVID-19 incidence, and associated hospitalizations and deaths in Alaska reported to AKDHSS Section of Epidemiology during March 12, 2020-December 31, 2021.* Data analyzed consisted of a limited data set received through a data sharing agreement with AKDHSS Section of Epidemiology. COVID-19 cases were defined in accordance with CDC's National Notifiable Disease Surveillance System. COVID-19associated hospitalizations were defined as hospital admissions of COVID-19 patients because of severity and complications of COVID-19. Deaths were determined with death certificate audits and included decedents who had received a diagnosis of laboratory-confirmed COVID-19, as well as deaths that were likely COVID-19-related based on clinical and epidemiologic * Data were retrieved on February 2, 2022. https://ndc.services.cdc.gov/case-definitions/coronavirus-disease-2019-2021/ Abbreviation: AI/AN = American Indian or Alaska Native. * AI/AN race alone or in combination with other races. White race alone. Included Asian, Black or African American, Native Hawaiian or other Pacific Islander race and ethnicities, or multiple races not including AI/AN heritage. Race was not recorded and cases are still under investigation. US Department of Health and Human Services/Centers for Disease Control and Prevention and COVID-19-related death compared with other races. Culturally competent public health efforts that are designed in collaboration with AI/AN persons and communities, including support for vaccination and other proven COVID-19 prevention or treatment strategies, are critical to reducing COVID-19-associated disparities among AI/AN persons in Alaska.