COVID-19 Mortality Among American Indian and Alaska Native Persons — 14 States, January–June 2020
Jessica Arrazola, Matthew M. Masiello, Sujata Joshi, Adrian Dominguez, Amy Poel, Crisandra Wilkie, Jonathan Bressler, Joseph McLaughlin, J Kraszewski, Kenneth Komatsu, Xandy Peterson Pompa, Megan Jespersen, Gillian Richardson, Nicholas Lehnertz, Pamela L. LeMaster, Britney Rust, Alison Keyser Metobo, Brooke Doman, David Casey, Jessica Kumar, Alyssa L. Rowell, Tracy K. Miller, Mike Mannell, Ozair Naqvi, Aaron M. Wendelboe, Richard Leman, Joshua L. Clayton, Bree Barbeau, Samantha Rice, Victoria Warren‐Mears, Abigail Echo‐Hawk, Andria Apostolou, Michael Landen
Abstract
American Indian/Alaska Native (AI/AN) persons experienced disproportionate mortality during the 2009 influenza A(H1N1) pandemic (1,2). Concerns of a similar trend during the coronavirus disease 2019 (COVID-19) pandemic led to the formation of a workgroup* to assess the prevalence of COVID-19 deaths in the AI/AN population. As of December 2, 2020, CDC has reported 2,689 COVID-19associated deaths among non-Hispanic AI/AN persons in the United States. A recent analysis found that the cumulative incidence of laboratory-confirmed COVID-19 cases among AI/AN persons was 3.5 times that among White persons (3). Among 14 participating states, the age-adjusted AI/AN COVID-19 mortality rate (55.8 deaths per 100,000; 95% confidence interval [CI] = 52.5-59.3) was 1.8 (95% CI = 1.7-2.0) times that among White persons (30.3 deaths per 100,000; 95% CI = 29.9-30.7). Although COVID-19 mortality rates increased with age among both AI/AN and White persons, the disparity was largest among those aged 20-49 years. Among persons aged 20-29 years, 30-39 years, and 40-49 years, the COVID-19 mortality rates among AI/AN were 10.5, 11.6, and 8.2 times, respectively, those among White persons. Evidence that AI/AN communities might be at increased risk for COVID-19 illness and death demonstrates the importance of documenting and understanding the reasons for these disparities while developing collaborative approaches with federal, state, municipal, and tribal agencies to minimize the impact of COVID-19 on AI/AN communities. Together, public health partners can plan for medical countermeasures and prevention activities for AI/AN communities.