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COVID-19 Mortality Among American Indian and Alaska Native Persons - 14 States, January-June 2020

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. 2020 Dec 11;69(49):1853-1856. doi: 10.15585/mmwr.mm6949a3. COVID-19 Mortality Among American Indian and Alaska Native Persons - 14 States, January-June 2020 Matthew M Masiello, Sujata Joshi, Adrian E Dominguez, Amy Poel, Crisandra M Wilkie, Jonathan M Bressler, Joseph McLaughlin, Jennifer Kraszewski, Kenneth K Komatsu, Xandy Peterson Pompa, Megan Jespersen, Gillian Richardson, Nicholas Lehnertz, Pamela 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 K Rice, Samantha JH Rolland, Victoria Warren-Mears, Abigail Echo-Hawk, Andria Apostolou, Michael Landen

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COVID-19 Mortality Among American Indian and Alaska Native Persons - 14 States, January-June 2020

Jessica Arrazola et al. MMWR Morb Mortal Wkly Rep. 2020.

. 2020 Dec 11;69(49):1853-1856. doi: 10.15585/mmwr.mm6949a3. Authors Jessica Arrazola, Matthew M Masiello, Sujata Joshi, Adrian E Dominguez, Amy Poel, Crisandra M Wilkie, Jonathan M Bressler, Joseph McLaughlin, Jennifer Kraszewski, Kenneth K Komatsu, Xandy Peterson Pompa, Megan Jespersen, Gillian Richardson, Nicholas Lehnertz, Pamela 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 K Rice, Samantha JH Rolland, Victoria Warren-Mears, Abigail Echo-Hawk, Andria Apostolou, Michael Landen

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Erratum in 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-19-associated 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.

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Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Figures

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Percentage distribution of COVID-19–associated deaths among…

FIGURE

Percentage distribution of COVID-19–associated deaths among American Indian/Alaska Native and non-Hispanic White persons aged…

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Percentage distribution of COVID-19–associated deaths among American Indian/Alaska Native and non-Hispanic White persons aged ≥20 years, by age group — 14 states, January 1–June 30, 2020 Abbreviation: COVID-19 = coronavirus disease 2019. * Includes Hispanic and non-Hispanic ethnicities. † Percentages by age group are not age-adjusted. § Alaska, Arizona, Louisiana, Minnesota, Mississippi, Nebraska, New Mexico, New York, North Dakota, Oklahoma, Oregon, South Dakota, Utah, and Washington.

Similar articles Cited by References
    1. CDC. Deaths related to 2009 pandemic influenza A (H1N1) among American Indian/Alaska Natives—12 states, 2009. MMWR Morb Mortal Wkly Rep 2009;58:1341–4. - PubMed
    1. Hennessy TW, Bruden D, Castrodale L, et al.; Investigative Team. A case-control study of risk factors for death from 2009 pandemic influenza A(H1N1): is American Indian racial status an independent risk factor? Epidemiol Infect 2016;144:315–24. 10.1017/S0950268815001211 - DOI - PMC - PubMed
    1. Hatcher SM, Agnew-Brune C, Anderson M, et al. COVID-19 among American Indian and Alaska Native persons—23 states, January 31–July 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1166–9. 10.15585/mmwr.mm6934e1 - DOI - PMC - PubMed
    1. Kakol M, Upson D, Sood A. Susceptibility of Southwestern American Indian tribes to coronavirus disease 2019 (COVID-19). J Rural Health 2020. Epub June 1, 2020. 10.1111/jrh.12451 - DOI - PMC - PubMed
    1. Mamelund SE, Shelley-Egan C, Rogeberg O. The association between socioeconomic status and pandemic influenza: protocol for a systematic review and meta-analysis. Syst Rev 2019;8:5. 10.1186/s13643-018-0931-2 - DOI - PMC - PubMed

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