1. COVID-19 Severity among American Indians and Alaska Natives in 16 States--January 1, 2020, to March 31, 2021.
- Author
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Arrazola, Jessica, Erickson, Scott, Chiao Wen Lan, Dominguez, Adrian, Joshi, Sujata, Apostolou, Andria, Busacker, Ashley, Casey, David, Coyle, Christiana, Helfrich, Kathryn, Kraszewski, Jennifer, Kim, Thomas, Lamont, Genelle, Leman, Richard, LeMaster, Pamela, Lehnertz, Nick, Mannell, Mike, Matson, Dakota, Merrill, Alex, and Miller, Tracy
- Subjects
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ALASKA Natives , *PUBLIC health surveillance , *COVID-19 , *GENERALIZED estimating equations , *COVID-19 pandemic - Abstract
Objective: To compare rates and risk factors of severe COVID-19-related outcomes between American Indian/Alaska Native (AI/AN) and non-Hispanic White people (NHW). Methods: Aggregate Social Vulnerability Index (SVI), COVID-19-related risk factor, hospitalization, and mortality data were obtained from 16 states for January 1, 2020-March 31, 2021. Generalized estimating equation Poisson regression models calculated age-adjusted cumulative incidences, incidence ratios (IR), and 95% confidence intervals (CI) comparing AI/AN and NHW persons by age, sex, and county-level SVI status. Results: Race data were missing for 42.7% of COVID-19 cases, 24.7% of hospitalizations, and 10.1% of deaths. Risk of AI/AN COVID-19 mortality was 2.6 times that of NHW persons (IR 2.6, 95% CI: 1.7 - 3.4); risk of COVID-19-related hospitalization among AI/AN persons was 3.5 times that of NHW (IR: 3.5, 95% CI: 2.7 - 4.3). Severe COVID-19 outcomes were significantly higher for AI/AN persons compared to NHW persons across all age and sex groups. There was no statistically significant difference in COVID-19 outcomes by SVI status. Associations between severe COVID-19 outcomes and co-morbid risk factors were inconsistent. Conclusions: Results describe increased risk of severe COVID-19 outcomes for AI/AN persons compared to NHW persons despite quality issues in public health surveillance data. Data linkages and improved ascertainment reduce race/ethnicity misclassification and improve data quality. COVID-19-related health burdens among AI/AN persons warrant improved access for AI/AN communities to medical countermeasures and healthcare resources. [ABSTRACT FROM AUTHOR]
- Published
- 2023