Explaining COVID-19 related mortality disparities in American Indians and Alaska Natives.

Publication date: Nov 28, 2023

American Indian and Alaska Native (AI/AN) individuals are more likely to die with COVID-19 than other groups, but there is limited empirical evidence to explain the cause of this inequity. The objective of this study was to determine whether medical comorbidities, area socioeconomic deprivation, or access to treatment can explain the greater COVID-19 related mortality among AI/AN individuals. The design was a retrospective cohort study of harmonized electronic health record data of all inpatients with COVID-19 from 21 United States health systems from February 2020 through January 2022. The mortality of AI/AN inpatients was compared to all Non-Hispanic White (NHW) inpatients and to a matched subsample of NHW inpatients. AI/AN inpatients were more likely to die during their hospitalization (13. 2% versus 7. 1%; odds ratio [OR] = 1. 98, 95% confidence interval [CI] = 1. 48, 2. 65) than their matched NHW counterparts. After adjusting for comorbidities, area social deprivation, and access to treatment, the association between ethnicity and mortality was substantially reduced (OR 1. 59, 95% CI 1. 15, 2. 22). The significant residual relation between AI/AN versus NHW status and mortality indicate that there are other important unmeasured factors that contribute to this inequity. This will be an important direction for future research.

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Concepts Keywords
Alaska Ai
Hispanic Alaska
Hospitalization American
January Area


Type Source Name
disease MESH COVID-19
drug DRUGBANK Coenzyme M
disease IDO history
disease MESH smallpox
disease MESH infection
disease MESH influenza
disease VO population
disease VO age
disease MESH Death
disease VO Gap
disease MESH comorbidity
disease IDO intervention
disease VO USA
disease MESH starvation
disease MESH historical trauma
drug DRUGBANK Nonoxynol-9
disease IDO facility
drug DRUGBANK Methionine
disease VO protocol
disease IDO algorithm
disease MESH causes
disease MESH obesity
disease MESH heart disease
disease MESH cancer
drug DRUGBANK Ethanol
disease VO vaccination
disease VO time
drug DRUGBANK Aspartame
disease VO vaccinated
disease MESH Chronic renal failure
drug DRUGBANK Ademetionine
disease IDO process
disease MESH liver disease
drug DRUGBANK Trestolone
disease MESH hepatic failure
disease MESH hepatitis
disease MESH educational attainment
disease MESH lifestyle factors
disease VO Equity
disease IDO entity
disease MESH Pneumonia
drug DRUGBANK Acetylcysteine
drug DRUGBANK Methyl isocyanate
disease VO USDA
drug DRUGBANK Serine
disease MESH HIV infection
disease IDO quality
disease VO report
disease VO Canada

Original Article

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