Original by German Lopez and Ashley Wu: The New York Times, Sept. 8, 2022

Graph from Scientific American

During 2020 and 2021 Native American communities suffered a great death count because of COVID. The outcomes weren't just deaths, but there was also great mental strain and community disruption. The life expectancy went from 71.8 years, down all the way to 65.2 years. All ethnicities in America had a lower life expectancy because of COVID, but Native Americans suffered the greatest decrease. This article by Germany Lopez and Ahsley Wu goes out to point how colossal this decrease was. They say that "experts start to worry when they see drops in life expectancy that measure in just tenths of a year." This was 60 times greater. Native Americans are now expected to live as long as the average American did in 1944. Compared to the COVID statistics of other ethnicities, Native American's had one of the highest mortality rates, even though they are relatively small.

There is no one cause for the high death rates, but instead an accumulation of many. There is the problem of poverty, health, health care access, food, and more. COVID put a lot of strain on the system and it was unable to provide for Native Americans.

Disparities in Demographics

Brookings released a great article on COVID death rates of Native Americans in different demographics. This article brings to light some important information. First, deaths are very common in young Native Americans, compared to the relatively high elderly death rate of Whites. Second, different states with different Native American populations can have very different results in death rates.

Table

To help illustrate the disparities between White and Native American deaths Brookings calculated the projected deaths if Whites had the same percentage of deaths that Native Americans.

Source: Brookings Table 1

In States like New Mexico the death rate of Whites would be 10 times worse. This data shows how rampant COVID has run in Native American communities and how much of a difference there is between the health of Native Americans and Whites.

Social Determinants of Health

COVID didn't just affect Native American communities more because they were more susceptible to it, but there were huge upstream causes that made them disproportionately affected than other ethnicities.

Poverty

In the summary I briefly talked about how poverty is a cause, but this doesn't just mean access to health care. In the case of COVID, poverty also means:

• Can't afford to take time off work to stop the spread.
• Don't have the ability to get a device for online school.
• Have to live close together, furthering risk of COVID.
• No means of transportation to get to health care.

Health Issues

Native Americans have historically had greater risk of certain health issues that in conjunction with COVID can increase death rates, such as diabetes. These are also greatly affected by poverty.

What does this mean?

Poverty, demographic, and health issues go hand in hand. In this case, poverty can decrease access to health care and other important tools to improve health. Because poverty prevents help, it leads to more issues, which can then increase death rates. Wealth is an upstream factor, but just focusing on that will not fully remove health disparities. A more balanced approach that targets various levels such as education, income, and access. These combined is what is needed for to minimize these downstream affects such as COVID.

Broader Reflection

In the book Caste we talked about how different races (levels of caste) are constantly affected in all aspects of life. In this case, there is a huge disparity between White Americans and Native Americans. Whites are in the top of the Caste system and have a much greater support system that is tailored to what they need. Native Americans have been suppressed for the past 300 years by Americans and their health system is extremely poor because of the many forced relocations. Whites are commonly in power and because of that they don't dedicate resources to people they view as less than them. This effect may even be subconscious, but it is still extremely important to remedy this.

For the presentation of diabetes in Native American communities we read Native Americans: A Crisis in Health Equity. This article talks about a lot of the health disparities that Native American faces. On top of the ones I talked to above, the article talks about how "Native Americans continue to die at higher rates than other Americans in many categories of preventable illness." These preventable illnesses are another case of underfunding and limited support to Native Americans. These illnesses form from upstream causes like poverty. Recent interventions have focused more on downstream causes, but this does not prevent other health issues.