tetano
Editor, Senior Moderator
J Racial Ethn Health Disparities
. 2025 Jul 21.
doi: 10.1007/s40615-025-02492-9. Online ahead of print. Incidence Rates of COVID-19-Associated Hospitalization and Risk Factors for Severe Disease Among American Indian and Alaska Native Persons in the Southwest USA and Alaska
Chelsea S Lutz[SUP] 1 [/SUP], Catherine G Sutcliffe[SUP] 1 2 [/SUP], James W Keck[SUP] 3 [/SUP], Rachel M Hartman[SUP] 1 [/SUP], Christine Desnoyers[SUP] 4 [/SUP], Amy Swango-Wilson[SUP] 3 [/SUP], Amanda B Burrage[SUP] 5 [/SUP], Angela P Campbell[SUP] 6 [/SUP], Loretta Christensen[SUP] 7 [/SUP], Ryan M Close[SUP] 8 [/SUP], Shawnell Damon[SUP] 9 [/SUP], Jennifer Dobson[SUP] 4 [/SUP], Starla Garcia[SUP] 1 [/SUP], Natasha Halasa[SUP] 10 [/SUP], Elvira Honie[SUP] 1 [/SUP], Verlena Little[SUP] 1 [/SUP], Meredith L McMorrow[SUP] 6 [/SUP], Dennie Parker[SUP] 1 [/SUP], Mila M Prill[SUP] 6 [/SUP], Jennifer Richards[SUP] 1 [/SUP], Puthiery Va[SUP] 11 [/SUP], Mark Veazie[SUP] 11 [/SUP], Dan VanDeRiet[SUP] 1 [/SUP], Del Yazzie[SUP] 12 [/SUP], Rosalyn J Singleton[SUP] 3 [/SUP], Laura L Hammitt[SUP] 13 [/SUP]
Affiliations
Introduction: COVID-19 causes significant morbidity in the USA, particularly among American Indian/Alaska Native (AI/AN) persons. Estimates of COVID-19 burden among AI/AN communities are needed to identify health outcome disparities and inform prevention strategies, but under-ascertainment of AI/AN status in national data may result in underestimation of COVID-19 disease burden.
Methods: Surveillance for acute respiratory illness was conducted among AI/AN persons at eight healthcare facilities in Arizona and Alaska to identify COVID-19-associated hospitalizations and outpatient visits. Weekly and annual incidence rates of COVID-19-associated hospitalizations per 100,000 persons were calculated overall and by site and age. Risk factors for COVID-19-associated hospitalizations (versus outpatient visits) were assessed.
Results: From January 2021 to December 2022, 1159 COVID-19-associated hospitalizations were identified. Incidence rates were 439.8 per 100,000 in 2021 and 332.6 per 100,000 in 2022 and highest among adults ≥ 65 years at all sites. Compared to national estimates from 2021 to 2022, incidence rates by time and age were similar among older adults, whereas incidence rates among AI/AN children were over twice as high. Among adults, older age, chronic lung disease, chronic kidney disease, and diabetes increased the risk of hospitalization; frequent mask use outside the home and COVID-19 vaccination were protective, particularly if vaccinated within the past year. Among children, younger age and heart conditions increased the risk of hospitalization.
Conclusions: The findings demonstrate a substantial burden of COVID-19 in AI/AN persons and provide critically needed data regarding the risks for severe outcomes. AI/AN children experience a disproportionate burden of COVID-19 disease.
Keywords: COVID-19; Indigenous health; Risk factor; SARS-CoV-2.
. 2025 Jul 21.
doi: 10.1007/s40615-025-02492-9. Online ahead of print. Incidence Rates of COVID-19-Associated Hospitalization and Risk Factors for Severe Disease Among American Indian and Alaska Native Persons in the Southwest USA and Alaska
Chelsea S Lutz[SUP] 1 [/SUP], Catherine G Sutcliffe[SUP] 1 2 [/SUP], James W Keck[SUP] 3 [/SUP], Rachel M Hartman[SUP] 1 [/SUP], Christine Desnoyers[SUP] 4 [/SUP], Amy Swango-Wilson[SUP] 3 [/SUP], Amanda B Burrage[SUP] 5 [/SUP], Angela P Campbell[SUP] 6 [/SUP], Loretta Christensen[SUP] 7 [/SUP], Ryan M Close[SUP] 8 [/SUP], Shawnell Damon[SUP] 9 [/SUP], Jennifer Dobson[SUP] 4 [/SUP], Starla Garcia[SUP] 1 [/SUP], Natasha Halasa[SUP] 10 [/SUP], Elvira Honie[SUP] 1 [/SUP], Verlena Little[SUP] 1 [/SUP], Meredith L McMorrow[SUP] 6 [/SUP], Dennie Parker[SUP] 1 [/SUP], Mila M Prill[SUP] 6 [/SUP], Jennifer Richards[SUP] 1 [/SUP], Puthiery Va[SUP] 11 [/SUP], Mark Veazie[SUP] 11 [/SUP], Dan VanDeRiet[SUP] 1 [/SUP], Del Yazzie[SUP] 12 [/SUP], Rosalyn J Singleton[SUP] 3 [/SUP], Laura L Hammitt[SUP] 13 [/SUP]
Affiliations
- PMID: 40691741
- DOI: 10.1007/s40615-025-02492-9
Introduction: COVID-19 causes significant morbidity in the USA, particularly among American Indian/Alaska Native (AI/AN) persons. Estimates of COVID-19 burden among AI/AN communities are needed to identify health outcome disparities and inform prevention strategies, but under-ascertainment of AI/AN status in national data may result in underestimation of COVID-19 disease burden.
Methods: Surveillance for acute respiratory illness was conducted among AI/AN persons at eight healthcare facilities in Arizona and Alaska to identify COVID-19-associated hospitalizations and outpatient visits. Weekly and annual incidence rates of COVID-19-associated hospitalizations per 100,000 persons were calculated overall and by site and age. Risk factors for COVID-19-associated hospitalizations (versus outpatient visits) were assessed.
Results: From January 2021 to December 2022, 1159 COVID-19-associated hospitalizations were identified. Incidence rates were 439.8 per 100,000 in 2021 and 332.6 per 100,000 in 2022 and highest among adults ≥ 65 years at all sites. Compared to national estimates from 2021 to 2022, incidence rates by time and age were similar among older adults, whereas incidence rates among AI/AN children were over twice as high. Among adults, older age, chronic lung disease, chronic kidney disease, and diabetes increased the risk of hospitalization; frequent mask use outside the home and COVID-19 vaccination were protective, particularly if vaccinated within the past year. Among children, younger age and heart conditions increased the risk of hospitalization.
Conclusions: The findings demonstrate a substantial burden of COVID-19 in AI/AN persons and provide critically needed data regarding the risks for severe outcomes. AI/AN children experience a disproportionate burden of COVID-19 disease.
Keywords: COVID-19; Indigenous health; Risk factor; SARS-CoV-2.