• Native American communities have seen higher COVID-19 infection and mortality rates across most states
  • Preexisting health conditions, poverty and multi-generational homes are largely to blame
  • Still, some communities are doing well: In the Upper Great Lakes region Native communities are actually doing better than the national average due to careful planning and early action

The COVID-19 pandemic has proven to be particularly deadly for Native Americans.

An analysis by U.S. News & World Report indicates that Native Americans have the highest racial disparity when it comes to COVID-19 hospitalizations of any group in the U.S. Native Americans are 5.3 times more likely to be hospitalized due to COVID-19 than white Americans. 

native americans Phil Little Thunder from the Rosebud Reservation wears his ceremonial outfit in the tribal area on the grounds of the Fort Laramie National Historic Site in Fort Laramie, Wyoming, April 29, 2018. Photo: REUTERS/Stephanie Keith

The inquiry shows that in 23 of the 31 states studied, Native Americans were at greater risk for COVID-19 infection. In Arizona, Mississipi, Montana, New Mexico and Oregon, Native Americans were more than four times more likely to contract the disease.

New Mexico’s disparity was particularly severe, with Native Americans more than 15 times more susceptible. Death rates for those who fell ill were also higher in 15 of the measured states. Here are three of the biggest contributing factors:


Native Americans comprise the most impoverished ethnic group in the U.S. Native Americans are more likely to lack access to clean water and plumbing, for example.

Health care is often lacking for Native Americans, particularly due to the perpetually struggling Indian Health Services. Even before COVID-19 they suffered from worse health outcomes and shorter life expectancy. The pandemic has only worsened these trends, with COVID-19 exacerbated by other health conditions.


Poverty and a lack of access to health care have contributed to a rash of conditions that make COVID-19 infections worse, particularly diabetes, heart disease, asthma, and obesity. It’s these comorbidities that drastically increase the mortality rates among Native populations.

An inquiry by the Kaiser Family Foundation found that Native American adults were 13% more likely to be at risk for serious illness from COVID-19.

Social Practices

Many Native American groups practice multi-generational living in large homes, limiting the possibility of social distancing and posing a particular risk to the elderly. Older adults are at greater risk of dying from the respiratory virus. Native groups who have seen success battling COVID-19’s spread put a particular emphasis on keeping older members isolated.

Jackie Dionne, a member of the North Dakota Chippewa Indians, told U.S. News & World Report, “There was a big push made by tribal elected leaders to wear a mask, to not gather for the sake of keeping our elders safe."

There have been some success stories among Native American populations. In Minnesota and across the whole nothern region of the Great Lakes, careful planning by tribal leadership has helped their communities avoid the brunt of the pandemic. In Illinois, Indiana, Michigan, Minnesota and Wisconsin, COVID-19 test rates among Native Americans return positive results at less than half the nationwide rate.

Still, there are challenges. Homelessness in urban areas is more common among Native Americans than among other ethnicities, and those people don’t have access to many resources. 

"We're not hearing tribes concerned about hospitalizations, but most of our American Indian population doesn't live on reservations," Dionne said. "But we are seeing it, in urban areas, in the homeless population. It's a really precarious situation."