ArticleJournal of racial and ethnic health disparities2022
The Role of Community-Level Factors on Disparities in COVID-19 Infection Among American Indian/Alaska Native Veterans.
Article in Journal of racial and ethnic health disparities, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 14 citations in OpenAlex.
- "It Changed Everything": Challenges to Indigenous Recovery Practices Amid the COVID-19 Pandemic.Genealogy · 2025Article
- A qualitative exploration of the impacts of COVID-19 in two rural Southwestern Alaska communities.International journal of circumpolar health · 2024Article
- Recognising the heterogeneity of Indigenous Peoples during the COVID-19 pandemic: a scoping review across Canada, Australia, New Zealand and the USA.BMJ public health · 2024Article
- Investigation of the role of perceived access to primary care in mediating and moderating racial and ethnic disparities in chronic disease control in the veterans health administration.Health services research · 2024Article
- Explaining COVID-19 related mortality disparities in American Indians and Alaska Natives.Scientific reports · 2023Article
- Infectious diseases in Indigenous populations in North America: learning from the past to create a more equitable future.The Lancet. Infectious diseases · 2023Review
- Inclusion of Race and Ethnicity With Neighborhood Socioeconomic Deprivation When Assessing COVID-19 Hospitalization Risk Among California Veterans Health Administration Users.JAMA network open · 2023Article
- Temporal variation in individual social risk factors associated with testing positive for SARS-CoV-2 among veterans in the veterans health administration.Annals of epidemiology · 2022Article
- The Role of Complicated Grief in Health Inequities in American Indian Communities.Journal of prevention and health promotionArticle
- Impact of In-Home Handwashing Stations on Hand Hygiene During the COVID-19 Pandemic in Unpiped Rural Alaska Native Homes.Public health reports (Washington, D.C. : 1974)Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesAmerican Indian and Alaska Native (AI/AN) communities have been disproportionately affected by the coronavirus disease 2019 (COVID-19) pandemic. This study examines whether neighborhood characteristics mediate AI/AN versus White-non-Hispanic Veteran COVID-19 infection disparities, and whether mediation differs based on proximity to reservations.
methodsUsing Veteran Health Administration's (VHA) national database of VHA users evaluated for COVID-19 infection (3/1/2020-8/25/2020), we examined whether census tract neighborhood characteristics (percent households overcrowded, without complete plumbing, without kitchen plumbing, and neighborhood socioeconomic status [n-SES]) mediated racial disparities in COVID-19 infection, using inverse odds-weighted logistic models controlling for individual-level characteristics. Using moderated mediation analyses, we assessed whether neighborhood mediating effects on disparities differed for those residing in counties containing/near federally recognized tribal lands (i.e., Contract Health Service Delivery Area [CHSDA] counties) versus not.
resultsThe percent of households without complete plumbing, percent without kitchen plumbing, and n-SES partially mediated AI/AN-White-non-Hispanic COVID-19 infection disparities (accounting for 17-35% of disparity) to a similar extent in CHSDA and non-CHSDA counties. The percent of households without kitchen plumbing had stronger mediating effects for CHSDA than non-CHSDA residents.
conclusionsNeighborhood-level social determinants of health may contribute to the disproportionate COVID-19 infection burden on AI/ANs; differences are exacerbated among AI/ANs living near reservations.
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