COVID-19 Presents Significant Risks For American Indians With Diabetes by Kylee Carter
More than 16% of American Indian and Alaska Native adults have been diagnosed with diabetes, which is more than double the prevalence rate for the general population in the U.S. - according to the National Indian Council on Aging. This puts them at a greater risk for COVID-19, indicating that a greater response effort will be needed to reduce the widening of disparities and in order to fulfil the government’s federal trust responsibility. In June 2020, Tracey Brown, CEO of the American Diabetes Association, stressed the importance of doing more for high-risk groups. Brown herself has Type 2 diabetes, and recently wrote an op-ed piece to support COVID-19 diagnosis and care for minorities.
An Urgent Appeal
Tracey Brown co-wrote her report alongside U.S. representative Bobby Rush in an effort to ensure that more low-income and minority communities receive greater testing and access. The report states that minority communities (including American Indians and Alaskan natives) have higher numbers, not only of diabetes, but also of other underlying conditions. It highlights the need for a dedicated program run by the CDC to mobilize testing and contact tracing work. Diabetes is just one disease that is more prevalent in American Indians; the list of conditions also includes heart disease, asthma and obesity. All of these are also risk factors for worse COVID-19 outcomes.
Why Are Diabetes Rates High Among American Indians?
The CDC reports that American Indians are five times more likely than white Americans to have kidney failure from diabetes. They are also more likely to have diabetic foot disease. Moreover, foot ulceration and amputation are up to three times more common (and they occur at a younger age) in American Indians. Preventing the effects of diabetic foot is complex, as are many other measures to stave off the more serious effects of diabetes. A report by D Schoen and P Norman states that these issues are more serious for American Indians owing to various factors - including “complex social and political factors such as geographical isolation, infrastructure, education and employment disadvantage, and cultural and linguistic differences.” All these are good reasons why American Indians need to be supported, both in the fight against diabetes and against COVID-19, via dedicated programs crafted around their needs.
The Coronavirus Aid Relief And Economic Security Act
This act, drafted by the federal government, aims to provide relief and support to federally recognized tribes and tribal business groups. This and other programs should be put into motion and later analyzed to test whether or not they are successful at reducing the effect of large health and economic disparities. Further work is needed, however, in areas like outreach and education, financial aid, and improved testing and treatment access. Brown notes that “There are pop-up drive-thru testing sites, but again if you don’t have a car, your ability to get through drive-thru testing is limited.” In other words, it is vital to take testing into the communities so that those who test positive can be quarantined.
COVID-19 is a greater risk for American Indians owing to the fact that this population has a higher rate of diseases that can result in major complications. Obesity, asthma and diabetes are just a few diseases which are present at higher rates in the American Indian community. Greater access is needed to testing and treatment within the communities themselves, as is a stronger focus on education and awareness on prevention, symptoms, and the like.