Indigenous people are not more clinically vulnerable to COVID-19. Instead, they face increased risks due to inequalities created by current and historic systemic racism and discrimination. Systemic racism is ingrained in the economic, social and political structures of society. It compromises indigenous people’s access to health and education and is a key contributor to why indigenous people continue to experience much poorer health outcomes.

Racial discrimination and poverty underlie the following list of factors that contribute to the vulnerability of indigenous people:

Factors related to increased COVID-19 exposure

  • Communal ways of life: Traditional gatherings are often at the core of indigenous people’s way of life. Gatherings for events like marriages, burials, coming of age ceremonies and harvests during the pandemic put the community at particular risk of exposure to COVID-19. In some communities, communal living where multiple families live together in large dwellings is normal but increases the risk of transmission further if anyone living in such dwellings contracts COVID-19.
  • Logging and mining indigenous territories: Loggers and miners’ activities in indigenous territories, whether legal or not, increase the risk of introducing the virus to indigenous groups living in geographically isolated areas. This may contribute to the increased risk of exposure to the virus in indigenous communities.

Factors related to increased severity of COVID-19 disease

  • Increased prevalence of chronic disease: In many countries, rates of chronic diseases (such as respiratory conditions, heart disease and diabetes) are higher among indigenous people compared to non-indigenous people. This results in an increased risk of severity of COVID-19 disease in indigenous people who contract the virus. The likelihood of having severe outcomes or deaths due to COVID-19 is increased in people with certain pre-existing conditions.
  • Limited access to health services: Many indigenous communities may have limited access to health care or may face additional barriers in accessing acceptable and appropriate care. Disparities in accessing health care between indigenous and non-indigenous populations have been well documented in relation to non-COVID-19 health issues and consequently, this results in adverse health outcomes for indigenous populations. The lack of health workers, protective equipment and testing facilities in the villages and territories of indigenous people means disease surveillance and monitoring and response systems may be slow to activate or completely absent in the face of the pandemic.

Factors related to both increased exposure and severe disease outcomes due to COVID-19

  • Limited access to water, sanitation and hygiene: Safe water and hygiene infrastructure are crucial to prevent infection and spread of COVID-19. Due to low coverage of sanitation and water services found in many indigenous communities, there may be an increased risk for the spread of COVID-19 in indigenous communities.
  • Remote living: Accessing health services can be challenging for indigenous people in geographically isolated settlements. Indigenous people often inhabit remote regions and isolated areas with limited access to healthcare and inadequate water and sanitation and hygiene infrastructure. In these settings, there may be limited or no testing capacity for COVID-19, there may be challenges for contact tracing and a lack of access to preventative products such as soaps, masks and cleaning materials. Limited social mobility and practising self-reliance can both increase and decrease the indigenous population's vulnerability to the pandemic. For further information about how to respond to COVID-19 for indigenous populations living in remote areas, read our summary report on responding to COVID-19 in rural settings.
  • Lack of appropriate tools for communication: Due to a lack of communication technologies, information about the pandemic is often inadequate and delayed in indigenous languages.
  • Income and food insecurity: To curb the spread of COVID-19, it is key to implement measures like physical distancing. Such practices may be challenging or impossible to adapt in some settings where indigenous people make a living off traditional lands and territories in subsistence economies.

The specific needs of indigenous people have not gone unrecognised in the current pandemic. Several United Nations’ institutions, departments and working groups have issued statements and raised awareness, including the UN Department of Economic and Social Affairs, UN Expert Mechanism on the Rights of Indigenous Peoples, the Pan American Health Organization, UNICEF, Médecins Sans Frontières, Oxfam, The World Bank and more. Comments and editorials have been published in journals. Despite the acknowledgement of the particular vulnerability of indigenous populations in the face of COVID-19, there may not be adequate response and relief efforts as indigenous people have been disproportionately affected by the pandemic.

Want to know more about engaging with indigenous people for COVID-19 response?

Editor's note

Author: Astrid Hasund Thorseth

Reviewers: Delmo Roncarati Vilela, Bethany Caruso, Susannah Mayhew, Sian White

Last update: 28.10.20

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