New paper out: Investigating COVID-19 transmission and mortality differences between indigenous and non-indigenous populations in Mexico

We have just published our second paper which is part of our 2022-23 academic year project at the Centre for Advanced Study Social Science Meets Biology: Indigenous People and Severe Influenza Outcomes – CAS. You can read the whole paper here: Investigating COVID-19 transmission and mortality differences between indigenous and non-indigenous populations in Mexico – International Journal of Infectious Diseases (ijidonline.com)

Highlights

  • Indigenous groups had a 68% higher COVID-19 mortality rate than the non-indigenous groups.
  • Of 32 federal entities, 23 had a higher mortality rate among the indigenous groups.
  • The mortality rate ratio and the reproduction number were highest during the fourth wave of the COVID-19 pandemic.
  • Indigenous populations had a higher care-seeking delay than the non-indigenous populations.
  • The hazard ratio decreased from 1.67 (unadjusted) to 1.08 in the adjusted model.

Abstract

Objectives

Indigenous populations have been disproportionately affected during pandemics. We investigated COVID-19 mortality estimates among indigenous and non-indigenous populations at national and sub-national levels in Mexico.

Methods

We obtained data from the Ministry of Health, Mexico, on 2,173,036 laboratory-confirmed RT-PCR positive COVID-19 cases and 238,803 deaths. We estimated mortality per 1000 person-weeks, mortality rate ratio (RR) among indigenous vs. non-indigenous groups, and hazard ratio (HR) for COVID-19 deaths across four waves of the pandemic, from February 2020 to March 2022. We also assessed differences in the reproduction number (Rt).

Results

The mortality rate among indigenous populations of Mexico was 68% higher than that of non-indigenous groups. Out of 32 federal entities, 23 exhibited higher mortality rates among indigenous groups (P < 0.05 in 13 entities). The fourth wave showed the highest RR (2.40). The crude HR was 1.67 (95% CI: 1.62, 1.72), which decreased to 1.08 (95% CI: 1.04, 1.11) after controlling for other covariates. During the intense fourth wave, the Rt among the two groups was comparable.

Conclusion

Indigenous status is a significant risk factor for COVID-19 mortality in Mexico. Our findings may reflect disparities in non-pharmaceutical (e.g., handwashing and using facemasks), and COVID-19 vaccination interventions among indigenous and non-indigenous populations in Mexico.

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