Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Russ Kauffman


American Indians; Native Americans; American natives; Indians, North America; Indigenous; COVID-19; Coronavirus; SARS-CoV-2


COVID-19 has been most devastating to the elderly and those living in dense communities, which disproportionately affects American Indians as they are medically underserved. American Indians tend to live in multigenerational housing which puts them at higher risk for transmission of COVID-19. To determine other risk factors and the long-term physical and mental health impacts of COVID-19 on American Indians, a literature review was completed using metaanalyses and case studies. The results of this study confirm that age is the most substantial risk factor for severe COVID-19 illness, complication, and mortality, regardless of race or ethnicity. However, American Indians are 3.5 times more likely to contract COVID-19 and almost twice as likely to die compared to Caucasian Americans. American Indians under 60 had significantly higher mortality rates than Caucasian Americans, as well. Overcrowding in multigenerational housing, as well as the higher prevalence of comorbidities in American Indians, correlates with more significant COVID-19 illness burden and mortality. Historical trauma and racial and structural inequalities, considered adverse life events, contribute to chronic disease vulnerabilities, like cardiovascular disease, diabetes, and chronic respiratory disease, which also correlate with higher morbidity and mortality from COVID-19.