TUESDAY, June 16, 2020 (HealthDay News) — The rate of COVID-19 cases is increased on American Indian reservations with larger proportions of homes lacking complete indoor plumbing, according to a study published in the July/August issue of the Journal of Public Health Management & Practice.

Desi Rodriguez-Lonebear, Ph.D., from the University of Arizona School of Sociology in Tucson, and colleagues conducted a multivariate analysis to examine the household and community characteristics most closely associated with variation in COVID-19 incidence on American Indian reservations in the lower 48 states. As of April 10, 2020, there were 861 COVID-19 cases on 287 American Indian Reservations and tribal homelands.

The researchers found that the rate of COVID-19 cases per 1,000 people was higher on reservations with larger proportions of homes lacking complete indoor plumbing (10.83 per 1,000) and was lower on reservations that had a higher percentage of English language-only households (−2.43 per 1,000). There was no significant correlation seen for household overcrowding measures.

“Together, these findings support assertions regarding the structural determinants of this disease,” the authors write. “Specifically, the social conditions defining day-to-day life — whether or not families have access to water and whether or not health directives are accessible to their understanding — are as consequential as the viral properties that define infectivity and pathogenesis.”

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