Risk Factors Associated to Mortality in the Indigenous Population with COVID-19 in Mexico

Abstract

Objective: During the COVID-19 pandemic, the Indigenous population in Mexico was subject to several factors that caused them to have a higher mortality risk than the non-Indigenous population. These risk factors included language barriers, poverty, comorbidities, inadequate access to health services, lack of social security, limited education, and substandard housing, inter alia. This study aims to determine the factors associated with COVID-19 mortality in the Indigenous population in Mexico.

Study design: Cohort study.

Methods: This study utilized data from the National Epidemiological Surveillance System for Viral Respiratory Disease (SISVER) collected during 2020 and 2021 to examine the population recognized as Indigenous.

Results: A total of 506,956 COVID-19 cases were reported, with 0.75% identified as Indigenous. The logistic regression assessed the combined effect of Indigenous status and each risk factor. Adjusted odds ratios (aORs) with or without interaction terms were reported. The identified risk factors were the following: age of > 60 years × Indigenous (aOR 9.19, CI 95% 6.38-13.2, p < 0.001); male × Indigenous (aOR 3.38, CI 95% 2.72-5.53, p < 0.001); and time from symptom onset to seeking care > 7 days × Indigenous (aOR 5.86, CI 95% 4.10-8.37, p < 0.001).

Conclusions: Belonging to the Indigenous population is a significant risk factor for COVID-19 mortality in Mexico. Although both Indigenous and non-Indigenous groups share common risk factors, the combined effect of Indigenous status and each risk factor reveals greater vulnerability among the former. Significant interactions were observed with age over 60 years, sex, and delays in seeking medical care after the onset of symptoms.

Keywords: COVID-19; Mortality; Risk factors; Vulnerable populations.