Investigating Risk Factors Contributing to the High Incidence of COVID-19 Among the Diné People of the Navajo Nation

Background: COVID-19 became international news in December 2019 and subsequently impacted global health. The research shows that the Diné people of the Navajo Nation were one of the most severely impacted populations¹. The Navajo Nation is a region spanning Arizona, New Mexico, and Utah that is composed of North American indigenous people known as the Diné. Purpose: To explore the risk factors contributing to the increased rates of COVID-19 infection and severity of infection among the Diné people. Methods: This literature review research process utilized PubMed and JAMA to find scholarly articles on this topic. Search terms included: Navajo, Diné, COVID-19, respiratory illness, health disparity, healthy equity, vaccine, nutrition, smoking, healer, medical mistrust, and resources. Results: The findings of this review show that factors that contributed to the high incidence of COVID-19 within the Diné population include high rates of co-morbid conditions, lack of access to resources, and social determinants of health rooted in the history of the Navajo Nation. These results may be limited by underreporting of the American Indian population's health and by avoidance of the healthcare system by the Diné. Conclusion: The results in this paper highlight the importance of addressing fundamental inequities that exist in society to lessen their impact on health outcomes of vulnerable populations.