Evaluating environmental and built-environment factors associated with COVID-19 cases on the Navajo Nation

Keywords: Environmental health, Indigenous, environmental justice, spatial analysis
Abstract Type: Paper Abstract

Abstract

Navajo Nation residents experience significant food, energy, and water insecurity that likely impact community resilience to events like the COVID-19 pandemic. In this analysis we investigated associations between COVID-19 rates and socio-demographic and built environment variables, abstracted to the eight Indian Health Service units on the Navajo Nation. We hypothesized that areas characterized by at-risk populations due to age, lack of critical infrastructure, and household overcrowding would be positively associated with COVID-19 cases. Secondary data were accessed through the American Community Survey, Indian Health Service, and Navajo Nation Department of Health COVID-19 dashboard. Results indicated that the percentage of individuals who spoke English only was associated with decreased COVID-19 cases in Spring 2020. We also observed a positive association between COVID-19 cases during Winter 2020 and areas demonstrating larger, overcrowded households lacking drinking water supply, and negative associations with more isolated communities and areas with an older population living in smaller households. This ecological analysis suggests that food, water, and energy insecurity - due to lack of critical infrastructure - may have contributed to COVID-19 cases on the Navajo Nation. Further analysis is needed to assess the validity of this interpretation using chapter or individual-level data and to evaluate the relative contributions of underlying biomedical factors that increase susceptibility to COVID-19 infection and complications.