Ethnic disparities in COVID-19 mortality in Mexico: A cross-sectional study based on national data

Abstract

Introduction Across the world, the COVID-19 pandemic has disproportionately affected racial and ethnic minorities. How ethnicity affects Indigenous peoples in Mexico is unclear. The aim of this cross-sectional study was to determine the mortality associated with ethnicity, particularly of Indigenous peoples, in a large sample of patients with COVID-19 in Mexico. Methods We used open access data from the Mexican Ministry of Health, which includes data of all confirmed COVID-19 cases in the country. We used descriptive statistics to compare differences among different groups of patients. Logistic regression was used to calculate odds ratios while adjusting for confounders. Results From February 28 to August 3, 2020, a total of 416546 adult patients were diagnosed with COVID-19. Among these, 4178 were Indigenous peoples. Among all patients with COVID-19, whether hospitalized or not, a higher proportion of Indigenous peoples died compared to non-Indigenous people (16.5% vs 11.1%, respectively). Among hospitalized patients, a higher proportion of Indigenous peoples died (37.1%) compared to non-Indigenous peoples (36.3%). Deaths outside the hospital were also higher among Indigenous peoples (3.7% vs 1.7%). A higher proportion of Indigenous peoples died in both the private and public health care sectors. The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was 1.13 (95% confidence interval 1.03 to 1.24). The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was higher among those who received only ambulatory care (1.55, 95% confidence interval 1.24 to 1.92). Discussion In this large sample of patients with COVID-19, the findings suggest that Indigenous peoples in Mexico have a higher risk of death from COVID-19, especially outside the hospital. These findings suggest Indigenous peoples lack access to care more so than non-Indigenous people during the COVID-19 pandemic in Mexico.

Disparities in Excess Mortality Between Indigenous and Non-Indigenous Brazilians in 2020: Measuring the Effects of the COVID-19 Pandemic

“…Studies reported a disproportionately higher impact of COVID-19 among Indigenous populations from Mexico, Colombia, and among Mayan immigrants living in the USA when compared to their non-Indigenous counterparts [ 42 – 45 ]. Indigenous Ecuadorians experienced a 220% increase in the expected number of deaths during the pandemic, the highest level of excess deaths among all ethnic groups [ 46 ].…”

COVID-19: Evidenced Health Disparity

“…In addition, African Americans were more impacted because they have limited access to single-family homes due to historical institutional discriminatory policies (e.g., redlining and FHA policies) that force them to converge in mostly the poorest, densely populated inner-city spaces [78]. Similar experiences exist for Black, Asian, and Minority Ethnic (BAME) groups in the United Kingdom [34,[86][87][88][89] and indigenous populations around the world [90][91][92][93]. Generally, minorities are disproportionately overrepresented in neighborhoods of concentrated poverty [94], which is detrimental to mental and physical health and wellbeing.…”

Out-of-pocket spending as share of final household consumption, 2019 (or nearest year)

“…• In Mexico, Indigenous people had higher odds of dying than non-Indigeneous people,with hospitalised Indigenous patients at 1.13 times higher risk of dying of COVID-19 than non-Indigenous patients (Ibarra-Nava et al, 2021 [75]).…”