Article Text
Abstract
Background Despite having a large indigenous population, little is known about the differences in COVID-19-related health outcomes between indigenous and non-indigenous patients in Mexico. The aim of this study is to analyse the variation in hospitalisation and death between indigenous and non-indigenous patients with COVID-19 to guide future policies and clinical practice.
Methods We used data from the Mexican Ministry of Health (MoH) to study the hospitalisation and death of adults with laboratory-confirmed SARS-CoV-2 in MoH facilities between 1 March 2020 and 28 February 2021. Predicted probabilities of hospitalisation and death were adjusted for sociodemographic and presentation to care characteristics as well as municipal social deprivation index and health jurisdiction-level index of human resource and hospital equipment availability.
Results Of 465 676 hospitalised adults with COVID-19, 5873 (1.3%) were identified as indigenous. Indigenous patients had higher odds of hospitalisation (adjusted OR (aOR)=1.9, 95% CI 1.8 to 2.0), death (aOR=1.3, 95% CI 1.1 to 1. 3) and early mortality (aOR=1.2, 95% CI 1.0 to 1.4), compared with non-indigenous patients. Living in municipalities with high social deprivation was associated with a higher risk of hospitalisation and early death. Living in areas with low healthcare resources was associated with a higher risk of hospitalisation but not death. Being male, aged 51 years or older, having diabetes, hypertension and obesity were associated with an incremental probability of hospitalisation and death among indigenous patients.
Conclusions Indigenous patients with COVID-19 in Mexico have a higher risk of hospitalisation and death than non-indigenous individuals. Our findings can guide future efforts to protect this population from SARS-CoV-2 infection and associated outcomes.
- COVID-19
- inequalities
- mortality
- morbidity
- ethnic groups
Data availability statement
Data are available in a public, open-access repository. The repository name is Datos Abiertos Dirección General de Epidemiología. The URL is https://www.gob.mx/salud/documentos/datos-abiertos-152127?idiom=es. The data can be freely downloaded and do not require a licence or are under embargo. The data available here are anonymised data on individuals tested for COVID-19 in Mexico.
This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
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Data availability statement
Data are available in a public, open-access repository. The repository name is Datos Abiertos Dirección General de Epidemiología. The URL is https://www.gob.mx/salud/documentos/datos-abiertos-152127?idiom=es. The data can be freely downloaded and do not require a licence or are under embargo. The data available here are anonymised data on individuals tested for COVID-19 in Mexico.
Footnotes
Contributors ESM, JAS and VJW conceptualised the study. ESM conducted the statistical analysis. JAS, VJW and OGD contributed to the data interpretation. ESM, JAS and VJW drafted the initial manuscript, which was revised by OGD. All authors critically revised the manuscript and approved the final version.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.