Health Delivery Systems in Response To Covid-19: The Need for Indigenous Led Responses in the USA

The indigenous American Indian/ Alaskan Native (AI/AN) communities in North America have experienced inequitably higher rates of Covid-19 related morbidity, hospitalisation, and mortality than the majority, non-Hispanic white population. These inequalities are the result of centuries of racism and oppression. Mainstream health services have struggled financially to survive the crisis and are poorly positioned or trained to meet the needs of tribal members. The Indian Health Service, being both poorly funded and often suspect, largely failed to mitigate the impact of Covid-19 on these vulnerable communities. There is an urgent need for the expansion of indigenous led health providers.