Much like other minority groups in America (and across the world), the socioeconomic disproportions that indigenous people see across healthcare and education are being mirrored in the way COVID-19 is affecting their communities. The United States' infection rate is already higher than the vast majority of other countries (and higher than all similarly populated countries), but within some indigenous communities, the infection rate is up to five times higher than that of the United States as a whole.
There are many contributing factors, both economic and otherwise, all contributing to a staggering disproportion that needs to be treated with extra caution.
Chosen Lifestyle
Religious gatherings and rituals have always been an integral part of indigenous life, and choosing to continue these practices during the coronavirus outbreaks has certainly had an affect on the high numbers. The disease outbreak wasn't particularly centric to indigenous communities, but it did prove to be more difficult to contain in these communities, and treatment practices were also lacking due to a lack of information.
Large-scale celebrations like Canada's National Indigenous Peoples Day were cancelled, for the most part, and celebrators were urged to stay home and practice social distancing while they paid respects to the natives of the land.
Forced Lifestyle
Locale and economic demographics have also played their parts in the increased risks to indigenous people, but fixing this issue is much more difficult than encouraging better sanitization and social distancing practices. Cultural diversity in healthcare is an issue that affects all minority neighborhoods, and it is deeply ingrained in systemic oppression. Since the dawning of the modern United States as a country, indigenous people have been forced from their land and sent to live in areas that were much less desirable to live in.
These areas historically receive less government aid for things like healthy food and education, and the economic disparities are directly related to gaps in healthcare coverage and lacks of knowledge regarding standard self-help practices, especially during unique situations such as COVID-19. Fixing this issue starts with legalities, and measures to ensure more equality in care when these indigenous communities are compared to areas with higher income levels.
Other Factors
Even when communities are well-informed and decide as a group to social distance and take other necessary precautions regarding the slow of the disease spread, they are still met with challenges, many of which also come from socioeconomic disparities. Washing your hands is not possible without access to clean water, and lacks of proper housing make social distancing much more difficult in densely populated areas than suburban streets with backyards and large parks.
Even when these indigenous people are in areas with solid healthcare options, they are often discriminated against when it comes to one-on-one care, simply due to healthcare workers' implicit biases that statistically drive them to treat members of their own race and income levels with greater levels of compassion. It is also statistically more difficult for indigenous people to get prescriptions written for them, or to get treatment in the same amount of time that a Caucasian counterpart would receive the same treatment.
Looking Ahead
As the coronavirus is expected to run rampant without a vaccine until at least the end of the year, there is still plenty of time to make these disparities less staggering and be able to look back on it as a problem that was acted upon and not a problem that was just discussed after the fact. The disparities that exist in access to care need to be addressed locally, and indigenous communities need to be as informed as any other community in the country.