Social Determinants of Health, Tribal Payments, and Probability of Contracting COVID-19 in American Indian and Alaska Native Peoples.

This article examines the relationships between demographic and economic social determinants of health (SDH), including tribal payment programs, and the risk of contracting COVID-19 among urban American Indian and Alaska Native (AI/AN) peoples. Surveying 767 AI/AN patients from five urban health organizations between January and May 2021, the study found that individuals living in multigenerational households had a significantly higher risk of COVID-19, while receipt of regular tribal payments—defined as ongoing financial distributions from tribes—was associated with a reduced risk. Age under 55 was also linked to higher COVID-19 risk, whereas education and household income showed no significant association. These findings suggest that targeted interventions to reduce intrahousehold transmission and support through tribal payment programs may improve health outcomes in urban AI/AN communities.