There are not yet clear data on how infant mortality has (or has not) shifted among indigenous groups in the U.S., Canada, or other countries around the world since before and after the start of the COVID-19 pandemic. However, data indicate that it is possible that the infant mortality rate among these groups increased during the pandemic and that the disparity between infant mortality rates among indigenous peoples and non-indigenous peoples grew. This possibility is due to a few main factors, including:

1. the fact that infant mortality appears to have increased overall due to the COVID-19 pandemic,
2. the fact that infant mortality rates among indigenous people were already high before the pandemic (and higher than non-indegenous groups),
3. the fact that some data shows that life expectancy dropped among indigenous groups during the COVID-19 pandemic, and
4. the fact that access to healthcare overall and for indigenous groups worsened during the COVID-19 pandemic.
   

Existing high infant mortality rates overall during COVID-19 pandemic

Infant mortality in public health is considered to be any death of an infant before their first birthday. Early data show that infant mortality may have increased during COVID-19. For instance, a study using modeling in the British Medical Journal found that an extra 267,000 infants likely died in 2020 in low and middle income countries as a result of the economic downturn caused by COVID-19. These data show that we can expect higher infant mortality rates overall.

Existing high infant mortality rates among indigenous people

As of 2020, based on 2018 data from the U.S. Centers for Disease Control and Prevention, there were 8.2 deaths per 1,000 live births among American Indian and Alaskan Natives in the United States, compared to 4.6 deaths per 1,000 live births among non-Hispanic whites. This means that the infant mortality rate among American Indian and Alaskan Natives in the U.S. was almost twice the infant mortality rate as non-Hispanic whites just before the pandemic.

In Canada, the data are similar. As of 2018, based off of data from 2008 - 2011, the infant mortality rate among First Nations peoples was 8.1 deaths per 1,000 live births, 6.6 deaths per 1,000 live births among Métis peoples, 13.5 deaths per 1,000 live births among Inuit peoples, and 3.5 deaths per 1,000 live births among communities with low a low concentration of First Nations/Uniut/Métis peoples.

There are similar data that show high infant mortality rates among indigenous peoples compared to non-indigenous populations in other countries in other parts of the world, such as Australia and Brazil, meaning these disparities are not specific to one region.

Drop in life expectancy overall among indigenous people

In addition to existing high infant mortality rates among indienous peoples, life expectancy has been shown to have decreased among indigenous populations according to some research. For instance, one 2022 study found that the pandemic reduced Native American life expectancy at birth from the already low 72 years in 2019 to about 67 years in 2020 and about 65 years in 2021. We do not have enough data yet to know how life expectancy has changed during the pandemic for indigenous populations in other countries, but the U.S. data show that it’s possible it has decreased in other countries and regions as well.

Lower access to healthcare during the COVID-19 pandemic

While it’s unclear precisely how why life expectancy has dropped so much among indigenous people, it’s likely due to a combination two factors:

1) the fact that indigenous people were disproportionately impacted by COVID-19 around the world and because; for example, the case rate among Native Americans and Alaska Natives in the U.S. was 50% higher than among white Americans; and

2) the discrimination and lack of resources experienced among indigenous peoples globally; for instance, in Canada, First Nations people living off reserve (21%) were more likely than non-Indigenous people (15%) to report an unmet need for such services in the first year of the pandemic. As further evidence of this, research has found that Indigenous participants in studies on the impact of the pandemic, including those with disabilities and long-term conditions, reported worsened overall health and in particular mental health at higher levels than non-Indigenous participants.

These factors outlined do not at all prove that infant mortality has worsened among indigenous populations during the pandemic, but show that it is possible if not likely.

The impacts of the COVID-19 pandemic are still being researched as the virus continues to spread. Some data can take years to collect and analyze because of the large scale and, in this case, because of difficulties in collecting data and reaching a population during a health crisis. For instance, the rate of home births rose by 19% in 2020 in the U.S. as the pandemic hit, which might have an impact on how data is collected.

Infant mortality rates are one of the data points that will take some time to have clear data on in the context of the pandemic. That being said, we can use other data to get a sense of how those rates may have changed. Generally, health outcomes worsened in the wake of the COVID-19 pandemic, especially for already marginalized groups such as indigenous peoples.