The Canary in The Coal Mine: COVID and Health in the Diné (Navajo) Nation

By Kelly Tabbutt

Read about COVID-19 in Indian Country, and specifically, the Navajo (Diné) Nation.

The Navajo Nation lives in New Mexico, Utah, and Arizona, and occupy the most land of any indigenous tribe in the United States. The Navajo, who call themselves the Diné, have fought a difficult battle against the novel coronavirus, with 1,161 confirmed deaths since February 25, 2021. Read on to learn more about COVID-19 and the Diné. (I will refer to the Navajo and Diné interchangeably in this blog post.)

photo of monument valley tribal park in the navajo nation
Monument Valley Tribal Park in the Navajo Nation. Photo by Matteo Di Iorio on Unsplash

Table of Contents:
COVID-19 in Indian Country
Colonialism and The Federal-Tribal Trust Relationship
The Diné (Navajo) Nation
Economic Conditions
Environmental Conditions
COVID-19 Comorbidities


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Most people familiar with U.S. colonial history and European settlement are also familiar with the dire drop in the indigenous population beginning with the first European encounter. Deadly diseases – mainly smallpox – continued to ravage Native people through the 1700s, and resulted in the deaths of 90% of the Native population in the Americas. COVID-19 has not had anywhere near this level of destruction, but it has infected the Native population at a high rate due to structural health disparities

Overall, the rates of infection are higher among all Native people, compared to the general U.S. population. Specifically, as 17% of the Diné (Navajo) people have experienced a COVID-19 infection (29,655 cases among approximately 173,000 reservation residents as of February 25, 2021) – compared to a rate of 8.7% for the US. This means that Diné people are infected at a rate approximately twice that of the general U.S. population. Further, the death rates from COVID-19 among Native people as a whole are also twice as high as those for the U.S. population, with 1 in every 475 Native individuals succumbing to the disease. Vaccination efforts are slowly progressing: as of writing on February 26, 2021, nearly 70% of Navajo Nation residents have received at least one dose of the COVID-19 vaccine, and 23% of Navajo Nation members are fully immunized against COVID-19. Despite this, there are many factors related to the unique position of Native people and reservations within the US which contribute to this disparity in infection rates.

In this article, I will introduce the issue of the unequal ravages of COVID-19 experienced by the Diné (Navajo) Nation as an exemplary case study. I focus on the connection between this disparity and the broader context of the health challenges faced by modern reservation-based Native Nations generally. I also discuss the foundation of these modern challenges in the system of settler colonialism that still shapes the inequalities experienced by Native Nations and members.


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Over 500 years ago, Columbus landed on the shores of the Americas, which began a chain reaction of increasing European colonization and settlement. Colonialism prevailed as a means for controlling land and natural resources held and occupied by Native Nations. It continues to shape the life experiences of all Native people today – particularly those on Native Nation reservations.

United States Federal Indian Policy pertains to Native Nations and people and delineates their relationship with the U.S. government. These federal policies position Native Nations and people within the U.S. as both separate – as “sovereign” nations with unique rights to self-government protected under treaties – and incorporated – as dependent “wards” under U.S. plenary power. This paradoxical positioning as “domestic dependent sovereigns” and “wards” of the U.S. government gives rise to unique challenges for Native people.

Treaty negotiations control the rights regarding land use and the services owed to Native people and nations in exchange for the land occupation and control granted to European settlers. The U.S. government is legally bound to protect these rights in what is referred to as a federal-tribal “trust relationship.” The responsibilities entailed in this “guardianship” position held by the U.S. government are maintained through the Department of the Interior, which includes providing funding for basic public services and infrastructure such as: health care through the Indian Health Service; education; housing through the Department of Housing and Urban Development; and tribal and non-tribal (Bureau of Indian Affairs and Federal Bureau of Investigation) law enforcement services in Native Nation territories. 


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The Diné, also called the “Navajo” Nation, are a culturally and spiritually vibrant people, with a strong governmental system, a fierce sense of collective survivance, and an uninterrupted history of resilience. However, the Diné also experience challenges which are nonetheless exemplary of the hardships still facing numerous Native Nations to this day such as extreme poverty, lack of access to running water or electricity, and food and employment scarcity.

The Treaty of Bosque Redondo (1868) is a legal document delineating the specific rights to land occupation and use reserved by the Diné. This treaty is understood by the U.S. government to set up the Diné Nation as “wards” of the U.S. government. The modern Diné Nation reservation stretches across Utah, New Mexico, and Arizona. The Diné Nation reservation is 27,000 acres, making it the largest reservation in the U.S. It’s also the most populous reservation, with nearly 180,000 residents, according to the Census.


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In 1928, the Meriam report was commissioned by the Institute for Government Research (now called the Brookings Institution) and submitted to the U.S. federal government. The report detailed the terrible conditions in Indian Country, largely focusing on the lack of infrastructure and extreme poverty. The take-home message: poverty in Indian Country is the direct result of segregation and discrimination, land and resource encroachment, and federal neglect – in short, it is the result of colonial design. 

Since this report, many tribes have managed to forge thriving economic systems, while others still face living conditions that have barely improved since the 1928 report. One in three Native people live in poverty, and the average income for Native people in the U.S. is $23,000. Compare this to the average among all those living in the U.S.: 15% live in poverty (more than 2.5 times lower than Native people) and according to Google, the average income for the U.S. as a whole is $31,000 (1.5 times higher than Native people). Further, as of February 2021 and amidst the COVID-19 pandemic, the average unemployment rate for Native people is 26%, which is four times the current national unemployment rate (6.3%).


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I previously wrote about structural racism and COVID-19 infection among minorities. Poverty plays a significant role in these disparities. The link between poverty and COVID-19 infection rates is painfully clear in the case of Indian Country.

Data from the Minneapolis Federal Reserve Bank from 2013-2017 shows that, among the Diné, the poverty rate is 40%, with 19% living in extreme poverty (remember, the poverty rate for the U.S. as a whole is about 15%). Unemployment among the Diné is about 19%, which is over three times the rate for the U.S. as a whole, and could be even greater due to COVID-19 impacts.

The effects of poverty are more than just a lack of money. These effects are compounded by the extreme rurality of most Native Nations based on reservations, and the lack of natural resource usage control, which presents barriers to access for things like electricity and clean, running water.

According to the Navajo Water Project, one in three residents of the Diné Nation do not have access to running water. About 30% of those living on the Navajo reservation do not have electricity. Finally, overcrowding within homes is a widespread issue among the Diné Nation members living on-reservation. Lack of access to running water, lack of access to electricity decrease the ability to maintain proper COVID-19 hygiene (such as frequent hand-washing with hot water). Overcrowding increases the risk of exposure (you cannot social-distance or quarantine in an overcrowded home). It should be noted that access to clean, running water; electricity; internet; and overcrowding are significant issues for numerous Native Nations across Indian Country. 


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The issues of poverty, isolation, lack of safe drinking water, having no electricity, and lack of access to healthy food all have compounding (and lasting) health effects for residents of Native Nations. These health issues, referred to as COVID-19 comorbidities, are important because they exacerbate the effects of COVID-19. Common comorbidities can include diabetes, high blood pressure, and obesity, to name a few. They make COVID-19 more severe and increase the risk of death or lasting after-effects of the disease.

Further, the use of Native land for resource mining has also produced detrimental and compounding effects on health. Take for example the case of uranium mining in Navajo territory. Much of this mining was surface mining, exposing uranium to open air (and uranium debris to water supplies), without the use of radiation detectors, ultimately exposing numerous Navajo miners and residents to uranium dust in the air and in the water. 

To this day, there are still elevated levels of uranium in Navajo water supplies, soil, and Navajo people – in their blood and bones. Uranium is found in about 5% of the general U.S. population. This number skyrockets to 27% for the Navajo. This exposure is causally related to the elevated instances of cancer – particularly lung, stomach, and kidney cancer – found in residents of the Navajo Nation. 

The Navajo experience high rates of lung, liver, stomach, and kidney cancer. Compared to the averages for the U.S. as a whole, among the Navajo, instances of liver cancer are twice as high, stomach cancer is 3.5 times higher, and kidney cancer rates are almost twice as high. Death rates due to liver cancer among the Diné are nearly twice that of the U.S. as a whole, nearly 2.5 times for stomach cancer, just over twice as high for kidney cancer, and more than 7 times as high for gallbladder cancer.


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The Navajo Nation experiences rates of COVID-19 infection, and COVID-19-associated mortality, that are higher than the U.S. as a whole. Disparities in health issues between the Navajo Nation residents and the U.S. as a whole are not unique to COVID-19; they follow the same pattern the Navajo have seen, for example, in cancer diagnosis and death rates. These disparities are not the result of a single environmental factor – such as poverty or lack of access to clean running water – or the result of modern life. Rather, they represent a convergence of compounding factors. 

Drastic disparities in the instances and outcomes of COVID among the Diné (Navajo) Nation are “the canary in the coal mine” or rather a canary (cancer is another) signaling the deadly effects of years, and centuries, of exposure to policies disregarding the well-being of Native people – with the Navajo as an exemplary case – in an effort to increase non-Native land and natural resource control and economic growth. The erasure of Native people from U.S. history or modernity is not merely a matter of genocide or relocation, but a continual process of imposed invisibility with dire effects.


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