Covid-19 Testing in Navajo Nation

In June 2020, when most people presumed urban areas such as New York City to be the center of the Covid-19 pandemic in the United States, it was Navajo Nation, the Native American reservation located in the southwest, that was hardest hit. The reservation, spanning the size of West Virginia, had an infection rate of 3.4% compared to that of New York state's 1.9% (Mozes). 

Several factors have been contributing to the Native American population's increased suffering from the coronavirus. A study published in the July/August 2020 Journal of Public Health Management and Practice found that the lack of indoor plumbing in households on Native American reservations was correlated to their increased number of Covid-19 cases. Additionally, many households across Native American reservations do not speak English; given that much of the health and safety information published was in English, it was found that the language barrier was correlated to the reservation's heightened quantity of cases (Rodriguez-Lonebear, et al.).

This study's results, specifically the latter finding, show that clear communication of information is crucial in fighting the Covid-19 pandemic. Given this fact, I was disappointed to see that the official map representing Navajo Nation's testing locations contained significant flaws.

The original map was built in ArcGIS, making it easy for me to access the same data set. My first task was to filter the data to ensure that only active testing sites were present on the map. The most efficient solution I found was to show only testing locations that did not have a specific date attached to them. When sorting through the data table, I was able to see that dates were only entered for testing locations after they had closed; the date column of the table was empty for all active testing sites.

Once I had filtered data, I decided to build two maps: one for functionality and another for analysis. My intention with Figure 1 was to demonstrate the areas across the Navajo Reservation that had access to a testing facility within 30 minutes of their home. I placed a 30-minute drive time around each location, indicated by a red border and a relatively transparent white fill. When individuals type in their location, they can easily see if they are within a 30-minute radius of a testing location. 

With both maps, it was important that key information associated with each testing site was easily accessible. In the pop-ups for both the driving time areas and the testing location, I have included the following information: Who can be testing, what to bring, hours of testing, website, telephone, and address.

Regarding Figure 2, I was interested in introducing Covid-19 case data into the map depicting testing locations. When searching for case data from Navajo Nation, an issue was a lack of consistency in how different areas were classified. For example, population and case data may be broken down by states, counties, or reservation chapters; these variations made it challenging to obtain normalized data. The data I used, sourced through ArcGIS, was organized by service units distinguished by the Indian Health Service.

At the outset of this project, I was interested in using Figure 2 as a form of analysis, looking at the correlation between testing and case data. As cases across the country surged, we saw a wave of politicians claiming that the rising cases numbers were linked strictly to an increase in testing. The issue was, and continues to be, more nuanced; an article from October 2020 highlights statements from doctors saying that while increased testing unveils more cases, the relentlessness of this virus is the genuine cause of rising cases (Chau). Another complication when looking at Figure 2, as mentioned earlier, is the lack of corresponding population data.

Keeping these nuances in mind, I was interested to see, in an area lacking medical and infrastructural federal resources, how this principle generally played out. With these caveats, it was interesting to see that there does seem to be a higher number of cases in areas with a higher concentration of testing locations. 

Additionally, Figure 1 demonstrates that a significant amount of Navajo Nation's population, specifically in the Western half, must travel over 30 minutes to obtain a Covid-19 test. 

While these two maps are just scratching the surface of the distress that Navajo Nation has been forced to face amidst this pandemic, I believe they highlight the systemic issues that Native American reservations across the country face regarding assistance from the United States federal government.

• Chau, Nicole Brown. “Is the Rise in U.S. COVID-19 Cases Because of Testing? It's Not That Simple, Doctors Say.” CBS News, CBS Interactive, 26 Oct. 2020, www.cbsnews.com/news/us-covid-19-cases-testing/. 
• Mozes, Alan. “COVID-19 Ravages the Navajo Nation.” WebMD, WebMD, 9 June 2020, www.webmd.com/lung/news/20200609/covid-19-ravages-the-navajo-nation#1. 
• Rodriguez-Lonebear, Desi PhD; Barceló, Nicolás E. MD; Akee, Randall PhD; Carroll, Stephanie Russo DrPH, MPH American Indian Reservations and COVID-19: Correlates of Early Infection Rates in the Pandemic, Journal of Public Health Management and Practice: July/August 2020 - Volume 26 - Issue 4 - p 371-377