The American Lung Association is committed to bringing awareness and support to communities most affected by COVID-19, including tribal communities. This Indigenous Peoples’ Day, we are highlighting community partner Angela Montiel of the Tucson Indian Center in Arizona. The Tucson Indian Center has hosted our tobacco cessation program, Freedom From Smoking and Montiel leads programs for youth and their parents on commercial tobacco use prevention and cessation.

After first being proposed at the 1977 United Nations Conference on Discrimination Against Indigenous Populations in the Americas, Indigenous Peoples’ Day is now recognized in more than 100 U.S. cities, towns, counties and states on October 12, the day that has historically been observed as Columbus Day. South Dakota became the first state to acknowledge Native Americans on this date, and Berkeley, CA, became the first U.S. city to specifically recognize Indigenous Peoples’ Day. Presently, there are 574 recognized tribes and approximately 5 million people who identify as fully or partially Indigenous in the U.S. 

“Every Indigenous tribe has their own unique language, culture and history,” Montiel said. “We are survivors of tragedy and victories. Indigenous Peoples’ Day gives us the opportunity to share, respect and honor our unique tribal histories, languages and cultures.”

There is longstanding precedent for public health crises disproportionately impacting tribal communities. Tribal communities have experienced enduring racial inequities and historical trauma that have negatively impacted their health and socioeconomic status. Worsening the situation, Indigenous people have a higher risk of serious complications because they are more likely to suffer from chronic illnesses, such as heart disease, hypertension and diabetes. Furthermore, compared to all other racial/ethnic groups, Indigenous people have the highest prevalence of a key risk factor for more severe COVID-19 symptoms: commercial tobacco use, specifically cigarette smoking. The higher COVID-19 incidence rates within this population might also relate to some tribal members’ reliance on shared transportation, limited access to running water and household size.

Unfortunately, during this Indigenous Peoples’ Day many tribal communities are grappling with the devastating effects of COVID-19. Earlier in the pandemic, the Navajo Nation — the second most-populous tribe in the U.S., whose territory stretches across parts of Arizona, New Mexico and Utah — had more people infected with the coronavirus per capita than any state in the country. A recent Centers for Disease Control and Prevention (CDC) study shows that Indigenous people (American Indians and Alaska Natives) are among the racial/ethnic groups at higher risk for severe COVID-19 outcomes. The study found that in 23 states, the overall incidence of COVID-19 cases among Indigenous Peoples was 3.5 times that of non-Hispanic white Americans. Additionally, Indigenous people are more likely to be hospitalized due to COVID-19 than any other race. According to the Indian Health Service, more than 52,000 Indigenous people have tested positive for the virus.  

“Indigenous communities currently have many health disparities. Regardless of a tribe’s economic standing, American Indians and Alaskan Natives experience lower life expectancy, and the highest rates of underlying health conditions  compared to other Americans. Many of us live in multi-generational homes. These risk factors make us more susceptible to higher rates of COVID-19. However, through health education and advocacy we can encourage healing for all our future generations,” Montiel explained.

The American Lung Association recognizes the strength and resilience of tribal communities as they have worked together to combat this pandemic, as well as the need to address the underlying health disparities that have made tribal communities more susceptible to COVID-19. Through our COVID-19 Action Initiative, the Lung Association aims to end COVID-19 and defend against future respiratory pandemics. An important part of this initiative is to provide free lung health education and masks to communities in most need, including Indigenous populations. Learn more at

Disclaimer: The information in this article was medically reviewed and accurate at the time of posting. Because knowledge and understanding of COVID-19 is constantly evolving, data or insights may have changed. The most recent posts are listed on the EACH Breath blog landing page. You may also visit our COVID-19 section for updated disease information and contact our Lung HelpLine at 1-800-LUNGUSA for COVID-19 questions.

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