967958

research-article2020
ALN0010.1177/1177180120967958AlterNative: An International Journal of Indigenous PeoplesMillalen et al.

Situation Reports

AlterNative

COVID-19 and Indigenous peoples 1­–4

© The Author(s) 2020
Article reuse guidelines:
in Chile: vulnerability to contagion sagepub.com/journals-permissions
https://doi.org/10.1177/1177180120967958
DOI: 10.1177/1177180120967958

and mortality journals.sagepub.com/home/aln

Pablo Millalen1,5, Hector Nahuelpan2,5 ,

Alvaro Hofflinger3 and Edgars Martinez4

Abstract
This research investigates whether Indigenous Populations are disproportionately vulnerable to COVID-19 infection
and deaths in Chile. To answer this question, we use a regression model to analyze data from the Chilean government.
Our analysis indicates that municipalities with a higher proportion of Indigenous people evinced higher rates of infection
and deaths to COVID-19. Indigenous groups were not only highly affected at the beginning of the coronavirus outbreak;
their rate of infection and mortality has increased as the virus has spread to the general population. We argue that the
COVID-19 pandemic can have devastating effects on Indigenous communities, mainly because it increases the historically
accumulated inequalities and structural racism linked to colonization, neoliberalism, and neo-extractivism in Chile.

Keywords
Indigenous peoples, COVID-19, Latin America, colonialism, and neoliberalism

Introduction and research problem
The Coronavirus pandemic is having a disproportionate
effect on particular communities, exacerbating social,
gender, and racial/ethnic inequalities (Comisión Económica
Para América Latina y el Caribe [CEPAL], 2020). Various
community leaders, human rights organizations, and
researchers have maintained that Indigenous populations
are among the most vulnerable groups to the pandemic and
that COVID-19 could have catastrophic effects on their life
systems (Ferrante & Fearnside, 2020; Fondo para el
Desarrollo de los Pueblos Indígenas de América Latina y El
Caribe, 2020; Laurencin & McClinton, 2020; Raifman &
Raifman, 2020). This outcome is plausible, fundamentally
because Indigenous peoples are facing the pandemic under
conditions of racism and structural violence, poverty,
inequality, and precariousness accumulated because of the
history of colonization (The Anti-Racist Research and
Action Network, 2020).
During the last decades, the effects of neoliberal and
neo-extractivist logics have increased the vulnerability of
Indigenous people in general (Veltmeyer & Petras, 2015),
particularly in Chile (CEPAL & Alianza Territorial
Mapuche, 2012; Toledo Llancaqueo, 2006). On the one
hand, neoliberalism has limited the role of the state as a
guarantor of social rights while commodifying them and
the conditions that sustain their communal living
(Coordinadora Arauco Malleco, 2019; Melin et al., 2017;
Svampa, 2019). To mitigate the impact of these conditions,
among other initiatives, Latin American governments have
implemented intercultural health models (Organización
Panamericana de la Salud, 2008). However, various studies
illustrate that the historical situation of impoverishment
and structural racism undermines the intended effect of
these health policies: Indigenous peoples continue to be
vulnerable in the contexts of health care and disease
prevention (Sacchi et al., 2007). It has also been
demonstrated that intercultural health initiatives act as
homogenizing and destabilizing forces against traditional
indigenous health systems in Latin America (Navarro et al.,
2017; Ramírez Hita, 2014) and Chile (Cuyul, 2012). Other
studies further expose the persisting inequalities in access
to health care between Indigenous people and the rest of the
population, mainly due to linguistic-cultural discrimination
(Amoroz, 2011).
1The University of Texas at Austin
2Universidad de Los Lagos, Chile
3Universidad de La Frontera, Chile
4Centro de Investigaciones y Estudios Superiores en Antropologia

increasing ethnic/racial inequalities in access to health care Social, Mexico

5Comunidad de Historia Mapuche, Chile
(Harvey, 2007; Meneses-Navarro et al., 2020). On the other
hand, neo-extractivism has hindered indigenous territorial Corresponding author:
self-determination through the dispossession and Hector Nahuelpan, Universidad de Los Lagos, Osorno 5290000, Chile.
exploitation of natural resources, as well as by undermining Email: hnahuelpan@gmail.com
2 AlterNative 00(0)

In the context of COVID-19 and the systemic vulnerabil- Table 1.  Regression model using the total number of
ities of Indigenous populations explained above, this study individuals infected with COVID-19 per 100,000 people at the
aims to answer the following research question: Do municipality level in Chile.
municipalities with a higher proportion of Indigenous people Period analyzed since the first case
experience a higher rate of cases and deaths of COVID-19? reported (Mar. 03)
To address this question, we use a multiple regression model
to analyze data from the Chilean government.   (3 months) (4 months) (5 months)
% men 5.34 5.93 14.76
% Indigenous population 5.10** 12.46*** 17.50***
Data and methods % rural population –2.89** –3.89* –2.35
The Chilean data stems from two sources. The first dataset Age groups
comes from the Ministry of Health of Chile (Ministerio de   % between 0 and 5 25.84 –6.16 70.11
Salud, 2020), and it provides information about the number   % between 6 and 13 –32.26 –45.61 –82.41
of cases and deaths due to COVID-19 at the municipal   % between 18 and 30 0.69 11.57 26.66
level. To control for the population of each municipality,   % between 41 and 50 0.00 0.00 0.00
  % between 51 and 65 6.93 –2.89 –11.78
we used the numbers of cases and deaths of COVID-19 per
  % age > 65 12.10 20.51 41.15
100,000 people. The second source comes from the Census
Population older than 17 years
of Population and Housing (Instituto Nacional de
  % unemployment 29.46 72.63+ 28.15
Estadísticas, 2017). We collapsed the individual data at the
 Average years of –31.79 –144.85*** –205.38***
municipal level to extract the following variables (by schooling
percentage): Indigenous population, gender, employment  % with higher 10.62* 33.07*** 52.58***
status, the population living in rural areas, age (eight education
categories), adult population with higher education, and  Observations 346 346 346
average years of schooling. (municipalities)
We used two regression models to determine whether R2 .67 .82 .79
municipalities with larger Indigenous populations see
The data are aggregated at the municipal level. We added a dummy
more cases and deaths of COVID-19 than the municipalities variable per region (16); municipalities are therefore compared to each
with smaller Indigenous populations. The dependent other within regions.
variables are the number of COVID-19 cases and number ***p < 0.001, **p < 0.01, *p < 0.05, +p < 0.10.
of deaths due to COVID-19 per 100,000 people in each
municipality. The independent variables were the
Table 2.  Regression model using the total number of deaths of
percentage of Indigenous population, men, rural
COVID-19 per 100,000 people at the municipality level in Chile.
population, age group (eight categories), unemployment,
population with higher education, and years of schooling. Period analyzed since the first case
To control for geographic differences, the models use a reported (Mar. 03)
dummy variable to identify the region where municipalities
  (3 months) (4 months) (5 months)
are located. Municipalities are then compared to each other
within each region. % men –0.04 –0.50 –1.36+
% Indigenous population 0.22*** 0.39*** 0.50***
% rural population –0.12*** –0.25*** –0.28***
Results Age groups
In this section, we present the evolution of infection and   % between 0 and 5 0.43 0.17 –1.82
mortality rates of COVID-19 over the five-month period   % between 6 and 13 –1.67+ –3.67* –5.89**
following the first reported case in Chile (March 03).   % between 18 and 30 0.17 0.14 –0.54
Table 1 illustrates that the rate of contagion among   % between 41 and 50 –0.00 –0.00 –0.00
  % between 51 and 65 0.12 0.44 0.80
municipalities with a high concentration of Indigenous
  % age > 65 1.00* 0.96 –0.08
citizens has increased as the virus has spread to the general
Population older than 17 years
population. For instance, an increase of 1% of the
  % unemployment 0.70 2.14 3.70+
Indigenous population per municipality implied an
 Average years of –1.48+ –4.70** –5.85**
increase of 5.1 cases of COVID-19 per 100,000 people at schooling
month 3 of the pandemic, 12.5 and 17.5 cases at months 4  % with higher 0.25 0.35 0.62
and 5, respectively. All the coefficients are statistically education
significant (p < .05).  Observations 346 346 346
Table 2 also shows an upward trend: as COVID-19 has (municipalities)
spread across the country, the mortality rate linked to the R2 .64 .74 .73
Indigenous population has risen. For example, an increase
The data are aggregated at the municipal level. We added a dummy
of 1% of the Indigenous population per municipality variable per region (16); municipalities are therefore compared to each
implied an increase of 0.22 deaths per 100,000 people other within regions.
month 3 of the pandemic, 0.39 and 0.50 deaths at 4 and 5 ***p < 0.001, **p < 0.01, *p < 0.05, +p < 0.10.
Millalen et al. 3
months, respectively. All the coefficients are statistically
significant (p < .05).
Discussion and conclusion
In this study, we have sought to determine whether the
Indigenous population in Chile is more vulnerable to
COVID-19 than the rest of the population. Our analysis
confirms that municipalities with a higher proportion of
Indigenous people are not only more susceptible to the
virus, but also evince more deaths to COVID-19.
These results point to the devastating effects that
COVID-19 is poised to have on the Indigenous population.
First, the pandemic may exacerbate the precariousness,
vulnerability, and poor living conditions that Indigenous
people have been subjected to because of the history of
colonization, neoliberalism, and neo-extractivism in Chile.
Extractivism is manifest mainly in forestry (radiata pine
and eucalyptus) and hydroelectric projects, which have
been strongly questioned by Mapuche communities through
social mobilization in recent decades (Mella Seguel, 2007).
Second, the pandemic has revealed underlying inequalities
in hegemonic health care systems, including intercultural
models that were already inadequate before COVID-19. In
the face of this adversity, Mapuche communities in
Southern Chile have not remained passive; instead, they
have activated diverse community responses to confront
the pandemic based on their strong tradition of organizing.
These responses include cordons sanitaires, food support
networks, strengthening their own health care systems, or
forms of mutual support, such as epu imple kelluwun
(mutual collaboration in the Mapuche language).
In sum, our analysis illustrates that the municipalities with
a higher percentage of Indigenous peoples present a higher
rate of infection and mortality to COVID-19. These findings
are consistent with previous studies demonstrating that
Indigenous Peoples are more vulnerable to infection and
deaths of COVID-19. One of the main limitations of this
study is the unit of analysis. The Chilean government data is
aggregated at the municipality level, which may obscure
relevant information for estimating the impact of COVID-19
on Indigenous populations. However, aggregated data are
widely used in social sciences and researchers are proof that
the results obtained between individual and aggregated data
may be almost identical (Bloom et al., 2007; Jacob et al.,
2014). Future studies should consider these limitations, as
well as how Indigenous communities have responded to
COVID-19, and how these responses are part of the exercising
autonomy and self-determination in a context of crisis.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support
for the research, authorship, and/or publication of this article: This
research is part of the FONDECYT Project No. 11170193.
ORCID iD
Hector Nahuelpan https://orcid.org/0000-0002-0088-1405.
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