The coronavirus is not equal in the destruction it causes.

A new report from the Centers for Disease Prevention and Control demonstrates that trend, finding the rate of COVID-19 in American Indians and Alaska Natives is 3-1/2 times higher than in non-Hispanic white people across 23 states.

Based on data from 340,000 confirmed virus cases spanning late January to early July, the cumulative incidence for American Indians and Alaskan Natives was 594 cases per 100,000 people, compared to 169 per 100,000 for the white population.

The difference is likely to be even larger than that, the CDC said, because of limitations in collecting data. For example, only cases from fewer than half the nation’s states could be included in the report because reporting from other states was incomplete. The states included represent about one-third of the national American Indian and Alaska Native populations.

Several studies have documented the disproportionate effects the coronavirus has on minorities. The CDC recently reported that the trend also extends to kids, with Hispanic, Latino and Black children hospitalized with the virus more frequently than white children.

This could also be true for American Indian and Alaska Native kids. The report found that a higher percentage of children among the groups were infected than in white kids. Nearly 13% of cases in the American Indian and Alaska Native populations were in people under the age of 18, compared to 4% in the white population.

The CDC points to “persisting racial inequality and historical trauma” as contributing factors to the health and socioeconomic disparities faced by American Indians and Alaska Natives.

“The elevated incidence within this population might also reflect differences in reliance on shared transportation, limited access to running water, household size, and other factors that might facilitate community transmission,” the CDC said.