Citation

Espey DK, Jim MA, Cobb N, Bartholomew M, Becker T, Haverkamp D, Plescia M. Am. J. Public Health 2014; 104(Suppl 3): S303-11.

Affiliation

David K. Espey, Melissa A. Jim, Don Haverkamp, and Marcus Plescia are with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. At the time of the study, Nathaniel Cobb was with and Michael Bartholomew is currently with the Division of Epidemiology and Disease Prevention, Indian Health Service (IHS), Rockville, MD. Tom Becker is with Oregon Health and Sciences University, Portland.

Copyright

(Copyright © 2014, American Public Health Association)

DOI

10.2105/AJPH.2013.301798

PMID

24754554

Abstract

OBJECTIVEs. We present regional patterns and trends in all-cause mortality and leading causes of death in American Indians and Alaska Natives (AI/ANs).

METHODS. US National Death Index records were linked with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN. We analyzed temporal trends for 1990 to 2009 and comparisons between non-Hispanic AI/AN and non-Hispanic White persons by geographic region for 1999 to 2009.

RESULTS focus on IHS Contract Health Service Delivery Area counties in which less race misclassification occurs.

RESULTS. From 1990 to 2009 AI/AN persons did not experience the significant decreases in all-cause mortality seen for Whites. For 1999 to 2009 the all-cause death rate in CHSDA counties for AI/AN persons was 46% more than that for Whites. Death rates for AI/AN persons varied as much as 50% among regions. Except for heart disease and cancer, subsequent ranking of specific causes of death differed considerably between AI/AN and White persons.

CONCLUSIONS. AI/AN populations continue to experience much higher death rates than Whites. Patterns of mortality are strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking, and social determinants. Much of the observed excess mortality can be addressed through known public health interventions. (Am J Public Health. Published online ahead of print April 22, 2014: e1-e9. doi:10.2105/AJPH.2013.301798).

Language: en