Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999-2009

• Published in: American journal of public health (1971) 2016-05, Vol.106 (5), p.906-914
• Main Authors: Jacobs-Wingo, Jasmine L, Espey, David K, Groom, Amy V, Phillips, Leslie E, Haverkamp, Donald S, Stanley, Sandte L
• Format: Article
• Language: English
• Subjects: Age; Age groups; AJPH Research; Alaska - epidemiology; Cancer; Cardiovascular disease; Cause of Death; Censuses; Chronic illnesses; Classification; Classification schemes; Death Certificates; Diabetes; Economic indicators; Epidemiology; Female; Health disparities; Health services; Health Status Disparities; Heart; Hispanic people; Humans; Indians, North American - statistics & numerical data; Inuit - statistics & numerical data; Liver cirrhosis; Liver diseases; Male; Maternal & child health; Middle Aged; Mortality; Native Americans; Native North Americans; Other Race/Ethnicity; Population; Population Surveillance; Public health; Race; Registries; Rural Population - statistics & numerical data; Software; Studies; United States - epidemiology; United States Indian Health Service - statistics & numerical data; Urban areas; Urban Health; Urban Population - statistics & numerical data; Vital statistics; White people; White People - statistics & numerical data; Womens health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2015.303033

To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999-2009 and compared those with corresponding urban White and rural AI/AN death rates. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities.