Infectious Disease Hospitalizations Among American Indian/Alaska Native and Non–American Indian/Alaska Native Persons in Alaska, 2010-2011

• Published in: Public health reports (1974) 2017-01, Vol.132 (1), p.65-75
• Main Authors: Gounder, Prabhu P., Holman, Robert C., Seeman, Sara M., Rarig, Alice J., McEwen, Mary, Steiner, Claudia A., Bartholomew, Michael L., Hennessy, Thomas W.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Aged, 80 and over; Alaska - epidemiology; Alaska Natives; Child; Child, Preschool; Communicable Diseases - diagnosis; Communicable Diseases - epidemiology; Cross-Sectional Studies; Data analysis; Epidemiology; Female; Health care; Health care policy; Health Services; Hospitalization; Hospitalization - statistics & numerical data; Humans; Hydrologic data; Infant; Infectious diseases; Male; Middle Aged; Native North Americans; Population Groups; Public health; Respiratory tract; Respiratory tract diseases; Risk; Risk analysis; Risk factors; Young Adult
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1177/0033354916679807

Objective: Reports about infectious disease (ID) hospitalization rates among American Indian/Alaska Native (AI/AN) persons have been constrained by data limited to the tribal health care system and by comparisons with the general US population. We used a merged state database to determine ID hospitalization rates in Alaska. Methods: We combined 2010 and 2011 hospital discharge data from the Indian Health Service and the Alaska State Inpatient Database. We used the merged data set to calculate average annual age-adjusted and age-specific ID hospitalization rates for AI/AN and non-AI/AN persons in Alaska. We stratified the ID hospitalization rates by sex, age, and ID diagnosis. Results: ID diagnoses accounted for 19% (6501 of 34 160) of AI/AN hospitalizations, compared with 12% (7397 of 62 059) of non-AI/AN hospitalizations. The average annual age-adjusted hospitalization rate was >3 times higher for AI/AN persons (2697 per 100 000 population) than for non-AI/AN persons (730 per 100 000 population; rate ratio = 3.7, P < .001). Lower respiratory tract infection (LRTI), which occurred in 38% (2486 of 6501) of AI/AN persons, was the most common reason for ID hospitalization. AI/AN persons were significantly more likely than non-AI/AN persons to be hospitalized for LRTI (rate ratio = 5.2, P < .001). Conclusions: A substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was LRTI. Public health programs and policies that address the risk factors for LRTI are likely to benefit AI/AN persons.