Mortality trends among Alaska Native people: successes and challenges

• Published in: International Journal of Circumpolar Health
• Main Authors: Peter Holck, Gretchen Ehrsam Day, Ellen Provost
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2013
• Subjects: Native American; unintentional injury; suicide; death; vital statistics; Arctic medicine. Tropical medicine; RC955-962; Arctic; Indian; Circumpolar Health; International Journal of Circumpolar Health; Alaska
• Online Access: https://doi.org/10.3402/ijch.v72i0.21185; https://doaj.org/article/1f6cff8fa3194565915a6f1cf8b4f63e

Background . Current mortality rates are essential for monitoring, understanding and developing policy for a population's health. Disease-specific Alaska Native mortality rates have been undergoing change. Objective . This article reports recent mortality data (2004–2008) for Alaska Native/American Indian (AN/AI) people, comparing mortality rates to US white rates and examines changes in mortality patterns since 1980. Design . We used death record data from the state of Alaska, Department of Vital Statistics and SEER*Stat software from the National Cancer Institute to calculate age-adjusted mortality rates. Results . Annual age-adjusted mortality from all-causes for AN/AI persons during the period 2004–2008 was 33% higher than the rate for US whites (RR=1.33, 95% CI 1.29–1.38). Mortality rates were higher among AN/AI males than AN/AI females (1212/100,000 vs. 886/100,000). Cancer remained the leading cause of death among AN/AI people, as it has in recent previous periods, with an age-adjusted rate of 226/100,000, yielding a rate ratio (RR) of 1.24 compared to US whites (95% CI 1.14–1.33). Statistically significant higher mortality compared to US white mortality rates was observed for nine of the ten leading causes of AN/AI mortality (cancer, unintentional injury, suicide, alcohol abuse, chronic obstructive pulmonary disease [COPD], cerebrovascular disease, chronic liver disease, pneumonia/influenza, homicide). Mortality rates were significantly lower among AN/AI people compared to US whites for heart disease (RR=0.82), the second leading cause of death. Among leading causes of death for AN/AI people, the greatest disparities in mortality rates with US whites were observed in unintentional injuries (RR=2.45) and suicide (RR=3.53). All-cause AN/AI mortality has declined 16% since 1980–1983, compared to a 21% decline over a similar period among US whites. Conclusion . Mortality rates and trends are essential to understanding the health of a ...