Trends and disparities in stroke mortality by region for American Indians and Alaska Natives

• Main Authors: Schieb, L.J., Ayala, C., Valderrama, A.L., Veazie, M.A.
• Format: Article in Journal/Newspaper
• Language: unknown
• Subjects: Indian; inuit; inuits; Alaska
• Online Access: http://hdl.handle.net/10.2105/AJPH.2013.301698

Objectives. We evaluated trends and disparities in stroke death rates for American Indians and Alaska Natives (AI/ANs) and White people by Indian Health Service region. Methods. We identified stroke deaths among AI/AN persons and Whites (adults aged 35 years or older) using National Vital Statistics System data for 1990 to 2009. We used linkages with Indian Health Service patient registration data to adjust for misclassification of race for AI/AN persons. Analyses excluded Hispanics and focused on Contract Health Service Delivery Area (CHSDA) counties. Results. Stroke death rates among AI/AN individuals were higher than among Whites for both men and women in CHSDA counties and were highest in the youngest age groups. Rates and AI/AN:White rate ratios varied by region, with the highest in Alaska and the lowest in the Southwest. Stroke death rates among AI/AN persons decreased in all regions beginning in 2001. Conclusions. Although stroke death rates among AI/AN populations have decreased over time, rates are still higher for AI/AN persons than for Whites. Interventions that address reducing stroke risk factors, increasing awareness of stroke symptoms, and increasing access to specialty care for stroke may be more successful at reducing disparities in stroke death rates. adult; aged; American Indian; article; Caucasian; cerebrovascular accident; comparative study; death certificate; ethnology; female; human; Inuit; male; middle aged; mortality; risk factor; statistics; United States; very elderly, Adult; Aged; Aged, 80 and over; Alaska; Death Certificates; European Continental Ancestry Group; Female; Humans; Indians, North American; Inuits; Male; Middle Aged; Risk Factors; Stroke; United States