| Summary: | Objectives. 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. Methods. 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. Results. 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. Conclusions. 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. Alaska; American Indian; Caucasian; cause of death; death certificate; epidemiology; female; health disparity; health survey; human; Inuit; male; middle aged; public health service; register; rural population; statistics and numerical data; United States; urban population, Alaska; Cause of Death; Death Certificates; European Continental Ancestry Group; Female; Health Status Disparities; Humans; Indians, North American; Inuits; Male; Middle Aged; Population Surveillance; Registries; Rural Population; United States; United States Indian Health Service; Urban Population
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