Chronic disease mortality among Wisconsin Native American Indians, 1984-1993.
Premature chronic disease mortality continues to be a problem among American Indian populations. To document the chronic disease burden in the Wisconsin American Indian population, age- and sex-specific incidence-density mortality rates for ten chronic diseases (ischemic heart disease, stroke, diabetes, chronic obstructive pulmonary disease, cirrhosis, and cancer of the breast, cervix, lung, colorectum and prostate) were estimated for a 10-year period (1984-1993) and compared with the Wisconsin non-Hispanic white population. Compared with whites, American Indians had markedly higher mortality rates from diabetes and cirrhosis in all age- and sex-specific groups. Ischemic heart disease mortality was significantly greater in both American Indian men and women 45-64 years of age (Rate Ratio [RR] = 1.7 and 2.1, respectively) compared to whites of the same age, but was lower in American Indians 65 years of age or older (RR = 0.9 for both sexes). Overall, these ten chronic diseases were responsible for a significant excess number of deaths in middle-aged American Indian men and women (i.e., 45-64 years of age), whereas the chronic disease mortality experience of older American Indian men and women (i.e., > or = 65 years of age) was similar to that of the older white population. Diabetes and cirrhosis were the most important causes of increased mortality overall; however, ischemic heart disease was responsible for a large number of excess deaths in middle-aged American Indian men and women.
Reeves
M J
MJ
Division of Field Epidemiology, Centers for Disease Control and Prevention, Atlanta, Ga, USA. Reevesm@state.mi.us
Remington
P L
PL
Nashold
R
R
Pete
J
J
D000368:Aged; D002423:Cause of Death; D002908:Chronic Disease / Q000401:mortality*; D005260:Female; D006801:Humans; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D044465:White People