title: Disparities in infectious disease hospitalizations for American Indian/ Alaska Native people.
abstract: OBJECTIVE
  We described disparities in infectious disease (ID) hospitalizations for American Indian/Alaska Native (AI/AN) people.
  
  
  METHODS
  We analyzed hospitalizations with an ID listed as the first discharge diagnosis in 1998-2006 for AI/AN people from the Indian Health Service National Patient Information Reporting System and compared them with records for the general U.S. population from the Nationwide Inpatient Survey.
  
  
  RESULTS
  The ID hospitalization rate for AI/AN people declined during the study period. The 2004-2006 mean annual age-adjusted ID hospitalization rate for AI/AN people (1,708 per 100,000 populiation) was slightly higher than that for the U.S. population (1,610 per 100,000 population). The rate for AI/AN people was highest in the Southwest (2,314 per 100,000 population), Alaska (2,063 per 100,000 population), and Northern Plains West (1,957 per 100,000 population) regions, and among infants (9,315 per 100,000 population). ID hospitalizations accounted for approximately 22% of all AI/AN hospitalizations. Lower-respiratory-tract infections accounted for the largest proportion of ID hospitalizations among AI/AN people (35%) followed by skin and soft tissue infections (19%), and infections of the kidney, urinary tract, and bladder (11%).
  
  
  CONCLUSIONS
  Although the ID hospitalization rate for AI/AN people has declined, it remains higher than that for the U.S. general population, and is highest in the Southwest, Northern Plains West, and Alaska regions. Lower-respiratory-tract infections; skin and soft tissue infections; and kidney, urinary tract, and bladder infections contributed most to these health disparities. Future prevention strategies should focus on high-risk regions and age groups, along with illnesses contributing to health disparities.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, 1600 Clifton Rd. NE, MS A-39, Atlanta, GA 30333, USA. RHolman@cdc.gov
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.forename: Arianne M
authors.initials: AM
authors.lastname: Folkema
authors.forename: Rosalyn J
authors.initials: RJ
authors.lastname: Singleton
authors.forename: John T
authors.initials: JT
authors.lastname: Redd
authors.forename: Krista Y
authors.initials: KY
authors.lastname: Christensen
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Steiner
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Schonberger
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Hennessy
authors.forename: James E
authors.initials: JE
authors.lastname: Cheek
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000208:ethnology*; D005260:Female; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012621:Seasons; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service / Q000706:statistics & numerical data; D055815:Young Adult