title: Mortality trends among Alaska Native people: successes and challenges.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Mortality rates and trends are essential to understanding the health of a population and guiding policy decisions. The overall AN/AI mortality rate is higher than that of US whites, although encouraging declines in mortality have occurred for many cause specific deaths, as well as for the overall rate. The second leading cause of AN/AI mortality, heart disease, remains lower than that of US whites.
authors: Division of Community Health Services, Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA.
authors: Peter
authors: P
authors: Holck
authors: Gretchen Ehrsam
authors: GE
authors: Day
authors: Ellen
authors: E
authors: Provost
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000413:Alaska / Q000453:epidemiology; D000437:Alcoholism / Q000401:mortality; D002423:Cause of Death / Q000639:trends; D002561:Cerebrovascular Disorders / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000401:mortality; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008107:Liver Diseases / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009369:Neoplasms / Q000401:mortality; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000401:mortality; D055815:Young Adult
keywords: Native American; death; suicide; unintentional injury; vital statistics
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