title: American Indian and Alaska Native infant and pediatric mortality, United States, 1999-2009.
abstract: OBJECTIVE
  We described American Indian/Alaska Native (AI/AN) infant and pediatric death rates and leading causes of death.
  
  
  METHODS
  We adjusted National Vital Statistics System mortality data for AI/AN racial misclassification by linkage with Indian Health Service (IHS) registration records. We determined average annual death rates and leading causes of death for 1999 to 2009 for AI/AN versus White infants and children. We limited the analysis to IHS Contract Health Service Delivery Area counties.
  
  
  RESULTS
  The AI/AN infant death rate was 914 (rate ratio [RR] = 1.61; 95% confidence interval [CI] = 1.55, 1.67). Sudden infant death syndrome, unintentional injuries, and influenza or pneumonia were more common in AI/AN versus White infants. The overall AI/AN pediatric death rates were 69.6 for ages 1 to 4 years (RR = 2.56; 95% CI = 2.38, 2.75), 28.9 for ages 5 to 9 years (RR = 2.12; 95% CI = 1.92, 2.34), 37.3 for ages 10 to 14 years (RR = 2.22; 95% CI = 2.04, 2.40), and 158.4 for ages 15 to 19 years (RR = 2.71; 95% CI = 2.60, 2.82). Unintentional injuries and suicide occurred at higher rates among AI/AN youths versus White youths.
  
  
  CONCLUSIONS
  Death rates for AI/AN infants and children were higher than for Whites, with regional disparities. Several leading causes of death in the AI/AN pediatric population are potentially preventable.
authors.affiliation: At the time of the study, Charlene A. Wong was with the Department of Pediatrics, Seattle Children's Hospital/University of Washington, Seattle. Francine C. Gachupin is with the Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson. Robert C. Holman is with the Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Marian F. MacDorman is with the Reproductive Statistics Branch, Division of Vital Statistics, National Center for Health Statistics, Hyattsville, MD. James E. Cheek is with the Public Health Program, Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque. Steve Holve is with Indian Health Service (IHS), Tuba City Regional Healthcare Corporation, Tuba City, AZ. Rosalyn J. Singleton is with the Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Anchorage, AK.
authors.forename: Charlene A
authors.initials: CA
authors.lastname: Wong
authors.forename: Francine C
authors.initials: FC
authors.lastname: Gachupin
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.forename: Marian F
authors.initials: MF
authors.lastname: MacDorman
authors.forename: James E
authors.initials: JE
authors.lastname: Cheek
authors.forename: Steve
authors.initials: S
authors.lastname: Holve
authors.forename: Rosalyn J
authors.initials: RJ
authors.lastname: Singleton
mesh_terms: D000293:Adolescent; D000413:Alaska / Q000453:epidemiology; D002423:Cause of Death; D002648:Child; D046688:Child Mortality / Q000208:ethnology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology*; D007231:Infant, Newborn; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D014481:United States / Q000453:epidemiology
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