title: Infectious disease mortality among American Indians and Alaska Natives, 1999-2009.
abstract: OBJECTIVE
  We described death rates and leading causes of death caused by infectious diseases (IDs) in American Indian/Alaska Native (AI/AN) persons. Methods. We analyzed national mortality data, adjusted for AI/AN race by linkage with Indian Health Service registration records, for all US counties and Contract Health Service Delivery Area (CHSDA) counties. The average annual 1999 to 2009 ID death rates per 100,000 persons for AI/AN persons were compared with corresponding rates for Whites.
  
  
  RESULTS
  The ID death rate in AI/AN populations was significantly higher than that of Whites. A reported 8429 ID deaths (rate 86.2) in CHSDA counties occurred among AI/AN persons; the rate was significantly higher than the rate in Whites (44.0; rate ratio [RR] = 1.96; 95% confidence interval [CI] = 1.91, 2.00). The rates for the top 10 ID underlying causes of death were significantly higher for AI/AN persons than those for Whites. Lower respiratory tract infection and septicemia were the top-ranked causes. The greatest relative rate disparity was for tuberculosis (RR = 13.51; 95% CI = 11.36, 15.93).
  
  
  CONCLUSIONS
  Health equity might be furthered by expansion of interventions to reduce IDs among AI/AN communities.
authors.affiliation: James E. Cheek is with the Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque. Robert C. Holman and Dana Haberling are with the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, GA. John T. Redd is with the Indian Health Service (HIS), Santa Fe, NM. Thomas W. Hennessy is with the Arctic Investigations Program, NCEZID, CDC, Anchorage, AK.
authors.forename: James E
authors.initials: JE
authors.lastname: Cheek
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.forename: John T
authors.initials: JT
authors.lastname: Redd
authors.forename: Dana
authors.initials: D
authors.lastname: Haberling
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Hennessy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology / Q000208:ethnology; D002423:Cause of Death; D003141:Communicable Diseases / Q000208:ethnology* / Q000401:mortality*; D003644:Death Certificates; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012042:Registries; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
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