title: Alcohol-attributable mortality among American Indians and Alaska Natives in the United States, 1999-2009.
abstract: OBJECTIVE
  We describe the relative burden of alcohol-attributable death among American Indians/Alaska Natives (AI/ANs) in the United States.
  
  
  METHODS
  National Death Index records were linked with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN. We calculated age-adjusted alcohol-attributable death rates from 1999 to 2009 for AI/AN and White persons by sex, age, geographic region, and leading causes; individuals of Hispanic origin were excluded.
  
  
  RESULTS
  AI/AN persons had a substantially higher rate of alcohol-attributable death than Whites from 2005 to 2009 in IHS Contract Health Service Delivery Area counties (rate ratio = 3.3). The Northern Plains had the highest rate of AI/AN deaths (123.8/100,000), and the East had the lowest (48.9/100,000). For acute causes, the largest relative risks for AI/AN persons compared with Whites were for hypothermia (14.2) and alcohol poisoning (7.6). For chronic causes, the largest relative risks were for alcoholic psychosis (5.0) and alcoholic liver disease (4.9).
  
  
  CONCLUSIONS
  Proven strategies that reduce alcohol consumption and make the environment safer for excessive drinkers should be further implemented in AI/AN communities.
authors.affiliation: Michael Landen and Jim Roeber are with the Epidemiology and Response Division, New Mexico Department of Health, Santa Fe. Tim Naimi is with the Section of Internal Medicine, Boston Medical Center, MA. Larry Nielsen is with the National Association for Public Health Statistics and Information Systems, Silver Spring, MD. Mack Sewell is with the Wyoming Department of Workforce Services, Cheyenne.
authors.forename: Michael
authors.initials: M
authors.lastname: Landen
authors.forename: Jim
authors.initials: J
authors.lastname: Roeber
authors.forename: Tim
authors.initials: T
authors.lastname: Naimi
authors.forename: Larry
authors.initials: L
authors.lastname: Nielsen
authors.forename: Mack
authors.initials: M
authors.lastname: Sewell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology / Q000208:ethnology; D000428:Alcohol Drinking / Q000208:ethnology* / Q000401:mortality*; D002423:Cause of Death; 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; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
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