title: Disparities in life expectancy of pacific northwest American Indians and Alaska natives: analysis of linkage-corrected life tables.
abstract: OBJECTIVE
  American Indians and Alaska Natives (AI/ANs) experience a high burden of mortality and other disparities compared with the general population. Life tables are an important population health indicator; however, federal agencies have not produced life tables for AI/ANs, largely due to racial misclassification on death certificates. Our objective was to correct this misclassification and create life tables for AI/ANs who resided in the Pacific Northwest region of the U.S., making comparisons with the general population.
  
  
  METHODS
  To correct racial misclassification, we conducted probabilistic record linkages between death certificates from three Northwest states-Idaho, Oregon, and Washington State-issued during 2008-2010, and AI/AN patient registration records. We calculated mortality rates and generated period life tables for AI/ANs and non-Hispanic white (NHW) Americans.
  
  
  RESULTS
  Overall life expectancy at birth for Northwest AI/ANs was 72.8 years, which was 6.9 years lower than that of NHW Americans. Male AI/ANs had a lower life expectancy (70.9 years) than female AI/ANs (74.6 years). The disparity in life expectancy between AI/ANs and their NHW counterparts was higher for females (with AI/ANs living 7.3 years fewer than NHW females) than for males (with AI/ANs living 6.7 years fewer than NHW males). The greatest disparity in mortality rates was seen among young adults.
  
  
  CONCLUSIONS
  Data linkage with a registry of known AI/ANs allowed us to generate accurate life tables that had not previously been available for this population and revealed disparities in both life expectancy at birth and survival across the life span. These results represent an important tool to help AI/AN communities as they monitor their health and promote efforts to eliminate health disparities.
authors.affiliation: Northwest Portland Area Indian Health Board, Improving Data & Enhancing Access Project, Portland, OR.
authors.forename: Jenine
authors.initials: J
authors.lastname: Dankovchik
authors.affiliation: Northwest Portland Area Indian Health Board, Improving Data & Enhancing Access Project, Portland, OR.
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Hoopes
authors.affiliation: Northwest Portland Area Indian Health Board, Improving Data & Enhancing Access Project, Portland, OR ; Northwest Portland Area Indian Health Board, Northwest Tribal Epidemiology Center, Portland, OR.
authors.forename: Victoria
authors.initials: V
authors.lastname: Warren-Mears
authors.affiliation: Seattle Indian Health Board, Urban Indian Health Institute, Seattle, WA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Knaster
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007223:Infant; D004930:Inuit / Q000706:statistics & numerical data; D008017:Life Expectancy / Q000208:ethnology*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States / Q000453:epidemiology; D044469:Racial Groups / Q000706:statistics & numerical data*; D017678:Sex Distribution; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult