American-Indian diabetes mortality in the Great Plains Region 2002-2010.
OBJECTIVE
To compare American-Indian and Caucasian mortality rates from diabetes among tribal Contract Health Service Delivery Areas (CHSDAs) in the Great Plains Region (GPR) and describe the disparities observed.


METHODS
Mortality data from the National Center for Vital Statistics and Seer*STAT were used to identify diabetes as the underlying cause of death for each decedent in the GPR from 2002 to 2010. Mortality data were abstracted and aggregated for American-Indians and Caucasians for 25 reservation CHSDAs in the GPR. Rate ratios (RR) with 95% CIs were used and SEER*Stat V.8.0.4 software calculated age-adjusted diabetes mortality rates.


RESULTS
Age-adjusted mortality rates for American-Indians were significantly higher than those for Caucasians during the 8-year period. In the GPR, American-Indians were 3.44 times more likely to die from diabetes than Caucasians. South Dakota had the highest RR (5.47 times that of Caucasians), and Iowa had the lowest RR, (1.1). Reservation CHSDA RR ranged from 1.78 to 10.25.


CONCLUSIONS
American-Indians in the GPR have higher diabetes mortality rates than Caucasians in the GPR. Mortality rates among American-Indians persist despite special programs and initiatives aimed at reducing diabetes in these populations. Effective and immediate efforts are needed to address premature diabetes mortality among American-Indians in the GPR.
Department of Public Health Education , University of North Carolina at Greensboro , Greensboro, North Carolina , USA.
Allyson
A
Kelley
Department of Public Health Education , Great Plains Tribal Chairman's Health Board , USA.
Jennifer
J
Giroux
Department of Public Health Education , University of North Carolina at Greensboro , Greensboro, North Carolina , USA.
Mark
M
Schulz
Department of Public Health Education , Taylor University , USA.
Bob
B
Aronson
Department of Public Health Education , University of North Carolina at Greensboro , Greensboro, North Carolina , USA.
Debra
D
Wallace
Department of Nursing , Wake Forest University , USA.
Ronny
R
Bell
Department of Public Health Education , University of North Carolina at Greensboro , Greensboro, North Carolina , USA.
Sharon
S
Morrison
Mortality; Native Americans; Quantitative Methods