title: Infectious Disease Hospitalizations Among American Indian/Alaska Native and Non-American Indian/Alaska Native Persons in Alaska, 2010-2011.
abstract: Reports about infectious disease (ID) hospitalization rates among American Indian/Alaska Native (AI/AN) persons have been constrained by data limited to the tribal health care system and by comparisons with the general US population. We used a merged state database to determine ID hospitalization rates in Alaska.
  
  
  
  We combined 2010 and 2011 hospital discharge data from the Indian Health Service and the Alaska State Inpatient Database. We used the merged data set to calculate average annual age-adjusted and age-specific ID hospitalization rates for AI/AN and non-AI/AN persons in Alaska. We stratified the ID hospitalization rates by sex, age, and ID diagnosis.
  
  
  
  ID diagnoses accounted for 19% (6501 of 34 160) of AI/AN hospitalizations, compared with 12% (7397 of 62 059) of non-AI/AN hospitalizations. The average annual age-adjusted hospitalization rate was >3 times higher for AI/AN persons (2697 per 100 000 population) than for non-AI/AN persons (730 per 100 000 population; rate ratio = 3.7, P < .001). Lower respiratory tract infection (LRTI), which occurred in 38% (2486 of 6501) of AI/AN persons, was the most common reason for ID hospitalization. AI/AN persons were significantly more likely than non-AI/AN persons to be hospitalized for LRTI (rate ratio = 5.2, P < .001).
  
  
  
  A substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was LRTI. Public health programs and policies that address the risk factors for LRTI are likely to benefit AI/AN persons.
authors.affiliation: 1 Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA.
authors.forename: Prabhu P
authors.initials: PP
authors.lastname: Gounder
authors.affiliation: 1 Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.affiliation: 2 Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Seeman
authors.affiliation: 3 Division of Public Health, Alaska Department of Health and Social Services, Juneau, AK, USA.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Rarig
authors.affiliation: 3 Division of Public Health, Alaska Department of Health and Social Services, Juneau, AK, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: McEwen
authors.affiliation: 4 Healthcare Cost and Utilization Project, Center for Delivery, Organization, and Markets, Agency for Healthcare and Research and Quality, Rockville, MD, USA.
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Steiner
authors.affiliation: 5 Division of Epidemiology and Disease Prevention, Indian Health Service, Rockville, MD, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Bartholomew
authors.affiliation: 1 Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Hennessy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology; D000072957:Alaska Natives; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D044382:Population Groups; D055815:Young Adult
keywords: Indian Health Service; Native American; epidemiology; minority health