Department of Public Health Education , University of North Carolina at Greensboro , Greensboro, North Carolina , USA.
Department of Public Health Education , Great Plains Tribal Chairman's Health Board , USA.
BMJ Open Diabetes Res Care. 2015 Apr 15;3(1):e000070. doi: 10.1136/bmjdrc-2014-000070. eCollection 2015.
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.
Mortality data from the National Center for Vital Statistics and SeerSTAT 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 SEERStat V.8.0.4 software calculated age-adjusted diabetes mortality rates.
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.
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.
比较大平原地区部落合同医疗服务提供区(CHSDA)中美洲印第安人和高加索人因糖尿病导致的死亡率,并描述观察到的差异。
利用国家生命统计中心和 SeerSTAT 的死亡率数据,确定 2002 年至 2010 年大平原地区每位死者的糖尿病是主要死因。从大平原地区 25 个保留地 CHSDA 中提取并汇总了美洲印第安人和高加索人的死亡率数据。使用率比(RR)和 95%置信区间,并使用 SEERStat V.8.0.4 软件计算年龄调整后的糖尿病死亡率。
8 年内,美洲印第安人的年龄调整死亡率明显高于高加索人。在大平原地区,美洲印第安人死于糖尿病的风险比高加索人高 3.44 倍。南达科他州的 RR 最高(高加索人的 5.47 倍),爱荷华州的 RR 最低(1.1)。保留地 CHSDA 的 RR 范围为 1.78 至 10.25。
大平原地区的美洲印第安人糖尿病死亡率高于该地区的高加索人。尽管针对这些人群的糖尿病预防计划和倡议,但美洲印第安人的死亡率仍然居高不下。需要采取有效和即时的措施来解决大平原地区美洲印第安人因糖尿病导致的过早死亡问题。