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1999 - 2009年美国城市印第安人和阿拉斯加原住民人口死亡率的原因及差异

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999-2009.

作者信息

Jacobs-Wingo Jasmine L, Espey David K, Groom Amy V, Phillips Leslie E, Haverkamp Donald S, Stanley Sandte L

机构信息

Jasmine L. Jacobs-Wingo, at the time of the study, was with the Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. David K. Espey is with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Amy V. Groom is with the Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Leslie E. Phillips, at the time of the study, was with the Urban Indian Health Institute, Seattle, WA. Donald S. Haverkamp is with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. At the time of study, Sandte L. Stanley was with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.

出版信息

Am J Public Health. 2016 May;106(5):906-14. doi: 10.2105/AJPH.2015.303033. Epub 2016 Feb 18.

DOI:10.2105/AJPH.2015.303033
PMID:26890168
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4985112/
Abstract

OBJECTIVES

To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations.

METHODS

We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999-2009 and compared those with corresponding urban White and rural AI/AN death rates.

RESULTS

The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions.

CONCLUSIONS

Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities.

摘要

目的

确定美国城市印第安/阿拉斯加原住民（AI/AN）人群的主要死因，并与城市白人及农村AI/AN人群进行比较。

方法

我们将印第安卫生服务机构的患者登记记录与国家死亡索引相链接，以减少死亡证明数据中的种族错误分类。我们计算了1999 - 2009年期间城市AI/AN人群的年龄调整死亡率，并将其与相应的城市白人及农村AI/AN人群的死亡率进行比较。

结果

城市AI/AN人群的前5位主要死因是心脏病、癌症、意外伤害、糖尿病以及慢性肝病和肝硬化。与城市白人相比，城市AI/AN人群在前5位主要死因中的死亡率均显著更高。差异最大的是糖尿病以及慢性肝病和肝硬化。总体而言，城市和农村AI/AN人群的主要死因相同，不过在大多数情况下城市AI/AN人群的死亡率较低。

结论

与白人相比，城市AI/AN人群在死亡率方面存在显著差异。公共卫生和临床干预应针对城市AI/AN人群，以解决导致健康差异的行为和状况。