Epidemic Intelligence Service, Epidemiology Workforce Branch, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Northwest Portland Area Indian Health Board, Northwest Tribal Epidemiology Center, Portland, OR, USA.
Public Health Rep. 2020 Jan;135(1):66-73. doi: 10.1177/0033354919887748. Epub 2019 Nov 25.
American Indian and Alaska Native (AI/AN) persons are commonly misclassified in epidemiologic and administrative data sets. The race-corrected hepatitis C virus (HCV)-related mortality rate among AI/AN persons in the Northwest United States (Idaho, Oregon, and Washington State) is unknown. We quantified the disparity in HCV-related mortality between AI/AN persons and non-Hispanic white (NHW) persons in the Northwest during 2006-2012 after correcting misclassified AI/AN race.
After conducting probabilistic record linkage between death records and the Northwest Tribal Registry, we calculated HCV-related mortality rates for AI/AN and NHW persons by using National Center for Health Statistics bridged-race estimates standardized to the US 2000 standard population.
The 2006-2012 aggregate age-adjusted HCV-related mortality rate per 100 000 population in the Northwest was 19.6 (95% confidence interval [CI], 17.3-22.2) for AI/AN persons and 5.9 (95% CI, 5.7-6.1) for NHW persons (rate ratio [RR] = 3.3; 95% CI, 3.0-3.8). The disparity was larger among females (RR = 4.6; 95% CI, 3.8-5.5) than among males (RR = 2.9; 95% CI, 2.5-3.4).
The disproportionate rate of HCV-related mortality among AI/AN persons in the Northwest highlights the need to expand HCV education, screening, and treatment among this population.
美国印第安人和阿拉斯加原住民(AI/AN)人群在流行病学和行政数据集中经常被错误分类。美国西北部(爱达荷州、俄勒冈州和华盛顿州)AI/AN 人群的经种族校正后的丙型肝炎病毒(HCV)相关死亡率尚不清楚。我们量化了 2006-2012 年期间,在对 AI/AN 人群的种族进行重新分类后,美国西北部 HCV 相关死亡率在 AI/AN 人群和非西班牙裔白人(NHW)人群之间的差异。
在对死亡记录和西北部落登记处进行概率记录链接后,我们使用国家卫生统计中心 bridged-race 估计数,根据美国 2000 年标准人口对 AI/AN 和 NHW 人群的 HCV 相关死亡率进行了计算。
2006-2012 年,美国西北部每 10 万人的年龄调整后 HCV 相关死亡率总和为 AI/AN 人群 19.6(95%置信区间[CI],17.3-22.2),NHW 人群 5.9(95% CI,5.7-6.1)(RR=3.3;95% CI,3.0-3.8)。女性(RR=4.6;95% CI,3.8-5.5)的差异大于男性(RR=2.9;95% CI,2.5-3.4)。
美国西北部 AI/AN 人群 HCV 相关死亡率过高,这突出表明需要在该人群中扩大 HCV 教育、筛查和治疗。