An analysis of pediatric mortality among three Native American tribes and the non-tribal areas of Navajo County, Arizona: A disparity within disparities

BACKGROUND: Disparities in health status between Native Americans and non-Native Americans have been studied extensively and reasons such as racial bias and discrimination, limited access to appropriate health services, poor access to health insurance, insufficient federal funding, quality of care, availability of culturally competent health services, disproportionate poverty and poor education, and behavior or lifestyle choices have been postulated for these disparities. Presented is an analysis of disparities that exist between various Native American tribes within a single county in spite of the fact that they live in close proximity to each other and share many of the same problems and issues mentioned above as well as similar health care systems and delivery.

OBJECTIVE: Pediatric mortality rates in Navajo County, Arizona were compared over a 9 year period between the White Mountain Apache tribe, the Hopi tribe, the Navajo Nation, non-tribal lands, and the overall pediatric population in general.

METHODS: An observational, population-based study design was used to examine mortality rates in children (aged 0-18 years) in Navajo County, Arizona over the nine year period from January 1, 1998 to December 31, 2006.

RESULTS: The White Mountain Apache tribe had a higher pediatric mortality rate for males than any other subgroup and a higher female mortality rate than all other subgroups except for the Hopi tribe. (p < .05)

CONCLUSIONS: Pediatric mortality rates are higher in the White Mountain Apache tribe than in any other tribe and non-tribal area in Navajo County. Reasons for this should be pursued in future studies.