American Indian and Alaska Native infant and pediatric mortality, United States, 1999-2008
Methods: National Vital Statistics Surveillance System mortality data were adjusted for AI/AN racial misclassification by linkage with Indian Health Service (IHS) AI/AN registration records. Mortality rates (per 100,000 persons) and leading causes of death for 1999-2008, based on ICD-10 codes, were determined for AI/AN infants (<1 year old) and children aged 1-19 years. Rates were compared to those for non-Hispanic white (NHW) infants and children using rate ratios (RRs).
Results: The AI/AN infant mortality rate was 779 (RR=1.39 versus NHW). Regionally, the rates were highest for Alaska (1147) and Northern Plains (1081). Leading causes of infant death with a higher AI/AN burden were congenital abnormalities, sudden infant death syndrome (SIDS), unintentional injuries and influenza. The overall AI/AN pediatric mortality rates were 60 (age 1-4 years, RR=2.17), 27 (5-9, RR=1.92), 37 (10-14, RR=2.07), and 148 (15-19, RR=2.46). The Northern Plains, Alaska and Southwest regions had the highest regional AI/AN mortality rates across all age groups. Unintentional injuries and suicide occurred at significantly higher rates among AI/AN youth compared to NHW.
Conclusions: AI/AN infants and children have higher mortality rates than NHW infants and children, with significant regional disparities. Several of the leading causes of death with a higher rate in AI/AN youth are potentially preventable, including unintentional injuries, SIDS, suicide and influenza.
Public health or related research
Describe American Indian/Alaska Native (AI/AN) infant and pediatric mortality rates and the leading causes of death, nationally and by IHS region. Compare AI/AN infant and pediatric mortality rates to those of non-Hispanic white infants and children.
Keyword(s): Infant Mortality, Indigenous Populations
Qualified on the content I am responsible for because: I am a practicing pediatrician and have been involved in research of the AI/AN population through the CDC and Indian Health Services since 2008. My research focuses in this population have included infant and pediatric mortality and cancer epidemiology and prevention. I am the principal investigator on the submitted study.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.