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338708
Unintentional Injury Mortality among Alaska Native/American Indian People in Alaska, 1999–2008


Monday, November 2, 2015

Carla Britton, PhD, MS, Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK
Gretchen Day, MPH, Alaska Native Tribal Health Consortium, Anchorage, AK
Ellen Provost, DO, MPH, Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK
Peter Holck, PhD, Alaska Native Tribal Health Consortium, Anchorage, AK
Background/Purpose: Alaska Native/American Indian (ANAI) people are disproportionately affected by unintentional injury (UI). During 1999–2008, UI was the third leading cause of ANAI death and rates were 1.3 times higher than those of U.S. Whites  and over twice that of Alaska Whites (AKW). We compared the 5 Alaska UI leading causes by race and rural/urban status.

Methods: We included State of Alaska Bureau of Vital Statistics UI mortality data for resident ANAI and AKW who died in Alaska during 1999–2008. We calculated age-adjusted rates and rate ratios for leading causes by race and rural/urban status.

Results/Outcomes: During 1999–2008, 992 ANAI and 1,971 AKW resident UI deaths occurred. Overall, the ANAI UI rate was 104.1/100,000 compared with 45.9/100,000 for AKW (Rate Ratio (RR)=2.4, 95% CI: 2.17–2.56). Poisoning was the leading cause of ANAI UI death (20.9/100,000) whereas traffic-related motor vehicle events were the leading cause of AKW UI death (12.7/100,000). Rural UI mortality was significantly higher among ANAI and  AKW compared with urban counterparts (ANAI RR=1.2, 95% CI: 1.06–1.46; AKW RR=1.5, 95% CI: 1.38–1.68). Among ANAI, rural rates associated with drowning/submersion (RR=3.2, 95% CI: 1.72–5.91) and other land transport such as snowmobiles (RR=4.6, 95% CI: 2.19–9.65) were significantly elevated compared with urban ANAI rates.

Conclusions:  Rural residents of Alaska experience higher UI mortality rates than urban residents and ANAI are disproportionately affected. Better injury surveillance systems capturing increased detail could inform targeted prevention efforts by improving information about injury circumstances for both fatal and nonfatal injuries.

Learning Areas:

Epidemiology

Learning Objectives:
Describe the unintentional injury mortality disparity between American Indian/Alaska Native population and the Alaska White population in Alaska. Name the leading causes of unintentional injury mortality in Alaska for the American Indian/Alaska Native population and the Alaska White population.

Keyword(s): Violence & Injury Prevention, Native Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in injury epidemiology and injury prevention in academia and in state and tribal public health and have completed projects describing injuries in wildland firefighters, to park visitors, and among EMS utilizers.
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.

Back to: 3303.0: Evaluation Approaches and Injury Surveillance