Mortality Trends and Disparities in the Alaska Native and American Indian Population Living in Alaska, 1980-2011
METHODS: Using data from the Alaska Bureau of Vital Statistics, we examined trends in mortality of AN/AI people over a 32 year period. Four-year average annual age-adjusted mortality rates were computed by cause, gender, and age group.
RESULTS: While the AN/AI all-cause mortality rate decreased on average 3% per decade during 1980-2011 (p<0.01), sharper declines were observed among non-Natives and USW. During 2008-2011, AN/AI rates were 67% (RR=1.67) higher than non-Natives and 51% higher (RR=1.51) than USW.
Cancer, heart disease, unintentional injury, and suicide were leading causes of death in every time period. Declines occurred in many cause-specific death rates including unintentional injury and heart disease. Due to a slower rate of decrease, the AN/AI heart disease mortality rate surpassed that of non-Natives and USW in 2008-2011 despite having been lower in previous years. No significant change occurred in AN/AI cancer mortality rates, in contrast to non-Natives and USW. AN/AI suicide mortality rates did not change significantly, and COPD mortality rates increased on average 2.0% per year (p<0.05).
Mortality rates of AN/AI males were higher than females for all-causes, heart disease, unintentional injury and suicide, in all time periods. Female all-cause mortality rates increased an average of 0.4% per year (p<0.01) while decreasing an average 0.7% per year (p<0.01) among males. For each age-group examined, AN/AI all-cause mortality rates were higher than rates of non-Natives and USW.
CONCLUSIONS: There have been significant improvements in AN/AI all-cause mortality rates since 1980. Despite these improvements, cancer and suicide mortality rates haven’t changed significantly, and the COPD mortality rate has increased. Differences in rates between AN/AI and both non-Natives and USW have increased for all-causes, cancer, COPD, and heart disease.