Trends in Infant Mortality among Alaska Native People Living in Alaska, USA
Alaska Native (AN) people experience substantial disparities in various health indicators when compared with both non-Alaska Natives (NAN) and with the United States white population. Infant mortality rates (IMRs) reflect the impact of access to and quality of healthcare, socioeconomic factors, and living conditions on maternal and infant health. We examined trends in AN infant mortality statewide and by rurality of maternal residence.
METHODS:
Using birth and death data for 1981–2010 for the State of Alaska, we calculated IMRs/1,000 live births by 5-year period for ANs and NANs. AN infants were identified using both parent’s race from the birth certificate. Trends in IMR were evaluated using Poisson regression. Rurality was determined using maternal residence and categorized as rural, hub (serving several outlying communities), or city. Odds ratios (ORs) were calculated to evaluate significance.
RESULTS:
During 1981–2010, the AN IMR decreased from 17.1/1,000 in 1981–1985 to 9.2/1,000 in 2006–2010 (p<0.01). The NAN IMR decreased similarly from 8.4/1,000 to 3.8/1,000 (p<0.01). During 2006–2010, AN infants of mothers living in rural villages were at significantly increased risk for mortality compared with their city (OR: 2.1, 95% CI 1.4–3.0) or hub (OR: 1.29, 95% CI 1.01–1.70) counterparts. No significant difference in risk for mortality between AN infants of mothers living in hubs compared with cities was observed (OR: 1.2, 95% CI 0.68–2.12). No difference in risk for infant mortality by rurality of maternal residence was observed among NANs.
CONCLUSIONS:
Although IMRs declined during 1981–2010 among both AN and NAN people, the disparity observed between the populations remains. Further evaluation to improve public health interventions should focus on infants of mothers in rural areas where risk for mortality during 2006–2010 was significantly increased compared with more urban counterparts.