To the Editor.
—The recent article by Gallaher et al1 concerning the excess mortality due to unintentional injuries among Native Americans in New Mexico highlights a major health problem related to alcohol abuse in the population studied. Lujan's2 Editorial cautions against generalized solutions across American Indian tribes. As she points out, there are many similarities, but also many differences among Native American tribes. However, the mortality statistics for American Indians living in the 33 reservation states make it essential that attention be given to the major causes of excess mortality. For example, of all American Indian and Alaska Native people who died during 1986 through 1988, 33% were under 45 years of age, compared with 11% of the non—American Indian population.3Mortality statistics represent the tip of the iceberg—only one extreme of a continuum of morbidity, disability, and reduced quality of life caused by disease and injuries
Shuster AL, Hearn RP, Reynolds RC, Schroeder SA. Alcohol-Related Deaths of American Indians. JAMA. 1992;268(23):3317-3318. doi:10.1001/jama.1992.03490230047024