Analysis of most recent data sets (1990-2009) that link Indian Health Services registration records to death certificate data reveal significant disparities in mortality for non-Hispanic American Indians and Alaska Natives (AI/ANs), particularly relative to non-Hispanic whites. Linking these 2 data sources substantially increased the reported all-cause death rate of AI/ANs, providing a more accurate accounting of mortality trends. The AI/AN population in CHSDA counties had the lowest life expectancy relative to other racial/ethnic groups, with a 6.4- to 8-year decrease in life expectancy compared with whites. Regardless of sex, AI/ANs were more likely to die of diabetes, chronic liver disease, accidents, and suicide than whites. However, AI/AN males were more likely to die of assault (homicide) than white males. Accidents were the third leading cause of death for AI/ANs and the rate of motor vehicle traffic death, the highest among all other reported unintentional causes of death, was nearly 3 times that of whites. AI/AN were also more likely to die of cirrhosis, one of the main causes of chronic liver disease. The leading driver of cirrhosis deaths for both AI/ANs and whites was alcoholic liver disease (ALD). However, the ALD death rate for AI/ANs was nearly 10 times higher than that of whites for those in the 25- through 44-year age range. For those younger than 45 years, the suicide death rate was about 2- to 3-fold higher for AI/ANs than whites, but for those aged 45 years or older, the rate was lower for AI/ANs than whites.
Source: Espey D, guest ed. American Indian and Alaska Native mortality. Am J Public Health. 2014;104(suppl 3):S251-S506.