Diabetes-Related Mortality Among American Indians and Alaska Natives, 1990-2009

• Published in: American journal of public health (1971) Vol. 104; no. S3; pp. S496 - S503
• Main Authors: PYONE CHO, GEISS, Linda S, BURROWS, Nilka Rios, ROBERTS, Diana L, BULLOCK, Ann K, TOEDT, Michael E
• Format: Journal Article
• Language: English
• Published: Washington, DC American Public Health Association 01.06.2014
• Subjects: Adult; Age groups; Aged; Aged, 80 and over; Alaska - epidemiology; Alaska - ethnology; Biological and medical sciences; Cause of Death; Death Certificates; Diabetes; Diabetes Mellitus - ethnology; Diabetes Mellitus - mortality; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; European Continental Ancestry Group - statistics & numerical data; Family medical history; Female; General aspects; Health services; Hispanic people; Humans; Indians, North American - statistics & numerical data; Inuits - statistics & numerical data; Male; Medical sciences; Middle Aged; Miscellaneous; Mortality; Native Americans; Native North Americans; Population; Population Surveillance; Prevention; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Race; Registration; Registries; Research and Practice; Sexes; Trends; United States - epidemiology; White people; Alaska; United States; North America; America; United States > US; Endocrinopathy; 2009; Amerindian; Diabetes mellitus; Mortality; 1990; Epidemiology; Ethnic group; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2014.301968

We assessed diabetes-related mortality for American Indians and Alaska Natives (AI/ANs) and Whites. Study populations were non-Hispanic AI/AN and White persons in Indian Health Service (IHS) Contract Health Service Delivery Area counties; Hispanics were excluded. We used 1990 to 2009 death certificate data linked to IHS patient registration records to identify AI/AN decedents aged 20 years or older. We examined disparities and trends in mortality related to diabetes as an underlying cause of death (COD) and as a multiple COD. After increasing between 1990 and 1999, rates of diabetes as an underlying COD and a multiple COD subsequently decreased in both groups. However, between 2000 and 2009, age-adjusted rates of diabetes as an underlying COD and a multiple COD remained 2.5 to 3.5 times higher among AI/AN persons than among Whites for all age groups (20-44, 45-54, 55-64, 65-74, and ≥ 75 years), both sexes, and every IHS region except Alaska. Declining trends in diabetes-related mortality in both AI/AN and White populations are consistent with recent improvements in their health status. Reducing persistent disparities in diabetes mortality will require developing effective approaches to not only control but also prevent diabetes among AI/AN populations.