Disparities in Life Expectancy of Pacific Northwest American Indians and Alaska Natives: Analysis of Linkage-Corrected Life Tables

• Published in: Public health reports (1974) Vol. 130; no. 1; pp. 71 - 80
• Main Authors: Dankovchik, Jenine, Hoopes, Megan J., Warren-Mears, Victoria, Knaster, Elizabeth
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA Association of Schools and Programs of Public Health 01.01.2015; SAGE Publications; SAGE PUBLICATIONS, INC; Association of Schools of Public Health
• Subjects: Adolescent; Adult; Adults; Age Distribution; Aged; Aged, 80 and over; Alaska Natives; American Indians; Birth; Censuses; Certificates; Child; Child, Preschool; Community health; Comparative studies; Continental Population Groups - statistics & numerical data; Death Certificates; European Continental Ancestry Group - statistics & numerical data; Female; Females; Government agencies; Health; Health disparities; Health education; Humans; Indians, North American - statistics & numerical data; Indigenous peoples; Infant; Inuits - statistics & numerical data; Life expectancy; Life Expectancy - ethnology; Life span; Life Tables; Linkage analysis; Linkages; Male; Males; Medical statistics; Middle Aged; Mortality; Mortality rates; Native Americans; Native North Americans; Northwestern United States - epidemiology; Patients; Population; Public health; Registration; Reproduction; Sex Distribution; Tables (data); Young Adult; Young adults; Northwestern United States; Pacific Northwest; United States > US; Alaska
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1177/003335491513000109

Objectives. American Indians and Alaska Natives (AI/ANs) experience a high burden of mortality and other disparities compared with the general population. Life tables are an important population health indicator; however, federal agencies have not produced life tables for AI/ANs, largely due to racial misclassification on death certificates. Our objective was to correct this misclassification and create life tables for AI/ANs who resided in the Pacific Northwest region of the U.S., making comparisons with the general population. Methods. To correct racial misclassification, we conducted probabilistic record linkages between death certificates from three Northwest states—Idaho, Oregon, and Washington State—issued during 2008-2010, and AI/AN patient registration records. We calculated mortality rates and generated period life tables for AI/ANs and non-Hispanic white (NHW) Americans. Results. Overall life expectancy at birth for Northwest AI/ANs was 72.8 years, which was 6.9 years lower than that of NHW Americans. Male AI/ANs had a lower life expectancy (70.9 years) than female AI/ANs (74.6 years). The disparity in life expectancy between AI/ANs and their NHW counterparts was higher for females (with AI/ANs living 7.3 years fewer than NHW females) than for males (with AI/ANs living 6.7 years fewer than NHW males). The greatest disparity in mortality rates was seen among young adults. Conclusion. Data linkage with a registry of known AI/ANs allowed us to generate accurate life tables that had not previously been available for this population and revealed disparities in both life expectancy at birth and survival across the life span. These results represent an important tool to help AI/AN communities as they monitor their health and promote efforts to eliminate health disparities.