Pneumonia and Influenza Mortality Among American Indian and Alaska Native People, 1990-2009

• Published in: American journal of public health (1971) Vol. 104; no. S3; pp. S460 - S469
• Main Authors: GROOM, Amy V, HENNESSY, Thomas W, SINGLETON, Rosalyn J, BUTLER, Jay C, HOLVE, Stephen, CHEEK, James E
• Format: Journal Article
• Language: English
• Published: Washington, DC American Public Health Association 01-06-2014
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Alaska - epidemiology; Alaska - ethnology; Biological and medical sciences; Cause of Death; Child; Child, Preschool; Children & youth; Classification; Death Certificates; Epidemiology; European Continental Ancestry Group - statistics & numerical data; Female; General aspects; Health risk assessment; Health services; Hispanic people; Hospitalization; Human viral diseases; Humans; Immunization/Vaccines; Indians, North American - statistics & numerical data; Infant; Infant, Newborn; Infectious diseases; Influenza; Influenza, Human - ethnology; Influenza, Human - mortality; Inuits - statistics & numerical data; Male; Medical sciences; Middle Aged; Miscellaneous; Mortality; Native Americans; Native North Americans; Other Race/Ethnicity; Pneumology; Pneumonia; Pneumonia - ethnology; Pneumonia - mortality; Population; Population Surveillance; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Race; Registration; Registries; Research and Practice; Respiratory syncytial virus; Respiratory system : syndromes and miscellaneous diseases; Streptococcus infections; Studies; United States - epidemiology; Vaccines; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Vital statistics; Alaska; United States; North America; America; United States > US; Amerindian; Lung disease; Pneumonia; Respiratory disease; Mortality; 1990; Epidemiology; Ethnic group; Infection; 2009; Viral disease; Influenza; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2013.301740

We compared pneumonia and influenza death rates among American Indian/Alaska Native (AI/AN) people with rates among Whites and examined geographic differences in pneumonia and influenza death rates for AI/AN persons.
We adjusted National Vital Statistics Surveillance mortality data for racial misclassification of AI/AN people through linkages with Indian Health Service (IHS) registration records. Pneumonia and influenza deaths were defined as those who died from 1990 through 1998 and 1999 through 2009 according to codes for pneumonia and influenza from the International Classification of Diseases, 9th and 10th Revision, respectively. We limited the analysis to IHS Contract Health Service Delivery Area counties, and compared pneumonia and influenza death rates between AI/ANs and Whites by calculating rate ratios for the 2 periods.
Compared with Whites, the pneumonia and influenza death rate for AI/AN persons in both periods was significantly higher. AI/AN populations in the Alaska, Northern Plains, and Southwest regions had rates more than 2 times higher than those of Whites. The pneumonia and influenza death rate for AI/AN populations decreased from 39.6 in 1999 to 2003 to 33.9 in 2004 to 2009.
Although progress has been made in reducing pneumonia and influenza mortality, disparities between AI/AN persons and Whites persist. Strategies to improve vaccination coverage and address risk factors that contribute to pneumonia and influenza mortality are needed.