Identifying Disparities in Health Outcomes and Mortality for American Indian and Alaska Native Populations Using Tribally Disaggregated Vital Statistics and Health Survey Data
Identifying Disparities in Health Outcomes and Mortality for American Indian and Alaska Native Populations Using Tribally Disaggregated Vital Statistics and Health Survey Data
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DOI：
10.2105/ajph.2021.306427
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发表时间：
2021-07-01
影响因子：
12.7
通讯作者：
Akee, Randall
中科院分区：
文献类型：
--
作者：
Small-Rodriguez, Desi;Akee, Randall
目标.确定分类死亡率和健康监测数据对识别美国印第安人和阿拉斯加原住民（AI/AN）亚群健康差异的能力的影响。我们对美国所有50个州的官方死亡证明上AI/AN死者的报告类别进行了系统性审查。使用2017-2018年加州健康访谈调查（CHIS）的公开数据，我们进行了双变量和多变量分析，以评估与非西班牙裔白人相比，部落登记和非部落登记的AI/AN人员的健康状况和结果的差异。在所有50个州的死亡证明上，没有收集部落登记数据或AI/AN种族的标准。部落登记的AI/AN亚群、非部落登记的AI/AN亚群和非西班牙裔白色对照组在各种健康危险因素和慢性病的发病率和患病率方面存在明显差异。在生命统计和健康监测系统中收集部落登记数据对于识别和应对AI/AN亚群之间的健康差异是必要的。这些努力必须与部落民族合作进行，并考虑到土著数据主权。
Objectives. To determine the impact of disaggregated mortality and health surveillance data on the ability to identify health disparities for American Indian and Alaska Native (AI/AN) subpopulations.Methods. We conducted a systematic review of reporting categories for AI/AN decedents on official death certificates for all 50 US states. Using public data from the 2017-2018 California Health Interview Survey (CHIS), we conducted bivariate and multivariate analyses to assess disparities in health conditions and outcomes for tribally enrolled and non-tribally enrolled AI/AN persons compared with non-Hispanic Whites.Results. There was no standard for the collection of tribal enrollment data or AI/AN race on death certificates across all 50 states. There were stark differences in the incidence and prevalence of various health risk factors and chronic diseases for the tribally enrolled AI/AN subpopulation, non-tribally enrolled AI/AN subpopulation, and non-Hispanic White comparison group.Conclusions. The collection of tribal enrollment data in vital statistics and health surveillance systems is necessary to identify and respond to health disparities among AI/AN subpopulations. These efforts must be conducted in partnership with tribal nations and consider Indigenous data sovereignty.