Infectious Disease Mortality Among American Indians and Alaska Natives, 1999-2009
Infectious Disease Mortality Among American Indians and Alaska Natives, 1999-2009
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DOI：
10.2105/ajph.2013.301721
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发表时间：
2014-06-01
影响因子：
12.7
通讯作者：
Hennessy, Thomas W.
中科院分区：
文献类型：
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作者：
Cheek, James E.;Holman, Robert C.;Hennessy, Thomas W.
目标.我们描述了美国印第安人/阿拉斯加原住民（AI/AN）感染性疾病（ID）引起的死亡率和主要死亡原因。我们分析了美国所有县和合同卫生服务提供区（CHSDA）县的全国死亡率数据，并通过与印度卫生服务登记记录的联系对AI/AN种族进行了调整。将1999年至2009年每10万人中AI/AN的平均年ID死亡率与白人的相应比率进行比较。AI/AN人群ID死亡率显著高于白人。CHSDA县报告的8429例ID死亡（发生率86.2）发生在AI/AN人群中;该比率显著高于白人（44.0;率比[RR] = 1.96; 95%置信区间[CI] = 1.91，2.00）。印第安人/土著民族的前10大ID潜在死亡原因的比率明显高于白人。下呼吸道感染和败血症是排在首位的原因。相对危险度差异最大的是结核病（RR = 13.51; 95%CI = 11.36，15.93）。通过扩大干预措施以减少AI/AN社区中的ID，可能会进一步促进健康公平。
Objectives. We described death rates and leading causes of death caused by infectious diseases (IDs) in American Indian/Alaska Native (AI/AN) persons.Methods. We analyzed national mortality data, adjusted for AI/AN race by linkage with Indian Health Service registration records, for all US counties and Contract Health Service Delivery Area (CHSDA) counties. The average annual 1999 to 2009 ID death rates per 100 000 persons for AI/AN persons were compared with corresponding rates for Whites.Results. The ID death rate in AI/AN populations was significantly higher than that of Whites. A reported 8429 ID deaths (rate 86.2) in CHSDA counties occurred among AI/AN persons; the rate was significantly higher than the rate in Whites (44.0; rate ratio [RR] = 1.96; 95% confidence interval [CI] = 1.91, 2.00). The rates for the top 10 ID underlying causes of death were significantly higher for AI/AN persons than those for Whites. Lower respiratory tract infection and septicemia were the top-ranked causes. The greatest relative rate disparity was for tuberculosis (RR = 13.51; 95% CI = 11.36, 15.93).Conclusions. Health equity might be furthered by expansion of interventions to reduce IDs among AI/AN communities.