Changing patterns of mortality among American Indians
Changing patterns of mortality among American Indians
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DOI：
10.2105/ajph.2007.114538
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发表时间：
2008-03-01
影响因子：
12.7
通讯作者：
Kunitz, Stephen J.
中科院分区：
文献类型：
--
作者：
Kunitz, Stephen J.
美国印第安人（包括阿拉斯加原住民）的死亡率在20世纪的大部分时间里都在下降，但印第安人卫生服务局公布的数据表明，自20世纪80年代中期以来，这一人群的年龄调整死亡率在绝对值和与美国白色人口的比率相比都有所增加。这种增加似乎主要是由于2型糖尿病的直接和间接影响。尽管增加了对印度人特殊糖尿病计划的拨款，但印度人的人均医疗支出，包括第三方报销，仍然大大低于其他美国人，并且在调整通货膨胀后，自20世纪90年代初以来基本上没有变化。我认为，卫生服务资金不足，大大增加了死亡率。
Mortality rates for American Indians (including Alaska Natives) declined for much of the 20th century, but data published by the Indian Health Service indicate that since the mid-1980s, age-adjusted deaths for this population have increased both in absolute terms and compared with rates for the White American population. This increase appears to be primarily because of the direct and indirect effects of type 2 diabetes. Despite increasing appropriations for the Special Diabetes Program for Indians, per capita expenditures for Indian health, including third-party reimbursements, remain substantially lower than those for other Americans and, when adjusted for inflation, have been essentially unchanged since the early 1990s. I argue that inadequate funding for health services has contributed significantly to the increased death rate.