BACKGROUND: Injury is the leading cause of death among Alaska Native people (AN). AN life expectancy, a major population health status indicator, is 7.2 years lower than U.S. Whites (2004- 2008). Most of this disparity can be attributed to injury mortality. Many injury deaths are preventable. Findings from an analysis of AN injury mortality for 2002-2011 are presented.
METHODS: Mortality data were obtained from death certificate information provided by the Alaska Bureau of Vital Statistics. Leading causes of death by age were obtained from the National Center for Injury Prevention and Control WISQARS database. Population data were obtained from the Alaska Department of Labor and Workforce Development. Age-adjusted rates were standardized to the 2000 U.S. standard population and trends were calculated.
RESULTS: Injury deaths, intentional and unintentional combined, were the top cause of death over all ages and for persons age 1 to 44 years of age. Unintentional injury (UI) deaths ranked third among all causes of death (2001-2010). UI deaths (1,037) represented 60.3% of all injury deaths (1,718). Most of UI deaths (63%) were among AN people under 45 years old. UI deaths accounted for 25% of all years of life lost before age 75 (2004-2008). Poisonings (26.6%), motor and off-road vehicle-related deaths (24.6%), and drowning (16.3%) comprised 67.6% of all UI deaths. These top three causes were similar between AN males and AN females, however the proportion of each cause by gender differed. Poisoning deaths were 2.1 times more likely among females (25.2% vs 12.2%) and drowning deaths were 2.5 times more likely among males (11.9% vs 4.8%). Illicit and prescription drugs were responsible for more than half of the UI poisoning deaths (51.4%) and alcohol was responsible for an additional 41.3%. UI death rates have declined 47% between 1980-1983 and 2004- 2008, and 13.2% between 1992-1995 and 2008-2011. A disparity in UI death rates of about 2.3 times persists for AN people compared to Alaska non-Natives.
CONCLUSIONS: Injury remains the leading cause of death among Alaska Native people. Unintentional mortality rates have decreased over the past three decades however the rate of decrease has slowed. In addition, a disparity in injury rates still persists. Further improvements in prevention of unintentional injuries are needed. By addressing and implementing these needed improvements, communities, and the programs that support them, can begin to close the gap in AN life expectancy.