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Perspectives in diabetes
American-Indian diabetes mortality in the Great Plains Region 2002–2010
  1. Allyson Kelley1,
  2. Jennifer Giroux2,
  3. Mark Schulz1,
  4. Bob Aronson3,
  5. Debra Wallace1,
  6. Ronny Bell4,
  7. Sharon Morrison1
  1. 1Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
  2. 2Department of Public Health Education, Great Plains Tribal Chairman's Health Board, USA
  3. 3Department of Public Health Education, Taylor University, USA
  4. 4Department of Nursing, Wake Forest University, USA
  1. Correspondence to Dr Allyson Kelley; A_kelle2{at}uncg.edu

Abstract

Objective To compare American-Indian and Caucasian mortality rates from diabetes among tribal Contract Health Service Delivery Areas (CHSDAs) in the Great Plains Region (GPR) and describe the disparities observed.

Research design and methods Mortality data from the National Center for Vital Statistics and Seer*STAT were used to identify diabetes as the underlying cause of death for each decedent in the GPR from 2002 to 2010. Mortality data were abstracted and aggregated for American-Indians and Caucasians for 25 reservation CHSDAs in the GPR. Rate ratios (RR) with 95% CIs were used and SEER*Stat V.8.0.4 software calculated age-adjusted diabetes mortality rates.

Results Age-adjusted mortality rates for American-Indians were significantly higher than those for Caucasians during the 8-year period. In the GPR, American-Indians were 3.44 times more likely to die from diabetes than Caucasians. South Dakota had the highest RR (5.47 times that of Caucasians), and Iowa had the lowest RR, (1.1). Reservation CHSDA RR ranged from 1.78 to 10.25.

Conclusions American-Indians in the GPR have higher diabetes mortality rates than Caucasians in the GPR. Mortality rates among American-Indians persist despite special programs and initiatives aimed at reducing diabetes in these populations. Effective and immediate efforts are needed to address premature diabetes mortality among American-Indians in the GPR.

  • Mortality
  • Quantitative Methods
  • Native Americans

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2014-000070

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