The Decrease in the Unintentional Injury Mortality Disparity Between American Indians/Alaska Natives and Non–American Indians/Alaska Natives in New Mexico, 1980 to 2009

摘要

Objectives. We tracked the unintentional injury death disparity between American Indians/Alaska Natives and non–American Indians/Alaska Natives in New Mexico, 1980 to 2009. Methods. We calculated age-adjusted rates and rate ratios for unintentional injury deaths and their external causes among American Indians/Alaska Natives and non–American Indians/Alaska Natives. We tested trend significance with the Mann–Kendall test. Results. The unintentional injury death rate ratio of American Indians/Alaska Natives to non–American Indians/Alaska Natives declined from 2.9 in 1980–1982 to 1.5 in 2007–2009. The rate among American Indians/Alaska Natives decreased 47.2% from 1980–1982 to 1995–1997. Among non–American Indians/Alaska Natives, the rate declined 25.3% from 1980–1982 to 1992–1994, then increased 31.9% from 1992–1994 to 2007–2009. The motor vehicle traffic and pedestrian death rates decreased 57.8% and 74.6%, respectively, among American Indians/Alaska Natives from 1980–1982 to 2007–2009. Conclusions. The unintentional injury death rate disparity decreased substantially from 1980–1982 to 2007–2009 largely because of the decrease in motor vehicle crash and pedestrian death rates among American Indians/Alaska Natives and the increase in the poisoning death rate among non–American Indians/Alaska Natives. New Mexico had the highest unintentional injury death rate in the nation for the years 2006 through 2008. 1 The unintentional injury death rate in the state, 67.1 deaths per 100?000 population, was 1.7 times higher than the US unintentional injury death rate, 39.7 per 100?000 population. In New Mexico, unintentional injuries are the third leading cause of death for all ages and are the leading cause of death for persons aged 1 to 44 years. From 2007 through 2009, poisoning was the leading cause of unintentional injury death. Motor vehicle crashes and falls were the second and third leading causes of unintentional injury death, respectively. These 3 leading causes of unintentional injury death accounted for 85% of all unintentional injury deaths in the state. Nationally, the unintentional injury death rate among the American Indian/Alaska Native (AI/AN) population in the Indian Health Service Area from 2004 to 2006 was 2.4 times higher than the rate for all races in the United States in 2005. 2 Whereas American Indians/Alaska Natives in New Mexico have lower rates of death from heart disease, cancer, chronic obstructive pulmonary disease, and stroke than non–American Indian/Alaska Natives, their unintentional injury death rate is higher than the rate among non–American Indians/Alaska Natives. 3 Among New Mexico residents, American Indians had the highest total injury mortality rate from 1958 to 1982. 4 However, the trend in the disparity in the unintentional injury death rate between American Indians/Alaska Natives and non–American Indians/Alaska Natives in New Mexico has not been examined. The 2007–2009 AI/AN population in New Mexico averaged 201?952, which represented 10.2% of the state’s population. 5 The non–AI/AN population averaged 1?786?436, which represented 89.8% of the state’s population. 5 By comparison, American Indians/Alaska Natives comprised 1.1% of the US population for 2007 through 2009. 5 The purpose of this study was to track the disparity in unintentional injury death and external causes of unintentional injury death between the AI/AN population and the non-AI/AN population in New Mexico from 1980 to 2009.