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Native Americans
and Injury |
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Fact Sheet |
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Mortality Atlas Summary
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Executive Summary: Atlas of Injury Mortality Among American Indian
and Alaska Native Children and Youth, 1989-1998
Injuries, from both unintentional and
intentional causes, are third behind heart disease and cancer as the leading
cause of death among all American Indians and Alaskan Natives (Native
Americans) and are the leading cause of death in the U.S. among those ages
one to 44 years.1 This Atlas presents injury mortality data from 1989 through
1998 for American Indian and Alaskan Native (also referred to as Native
American) children and youth ages 0 to 19 years residing in the 12 Areas
referred to as Indian Health Service (IHS) Areas. Eight major causes of
injury-related death are included as follows: motor vehicle-related,
pedestrian-related, firearm-related, suicide, homicide, drowning, fire and
burns, and suffocation. For each cause of injury, composite maps of the IHS
Area rates as well as individual maps are shown to allow for rate
comparisons among Areas and with national all-race rates. In addition,
trends in death rates by race, age-sex-specific rates, and subcategories of
cause are provided for each of the eight causes of injury.
During 1989-1998, injuries caused the deaths of 3,718 (adjusted for racial
misclassification) Native Americans ages 0 through 19 years in the 12
specified IHS Areas. The main findings from the analysis of these injury
deaths are:
- Injuries and violence are the leading
killers of Native American children and youth, accounting for 75% of all
deaths among one to 19 year olds.
- Native American males ages 15 to 19
years had the highest number of deaths for six causes of injury: motor
vehicle-related, pedestrian-related, firearm-related, homicide, suicide,
and drowning.
- The Alaska Area had the highest rates
for four causes of injury death: firearm-related, suicide, drowning, and
suffocation.
- Patterns and rates of injury death among
Native American children and youth differed significantly among the 12 IHS
Areas.
- Motor vehicle-related death rates for
nine of the 12 Areas were equal to or greater than the top 5% (95th
percentile) of state injury rates in the U.S.
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Additional Findings and Maps
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Racial Disparity
- Compared to Black and White children
and youth, Native American children and youth had the highest injury
death rates for motor vehicle crashes, pedestrian-related deaths, and
suicide.
- Black children and youth had the
highest rates for homicide and firearms.
- Native American and Black children and
youth had similar rates for fire-related deaths and drowning.
- Among all injury causes, Native
American rates were higher than White rates.
Motor Vehicle-Related Deaths
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- Motor vehicle crashes were the
leading cause of death among Native Americans one to 19 years of age.
Motor vehicle crashes were also the leading cause of injury death in
all IHS Areas except Alaska where firearm use was the leading cause.
- During 1989-1998, there was a 21%
decrease in male death rates. Female rates decreased by 12%.
- In the Alaska, Navajo, and Tucson
Areas, more than 25% of the children and youth killed in motor vehicle
crashes were pedestrians.
- The Navajo, Aberdeen, and Billings
Areas had motor vehicle-related death rates at least three times
greater than national rates.
Pedestrian-Related Deaths
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- Native American males were over
two times more likely than Black males and nearly four times more
likely than White males to be killed as a pedestrian. Native
American female pedestrian death rates were higher than those for
either Black or White males.
- The majority (74%) of Native
American pedestrian-related deaths occurred on public roads.
However, over half of pedestrian-related deaths observed among one
to four year-old children occurred in non-traffic locations, such as
private driveways.
- Pedestrian death rates in the
Tucson, Albuquerque, and Navajo Areas ranged from five to seven
times greater than national rates.
- Over the ten year period,
pedestrian-related death rates declined 56%.
Firearm-Related Deaths
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- The majority (78%) of all
firearm-related deaths among Native American children involved
intentional use of the weapon. Only 18% of firearm-related deaths
were recorded as being unintentional.
- Firearm-related injury was the
second leading cause of injury death in five Areas: California,
Oklahoma, Phoenix, Portland, and Tucson. It was the primary cause
of injury death in Alaska.
- Native American male
firearm-related death rates increased while female rates dropped
during 1989-1998. During the most recent period, 1997-1998, male
rates were over eight times greater than female rates.
- Suicides accounted for 46% of
the firearm-related deaths.
- Tucson and Alaska Area death
rates ranged from two to almost four times greater than national
rates.
Suicide
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- Suicide rates were highest
among 15 to 19 year-olds. During 1997-1998, Native American
males had suicide rates almost five times higher than Native
American females. Rates remained unchanged over the ten year
period.
- Over half of Native American
suicides were committed with a firearm, and more than one third
were by hanging.
- The highest rates of youth
suicide occurred in the Alaska, Aberdeen, and Tucson Areas.
These Areas had rates that were six to eight times greater than
national rates.
Homicide
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- Forty percent of Native
American homicides among zero to 19 year olds involved a
firearm. Firearm use was the leading cause of homicide among
15 to 19 year-olds (52%), while child maltreatment was the
leading cause among zero to four year olds (34%).
- During 1989-1998, homicide
rates increased for males, but remained unchanged for females.
Increases in the rate of firearm-related homicide accounted
for the overall increase in the total homicide rate.
- Homicide rates were highest
among 15 to 19 year-old males, followed by children under one
year of age. After suffocation and choking, homicide was the
second leading cause of injury death among infants.
- The highest rates of
homicide occurred in the Tucson, Billings, Phoenix, and
Aberdeen Areas. The Tucson Area homicide rate was almost three
times greater than national rates.
Drowning
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- Drowning rates were
similar among males and females ages one to four years, but
male rates for 15 to 19 year olds were eleven times greater
than female rates.
- Native American male
drowning rates declined by approximately 66% during
1989-1998, while female rates doubled.
- During the most recent
years, 1997-1998, Native American and Black males had
similar drowning rates. Native American male rates were
almost two times greater than White rates. Native American
female rates were higher than Black and White females.
- The Alaska Area had the
highest drowning rate of all the IHS Areas, with a rate
seven times greater than the national rate. The Alaska rate
was three times that of Phoenix, which had the next highest
rate.
Fire-Related Deaths
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- Children ages zero to
four years had the highest fire-related death rates.
- Fire-related death rates
increased among males during the years, 1989-1994,
however, decreased thereafter. Female rates followed a
similar pattern.
- House fires accounted
for 93% of fire-related deaths among Native American
children and youth.
- Fire-related death rates
were highest in the Alaska, Aberdeen, and Bemidji Areas,
with rates six to seven times greater than national rates.
Suffocation
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- Suffocation, choking,
and strangulation were the leading causes of infant
injury death. Over two times as many infants died from
suffocation/choking as from motor vehicle crashes.
- Approximately 58% of
all Native American childhood suffocation/choking deaths
occurred among infants.
- The highest rates of
suffocation occurred in the Billings, Bemidji, Tucson,
Navajo, Aberdeen, and Alaska Areas with rates
approximately three to five times greater than national
rates.
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References
- Indian Health Service. Trends in Indian
Health, 1997. Rockville MD: US Public Health Service, 1997.
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