American Indians and Alaska Natives may be at greater health risk from smoking-related illnesses, diabetes, or motor vehicle injuries depending on where they live and whether they're male or female, according to new data from the Centers for Disease Control and Prevention (CDC).

Analysis of data from CDC's Behavioral Risk Factor Surveillance System (BRFSS), a monthly telephone survey of U.S. adults, for the years 1995 through 1998 found substantial differences among American Indians and Alaska Natives by geographic region and sex for three risk factors: current cigarette smoking, awareness of having diabetes, and not wearing a safety belt while driving or riding in a car. The BRFSS is the only continuous source of population-based information on the health behaviors of American Indians and Alaska Natives.

Differences by Region

• Current cigarette smoking was most common in the Northern Plains (45%) and least common in the Southwest (22%).
• Awareness of having diabetes was least common in Alaska (3%).
• Not wearing a safety belt when driving or riding in a car was most common in the Northern Plains (54%), and least common on the Pacific Coast (19%).

Differences by Gender

• Men (34.7%) were more likely than women (27.9%) to be current smokers.
• Men (39.7%) were also at higher risk than women (30.5%) for not wearing a seatbelt when driving or riding in a car.
• Men (6.4%) were less likely than women (8.4%) to be aware of having diabetes.

"Knowing that American Indians and Alaska Natives in some parts of our country are at greater health risk and that there are differences between the sexes are important steps toward improving the health of these men and women," said James S. Marks, MD, MPH, director of CDC's National Center for Chronic Disease Prevention and Health Promotion. "We encourage public health and Indian Health Service officials to use this information to bolster local policies and programs to eliminate these differences, which is an important priority of the President's Race Initiative and Healthy People 2010."

The CDC authors believe that the risk factors among American Indians/Alaska Natives may be higher than reported because 23% of that population does not have a telephone–the highest percentage of any racial or ethnic group in the United States.

Smoking-related illness, diabetes, and motor vehicle injuries are major causes of death among American Indians and Alaska Natives.