Table Of Content

Indian Health Focus ::v< •<m^ ^J&.-% '^^^" m «& 7 1998-99 U.S. Department ofHealth and Human Services Indian Health Service Office ofPublic Health <V oo Qio Office ofProgram Support CM Program Statistics Team H ^^US32S <$MT# Indian Health Focus **S-\<& 1998-99 IndianHealth Service Michael H.Trujillo, MD, MPH, MS Director o o T— ~tZ 0CD'<5£ ^<M OfficeofPublicHealth Gary Hartz, PE co cv u: J. ^Q? 3> Acting Director OfficeofProgram Support 4- cd o -i— MD Phillip L. Smith, O £ Director IO Program StatisticsTeam EdnaL.Paisano Team Leader 1 Table of Contents — Introduction .1 Chart 3.3 Birth Order byAge ofMother US.White 13 Summary ofDataShown .... 2 Table 3 Number and Percent Distribution Sources and Limitation ofData 5 ofLive Births byAge ofMother within Birth Order .14 Population Statistics .5 Chart 4 Infant Mortality Rates byAge 15 Vital Event Statistics 5 Table 4 Infant Mortality Rates byAge 16 Patient Care Statistics Chart 5 Age-Specific Death Rates, Ratio of Sources ofAdditional Information 7 Indians to US. All Races ..16 Table 5 Age-Specific Death Rates 17 CHARTS & TABLES Chart 6.1 Deaths byAge and Race 18 Chart 1 Population by Age, 1990 9 Chart 6.2 Deaths by Age and Sex 18 Table 1 PercentAge Distribution 9 Table 6 Number and Percent Distribution ofDeaths by Age and Sex ..19 Chart 2.1 Educational Attainment 10 Chart 7.1 Leading Causes ofInfant Deaths Chart 2.2 Income Status in 1989 10 (Births to Under 1 Year) 20 Table 2 Selected Economic Profiles for Chart 7.2 Leading Causes ofNeonatal Deaths the United States, 1990 Census ....1 (Under 28 Days) 21 — Chart 3.1 Birth Order by Age ofMother Chart 7.3 Leading Causes of American Indians and Postneonatal Deaths Alaska Natives 12 (28 Days to Under 1 Year) 22 — Chart 3.2 Birth Order byAge ofMother Table 7 Leading Causes ofInfant Deaths U.S.All Races 12 by Age 23 Table of Contents Chart 8 Death Rates, Leading Causes: Chart 14 Suicide Death Rates Ages 1 to 4 24 by Age and Sex 36 Table 8 Ten Leading Causes ofDeath for Table 14 Suicide Death Rates Decedents 1 to 4Years ofAge 25 by Age and Sex 37 Chart 9 Death Rates, Leading Causes: Chart 15 Homicide Death Rates Ages 5 to 14 26 by Age and Sex 38 Table 9 Ten Leading Causes ofDeath for Table 15 Homicide Death Rates Decedents 5 to 14Years ofAge ... .27 by Age and Sex 39 Chart 10 Death Rates, Leading Causes: Chart 16 Pneumonia and Influenza Ages 15 to 24 28 Death Rates by Age and Sex 40 Table 10 Ten Leading Causes ofDeath Table 16 Pneumonia and Influenza for Decedents 15 to 24 Death Rates by Age and Sex 41 Years ofAge 29 Chart 17 Immunization Rates, Chart 11 Alcoholism Death Rates 0-27 Months 42 by Age and Sex 30 Table 17 Population and Rate of Table 11 Alcoholism Death Rates Immunizations, 0-27 Months 43 by Age and Sex 31 Chart 18 Hospital Discharge Rates byAge .44 . . Chart 12 Drug-Related Death Rates by Age and Sex 32 Table 18 Comparison ofIHS and U.S. Hospital Discharge Rates by Age .45 . . Table 12 Drug-Related Death Rates by Age and Sex 33 Chart 19.1 Percent Distribution for Population and Patient Care Workloads, Chart 13 Accident Death Rates Ages Under 25 46 by Age and Sex 34 Chart 19.2 Percent Distribution for Population Table 13 Accident Death Rates and Patient Care Workloads, by Age and Sex 35 Ages Over 24 47 Table ofContents Table 19 Percent Distribution for Estimated Table 24 Ten Leading Causes ofAmbulatory Population, Ambulatory Medical Medical Clinical Impressions for Clinical Impressions, and Inpatient Patients Under 1 Year ofAge 58 Discharges and Days 48 Chart 25 Leading Causes ofAmbulatory Chart 20 Leading Causes ofHospitalization: MedicalVisits: Ages 1 to 4Years . . .59 Ages Under 1 Year 49 Table 25 Ten Leading Causes ofAmbulatory Table 20 Ten Leading Causes ofHospitalization Medical Clinical Impressions for GM&S for Patients Under Patients 1 to 4Years ofAge 60 1 Year ofAge 50 Chart 26 Leading Causes ofAmbulatory Chart 21 LeadingCauses ofHospitalization: MedicalVisits: Ages 5 to 14Years .61 . . Ages 1 to 4Years 51 Table 26 Ten Leading Causes ofAmbulatory Table 21 Ten Leading Causes of Medical Clinical Impressions for GM&S Hospitalization for Patients Patients 5 to 14Years ofAge 62 1 to 4Years ofAge 52 Chart 27 Leading Causes of Chart 22 Leading Causes ofHospitalization: Ambulatory MedicalVisits: Ages 5 to 14Years 53 Ages 15 to 24Years 63 Table 22 Ten Leading Causes of Table 27 Ten Leading Causes ofAmbulatory GM&S Hospitalization for Patients Medical Clinical Impressions for 5 to 14Years ofAge 54 Patients 15 to 24Years ofAge 64 Chart 23 Leading Causes ofHospitalization: Ages 15 to 24Years 55 Glossary of ICD-9 Codes 65 Table 23 Ten Leading Causes of GM&S Hospitalization for Patients 15 to 24Years ofAge 56 Chart 24 Leading Causes ofAmbulatory MedicalVisits: Ages Under 1 Year .57 . INTRODUCTION The Indian Health Service (IHS) is an agency of the Department of Health and Human Services.The IHS goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people. The mission of the IHS, in partnership with American Indian and Alaska Native people, is to raise their physical, mental, social, and spiritual health to the highest level. The IHS has carried out its responsibilities through developing and operating a health services delivery system designed to provide a broad-spectrum program of preventive, curative, rehabilitative, and environmental services. This system integrates health services delivered directly through IHS facilities, purchased by IHS through contractual arrangements with providers in the private sector, and delivered through Tribally-operated programs and urban Indian health programs. The IHS is concerned with the health ofAmerican Indians and Alaska Natives of all ages. The IHS presents an overview ofthe health status of Indians in its annual publication, Trends in Indian Health. However, IHS recognizes that there are segments and conditions of the Indian population that require special attention, such as infants, youth, women, the elderly, and injuries. This publication examines the health status of Indian youth beginning with birth. It is based on data published in the IHS publications 1998-99 Trends in Indian Health and 1998-99 Regional Differences in Indian Health. The population of interest for this publication is American Indian and Alaska Native youth residing in the IHS service area. The IHS service area comprises the geographic areas in which IHS has responsibility (counties on and near reservations). Approximately 60 percent ofAmerican Indians and Alaska Natives in the U.S. reside in the IHS service area. In 1999, there were 1.49 million Indians in the IHS service area compared to 2.44 million in the entire U.S. Summary of Data Shown The American Indian and Alaska Native population Indians die at relatively younger ages than thegeneral is a younger population than the general U.S. population.Twelve percent ofIndian deaths pertain population. According to the U.S. 1990 Census, to ages under 25 compared to 4 and 2 percent for the 33 percent ofthe population is younger than 15 years U.S.All Races andWhite populations, respectively. in contrast to 22 and 20 percent for the U.S. All Races Indian males under 25 die at a relatively higher and White populations, respectively. Indians also proportion than Indian females.The percentage of have less education and income than the general Indian male deaths pertaining to ages under 25 is population.The 1990 Census also showed that 65.3 14 in contrast to 10 for females.These Indian rates percent ofIndians aged 25 and older are high school are adjusted for misreportingofIndian race on graduates or higher, compared with 75.2 and 77.9 state death certificates. percent for the U.S.All Races andWhite populations, respectively.The 1990 Census indicates that 37.7 The top two leadingcauses ofIndian infant deaths percent ofIndians aged 6 to 11 years live below the are sudden infant death syndrome and congenital poverty level in contrast to 18.3 and 12.5 percents anomalies; the order is reversed for Whites. ForAll for the U.S.All Races andWhite populations, respec- Races, the leading causes are congenital anomalies tively. For 12 to 17 year old youth, the corresponding and disorders related to short gestation and low percentages are 33.1, 16.3, and 11.0. birthweight.Accidents is the leading cause ofdeath amongage groups, 1 to 4, 5 to 14, and 15 to 24 years, Indian women become mothers at relatively young for the Indian and U.S. All Races andWhite popu- ages. For Indians, 45.7 percent ofmothers having lations. For 1 to 4 year old Indian youth, the second their first child are under age 20.This compares to leading cause ofdeath is homicide. For U. S.All 24.9 percent for the U.S. All Races population and Races andWhites in this same agegroup, congenital 22.3 percent for the U.S. White population.The anomalies is the second leading cause ofdeath. infants ofIndian mothers are more likely to die before Homicide is the second leading cause ofdeath for 5 their first birthday than those of U.S. All Races or to 14year oldIndianyouth. Malignant neoplasms is White mothers. However, the distribution ofinfant the second leadingcause ofdeath for 5 to 14 year old deaths by age differs for the Indian population in U. S. All Races andWhite youth.The second and comparison to the U.S. All Races and White popula- third leading causes for Indians andWhites aged 15 tions.That is, Indian infants are more likely to die to 24 years are suicide and homicide. For the U.S. during the postneonatal period (28 days to 1 year All Races population, the order is reversed.These after birth) than the neonatal period (birth to under Indian rates are adjusted for misreporting ofIndian 28 days), whereas the risks are reversed for the race on state death certificates. other two population groups.