Addressing disparities in the health of American Indian and Alaska Native people: the importance of improved public health data

While heart disease and lung cancer mortality among non-Hispanic White persons has decreased for both males and females, the rates have plateaued for non-Hispanic AI/AN males and are still increasing for females. 6 Overall, non-Hispanic AI/AN people have almost a 50% higher death rate than non-Hispanic White people, and the leading causes of death are distinctly different, with diabetes, intentional and unintentional injury, and chronic liver disease taking a particularly devastating toll.7 Linking mortality and central cancer registry data with IHS patient registration records has substantially improved the accurate classification of race for members of federally recognized tribes in these two data sets.8 These linkages are useful because self-identification of race generally does not occur with the medical records used for cancer registry data nor with funeral directors who provide information on death certificates.