Infectious disease hospitalizations among American Indian/Alaska Native and non–American Indian/Alaska Native persons in Alaska, 2010-2011

Prabhu P. Gounder, Robert C. Holman, Sara M. Seeman, Alice J. Rarig, Mary McEwen, Claudia A. Steiner, Michael L. Bartholomew, Thomas W. Hennessy

Research output: Contribution to journalArticle

Abstract

Objective: Reports about infectious disease (ID) hospitalization rates among American Indian/Alaska Native (AI/AN) persons have been constrained by data limited to the tribal health care system and by comparisons with the general US population. We used a merged state database to determine ID hospitalization rates in Alaska. Methods: We combined 2010 and 2011 hospital discharge data from the Indian Health Service and the Alaska State Inpatient Database. We used the merged data set to calculate average annual age-adjusted and age-specific ID hospitalization rates for AI/AN and non-AI/AN persons in Alaska. We stratified the ID hospitalization rates by sex, age, and ID diagnosis. Results: ID diagnoses accounted for 19% (6501 of 34 160) of AI/AN hospitalizations, compared with 12% (7397 of 62 059) of non-AI/AN hospitalizations. The average annual age-adjusted hospitalization rate was >3 times higher for AI/AN persons (2697 per 100 000 population) than for non-AI/AN persons (730 per 100 000 population; rate ratio = 3.7, P < .001). Lower respiratory tract infection (LRTI), which occurred in 38% (2486 of 6501) of AI/AN persons, was the most common reason for ID hospitalization. AI/AN persons were significantly more likely than non-AI/AN persons to be hospitalized for LRTI (rate ratio = 5.2, P < .001). Conclusions: A substantial disparity in ID hospitalization rates exists between AI/AN and non-AI/AN persons, and the most common reason for ID hospitalization among AI/AN persons was LRTI. Public health programs and policies that address the risk factors for LRTI are likely to benefit AI/AN persons.

Original languageEnglish (US)
Pages (from-to)65-75
Number of pages11
JournalPublic health reports
Volume132
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • Epidemiology
  • Indian health service
  • Minority health
  • Native american

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Gounder, P. P., Holman, R. C., Seeman, S. M., Rarig, A. J., McEwen, M., Steiner, C. A., Bartholomew, M. L., & Hennessy, T. W. (2017). Infectious disease hospitalizations among American Indian/Alaska Native and non–American Indian/Alaska Native persons in Alaska, 2010-2011. Public health reports, 132(1), 65-75. https://doi.org/10.1177/0033354916679807