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Comparative Study
. 2017 Jan/Feb;132(1):65-75.
doi: 10.1177/0033354916679807. Epub 2016 Dec 12.

Infectious Disease Hospitalizations Among American Indian/Alaska Native and Non-American Indian/Alaska Native Persons in Alaska, 2010-2011

Prabhu P Gounder  1 , Robert C Holman  1 , Sara M Seeman  2 , Alice J Rarig  3 , Mary McEwen  3 , Claudia A Steiner  4 , Michael L Bartholomew  5 , Thomas W Hennessy  1
Affiliations
Comparative Study

Infectious Disease Hospitalizations Among American Indian/Alaska Native and Non-American Indian/Alaska Native Persons in Alaska, 2010-2011

Prabhu P Gounder et al. Public Health Rep. 2017 Jan/Feb.

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.

Keywords: Indian Health Service; Native American; epidemiology; minority health.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure.
Figure.
Frequency of infectious disease (ID) hospitalizations among American Indian/Alaska Native (n = 6501) and non–American Indian/Alaska Native (n = 9397) persons in Alaska, 2010-2011. Perinatal infection was excluded for both groups because there were <10 hospitalizations in each group for which perinatal infection was the discharge diagnosis. Data sources: Indian Health Service and Alaska State Inpatient Database. Abbreviation: HIV, human immunodeficiency virus.
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