Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;135(1):66-73.
doi: 10.1177/0033354919887748. Epub 2019 Nov 25.

Hepatitis C-Related Mortality Among American Indian/Alaska Native Persons in the Northwestern United States, 2006-2012

Sarah M Hatcher  1   2 , Sujata Joshi  2 , Byron F Robinson  1 , Thomas Weiser  2   3
Affiliations

Hepatitis C-Related Mortality Among American Indian/Alaska Native Persons in the Northwestern United States, 2006-2012

Sarah M Hatcher et al. Public Health Rep. 2020 Jan.

Abstract

Objective: American Indian and Alaska Native (AI/AN) persons are commonly misclassified in epidemiologic and administrative data sets. The race-corrected hepatitis C virus (HCV)-related mortality rate among AI/AN persons in the Northwest United States (Idaho, Oregon, and Washington State) is unknown. We quantified the disparity in HCV-related mortality between AI/AN persons and non-Hispanic white (NHW) persons in the Northwest during 2006-2012 after correcting misclassified AI/AN race.

Methods: After conducting probabilistic record linkage between death records and the Northwest Tribal Registry, we calculated HCV-related mortality rates for AI/AN and NHW persons by using National Center for Health Statistics bridged-race estimates standardized to the US 2000 standard population.

Results: The 2006-2012 aggregate age-adjusted HCV-related mortality rate per 100 000 population in the Northwest was 19.6 (95% confidence interval [CI], 17.3-22.2) for AI/AN persons and 5.9 (95% CI, 5.7-6.1) for NHW persons (rate ratio [RR] = 3.3; 95% CI, 3.0-3.8). The disparity was larger among females (RR = 4.6; 95% CI, 3.8-5.5) than among males (RR = 2.9; 95% CI, 2.5-3.4).

Conclusion: The disproportionate rate of HCV-related mortality among AI/AN persons in the Northwest highlights the need to expand HCV education, screening, and treatment among this population.

Keywords: American Indian and Alaska Native; data linkage; health disparities; hepatitis; hepatitis C virus; minority health.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure.
Figure.
Age-adjusted hepatitis C–related mortality rate among American Indian and Alaska Native (AI/AN) and non-Hispanic white (NHW) persons, by year, Idaho, Oregon, and Washington State, 2006-2012. Error bars indicate 95% confidence intervals. Data source: Death records from the Idaho Bureau of Vital Records and Statistics, Oregon Center for Health Statistics, and Washington Center for Health Statistics. Death records were linked to the Northwest Tribal Registry to correct misclassified AI/AN records by the Northwest Portland Area Indian Health Board.
See this image and copyright information in PMC

References

    1. Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61(1 Suppl):S58–68. doi:10.1016/j.jhep.2014.07.012 - PubMed
    1. El-Kamary SS, Jhaveri R, Shardell MD. All-cause, liver-related, and non–liver-related mortality among HCV-infected individuals in the general US population. Clin Infect Dis. 2011;53(2):150–157. doi:10.1093/cid/cir306 - PMC - PubMed
    1. Ly KN, Xing J, Klevens RM, Jiles RB, Holmberg SD. Causes of death and characteristics of decedents with viral hepatitis, United States, 2010. Clin Infect Dis. 2014;58(1):40–49. doi:10.1093/cid/cit642 - PMC - PubMed
    1. Ly KN, Hughes EM, Jiles RB, Holmberg SD. Rising mortality associated with hepatitis C virus in the United States, 2003-2013. Clin Infect Dis. 2016;62(10):1287–1288. doi:10.1093/cid/ciw111 - PMC - PubMed
    1. Denniston MM, Klevens RM, McQuillan GM, Jiles RB. Awareness of infection, knowledge of hepatitis C, and medical follow-up among individuals testing positive for hepatitis C: National Health and Nutrition Examination Survey 2001-2008. Hepatology. 2012;55(6):1652–1661. doi:10.1002/hep.25556 - PMC - PubMed

Publication types