Atlas of Injuries among American Indians and Alaska Natives in California, 1991-2006

Tan P. Pham, U.S. Public Health Service
Robert Newsad, U.S. Public Health Service

Abstract

Injuries (unintentional and intentional combined) are the leading cause of death among American Indians and Alaskan Natives (AI/AN) ages 1-44. Unintentional injury alone is the leading cause of death of AI/AN ages 5-44. Intentional injuries (self-inflicted and assault) are in the top 10 leading causes of death among AI/AN. This atlas presents injury mortality and morbidity data from 1991 through 2006 for AI/AN in California. Major causes of injuries that are analyzed include: motor-vehicle injuries, assault/homicide, self-inflicted/suicide. Some injury cost data for California hospitalizations are also included.

From 1991 to 2006, injuries accounted for 2,457 (adjusted for racial misclassification) deaths of AI/AN and 12,130 hospitalizations of AI/AN in California. An analysis of these injuries revealed the following: - Compared to all races, AI/AN have a higher fatality injury rate when adjusted for underreporting. - Majority (~70%) of AI/AN fatal injuries were unintentional. - AI/AN females (~26%) were more likely to be injured through falls when compared to AI/AN males. - AI/AN males (~68%) were more likely to be injured through motor vehicle injuries when compared to AI/AN Females. - Intentional injuries (assault/homicide and self-inflicted/suicide) were most prevalent among the 35-44 age group. - Homicides/assault injuries were 11 times higher among AI/AN males when compared to female AI/AN. - Self-inflicted poisoning injuries were higher among the female (~90%) AI/AN population when compared to male AI/AN. - Injuries are the 3rd most expensive average cost per hospitalization when compared to other hospitalization causes. - During the year 2004, unintentional injuries accounted for the majority of medical treatment cost (~81%), with only (~19%) spent on intentional injuries (assault and self-inflicted). - Medical treatment cost for both fatal and non-fatal injuries among AI/AN increased 10 fold from 1991 to 2007.