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Disparities in notifiable diseases found for American Indians, Alaska Natives
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The incidence of 14 notifiable infectious diseases was higher among American Indian and Alaska Native populations compared with the white population, according to the most recent 5 years of data.
“American Indians/Alaska Natives have lower socioeconomic status overall, and although those who live on reservations and tribal members have access to Indian Health Service hospital services, not all American Indians/Alaska Natives might have ready access to health care,” researchers from the CDC and the New Mexico Department of Health wrote in MMWR. “State and local health departments with large segments of American Indian/Alaska Native populations have opportunities to develop efficient intervention efforts and programs tailored to this population.”
The researchers analyzed data for 2007 to 2011 from the National Notifiable Diseases Surveillance System. They evaluated 26 diseases for which a minimum of 20 cases was reported for the American Indian/Alaska Native (AI/AN) population, and compared the incidence rates to those of the white population.
Overall, 12,420,236 cases of the 26 notifiable diseases were reported during the time frame. Four diseases had incomplete race data: foodborne botulism, total ehrlichiosis, giardiasis and Lyme disease. The remaining 22 had complete race information for more than 70% of the cases. The rates for 12 diseases were higher among the AI/AN population.
The largest differences were for hantavirus, for which the rate was 15 times higher in the AI/AN population vs. whites, and tularemia, for which the rate was 6.8 times higher. The incidence rates also were greater for spotted fever rickettsiosis, Chlamydia trachomatis infections, gonorrhea, West Nile virus, tuberculosis, shigellosis, acute hepatitis C, invasive pneumococcal infection in children aged younger than 5 years, Haemophilus influenzae type b infection, and invasive pneumococcal infection for all ages.
There were 10 diseases for which the rates were lower among the AI/AN population. The largest differences were for varicella, for which the reported rate was 2.6 times higher among whites, and cryptosporidiosis, for which the rate was 2.2 times higher among whites. The rates among whites also were higher for acute hepatitis A, acute hepatitis B, legionellosis, meningococcal disease, pertussis, salmonellosis, shiga toxin-producing Escherichia coli and syphilis.
“Among potentially vaccine-preventable diseases, incidence rates were lower among AI/ANs than among whites for [five diseases]; rates were slightly higher for [two],” the researchers wrote. “These results suggest that, overall, the AI/AN population is receiving the full benefit of immunization programs.”
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