Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Alaska Native”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed2000

Preventing pneumococcal disease among infants and young children. Recommendations of the Advisory Committee on Immunization Practices (ACIP).

In February 2000, a 7-valent pneumococcal polysaccharide-protein conjugate vaccine (Prevnar, marketed by Wyeth Lederle Vaccines) was licensed for use among infants and young children. CDC's Advisory Committee on Immunization Practices (ACIP) recommends that the vaccine be used for all children aged 2-23 months and for children aged 24-59 months who are at increased risk for pneumococcal disease (e.g., children with sickle cell disease, human immunodeficiency virus infection, and other immunocompromising or chronic medical conditions). ACIP also recommends that the vaccine be considered for all other children aged 24-59 months, with priority given to a) children aged 24-35 months, b) children who are of Alaska Native, American Indian, and African-American descent, and c) children who attend group day care centers. This report includes ACIP's recommended vaccination schedule for infants at ages 2, 4, 6, and 12-15 months. This report also includes a pneumococcal vaccination schedule for infants and young children who are beginning their vaccination series at an older age and for those who missed doses. In addition, this report updates earlier recommendations for use of 23-valent pneumococcal polysaccharide vaccine among children aged > or =2 years. Among children aged 24-59 months for whom polysaccharide vaccine is already recommended, ACIP recommends vaccination with the new conjugate vaccine followed, > or =2 months later, by 23-valent polysaccharide vaccine. Conjugate vaccine has not been studied sufficiently among older children or adults to make recommendations for its use among persons aged > or =5 years. Persons aged > or =5 years who are at increased risk for serious pneumococcal disease should continue to receive 23-valent polysaccharide vaccine in accordance with previous ACIP recommendations.

Adult↗
PubMed2002

Trends in racial and ethnic-specific rates for the health status indicators: United States, 1990-98.

The Health Status Indicators (HSIs) were developed as part of the Healthy People 2000 process to facilitate the comparison of health status measures at national, State,and local levels. In this report national trends in racial and ethnic-specific rates for 17 HSIs are examined for the period from 1990-8. One of three overarching goals of Healthy People 2000 was to reduce health disparities. Examination of trends in the HSIs indicates that rates for most racial/ethnic groups improved. Rates for American Indian or Alaska Natives did not improve for six of the HSIs. An index of disparity, a summary measure of disparity among race/ethnic-specific rates, was used to measure changes in disparity between 1990 and 1998. The index of disparity decreased for 12 of the HSIs. Based on this index, racial/ethnic disparity in the percent of low birthweight infants declined by 19 percent, disparity in the percent of children under 18 years of age in poverty and in the syphilis case rate declined by 13 percent, and disparity in the stroke death rate declined by 11 percent. The index declined by less than 10 percent for eight other indicators. The index of disparity increased between 1990 and 1998 for the other five HSIs examined here. The index of disparity increased by more than 10 percent for work-related injury death rates, motor vehicle crash death rates, and suicide death rates. While rates for the HSIs have improved, not all groups have benefited equally and substantial differences among racial/ethnic groups persist.

Accidents, Occupational↗
PubMed2003

Traumatic brain injury-related hospital discharges. Results from a 14-state surveillance system, 1997.

PROBLEM/CONDITION: Previous studies indicate that each year in the United States, approximately 1.5 million Americans sustain a traumatic brain injury (TBI). Of those injured, approximately one quarter million are hospitalized. Approximately one third of adults hospitalized with TBI still need help with daily activities 1 year after their discharge. REPORTING PERIOD: This report summarizes surveillance data for TBI in the United States for January-December 1997. DESCRIPTION OF THE SYSTEM: Data are from 14 states that participated in an ongoing CDC-funded TBI surveillance system. State health departments used CDC guidelines to identify TBI cases from hospital discharge data or from other statewide injury data systems. Supplementary information was abstracted from medical records. RESULTS: The overall age-adjusted TBI-related live hospital discharge rate was 69.7/100,000 population. Rates were highest for American Indians and Alaska Natives (75.3/100,000) and Blacks (74.4/100,000). The age-adjusted rate for males was approximately twice as high as for females (91.9 versus 47.7/100,000 respectively). For both sexes, the rates were highest among those aged 15-19 years and >/= 65 years. Motor-vehicle crashes, falls, and assaults were the leading causes of injury for TBI-related discharges (27.9, 22.5, and 7.3/100,000 respectively). TBI-related discharge rates for falls were highest among those aged >/= 65 years (82.3/100,000). Black males and American Indian/Alaska Native males had the highest rates of TBI attributable to assault (31.3 and 29.5 per 100,000, respectively), approximately 4 times the rate for white males. An estimated 46% of injured motor-vehicle occupants, 53% of motorcyclists, and 41% of pedal cyclists reportedly were not using personal protective equipment (PPE) (e.g., seat belts or helmets) at the time of their TBI. With regard to outcome assessed before discharge from the hospital, approximately 17% of persons hospitalized with TBI had moderate to severe disability. INTERPRETATION: Data in this report, the most extensive to date from a multistate population-based TBI surveillance system, indicate the importance of TBI as a public health problem. Population-based information regarding TBI hospitalizations can be useful in assessing the effect of prevention efforts and planning for the service needs of persons with TBI.

Adolescent↗
PubMed2003

United States Census 2000 population with bridged race categories.

OBJECTIVES: The objectives of this report are to document the methods developed at the National Center for Health Statistics (NCHS) to bridge the Census 2000 multiple-race resident population to single-race categories and to describe the resulting bridged race resident population estimates. METHOD: Data from the pooled 1997-2000 National Health Interview Surveys (NHIS) were used to develop models for bridging the Census 2000 multiple-race population to single-race categories. The bridging models included demographic and contextual covariates, some at the person-level and some at the county-level. Allocation probabilities were obtained from the regression models and applied to the Census Bureau's April 1, 2000, Modified Race Data Summary File population counts to assign multiple-race persons to single-race categories. RESULTS: Bridging has the most impact on the American Indian and Alaska Native (AIAN) and Asian or Pacific Islander (API) populations, a small impact on the Black population and a negligible impact on the White population. For the United States as a whole, the AIAN, API, Black, and White bridged population counts are 12.0, 5.0, 2.5, and 0.5 percent higher than the corresponding Census 2000 single-race counts. At the sub-national level, there is considerably more variation than observed at the national level. The bridged single-race population counts have been used to calculate birth and death rates produced by NCHS for 2000 and 2001 and to revise previously published rates for the 1990s, 2000, and 2001. The bridging methodology will be used to bridge postcensal population estimates for later years. The bridged population counts presented here and in subsequent years may be updated as additional data become available for use in the bridging process.

Censuses↗
PubMed2004

Community-associated methicillin-resistant Staphylococcus aureus infections in Pacific Islanders--Hawaii, 2001-2003.

Methicillin-resistant Staphylococcus aureus (MRSA) is emerging as a cause of skin and soft-tissue infections in persons who have little or no contact with health-care settings. The majority of these infections are mild, involving skin and soft tissue; however, certain cases can progress to invasive tissue infections, bacteremia, and death. Transmission of MRSA has been reported most frequently in certain populations (e.g., children, sports participants, or jail inmates). Persons in the American Indian or Alaska Native population in the United States and aboriginals and Pacific Islanders (PIs) in Australia have high rates of MRSA colonization and infection. In 2003, clinicians reported an increased number of skin abscesses caused by MRSA among patients examined in ambulatory care settings. This report summarizes the findings of a retrospective study of community-associated MRSA (CA-MRSA) infections in Hawaii that identified a higher proportion of cases among PIs than were identified among Asians, compared with their respective proportions in the Hawaii population. Efforts to prevent CA-MRSA in Hawaii should focus on identifying factors causing the disproportionate number of infections among PIs.

Adolescent↗
PubMedDate not supplied

The Indian Health Service record of achievement.

The Indian Health Service (IHS) was transferred from the Department of Interior to the Public Health Service in the Department of Health, Education, and Welfare in 1955. At that time, the general health of Indian people substantially lagged behind the rest of the U.S. population. This gap was reflected in mortality rates which were several-fold higher for Indians, or reflected in time; there were decades between the dates when the U.S. population achieved certain lower death rates compared with the dates when similar reductions were achieved by Indians. As a result of preventive health programs, improvements in sanitation, and the development of a number of medical advances, substantial progress has been achieved in improving the health of American Indians and Alaska Natives. Life expectancy of Indians has increased 20 years between 1940 and 1980. From 1955 through 1982, the death rate for Indian infants dropped by 82 percent. Also, the age-adjusted death rate for tuberculosis decreased from 57.9 per 100,000 population in 1955 to 3.3 in 1983. These and other improvements are summarized in this paper.

Adolescent↗
PubMed1987

Pharmacy practice in the Indian Health Service.

The current status of pharmaceutical services in the Indian Health Service (IHS) is described. IHS is a nationwide program for providing health-care services to more than 960,000 American Indians and Alaska Natives who live on or near federal Indian reservations. Because IHS pharmacy practice revolves around the needs of the patient, pharmacists have close and frequent contact with patients and must have an acute sensitivity to and respect for the cultural values and beliefs of the patients. Ambulatory-care services are emphasized; pharmacists often provide primary care to patients and make frequent use of prescribing authority. All prescriptions are filled directly from the patient's permanent health record, and private patient consultation rooms are used extensively. In the inpatient setting, pharmacists obtain medication and related histories from newly admitted patients and provide patient counseling at the time of discharge. Pharmacists are also actively involved in facility-wide programs and committees (especially those that deal with quality assurance and facility accreditation) and serve as preceptors of pharmacy residents and students. In the future, IHS pharmacy practice will emphasize the expansion of patient-care activities and primary-care programs, effective use of prescribing authority, and the refinement of patient consultation services, services for the elderly, home health-care services, and inpatient clinical services.

Ambulatory Care↗
PubMed1995

Discrepancies between patient recall and the medical record. Potential impact on diagnosis and clinical assessment of chronic disease.

BACKGROUND: During a case-control study, data necessary for fulfilling diagnostic and classification criteria for spondyloarthropathy were collected from 121 patients. OBJECTIVE: To study the potential impact of differences between patient recall and the medical record on diagnosis and clinical characterization of spondyloarthropathy as a model of chronic disease. METHODS: The study was conducted among four Alaskan Eskimo populations served by the Alaska Native Health Service. Two sets of historical data were compiled for each subject, one acquired during the interview and the other derived from the medical record. Paired items from the interview and the medical record were analyzed to determine discrepancies and consequent effects on diagnosis, classification, and disease characterization. RESULTS: Significant differences were observed in the reporting of genitourinary or diarrheal illnesses preceding or associated with arthritis, the occurrence of eye inflammation in association with joint pain, the occurrence of joint pain and back pain together, and the age at onset of back pain all of which are important to the diagnosis and classification of spondyloarthropathy. In contrast, for information needed to establish the probable inflammatory nature of back pain, patient interview was more helpful than the medical records, which did not provide adequate details to differentiate inflammatory from mechanical back pain. CONCLUSIONS: Patient recall bias can substantially affect diagnosis and clinical assessment of chronic disease, as exemplified by spondyloarthropathy. Reliance on records alone, however, may lead to underestimation of features that require subjective appraisal by the patient.

Arthritis↗
PubMed1994

Prevalence of HTLV types I and II among drug users in King County, Washington.

We investigated the prevalence of human T-cell lymphotropic virus (HTLV) types I and II among drug users entering treatment in King County, Washington, between 1988 and 1990. Of 762 injection-drug users, 81 (10.6%) were HTLV-positive; of 89 noninjection-drug users, 2 (2%) were HTLV-positive. Most (95.8%) of those typed) were HTLV-II-positive. The relationship between HTLV and demographic and behavioral characteristics was further evaluated among injection-drug users. The prevalence rates for HTLV increased 25-fold from the youngest age group (15 to 24 years) to the oldest (older than 45 years), after adjusting for race. After adjustment for age, American Indians or Alaska Natives were 7.9 times, blacks 6.2 times, Asians or Pacific Islanders 4.7 times, and Hispanics 4.1 times as likely as whites to be HTLV-positive. The prevalence of HTLV among heroin injectors was more than double that observed among injectors of other drugs after adjusting for age, although this association was only marginally significant. The strong association between HTLV prevalence and age suggests that HTLV-II (the predominant virus) has been endemic among King County injection-drug users for some time. Its relatively high prevalence indicates that there is both an opportunity and a need to further investigate the epidemiologic and clinical implications of HTLV-II infection.

Adolescent↗
PubMedDate not supplied

The urban American Indian oversample in the 1988 National Maternal and Infant Health Survey.

Although more than two-thirds of American Indians and Alaska Natives (AI) live outside reservations and Tribal lands, few data sets describe social and maternal-child health risk factors among urban AI. The Indian Health Service sponsored a special effort to survey mothers of AI infants as part of the 1988 National Maternal and Infant Health Survey (NMIHS), a comprehensive national study conducted by the National Center for Health Statistics, Centers for Disease Control. The authors analyzed questionnaires completed by mothers residing in selected locations served by urban Indian health programs and compared the data with those for women of other races residing in metropolitan areas. After adjusting the sample for non participating States, the response rate in the Urban Indian Over sample was 60.8 percent (763 of 1,254). More than 45 percent of AI and black respondents, compared with 15 percent of white respondents, reported an annual household income of less than $10,000. About half of AI and black women, compared with nearly three-quarters of white women, reported having insurance or health maintenance organization coverage during pregnancy. Despite having a similarly low rate of health insurance coverage and low household income, AI respondents were far less likely than black respondents to have Medicaid coverage. A higher proportion of AI women than of black or white women reported difficulties in obtaining prenatal care, and AI women were less likely to obtain prenatal care. AI women were also less likely than white women to obtain prenatal care in the first trimester. Although a similar proportion of Al and white women reported that they consumed alcohol during the year before pregnancy, a higher proportion of Al drinkers than of white drinkers reported consuming one or more drinks weekly after finding out they were pregnant. The proportion of unwanted pregnancies was higher among Al women than among white women, but lower than among black women. Al and black women had a higher prevalence of depressive symptoms than did white women.The data suggest that urban Al mothers experience a disproportionate burden of economic, social, and behavioral risk factors for adverse pregnancy outcome.In spite of some data limitations, the Urban Indian Over sample of the NMIHS provides important information about social and health risk factors among urban Al mothers.

Adult↗
PubMedDate not supplied

Trends and effects of cigarette smoking among girls and women in the United States, 1965-1993.

Each year, cigarette smoking causes more than 140,000 deaths among women in the United States. Here, we describe smoking trends among girls and women, including women of reproductive age and pregnant women. We also provide data regarding the prevalence of indicators of nicotine dependence among women in the United States. The data were derived from the National Health Interview Survey, High School Seniors Survey, National Household Survey on Drug Abuse, and Teenage Attitudes and Practices Survey. The prevalence of smoking among women overall is now declining at a rate comparable to that of men, and women are attempting cessation and maintaining abstinence at the same rate as men. However, smoking prevalence among women in certain demographic groups such as American Indians and Alaska Natives is high. Although the prevalence of smoking increased among young women (particularly women of lower educational attainment) in the early 1980s, more recent surveys show it is declining. Smoking prevalence among young black and Hispanic women is decreasing, but progress in decreasing smoking prevalence among young white women is slow. Young women appear to be as nicotine dependent as older women, and light smokers of all ages report indicators of nicotine dependence.

Adolescent↗
PubMed1998

Suicide prevention evaluation in a Western Athabaskan American Indian Tribe--New Mexico, 1988-1997.

Since 1979, suicide and homicide have alternated as the second and third leading causes of death among young American Indians and Alaska Natives (AI/ANs). From 1979 through 1992, suicide rates for AI/ANs in all age groups were approximately 1.5 times the rates for the overall U.S. population. During 1991-1993, suicide rates for AI/ANs aged 15-24 and 25-34 years were 31.7 and 26.6 per 100,000 population, respectively; males aged 15-34 years accounted for 64% of all AI/AN suicides. In the overall U.S. population during 1991-1993, the rates for persons in these same age groups were 13.0 and 14.5, respectively. Since 1980, suicide has been either the second or third leading cause of death for persons aged 15-24 years in the overall U.S. population. Although knowledge about suicide among AI/ANs has increased, information about the efficacy of suicide prevention and intervention programs in general, and specifically in AI/AN communities, is scarce. In January 1990, following concern raised by tribal officials in 1988 about suicide among youth, a Western Athabaskan tribe in rural New Mexico implemented a suicide prevention and intervention program that targeted tribal members aged 15-19 years. This report summarizes the results of the program through 1997 and indicates that rates of suicide and attempted suicide among this target population decreased substantially after the program was implemented.

Adolescent↗
PubMed1999

Update: recommendations to prevent hepatitis B virus transmission--United States.

In October 1997, the Advisory Committee on Immunization Practices (ACIP) expanded its hepatitis B vaccination recommendations to include all unvaccinated children aged 0-18 years and made hepatitis B vaccine available through the Vaccines for Children program (VFC) for persons aged 0-18 years who are eligible for VFC. ACIP priorities for hepatitis B vaccination of children remain unchanged and include all infants; children in populations at high risk for hepatitis B virus (HBV) infection (e.g., Alaska Natives, Pacific Islanders, and children who reside in households of first-generation immigrants from countries where HBV infection is moderately or highly endemic); previously unvaccinated children aged 11-12 years; and older adolescents and adults in defined risk groups.

Adolescent↗
PubMed1999

Seroepidemiology of California and Bunyamwera serogroup (Bunyaviridae) virus infections in native populations of Alaska.

This study investigated the geographic distribution and prevalence of antibodies to California and Bunyamwera serogroup viruses in Native populations of Alaska, and demographic and ecologic risk factors associated with exposure. Sera (n = 1,635) from 18 communities were screened using an ELISA. All age groups were tested for antibodies to Jamestown Canyon (JC), Inkoo (INK), snowshoe hare (SSH), and Northway (NOR) viruses; persons > or = 45 years old (n = 90) from six communities were additionally tested for antibodies to Tahyna (TAH), Batai (BAT), Cache Valley (CV), and Sindbis (SIN) viruses. Thirty free-ranging mammals were tested by a plaque reduction neutralization test (PRNT) for antibodies to all eight viruses and to Getah (GET) virus. In Natives, overall antibody prevalence was 24.9% (JC = 17.6%, monotypic JC = 6.5%, INK = 11.1%, monotypic INK = 0.6%, SSH = 6.8%, monotypic SSH = 3.5%, and NOR = 6.2%). Five TAH, CV, and BAT virus exposures may be serologic cross-reactions, and no SIN virus antibodies were detected. Sindbis-like virus antibodies were found in 30% of the mammals. Most mammals had antibodies to NOR (83.3%) and California serogroup (70.0%) viruses; no GET virus exposures were found. Significant risk factors for human bunyavirus exposures were age group, ethnic-linguistic group, biotic province, climate zone, terrestrial vegetation, and presence of some ungulates and small mammals in communities. Sex was not a significant risk factor.

Adolescent↗
PubMed1985

The descriptive epidemiology of sudden infant deaths among natives and whites in Alaska.

From 1976-1980, the incidence of sudden infant deaths among native Alaskans was 2.9 times higher than that for white Alaskans (6.28 per 1,000 live births among natives vs. 2.14 per 1,000 live births among whites). Linked birth and death vital records data were used to compare the age-at-death distributions and relative risks associated with demographic factors for natives and whites. The purpose of the comparisons was to seek clues to the etiology of sudden infant death in natives. The age-at-death distributions for natives and whites were virtually identical (mean age at death 90.4 +/- 7.0 days for natives; 87.8 +/- 6.5 days for whites). The associations between the risk of sudden death and birth weight, marital status, season of birth, and residence were similar for natives and whites. The risk associated with young maternal age (less than 20 years) was significantly higher for whites than for natives (3.20 vs. 1.38). The sex ratio for sudden deaths among whites significantly favored males (relative risk = 1.78; female = reference); a significant sex ratio was not apparent for natives. Vital records data were useful for confirming the native-white difference in sudden infant death incidence, but not for elucidating etiologic differences between natives and whites.

Age Factors↗
PubMedDate not supplied

Infant mortality in Alaska: evidence of high postneonatal mortality rate.

Improvements in infant mortality (death less than 1 year of age) have been experienced by the United States and Alaska over the past decade. The decline in the Alaska neonatal mortality (death less than 28 days of age) rate has been the major factor in our improved infant mortality rate. Alaska's neonatal mortality rate is one of the lowest in the U.S. However, postneonatal mortality (28 days to 1 year of age) rate has not declined and is one of the highest in the U.S. In this study we used vital statistics records to examine socio-demographic and inter-regional factors that may help to explain Alaska's apparently high postneonatal mortality rate. The study population consisted of all live born infants in Alaska for 1975 to 1985, who died in infancy. The Alaska neonatal mortality rate has been lower, but postneonatal mortality rate has been higher than the U.S. average for the period under consideration (p less than .05). Comparison of alaska postneonatal mortality rate from 1975 to 1985 with the U.S. found Alaska Non-natives have higher postneonatal mortality rates than U.S. White, and Alaska Native have higher postneonatal mortality rates than other U.S. minorities. The rural areas of Alaska have a higher postneonatal mortality rate than urban areas, a phenomenon also observed for the U.S. as a whole.

Alaska↗
PubMed2005

Presentation and treatment of asthma among native children in southwest Alaska delta.

Our objective was to determine if a different presentation of asthma among Eskimo children in southwest Alaska influenced treatment for asthma. Data regarding symptoms, medication use, and hospitalization were obtained from the medical records of 58 Eskimo children diagnosed with asthma. Half of the children also had a diagnosis of chronic lung disease (CLD), and 57% had a history of allergies. CLD was associated with significantly more visits for wheeze (P=0.02), asthma (P <0.005), and lower respiratory tract illnesses (P <0.005), and a greater incidence (P <0.005) and frequency (P <0.005) of hospitalizations. Allergy status showed no similar relation with utilization of health services. Inhaled corticosteroids were prescribed for a minority (38%) of these asthmatic children. Allergic children tended to be more likely to receive inhaled steroids, and they received significantly more prescriptions for inhaled steroids compared to children without allergies. Those with CLD only were no more likely to receive inhaled steroids than other children, despite their higher incidence of hospitalization. Although the proportion of children with CLD or allergy did not differ significantly by village, there were significant regional differences in healthcare utilization and medication use. In conclusion, while CLD was the primary determinant of healthcare utilization among these native children with asthma, only allergic children with CLD were more likely to receive inhaled steroids.

Adolescent↗