Unintentional injury mortality among American Indians and Alaska Natives in the United States, 1990-2009.

OBJECTIVES We describe the burden of unintentional injury (UI) deaths among American Indian and Alaska Native (AI/AN) populations in the United States. METHODS National Death Index records for 1990 to 2009 were linked with Indian Health Service registration records to identify AI/AN deaths misclassified as non-AI/AN deaths. Most analyses were restricted to Contract Health Service Delivery Area counties in 6 geographic regions of the United States. We compared age-adjusted death rates for AI/AN persons with those for Whites; Hispanics were excluded. RESULTS From 2005 to 2009, the UI death rate for AI/AN people was 2.4 times higher than for Whites. Death rates for the 3 leading causes of UI death-motor vehicle traffic crashes, poisoning, and falls-were 1.4 to 3 times higher among AI/AN persons than among Whites. UI death rates were higher among AI/AN males than among females and highest among AI/AN persons in Alaska, the Northern Plains, and the Southwest. CONCLUSIONS AI/AN persons had consistently higher UI death rates than did Whites. This disparity in overall rates coupled with recent increases in unintentional poisoning deaths requires that injury prevention be a major priority for improving health and preventing death among AI/AN populations.