Health Issues Specific to Alaska Natives Jennifer Johnson, MPH, RD, LD, and Diana Redwood, MS, MPH
History In 1950, life expectancy for Alaska Natives was 46 years. In 1994-1998, it was 69 years. In 1950, tuberculosis and other infectious diseases were listed as the cause of death on 46% of all death certificates for Alaska Natives. For 1994-1998, chronic diseases (48%) were the leading causes of death.
Leading Causes of Death Among Alaska Natives, Males and Females Combined, 1950 Other Infections CNS Intentional Injury Cancer Cng/Peri/SIDS Heart Disease Unintentional Injury Respiratory
Leading Causes of Death Among Alaska Natives 1994-1998 All Other 24% Cancer 20% Homicide 2% Chronic Liver 2% Pneumonia & Influenza 3% Chronic Obstructive Pulmonary 4% Cerebrovascular 5% Suicide 7% Accidents 16% Heart Disease 17%
Age-Adjusted Mortality Rates for Alaska Natives and US Whites, 1989-1998 Male and Female Combined All Causes 100,000 Rate per 1000 750 500 250 0 779.8 Alaska Native 485.1* US White *Confidence intervals for rates are significantly different at the 0.05 level.
Cancer and Alaska Natives Over the 30-year period, 1969 to 1998, cancer incidence rates for Alaska Natives have increased 38%. Cancer incidence rates for Alaska Natives, all cancers combined, are now slightly, but significantly higher than rates for US Whites. The top three cancers for men and women combined, lung and bronchus, colon/rectum, and breast, have increased multifold times over the last thirty years and are diverging g from rates for US Whites and Blacks.
Five Leading Cancers 1984-1998 Alaska Natives 1. Lung/Bronchus 2. Colon/Rectum 3. Breast 4. Prostate 5. Stomach US Whites 1. Breast 2. Lung/Bronchus 3. Prostate 4. Colon/Rectum 5. Bladder
Cancer Risk Factors 1% 1% 1% 2% 2% 3% 4% 5% 7% 10% 31% 33% Diet and Exercise Tobacco Viruses/Infection Sexual Factors Unknown Industrial Occupations Alcohol Heredity Environmental Pollution Radiation Sunlight Additives
7 Diet and Health Guidelines for Cancer Prevention 1. Eat 5 or more servings of fruits and vegetables. 2. Eat foods low in saturated fat. 3. Keep physically active. 4. Don t smoke or chew tobacco. 5. Decrease alcohol intake. 6. Avoid direct sun exposure. 7. Get recommended cancer screenings.
Diabetes and Alaska Natives Data Source: Statewide Alaska Native Tribal Diabetes Registry, ANMC
Alaska Behavioral Risk Factor Surveillance System (BRFSS), 2002
BRFSS, 2002 data
BRFSS, 2002 data
BRFSS, 2002 data
BRFSS, 2002 data
Goal: To understand how traditional values, food intake, physical activity, and other lifestyle factors contribute to health and prevent diseases such as cancer, heart disease, diabetes, and lung disease
How Many People Will Be Involved in the EARTH Study? Navajo Nation 6,000 Alaska 5,000 Black Hills 5,000 Long-term goal 80,000
Why Study American Indian and Alaska Native Populations? American Indians and Alaska Natives have not been included in sufficient numbers in other cohort studies. It is important to examine the unique aspects of American Indian and Alaska Native lifestyles that may protect against chronic diseases such as cancer, heart disease, diabetes, and lung disease.
What is a Cohort Study? In a Prospective Cohort Study, data is collected at baseline on participants, who are then followed over time and observed for cause and effect relationships between health and disease over time.
STUDY DESIGN Recruit and enroll participants Collect baseline information about diet, physical activity, other lifestyle factors Follow people over time years Determine who remains healthy and who develops illnesses Determine what factors are related to remaining healthy
Conclusions EARTH study will give us more information about the current diet and physical activity patterns of Alaska Natives. Increasing Westernization of Alaska Native lifestyle is felt to be linked to the rise in chronic disease. Chronic diseases now play the largest role in causing death and disability. The leading causes of death for Alaska Native men and women are cancer, unintentional injury and heart disease.
Thank you! Jennifer Johnson Ph#729-3650 Diana Redwood Ph#729-3959