The recent article by Jones rightfully emphasizes the “Persistence of American Indian Health Disparities.” For many health indicators, American Indian/Alaska Native (AIAN) people have the poorest health and greatest health disparity of any population in the nation.1 Goal 2 of the national Healthy People 2010 2 plan targets the elimination of health disparities. Jones points out that for most of the leading causes of death in the AIAN population (heart disease, accidents, diabetes, alcohol, suicide, and tuberculosis), mortality rates for American Indian/Alaska Natives are 1.2- to 7.7-times higher than the general US population, although for all AIAN people combined, death rates for cancer are not higher than the general US population. However, the author states “recent trends suggest that disparities in cancer might also emerge.”1(p2131)
As has been frequently noted, data for all AIAN people combined do not show the large variation in rates between the multiple, diverse groups within the AIAN population. Disparities in cancer rates for Alaska Native people have been reported for over 25 years. Recent cancer mortality rates (1999–2003) show a 25% higher rate among Alaska Natives than among the US White population. There is no evidence this disparity is decreasing.3 The first report of cancer mortality among Alaska Natives (1960–1969) found that cancer mortality rates among Alaska Natives were slightly lower than among the US Whites population but higher than among other American Indian groups.4 A study by the National Cancer Institute of all racial/ ethnic groups in the United States (1988–1992) reported cancer death rates were highest among Alaska Native women and third for Alaska Native men.5 Cancer has been the leading cause of death among Alaska Native people since the mid-1990s. Evidence documents that a cancer disparity already exists. Having suffered through many infectious disease epidemics, Alaska Native people perceive that they are in the midst of a new epidemic. It is critical for policy makers to recognize existing disparities and take action necessary to meet the goal of Healthy People 2010 to eliminate documented disparities.
References
- 1.Jones ,, DS. The persistence of American Indian Health Disparities. Am J Public Health. 2006;96:2122–2134. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Healthy People 2010: Understanding and Improving Health. Washington, DC: US Department of Health and Human Services; 2000.
- 3.Day GE, Provost EM, Lanier AP. Alaska Native Mortality Update: 1999–2003. Anchorage: Alaska Native Tribal Health Consortium; 2006.
- 4.Blot WJ, Lanier A, Fraumeni JF Jr, Bender T. Cancer mortality among Alaskan Natives, 1960–69. J Natl Cancer Inst. 1975;55:547–554. [DOI] [PubMed] [Google Scholar]
- 5.Miller BA, Kolonel LN, Berstein L, et al. (eds). Racial/Ethnic Patterns of Cancer in the United States 1988–92. Bethesda, Md: National Cancer Institute, National Institutes of Health; 1996. NIH Pub. No. 96-4104.