TABLE 2—

Leading Rankable Causes of Infant, Neonatal, and Postneonatal Deaths and Average Annual Death Rates for American Indians/Alaska Natives, Compared With Whites: Contract Health Service Delivery Area Counties, United States, 1999–2009

	AI/AN			White
Age/Cause of Deatha	Rank	Count	Rate	Count	Rate	AI/AN:White RR (95% CI)
Infant
Congenital malformations	1	620	191.6	7396	134.9	1.42* (1.31, 1.54)
SIDS	2	421	130.1	2978	54.3	2.40* (2.16, 2.65)
Disorders related to short gestation and low birth weight, NEC	3	267	82.5	3958	72.2	1.14* (1.01, 1.29)
Unintentional injuries	4	219	67.7	1283	23.4	2.89* (2.49, 3.34)
Maternal complications of pregnancy	5	101	31.2	1706	31.1	1.00 (0.81, 1.23)
Complications of placenta, cord and membranes	6	81	25.0	1224	22.3	1.12 (0.88, 1.40)
Diseases of the circulatory system	7	78	24.1	700	12.8	1.89* (1.47, 2.39)
Influenza and pneumonia	8	76	23.5	265	4.8	4.86* (3.71, 6.29)
Bacterial sepsis of newborn	9	66	20.4	761	13.9	1.47* (1.12, 1.89)
Homicide	10	62	19.2	336	6.1	3.13* (2.34, 4.11)
Neonatal
Congenital malformations	1	396	122.4	5484	100.1	1.22* (1.10, 1.36)
Disorders related to short gestation and low birth weight, NEC	2	256	79.1	3897	71.1	1.11 (0.98, 1.26)
Maternal complications of pregnancy	3	101	31.2	1690	30.8	1.01 (0.82, 1.24)
Complications of placenta, cord, and membranes	4	80	24.7	1213	22.1	1.12 (0.88, 1.40)
Bacterial sepsis of newborn	5	62	19.2	723	13.2	1.45* (1.10, 1.88)
Necrotizing enterocolitis of newborn	6	39	12.1	347	6.3	1.90* (1.33, 2.66)
Respiratory distress of newborn	7	38	11.7	773	14.1	0.83 (0.58, 1.15)
Intrauterine hypoxia and birth asphyxia	8	36	11.1	641	11.7	0.95 (0.66, 1.33)
SIDS	9	33	10.2	276	5.0	2.03* (1.37, 2.91)
Neonatal hemorrhage	10	32	9.9	639	11.7	0.85 (0.58, 1.21)
Postneonatal
SIDS	1	388	119.9	2702	49.3	2.43* (2.18, 2.71)
Congenital malformations	2	224	69.2	1912	34.9	1.98* (1.72, 2.28)
Unintentional injuries	3	204	63.1	1127	20.6	3.07* (2.63, 3.56)
Influenza and pneumonia	4	73	22.6	249	4.5	4.97* (3.77, 6.47)
Diseases of the circulatory system	5	62	19.2	458	8.4	2.29* (1.73, 3.00)
Homicide	6	58	17.9	296	5.4	3.32* (2.46, 4.41)
Septicemia	7	25	7.7	232	4.2	1.83* (1.16, 2.76)
Other external causes	8	20	6.2	110	2.0	3.08* (1.81, 4.99)
Gastritis, duodenitis, and noninfective enteritis and colitis	9	19	5.9	183	3.3	1.76* (1.04, 2.83)
Meningitis	10	15	4.6	59	1.1	4.31* (2.27, 7.69)

Note. AI/AN = American Indian/Alaska Native; CI = confidence interval; NEC = necrotizing enterocolitis; SIDS = sudden infant death syndrome. Infant is defined as < 1 year; neonatal is defined as < 28 days, and postneonatal is defined as 28–364 days. Analyses are limited to persons of non-Hispanic origin. AI/AN race is reported from death certificates or through linkage with the Indian Health Service patient registration database. Rates are per 100 000 persons and are age-adjusted to the 2000 US standard population (11 age groups; Census P25-1130).²⁷ RRs are calculated in SEER*Stat before rounding of rates and may not equal RRs calculated from rates presented in table. Indian Health Service regions are defined as follows: AK^b; Northern Plains (IL, IN,^b IA,^b MI,^b MN,^b MT,^b NE,^b ND,^b SD,^b WI,^b WY^b); Southern Plains (OK,^b KS,^b TX^b); Southwest (AZ,^b CO,^b NV,^b NM,^b UT^b); Pacific Coast (CA,^b ID,^b OR,^b WA,^b HI); East (AL,^b AR, CT,^b DE, FL,^b GA, KY, LA,^b ME,^b MD, MA,^b MS,^b MO, NH, NJ, NY,^b NC,^b OH, PA,^b RI,^b SC,^b TN, VT, VA, WV, DC). Percent regional coverage of AI/AN persons in Contract Health Service Delivery Area counties to AI/AN persons in all counties: Northern Plains = 64.8%; Alaska = 100%; Southern Plains = 76.3%; Southwest = 91.3%; Pacific Coast = 71.3%; East = 18.2%; total US = 64.2%.

Source. AI/AN Mortality Database (AMD 1990–2009).

^aLeading causes of death created using the National Center for Health Statistics list of 130 selected causes of infant death based on the International Classification of Diseases, 10th Revision.¹⁷

^bIdentifies states with ≥ 1 county designated as Contract Health Service Delivery Area.

*P < .05.