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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.148221v1 99/11/1996    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Horner, R. D. Articles by Trimble, B. A. PubMed PubMed Citation Articles by Horner, R. D. Articles by Trimble, B. A. Related Collections Other Chronic Disease Epidemiology Native Americans Mortality

Ronnie D. Horner, PhD, Gretchen M. Day, MPH, Anne P. Lanier, MD, MPH, Ellen M. Provost, DO, MPH, Rebecca D. Hamel, BSN and Brian A. Trimble, MD

Ronnie D. Horner is with the Department of Public Health Sciences, University of Cincinnati Academic Health Center, Cincinnati, OH. At the time of the study, Gretchen M. Day and Anne P. Lanier were with the Office of Alaska Native Health Research, Alaska Native Tribal Health Consortium, Anchorage. Ellen M. Provost is with the Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage. At the time of the study, Rebecca D. Hamel and Brian A. Trimble were with the Division of Neurology, Department of Internal Medicine, Alaska Native Medical Center, Anchorage.

Correspondence: Correspondence should be sent to Brian A. Trimble, MD, Neurology Service, Alaska Native Medical Center, 4315 Diplomacy Dr, Anchorage, AK 99508 (e-mail: btrimble{at}anthc.org). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We aimed to describe the epidemiology of stroke among Alaska Natives, which is essential for designing effective stroke prevention and intervention efforts for this population.

Methods. We conducted an analysis of death certificate data for the state of Alaska for the period 1984 to 2003, comparing age-standardized stroke mortality rates among Alaska Natives residing in Alaska vs US Whites by age category, gender, stroke type, and time.

Results. Compared with US Whites, Alaska Natives had significantly elevated stroke mortality from 1994 to 2003 but not from 1984 to 1993. Alaska Native women of all age groups and Alaska Native men younger than 45 years of age had the highest risk, although the rates for those younger than 65 years were statistically imprecise. Over the 20-year study period, the stroke mortality rate was stable for Alaska Natives but declined for US Whites.

Conclusions. Stroke mortality is higher among Alaska Natives, especially women, than among US Whites. Over the past 20 years, there has not been a significant decline in stroke mortality among Alaska Natives.