All-cause, cardiovascular,and cancer mortality in Western Alaska native people: Western Alaska Tribal Collaborative for Health (WATCH)

Barbara V. Howard, Jesse S. Metzger, Kathryn R. Koller, Stacey E. Jolly, Elvin D. Asay, Hong Wang, Abbie W. Wolfe, Scarlett E. Hopkins, Cristiane Kaufmann, Terry W. Raymer, Brian Trimble, Ellen M. Provost, Sven O.E. Ebbesson, Melissa A. Austin, William James Howard, Jason G. Umans, Bert B. Boyer

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objectives. We determined all-cause, cardiovascular disease (CVD), and cancer mortality in western Alaska Native people and examined agreement between death certificate information and adjudicated cause of deaths. Methods. Data from 4 cohort studies were consolidated. Death certificates and medical records were reviewed and adjudicated according to standard criteria. We compared adjudicated CVD and cancer deaths with death certificates by calculating sensitivity, specificity, predictive values, and j statistics. Results. Men (n = 2116) and women (n = 2453), aged 18 to 95 years, were followed an average of 6.7 years. The major cause of death in men was trauma (25%), followed by CVD (19%) and cancer (13%). The major cause of death in women was CVD (24%), followed by cancer (19%) and trauma (8%). Stroke rates in both genders were higher than those of US Whites. Only 56% of deaths classified as CVD by death certificate were classified as CVD by standard criteria; discordance was higher among men (55%) than women (32%; js = 0.4 and 0.7). Conclusions. We found lower rates for coronary heart disease death but high rates of stroke mortality. Death certificates overestimated CVD mortality; concordance between the 2 methods is better for cancer mortality. The results point to the importance of cohort studies in this population in providing data to assist in health care planning.

Original languageEnglish (US)
Pages (from-to)1334-1340
Number of pages7
JournalAmerican journal of public health
Volume104
Issue number7
DOIs
StatePublished - Jul 2014

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Howard, B. V., Metzger, J. S., Koller, K. R., Jolly, S. E., Asay, E. D., Wang, H., Wolfe, A. W., Hopkins, S. E., Kaufmann, C., Raymer, T. W., Trimble, B., Provost, E. M., Ebbesson, S. O. E., Austin, M. A., Howard, W. J., Umans, J. G., & Boyer, B. B. (2014). All-cause, cardiovascular,and cancer mortality in Western Alaska native people: Western Alaska Tribal Collaborative for Health (WATCH). American journal of public health, 104(7), 1334-1340. https://doi.org/10.2105/AJPH.2013.301614