Injury mortality and prevention strategies for elderly American Indians in the Phoenix Area Indian Health Service.

Elder health and injury prevention are major initiatives of the Indian Health Service (IHS). Injuries are a significant cause of death among elderly American Indians and Alaska Natives (AI/ANs) - the fourth leading cause of death for persons 55-64 years old, and seventh leading cause of death for those ages 65 and over. This article examines the causes of American Indian elder deaths over a 15 year period in the Phoenix Area of the IHS, and offers guidance for elder American Indian injury prevention. The data set for this study includes all deaths of American Indians residing in the service area of the Phoenix Area IHS during 1979-1993. Service population figures for the IHS Phoenix Area were obtained from 1980 and 1990 revised census data. The U.S. All Races crude mortality rates for 1979-1993 for the grouped ages 55 and over were calculated from statistics obtained from the Center for Disease Control's National Center for Injury Prevention and Control. The International Classification of Diseases, 9th Revision, (ICD9) external cause of injury (E-codes) in the data set were used to identify causes of injury-related death (E800-999). There were 282 elder deaths due to injury during the 15-year time interval. The total injury mortality rate for Phoenix Area elders was more than double the U.S. All Races elderly rate. Phoenix Area elder injury mortality rates exceeded the U.S. All Races rates for every cause except self-inflicted. Motor vehicles accounted for 36.8% of all deaths. Phoenix Area elder injury mortality rates exceeded the U.S. All Races rates for every cause except self-inflicted. The all-injury mortality rate for Phoenix Area male elders was more than 3.5 times higher than for females. The Phoenix Area elderly suffer high rates of injury death. Given the limited resources, efforts should be concentrated on those causes of injury for which elders are at the highest risk of death. In the Phoenix Area, these are motor vehicle-related, falls, and environmental factors. Based upon sound epidemiological data, as well as proven intervention strategies, health officials can produce guidance to assist AI/AN elders in living full and complete lives without premature death or disability due to a predictable and consequently preventable injury.