Violence among American Indians and Alaska Natives: homicide and suicide surveillance, 1979-1991.

Violence is a leading cause of death and disability among all Americans, and is particularly devastating for American Indians and Alaska Natives (AI/AN) living in the rural western United States. This report is the first Center for Disease Control (CDC) homicide or suicide report focusing on the AI/ANs. This report provides a narrative summary and tabular details of suicide and homicide among AI/ANs. The information from homicide is drawn from three sources: detailed mortality tapes prepared by the National Center for Health Statistics (NCHS), CDC; mortality data derived from the Indian Health Service (IHS); and the Federal Bureau of Investigation's Supplementary Homicide report. The information on suicide for this report is drawn from NCHS mortality data and data from the IHS. From 1979 to 1989, age adjusted homicide and suicide rates for the majority of American Indians living on reservations and Alaska Natives were at or above the 90th percentile rates nationally for all Americans. During this period, homicide caused the deaths of 1779 American Indians and Alaska Natives residing in the twelve IHS Areas. Also during this period, suicide was the ninth leading cause of death overall and the fifth leading cause of years of potential life lost. This data and facts generated in this report will assist public health practitioners in identifying risk groups for possible interventions, and providing information for policy makers regarding violence among these high-risk populations. Multiple homicide and suicide intervention strategies tailored to specific tribal and local settings and problems are necessary.