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Am J Public Health. 2014 Jun;104 Suppl 3:S336-42. doi: 10.2105/AJPH.2014.301929. Epub 2014 Apr 22.

Suicide mortality among American Indians and Alaska Natives, 1999-2009.

Author information

Mose A. Herne is with the Division of Planning, Evaluation, and Research, Office of Public Health Support, Indian Health Service (IHS), Rockville, MD. Michael L. Bartholomew is with the Division of Epidemiology and Disease Prevention, Office of Public Health Support, Rockville, MD. Rose L. Weahkee is with Field Operations, Phoenix Area Office, IHS, Phoenix, AZ.



We assessed national and regional suicide mortality for American Indian and Alaska Native (AI/AN) persons.


We used 1999 to 2009 death certificate data linked with Indian Health Service (IHS) patient registration data to examine death rates from suicide in AI/AN and White persons. Analysis focused primarily on residents of IHS Contract Health Service Delivery Area counties; Hispanics were excluded. We used age-adjusted death rates per 100,000 population and stratified our analyses by age and IHS region.


Death rates from suicide were approximately 50% higher among AI/AN persons (21.2) than Whites (14.2). By region, rates for AI/AN people were highest in Alaska (rates = 65.4 and 19.3, for males and females, respectively) and in the Northern Plains (rates = 41.6 and 11.9 for males and females, respectively). Disparities between AI/AN and White rates were also highest in these regions.


A coordinated, multidisciplinary effort involving federal, state, local, and tribal health officials is needed to address this important public health issue.

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