Methods
Cause of Injuries
The causes of death included in this Atlas and the associated
International Classification of Diseases, Ninth Revision, External Cause
Codes (ICD9 E-Codes), are shown in Table 1.
Data Files
Data for the Atlas were drawn from two sources:
-
Detailed mortality data files prepared by
CDC's National
Center for Health Statistics (NCHS), based on data from
state death certificates.
-
NCHS mortality data that Indian Health
Service (IHS) has
categorized by Area.
All data were restricted to children and youth 0–19 years of
age.
The data derived from these sources follows:
| Source |
Type of Data
|
Population |
| IHS |
IHS death rates—Area Maps, age,and
sex |
Native Americans in IHS
service Areas (1989–1998) |
| NCHS |
Death rates—all other races |
Entire United States
(1989–1998) |
| NCHS |
10 leading causes of death |
All U.S. Native
Americans (1999–2000) |
Indian Health Service Injury Death
Data
Each year, NCHS provides IHS with a multiple-cause-of-death mortality tape
of all U.S. decedents. IHS categorizes these data by IHS area offices to
create its own mortality data set. The IHS data include those Native
Americans who lived within an IHS area at the time of death and were
eligible for IHS services (IHS service population). The service population
is estimated by counting those Native Americans (as identified during the
census) who live in the geographic areas in which IHS has responsibilities
(“on or near” reservations). Some individuals who are included in the IHS
service population do not live on reservations. The IHS service population
comprises about 60% of all Native Americans who live in 1the United
States. States that make up the service population have been grouped by
IHS into twelve administrative Areas, or IHS Areas: Aberdeen, Alaska,
Albuquerque, Bemidji, Billings, California, Nashville, Navajo, Oklahoma
City, Phoenix, Portland, and Tucson.
Table 1. Underlying causes of death and
associated ICD9 E-codes included in the IHS Childhood Injury Mortality
Atlas
| Cause of Death |
ICD9 E-Code |
| |
|
| Motor
vehicle-related* |
E810–E825 |
| |
|
| Pedestrian-related |
E810–E825 (.7) ** |
| |
|
| Drowning |
E830, E832, E910 |
| |
|
| Fire/burn-related |
E890–E899, E924 |
| |
|
| Suffocation
|
E911–E913 |
| |
|
Firearm-related***
(intentional, unintentional,
and undetermined intent) |
E922
E955.0–E955.4,
E965.0–E965.4, E970
E985.0–E985.4 |
| |
|
| Suicide |
E950–E959 |
| |
|
| Homicide |
E960–E969 |
| |
| * Motor
vehicle-related coding includes pedestrian-related injury deaths.
Codes 810–819 indicate traffic-related injury deaths. Codes
820–825 indicate nontraffic-related injury deaths.
** This parenthetical notation
implies that the decimal should be applied to each individual
three-digit E-code in the grouping.
*** Firearm-related coding
includes firearm-related deaths, homicide, suicide, and
unintentional events. |
|
Calculation of Rates and Leading
Causes
Rates per 100,000
population were calculated using estimates of the IHS service population
for 1989 to 1998, based on the revised 2000 census as denominators. At the
time of this project, 1998 was the most recent year of data available
through IHS. Data from 1981 to 1988 were used in conjunction with data
from 1989 to 1998 for illustrating injury trends by race group and
two-year periods. Calculations were based on injury deaths of children and
youth (0–19 years of age). Native American deaths were adjusted using the
IHS Area factors outlined in Adjusting for Miscoding of 4Indian Race on
State Death Certificates. These methods are similar to those used by IHS
in Regional Differences in Indian Health (JoAnn Papalardo, IHS Program
Statistics, personal communication 2004). All rates specific to IHS Areas,
race, and sex were age-adjusted by the direct method using the projected
2000 U.S. population as the standard. Injury death rates based on a small
number of deaths (< 20) may be unstable and should be interpreted with
caution.
Data for the ten leading causes of death
charts were taken from the compressed mortality file produced by NCHS and
include the deaths of all U.S. Native Americans. Race-specific data
presented for white and black children were also taken from the compressed
mortality file produced by NCHS.
Both the U.S. national rate and the Area
rates were used to calculate excess deaths due to injury by Area.
