One of my favorite publications is the Morbidity and Mortality Weekly Report (MMWR). It’s put out weekly by the CDC and allows for rapid communication of emerging or interesting health trends. This week the CDC is reporting an extraordinary death rate from influenza in American Indians/Native Alaskans (AI/NA). Collecting data like this presents several challenges, including under-reporting of AI/NA ethnicity and under-reporting of H1N1 as a cause of death, which makes the data even more sobering.
The death rate from H1N1 among AI/NA is 3.7 per 100,000 population, compared with 0.9 per 100,000 for all other ethnicities combined. This is probably an under-estimate.
Many native populations carry a high burden of high-risk health problems such as diabetes which are associated with complications of influenza. In fact, NA/AI have twice the rate of diabetes as the rest of the population (over 45%). However, the trend of H1N1 mortality is also true for other indigenous populations, such as native Australians. This would seem to implicate poverty, marginalization, and other social factors in the disparity in mortality.
In some ways, this is a good thing. We can’t change genetics, but we can improve social disparities—if we really want to.