Health Status Profile of American Indians in Arizona Population Health and Vital Statistics Section Bureau of Public Health Statistics Arizona Department of Services ~ Leadership for a Healthy Arizona ~ Janice K. Brewer, Governor State of Arizona Will Humble, Director Arizona Department of Health Services POPULATION HEALTH AND VITAL STATISTICS SECTION BUREAU OF PUBLIC HEALTH STATISTICS ARIZONA DEPARTMENT OF HEALTH SERVICES 150 North 18th Avenue, Suite 550 Phoenix, Arizona 85007 Phone: 602/542-7333; FAX: 602/542-2940 www.azdhs.gov/plan This publication can be made available in alternative format. Please contact the Bureau of Public Health Statistics at 602/542-7333 (voice) or call 1-800-367-8939 (TDD). The Arizona Department of Health Services is an Equal Employment Opportunity Agency. Permission to quote from or reproduce materials from this publication is granted when due acknowledgment is made. HEALTH STATUS PROFILE OF AMERICAN INDIANS IN ARIZONA: 2011 DATA BOOK by Nicholas J. Bishop, Ph.D., Arizona Vital Statistician Sanhita Gupta, Vital Statistics Health Management Analyst Clare Torres, Senior Health Data Analyst February 2014 Acknowledgment Grateful acknowledgement is made to Wes Kortuem, the GIS Coordinator, for spatially joining the American Indian birth and death data. HEALTH STATUS PROFILE OF AMERICAN INDIANS IN ARIZONA 2011 DATA BOOK TABLE OF CONTENTS Introduction ........................................................................................................................................................................................................................ 1 I. RISK PROFILE OF AMERICAN INDIANS IN ARIZONA: AN OVERVIEW OF SELECTED HEALTH PROBLEMS AND HEALTH RISKS AMONG AMERICAN INDIANS AND ALL RESIDENTS OF THE STATE IN 2011 ............................................................................................................................. 3 2011 Risk Profile of American Indians ........................................................................................................................................................................ 7 American Indians’ Standing in Arizona in 2011 on 70 Indicators of Health Status ............................................................................................................ 8 II COMPARISON OF AMERICAN INDIANS’ STANDING IN ARIZONA WITH RESPECT TO SELECTED HEALTH OBJECTIVES FOR THE YEAR 2011................................. 13 III. TRENDS IN SELECTED HEALTH PROBLEMS AND HEALTH RISKS AMONG AMERICAN INDIANS AND ALL RESIDENTS OF ARIZONA, 2001-2011 .......................... 15 IV. CHARACTERISTICS OF AMERICAN INDIAN NEWBORNS AND MOTHERS GIVING BIRTH BY PLACE OF RESIDENCE IN ARIZONA IN 2011 .................................... 17 SOCIODEMOGRAPHIC CHARACTERISTICS 4.1 4.2 4.3 4.4 4.5 4.6 Maternal Age ......................................................................................................................................................................................................... 20 Educational Attainment of Mother ............................................................................................................................................................................ 21 Marital Status of Mother.......................................................................................................................................................................................... 22 Race/Ethnicity of Father .......................................................................................................................................................................................... 23 Age of Father ........................................................................................................................................................................................................ 24 Source of Payment for Labor and Delivery ................................................................................................................................................................. 25 MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS 4.7 4.8 4.9 Maternal Weight Gain during Pregnancy .................................................................................................................................................................... 28 Medical Risk Factors of Pregnancy ............................................................................................................................................................................ 29 Substance Use during Pregnancy ............................................................................................................................................................................. 30 UTILIZATION OF MEDICAL SERVICES 4.10 4.11 4.12 4.13 4.14 4.15 Trimester of Pregnancy Prenatal Care Began ............................................................................................................................................................. 32 Number of Prenatal Visits ........................................................................................................................................................................................ 33 Obstetric Procedures .............................................................................................................................................................................................. 34 Complications of Labor and Delivery ......................................................................................................................................................................... 35 Method of Delivery ................................................................................................................................................................................................. 36 Attendant at Birth .................................................................................................................................................................................................. 37 NEWBORN’S HEALTH 4.16 4.17 4.18 4.19 4.20 4.21 Gestational Age ..................................................................................................................................................................................................... 40 Weight at Birth ...................................................................................................................................................................................................... 41 Abnormal Conditions of the Newborn ........................................................................................................................................................................ 42 Congenital Anomalies (Birth Defects)........................................................................................................................................................................ 43 Causes of Infant Death among American Indian Residents, Arizona, 2011 ..................................................................................................................... 44 Comparison of Selected Characteristics of American Indian Newborns and Women Giving Birth By County of Residence, Arizona, 2011 ..................................................................................................................................................................... 45 Health Status Profile of American Indians in Arizona, 2011 Data Book V. PATTERNS OF MORTALITY AMONG AMERICAN INDIANS BY PLACE OF RESIDENCE IN ARIZONA IN 2011 .......................................................................... 49 AGE-SPECIFIC MORTALITY 5.1 5.2 5.3 Age-Specific Mortality among American Indians in 2011 ............................................................................................................................................. 52 Age-Specific Mortality among American Indian Males in 2011 ...................................................................................................................................... 53 Age-Specific Mortality among American Indian Females in 2011 .................................................................................................................................. 54 CAUSE-SPECIFIC MORTALITY 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 Deaths by Gender for Selected 113 Causes among American Indians in 2011 .............................................................................................................. 56 Deaths by Age Group for Selected 113 Causes among American Indians in 2011 ......................................................................................................... 60 Deaths by Residence for Selected 113 Causes among American Indians in 2011 .......................................................................................................... 64 Deaths by County of Residence for Selected 113 Causes among American Indians in 2011 ............................................................................................ 68 Deaths from Motor Vehicle-Related Injuries among American Indians by Place of Residence, Gender, and Age Group, Arizona, 2011 ..................................................................................................................................................................... 72 Intentional Self-Harm (Suicide) among American Indians by Place of Residence, Gender, and Age Group, Arizona, 2011 ..................................................................................................................................................................... 73 Assault (Homicide) among American Indians by Place of Residence, Gender, and Age Group, Arizona, 2011 ........................................................................................................................................................................................................ 74 Diabetes-Related Deaths among American Indians by Place of Residence, Gender, and Age Group, Arizona, 2011 ........................................................................................................................................................................................................ 75 Alcohol-Induced Deaths among American Indians by Place of Residence, Gender, and Age Group, Arizona, 2011 ........................................................................................................................................................................................................ 76 COMPARATIVE CAUSE-SPECIFIC MORTALITY 5.13 5.14 5.15 5.16 5.17 5.18 5.19 Temporal Changes in the Selected Leading Causes of Death among American Indian Residents Of Arizona, 1991-2011 ........................................................................................................................................................................................... 78 Five Leading Causes of Death by Gender among American Indian Residents of Arizona in 2011 ....................................................................................... 79 Five Leading Causes of Death among American Indians by Gender and Residence On or Off Reservation, Arizona, 2011 ..................................................... 80 Proportional Mortality by Type of Cancer and Gender among American Indians and All Residents of Arizona, 2001-2011 .................................................... 81 Proportional Mortality by Mechanism of Unintentional Injury and Gender among American Indians and All Residents of Arizona, 2001-2011 ......................................................................................................................................................................... 82 Comparison of Mortality by Specific Type of Cancer by Gender among American Indians and All residents of Arizona, 2001-2011 ........................................ 83 Unintentional Injury Deaths by mechanism and Gender among American Indians and All Residents of Arizona, 2001-2011 ................................................. 84 TECHNICAL NOTES ............................................................................................................................................................................................................... 85 Sources of Data ..................................................................................................................................................................................................... 87 Definitions ......................................................................................................................................................................................................... 87 Rates ......................................................................................................................................................................................................... 87 Terms Related to Reproductive Health ............................................................................................................................................................. 87 Medical Terms Used on the Birth Certificate ............................................................................................................................................ 87 Medical risk factors for pregnancy ................................................................................................................................................... 87 Complications of labor and delivery ................................................................................................................................................. 88 Abnormal conditions of the newborn ................................................................................................................................................ 88 Congenital anomalies of child ......................................................................................................................................................... 88 Terms Related to Mortality ............................................................................................................................................................................. 89 ii Health Status Profile of American Indians in Arizona, 2011 Data Book INTRODUCTION The report Health Status Profile of American Indians in Arizona: 2011 Data Book is the annual update of population-level data on trends and patterns in natality and mortality among American Indians who were residents of specified tribal communities on reservations, and those who resided off reservation in Arizona in 2011. American Indian births are determined by mother's race as indicated on a birth certificate, that is, these are the births to American Indian mothers. American Indian deaths are determined by decedent's race as stated on the death certificate. The charts and tables comprising the 2011 Health Status Profile of American Indians in Arizona are grouped into five major sections: 1) a summary risk profile of American Indian residents of Arizona in 2011 on 70 indicators or measures of health status, 2) a comparison of American Indians’ standing in Arizona with respect to selected health objectives for the year 2010, 3) a section presenting trend data for 2001-2011 for selected health problems and health risks comparing American Indians to Arizona’s entire population, 4) a four-part section concerned with the characteristics of American Indian newborns and mothers giving birth, 5) a three-part section focused on patterns of cause-specific mortality among American Indians by age group, gender, and place of residence in Arizona in 2011. Beginning with the 2006 report, it also includes additional statistics on “Comparative Cause-Specific Mortality” focused on leading causes of death by gender and residence status on or off reservation, as well as patterns in cancer mortality and proportional mortality from specific unintentional injuries. These sections are followed by the Technical Notes, which provide information about the sources of data and definitions of terms used in the report. The causes of death for 2001-2011 are classified by the Tenth Revision (ICD-10). Health Status Profile of American Indians in Arizona, 2011 Data Book 1 Identifying whether the vital events occurring to Arizona’s Native American population were to those living on tribal reservations has posed a persistent challenge. Beginning with the first edition of this report published in 1995, vital events occurring on reservation were identified by place of residence. From 2002 - 2009, tribal affiliation combined with a specific place of residence was used in order to distinguish between American Indian residents of specified tribal communities and/or on reservations, and those who resided off reservation. In 2011, the identification of events occurring on or off tribal lands was based solely on whether or not the individual’s residence address was within the boundaries of a tribal reservation. While identifying a somewhat smaller number of on-reservation vital events than in previous years, this method provides a stricter definition of whether a specific vital event occurred to a Native American living within the boundaries of a reservation, and is also more reliable and reproducible than the method incorporating both residence address and tribal affiliation to identify on-reservation events. Future editions of the report will also use residence as the sole identifier of on-reservation vital events. Due to this change in methodology, the counts of vital events occurring on-oroff reservation in 2011 should not be directly compared to on-or-off reservation counts from previous years, specifically counts in Sections IV and V (excluding Section V Comparative Cause-Specific Mortality). The Health Status Profile of American Indians in Arizona: 2011 Data Book includes tables where small cells and related totals are suppressed. Using suppression rules similar to those used by the National Center for Health Statistics (NCHS), this report now attempts to maintain the anonymity of the individuals whose vital records are summarized herein. In cell suppression, the first task is primary suppression, or removing non-zero counts in the body of a table that fall below a certain number. Primary cells that were less than six but greater than zero were suppressed and identified with an asterisk (*). Next, secondary suppression is used to obfuscate the totals or sums with components, or addends, that fall below the threshold for primary suppression. These totals are typically reported in the margins of table rows and columns. Column or row totals that contained a non-zero addend less than 6 were rounded to the nearest tens-unit and identified with a dagger (†). In certain cases where these rules would have dictated the rounding of a row or column total but the value of the information contained in the total was identified as important or attainable from other sources, these rules were relaxed and the original value was reported. Health Status Profile of American Indians in Arizona was intended as a data book: a basic reference for some of the most frequently requested vital event statistics. The five sections of the report were computer-generated and contain information with little or no accompanying narrative. The online versions of the report for 1995–2010 are available at http://www.azdhs.gov/plan/report/hspam/index.htm 2 Health Status Profile of American Indians in Arizona, 2011 Data Book I. RISK PROFILE OF AMERICAN INDIANS IN ARIZONA: AN OVERVIEW OF SELECTED HEALTH PROBLEMS AND HEALTH RISKS AMONG AMERICAN INDIANS AND ALL RESIDENTS OF THE STATE IN 2011 Health Status Profile of American Indians in Arizona, 2011 Data Book 3 The risk profile presented on the following page summarizes how American Indians as a group compared in 2011 to the state average on 70 measures of health status. The 70 indicators used in the profile are individual measures of the various dimensions or facets of health status. The profile uses the percentages a racial/ethnic group is above or below the statewide average on each of the specific measures. In order to represent the level of each indicator for American Indians in comparison to the overall state level, the following formula was used:* THE VALUE OF A RATE OR RATIO IN A SPECIFIED GROUP - 1.0 X 100 THE AVERAGE VALUE OF A RATE OR RATIO FOR ALL GROUPS The above formula produces a score of 0.0 for a group with the same value as the statewide average. A negative value indicates better than average standing on an indicator. A positive value indicates worse than average standing on an indicator*. The profile visually describes the better-than-average and worse-than-average clusters of health status characteristics for American Indian residents of Arizona. Following the graphic profile is a detailed description of the 70 indicators. These indicators are organized around 9 major subject areas: (1) Teen Pregnancies, (2) Maternal Lifestyle and Health Characteristics, (3) Utilization of Prenatal Care Services, (4) Newborn's Health, (5) Mortality from Natural Causes (chronic or infectious diseases), (6) Mortality from Injuries, (7) Age-Specific Mortality, (8) Premature Mortality and (9) Reportable Diseases. IN 2011, AMERICAN INDIAN RESIDENTS OF ARIZONA: • ranked worse than the statewide average on 47 of 70 health indicators; • ranked poorly on measures of maternal lifestyle and health, as well as in utilization of prenatal care; • on average were 19 years younger at time of death compared to all racial/ethnic groups; • had high mortality from alcohol-induced causes, motor vehicle accidents, septicemia, influenza and pneumonia, and mortality from other unintentional injuries: all contributing to the premature death rate of 77.7 percent; • ranked better than average on a number of health indicators including (1) mortality rates for several chronic diseases (lung cancer, chronic lower respiratory diseases, breast cancer, Alzheimer’s disease, heart disease, all malignant neoplasms, and colorectal cancer), (2) tobacco use during pregnancy, (3) drug induced deaths, and (4) injury by firearms. * The comparative risk profiles for American Indian, White non-Hispanic, Hispanic or Latino, Black or African American, and Asian or Pacific Islander residents of Arizona were developed for a report “Differences in the Health Status among Ethnic Groups”. This publication is available online at http://www.azdhs.gov/plan/report/dhsag/index.htm. For consistency, the signs + and – for scores indicating the median age at death as higher or lower than the statewide average were reversed (indicators 8-1, 8-2, 8-3). Otherwise, a lower-than-average median age at death would signify a better than average standing on this indicators. A lower-than-average median age at death obviously reflects a worse off life expectancy. Health Status Profile of American Indians in Arizona, 2011 Data Book 5 2011 RISK PROFILE OF AMERICAN INDIANS (Percent above or below the average rate or ratio of all Arizona residents in 2011) BETTER THAN AVERAGE 5-7. 5-5. 5-8. 5-17. 2-2. 6-6. 6-5. 5-19. 5-3. 5-6. 4-1. 2-9. 5-2. 5-10. 5-1. 4-2. 4-10. 5-11. 6-8. 4-3. 5-4. 4-4. 4-8. 4-5. 5-20. 1-2. 8-3. 1-4. 8-1. 7-4. 9-5. 5-15. 7-1. 4-7. 8-2. 1-1. 4-6. 1-3. 2-10. 6-3. 8-4. 9-1. 5-9. 2-4. 2-8. 3-3. 2-6. 6-4. 4-9. 3-1. 2-1. 6-9. 2-7. 9-4. 4-11. 2-5. 7-3. 6-1. 9-2. 7-2. 3-2. 9-3. 5-13. 5-18. 5-12. 2-3. 5-14. 5-16. 6-2. 6-7. WORS E THAN AVERAGE -79.1 -68.6 -61.9 -48.6 -44.2 -42.9 -37.4 -36.1 -33.8 -33.4 -33.3 -30.0 -27.3 -26.1 -25.8 -20.4 -15.4 -13.6 -13.4 -3.2 -2.9 -1.4 Lung cancer Chronic lower respiratory diseases Breast cancer Alzheimer's disease Tobacco use during pregnancy Drug-induced deaths I njury by firearms Essential ( primary) hypertension Coronary heart disease Malignant neoplasms ( cancer) Hyaline membrane disease Genital herpes during pregnancy Diseases of the heart Colorectal cancer Cardiovascular diseases Newborn intensive care Neonatal mortality Prostate cancer I ntentional self-harm ( suicide) Born too early ( preterm or < 37 weeks) Cerebrovascular disease Born too small: low-birthweight ( <2,500 grams) Sudden I nfant Death Syndrome ( SI DS) Born too small: very low-birthweight ( <1,500 grams) Total mortality from all causes Pregnancies among females 14 and younger Median age at death from all causes among females Pregnancies among females 18-19 years old Median age at death from all causes Mortality among adults 45-65 years old I ncidence of HI V/ HI V/ AI DS HI V disease Mortality of children 1-14 years old I nfant mortality Median age at death from all causes among males Pregnancies among females 19 and younger I ncidence of congenital anomalies ( birth defects) Pregnancies among females 15-17 years old Weight gain of less than 21 pounds Fall-related injuries Percent of total deaths before expected years of life reached I ncidence of early syphilis Cervical cancer Chronic hypertension Pregnancy associated hypertension No prenatal care Anemia during pregnancy Drowning mortality Mortality of infants from low birthweight/ short gestation No care in the 1st trimester Unmarried mothers Assault ( homicide) Diabetes during pregnancy I ncidence of genital herpes Postneonatal mortality Dysfunctional labor Mortality among adults 20-44 years old Unintentional injuries I ncidence of gonorrhea Mortality of adolescents and young adults 15-19 years old Fewer than five prenatal visits I ncidence of chlamydia Diabetes Nephritis, nephrotic syndrome and nephrosis ( kidney disease) I nfluenza and pneumonia Alcohol use during pregnancy Chronic liver disease and cirrhosis Septicemia Motor vehicle-related injuries Alcohol-induced deaths 0.0 8.3 9.4 14.3 17.3 22.0 22.1 22.2 23.9 25.0 25.1 25.4 26.0 27.0 27.3 30.3 34.8 36.2 44.4 45.8 47.6 50.0 50.0 56.3 66.7 69.2 71.4 71.6 74.0 95.1 102.2 103.0 105.0 106.3 107.0 121.1 128.0 129.8 130.0 146.9 147.2 155.0 192.8 200.0 225.4 251.1 265.3 348.3 AVERAGE FOR ALL RES IDENTS -600.0 0.0 -300.0 Health Status Profile of American Indians in Arizona, 2011 Data Book 600.0 300.0 7 AMERICAN INDIANS’ STANDING IN ARIZONA IN 2011 ON 70 INDICATORS OF HEALTH STATUS 1. TEEN PREGNANCIES Figure Number (Number of pregnancies per 1,000 females in specified age group) Indicator 2011 rate for American Indians Percent above or below the average rate for all groups Average rate for all groups in 2011 Definitions 1-1 Pregnancies among females 19 and younger 29.2 27.0 23.0 The sum of live births, fetal deaths, and abortions per 1,000 females aged 19 or younger. 1-2 Pregnancies among females 14 and younger 0.8 14.3 0.7 The sum of live births, fetal deaths, and abortions per 1,000 females aged 14 or younger. 1-3 Pregnancies among females 15-17 years old 28.8 30.3 22.1 The sum of live births, fetal deaths, and abortions per 1,000 females aged 15-17 years. 1-4 Pregnancies among females 18-19 years old 94.2 22.0 77.2 The sum of live births, fetal deaths, and abortions per 1,000 females aged 18-19 years. 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Figure Number (All rates are per 100 live births) Indicator 2-1 Unmarried mothers 2-2 2011 rate for American Indians Percent above or below the average rate for all groups Average rate for all groups in 2011 Definitions 77.1 72.1 Tobacco use during pregnancy 2.4 -44.2 4.3 The number of mothers giving birth who self-reported tobacco use during pregnancy per 100 births. 2-3 Alcohol use during pregnancy 1.5 200.0 0.5 The number of mothers giving birth who self-reported alcohol use during pregnancy per 100 births. 2-4 Chronic hypertension 1.2 50.0 0.8 Blood pressure persistently greater than 140/90, diagnosed prior to onset of pregnancy or before the 20th week of gestation (the number of cases per 100 births). 2-5 Dysfunctional labor 3.3 106.3 2-6 Anemia during pregnancy 6.0 66.7 2-7 Diabetes during pregnancy 9.3 102.2 2-8 Pregnancy-associated hypertension 6.3 50.0 2-9 Genital herpes during pregnancy 0.7 -30.0 2-10 Weight gain of less than 21 pounds 35.6 34.8 8 44.3 The number of births to unmarried mothers per 100 births. 1.6 Failure to progress in a normal pattern of labor (the number of cases per 100 births). Hemoglobin level of less than 10.0 g/dL during pregnancy, or hematocrit of less than 30 percent during pregnancy (the number of cases per 100 births). Metabolic disorder characterized by excessive discharge of urine and persistent thirst; 4.6 includes juvenile onset, adult onset, and gestational diabetes during pregnancy (the number of cases per 100 births). An increase in blood pressure of at least 30 mm hg systolic or 15 mm hg diastolic on 4.2 two measurements taken 6 hours apart after the 20th week of gestation (the number of cases per 100 births). Infection of the skin of the genital area by herpes simplex virus (the number of cases 1.0 per 100 births). 3.6 26.4 The number of women giving birth who gained less than 21 pounds per 100 births. Health Status Profile of American Indians in Arizona, 2011 Data Book AMERICAN INDIANS’ STANDING IN ARIZONA IN 2011 ON 70 INDICATORS OF HEALTH STATUS (continued) 3. UTILIZATION OF PRENATAL CARE SERVICES Figure Number (Per 100 live births) Indicator st 2011 rate for American Indians Percent above or below the average rate for all groups 3-1 No care in the 1 trimester 31.4 71.6 3-2 Fewer than five prenatal visits 11.5 130.0 3-3 No prenatal care 2.5 56.3 Average rate for all groups in 2011 Definitions st The number of mothers giving birth who received no prenatal care in the 1 trimester of pregnancy per 100 births. The number of mothers giving birth who had fewer than five prenatal visits during 5.0 pregnancy per 100 births. 18.3 1.6 The number of mothers giving birth who received no prenatal care during pregnancy per 100 births. 4. NEWBORN'S HEALTH Figure Number (Infant, neonatal, and postneonatal rates are per 1,000 live births. All other indicators are expressed per 100 live births) Indicator 2011 rate for American Indians Percent above or below the average rate for all groups Average rate for all groups in 2011 Definitions 4-1 Incidence of hyaline membrane disease 0.2 -33.3 The number of cases of hyaline membrane disease per 100 births. Hyaline membrane disease is a disorder primarily of prematurity, manifested clinically by respiratory 0.3 distress and pathologically by pulmonary hyaline membranes and incomplete expansion of the lungs at birth. 4-2 Incidence of newborn intensive care 4.3 -20.4 5.4 The number of babies admitted to Newborn Intensive Care units per 100 births. 4-3 Born too early (preterm or < 37 weeks) 9.0 -3.2 4-4 Born too small: low-birthweight (<2,500 grams) 6.9 -1.4 4-5 Born too small: very low-birthweight (<1,500 grams) 1.3 8.3 4-6 Incidence of congenital anomalies (birth defects) 1.4 27.3 4-7 Infant mortality 7.4 25.4 4-8 Sudden Infant Death Syndrome (SIDS) 0.3 0.0 4-9 Mortality of infants from low birthweight/short gestation 1.2 71.4 4-10 Neonatal mortality 3.3 -15.4 4-11 Postneonatal mortality 4.1 105.0 Health Status Profile of American Indians in Arizona, 2011 Data Book The number of births before 37 weeks of gestation per 100 births. Preterm is any 9.3 neonate whose birth occurs through the end of the last day of the 37th week (259th day), following onset of the last menstrual period. The number of newborns weighing less than 2,500 grams per 100 births. Low7.0 birthweight is any neonate weighing less than 2,500 grams at birth (less than 5 pounds 8 ounces). The number of newborns weighing less than 1,500 grams per 100 births. Very low1.2 birthweight is any neonate whose weight at birth is 1,500 grams or less (less than 3 pounds 5 ounces). 1.1 The numbers of babies born with birth defects per 100 births. The number of infant deaths per 1,000 live births. Infant death is any death at any 5.9 time from birth up to, but not including, the first year of age (364 days, 23 hours, 59 minutes from the moment of birth). The number of infant deaths from Sudden Infant Death Syndrome (ICD-10 code R95) 0.3 per 1,000 live births. The number of infant deaths from low- birthweight/short gestation (ICD-10 code P07) per 1,000 live births. The number of neonatal deaths per 1,000 live births. Neonatal death is death of a 3.9 liveborn neonate before the neonate becomes 28 days old (up to and including 27 days, 23 hours, 59 minutes from the moment of birth). The number of postneonatal deaths per 1,000 live births. Postneonatal death is any 2.0 death of a liveborn infant at least 28 days of age but less than one year of age. 0.7 9 AMERICAN INDIANS’ STANDING IN ARIZONA IN 2011 ON 70 INDICATORS OF HEALTH STATUS (continued) 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) Figure Number (Number of deaths per 100,000 population age-adjusted to 2000 standard. The causes of death are classified by the Tenth Revision of the International Classification of Diseases or ICD-10) Indicator 2011 rate for American Indians Percent above or below the average rate for all groups Average rate for all groups in 2011 Definitions 5-1 Cardiovascular disease 149.2 -25.8 201.0 The number of deaths from cardiovascular diseases (ICD-10 codes I00-I78) per 100,000 age-adjusted population. 5-2 Diseases of the heart 111.1 -27.2 152.7 The number of deaths from disease of the heart (ICD-10 codes I00–I09, I11, I13, I20–I51) per 100,000 age-adjusted population. 5-3 Coronary heart disease 79.6 -33.8 120.3 The number of deaths from coronary heart disease (ICD-10 codes I200-I259) per 100,000 age-adjusted population. 5-4 Cerebrovascular disease 29.7 -2.9 30.6 The number of deaths from cerebrovascular disease (ICD-10 codes I60–I69) per 100,000 age-adjusted population. 5-5 Chronic lower respiratory diseases 14.4 -68.6 45.9 The number of deaths from chronic lower respiratory diseases (ICD-10 codes J40–J47) per 100,000 age-adjusted population. 5-6 Malignant neoplasm (cancer) 100.8 -33.4 151.3 5-7 Lung cancer 7.9 -79.1 37.8 The number of deaths from lung cancer (ICD-10 codes C33–C34) per 100,000 ageadjusted population. 5-8 Breast cancer 7.5 -61.9 19.7 The number of deaths from breast cancer (ICD-10 code C50) per 100,000 ageadjusted female population. 5-9 Cervical cancer 3.1 47.6 2.1 5-10 Colorectal cancer 9.9 -26.1 13.4 The number of deaths from colorectal cancer (ICD-10 codes C18–C21) per 100,000 age-adjusted population. 5-11 Prostate cancer 17.1 -13.6 19.8 The number of deaths from prostate cancer (ICD-10 code C61) per 100,000 ageadjusted male population. 5-12 Influenza and pneumonia 28.4 192.8 9.7 The number of deaths from influenza and pneumonia (ICD-10 codes J10–J18) per 100,000 age-adjusted population. 5-13 Diabetes 61.3 147.2 24.8 The number of deaths from diabetes (ICD-10 codes E10–E14) per 100,000 ageadjusted population. 5-14 Chronic liver disease and cirrhosis 43.6 225.4 13.4 The number of deaths from chronic liver disease and cirrhosis (ICD-10 codes K70, K73–K74) per 100,000 age-adjusted population. 5-15 HIV disease 2.0 25.0 1.6 The number of deaths from HIV disease (ICD-10 codes B20-B24) per 100,000 ageadjusted population. 5-16 Septicemia 16.5 251.1 4.7 The number of deaths from septicemia (ICD-10 codes A40-A41) per 100,000 ageadjusted population. 5-17 Alzheimer's disease 18.1 -48.6 35.2 5-18 Nephritis, nephrotic syndrome and nephrosis (kidney disease) 15.3 155.0 6.0 5-19 Essential (primary) hypertension 6.9 -36.1 10.8 5-20 Total mortality from all causes 765.5 9.4 10 The number of deaths from cancer (ICD-10 codes C00–C97) per 100,000 ageadjusted population. The number of deaths from cervical cancer (ICD-10 code C53) per 100,000 ageadjusted female population. The number of deaths from Alzheimer’s disease (ICD-10 code G30) per 100,000 ageadjusted population. The number of deaths from nephritis, nephritic syndrome, and nephrosis (ICD-10 codes N00–N07, N17–N19,N25–N27) per 100,000 age-adjusted population. The number of deaths from essential (primary) hypertension (ICD-10 codes I10, I12) per 100,000 age-adjusted population. 699.6 Total number of deaths from all causes per 100,000 age-adjusted population. Health Status Profile of American Indians in Arizona, 2011 Data Book AMERICAN INDIANS’ STANDING IN ARIZONA IN 2011 ON 70 INDICATORS OF HEALTH STATUS (continued) 6. MORTALITY FROM INJURIES Figure Number (Number of deaths per 100,000 population age-adjusted to 2000 standard. The causes of death are classified by the Tenth Revision of the International Classification of Diseases or ICD-10. Drug-induced deaths include accidental, suicidal, and homicidal poisoning by drugs, but also disorders due to use of psychoactive substances. Alcohol-induced deaths include accidental, suicidal, and homicidal by drugs, but also disorders due to use of alcohol) Indicator 6-1 Unintentional injuries 6-2 2011 rate for American Indians Percent above or below the average rate for all groups Average rate for all groups in 2011 100.6 121.1 45.5 Motor vehicle-related injuries 44.2 265.3 12.1 6-3 Fall-related injuries 15.8 36.2 11.6 6-4 Drowning mortality 2.2 69.2 1.3 6-5 Injury by firearms 9.2 -37.4 14.7 6-6 Drug-induced deaths 9.6 -42.9 16.8 6-7 Alcohol-induced deaths 64.1 348.3 14.3 6-8 Intentional self-harm (suicide) 14.9 -13.4 17.2 6-9 Assault (homicide) 11.9 95.1 6.1 Health Status Profile of American Indians in Arizona, 2011 Data Book Definitions The number of deaths from unintentional injuries in accidents (ICD-10 codes V01–X59, Y85–Y86) per 100,000 age-adjusted population. The number of deaths from motor vehicle-related injuries (ICD-10 codes V02–V04, V09.0, V09.2, V12–V14, V19.0–V19.2, V19.4–V19.6,V20–V79, V80.3–V80.5,V81.0–V81.1,V82.0–V82.1, V83–V86,V87.0–V87.8,V88.0–V88.8, V89.0,V89.2) per 100,000 age-adjusted population. The number of deaths from fall-related injuries (ICD-10 codes W00-W19) per 100,000 age-adjusted population. The number of deaths due to accidental drowning and submersion (ICD-10 codes W65W74) per 100,000 age-adjusted population. The number of deaths by firearms (ICD-10 codes W32–W34, X72–X74, X93–X95, Y22–Y24, Y 35.0) per 100,000 age-adjusted population. Causes of death attributable to firearm mortality include accidental discharge of firearms, intentional self-harm (suicide) by discharge of firearms, assault (homicide) by discharge of firearms, discharge of firearms -undetermined intent, and legal intervention involving firearm discharge. Deaths from injury by firearms exclude deaths due to explosives and other causes indirectly related to firearms. The number of drug-induced deaths (ICD-10 codes F11.0–F11.5, F11.7–F11.9, F12.0–F12.5, F12.7–F12.9, F13.0–F13.5, F13.7–F13.9, F14.0–F14.5, F14.7–F14.9, F15.0–F15.5, F15.7–F15.9, F16.0–F16.5, F16.7–F16.9, F17.0, F17.3–F17.5, F17.7–F17.9, F18.0–F18.5, F18.7–F18.9, F19.0–F19.5, F19.7–F19.9, X40–X44, X60–X64, X85, Y10–Y14) per 100,000 age-adjusted population. Causes of death attributable to drug-induced mortality include selected codes from the ICD-10 title Mental and behavioral disorders due to psychoactive substance use, accidental poisoning by and exposure to drugs, medicaments and biological substances; intentional self-poisoning (suicide) by and exposure to drugs; assault (homicide) by drugs, medicaments and biological substances; and poisoning by and exposure to drugs, medicaments and biological substances, undetermined intent. Drug-induced causes exclude accidents, homicides, and other causes indirectly related to drug use. Also excluded are newborn deaths associated with mother’s drug use. The number of alcohol-induced deaths (ICD-10 codes F10, G31.2, G62.1, I42.6, K29.2, K70, R78.0, X45, X65, Y15) per 100,000 age-adjusted population. Causes of death attributable to alcohol-induced mortality include mental and behavioral disorders due to alcohol use, degeneration of nervous system due to alcohol, alcoholic polyneuropathy, alcoholic cardiomyopathy, alcoholic gastritis, alcoholic liver disease, finding of alcohol in blood, accidental poisoning by and exposure to alcohol, intentional self-poisoning by and exposure to alcohol; and poisoning by and exposure to alcohol, undetermined intent. Alcohol-induced causes exclude accidents, homicides, and other causes indirectly related to alcohol use. The number of deaths due to intentional self-harm (ICD-10 codes X60-X84, Y87.0) per 100,000 age-adjusted population. The number of deaths due to assault (homicide; ICD-10 codes X85-X09, Y87.1) per 100,000 age-adjusted population. 11 AMERICAN INDIANS’ STANDING IN ARIZONA IN 2011 ON 70 INDICATORS OF HEALTH STATUS (continued) 7. PREMATURE MORTALITY Figure Number (Number of deaths per 100,000 persons in specific group) Indicator 7-1 Mortality of children 1-14 years old 7-2 2011 rate for American Indians Percent above or below the average rate for all groups Average rate for all groups in 2011 Definitions 21.9 25.1 17.5 The number of deaths per 100,000 children 1-14 years old. Mortality of adolescents 15-19 years old 114.2 129.8 49.7 The number of deaths per 100,000 adolescents 15-19 years old. 7-3 Mortality of young adults 20-44 years old 276.5 107.0 133.6 The number of deaths per 100,000 young adults 20-44 years old. 7-4 Mortality of middle-aged adults 45-64 years old 726.8 22.2 595.0 The number of deaths per 100,000 middle-aged adults 45-64 years old. 8. AGE-SPECIFIC MORTALITY Figure Number (Number of deaths per 100,000 persons in specific group) 8-1 8-2 8-3 8-4 Indicator 2011 rate for American Indians Median age at death from all causes Median age at death from all causes among males Median age at death from all causes among females Percent of total deaths before expected years of life reached Percent above or below the average for all groups* Average rate for all groups in 2011 Definitions 60.0 22.1 77.0 The median age (the age in the middle) of Arizonans who died in 2011. 54.0 26.0 73.0 The median age (the age in the middle) of Arizona males who died in 2011. 67.0 17.3 81.0 The median age (the age in the middle) of Arizona females who died in 2011. 77.7 44.4 53.8 The number of deaths before reaching 78.7 years (the life expectancy of all U.S. residents in 2011) per 100 deaths. Notes: For consistency, the signs + and – for scores indicating the median age at death as higher or lower than the statewide average were reversed. 9. REPORTABLE DISEASES Figure Number (Number of cases per 100,000 persons in specific group) Indicator 9-1 Incidence of early syphilis 9-2 2011 rate for American Indians Percent above or below the average rate for all groups Average rate for all groups in 2011 Definitions 10.5 45.8 Incidence of gonorrhea 162.8 128.0 71.4 Number of reported cases of gonorrhea per 100,000 population. 9-3 Incidence of chlamydia 1129.6 146.9 457.6 Number of reported cases of chlamydia per 100,000 population. 9-4 Incidence of genital herpes 68.4 103.0 9-5 Incidence of HIV/AIDS 11.4 23.9 12 7.2 Number of reported cases of early syphilis per 100,000 population. 33.7 Number of reported cases of genital herpes per 100,000 population. 9.2 Number of reported cases of HIV/AIDS per 100,000 population. Health Status Profile of American Indians in Arizona, 2011 Data Book II. COMPARISON OF AMERICAN INDIANS’ STANDING IN ARIZONA WITH RESPECT TO SELECTED HEALTH OBJECTIVES FOR THE YEAR 2011 Health Status Profile of American Indians in Arizona, 2011 Data Book 13 COMPARISON OF AMERICAN INDIANS' STANDING IN ARIZONA WITH RESPECT TO SELECTED HEALTH OBJECTIVES FOR THE YEAR 2011 National Year 2010 Objectives / Healthy People 2020 Objectives 2.1 Increase the proportion of women giving birth who receive prenatal care in the first trimester of pregnancy; 2010 objective (HP16-10a); 2020 objective (HP-MICH-10.1) 2.2 Reduce the rate of infant deaths; 2010 objective (HP16-1c); 2020 objective (HP-MICH-1.3) 2.3 Reduce postneonatal mortality; 2010 objective (HP16-1e); 2020 objective (HP-MICH-1.5) 2.4 Reduce deaths caused by unintentional injuries; 2010 objective (HP15-13); 2020 objective(HP-IVP-11) 2.5 Reduce deaths caused by motor vehicle crashes; 2010 objective (HP15-15); 2020 objective (HP-IVP-13.1) 2.6 Reduce the suicide rate; 2010 objective (HP18-1); 2020 objective (HP-MHMD-1) 2.7 Reduce the homicide rate; 2010 objective (HP15-32); 2020 objective (HP-IVP-29) 2.8 Reduce the diabetes-related death rate; 2010 objective (HP5-5); 2020 objective (HP-D-3) 2.9 Reduce the cirrhosis* death rate; 2010 objective (HP26-2); 2020 objective (HP-SA-11) 2.10 Reduce the cervical cancer death rate; 2010 objective (HP3-4); 2020 objective (HP-C-4) Indicator 2.1 Percent of American Indian women giving birth who received early prenatal care 2.2 2.3 2.4 2.5 Year 2020 2010 Objective Objective 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 90.0 77.9 64.6 64.4 68.8 69.0 67.9 65.9 65.9 65.1 66.0 69.4 68.6 Number of infant deaths per 1,000 American Indian live births (6 per 1,000) 6.0 6.0 10.7 7.0 7.5 7.2 8.3 6.4 8.1 8.2 8.4 8.1 7.4 Number of postneonatal (i.e., at least 28 days of age but less than one year of age) deaths per 1,000 American Indian live births (1.2 per 1000); (2.0 per 1000) 1.2 2.0 6.6 3.4 4.4 3.8 4.0 2.4 3.9 3.6 4.2 4.3 4.1 17.5 36.0 112.7 111.0 108.6 103.9 117.8 97.2 95.0 92.6 92.6 99.2 100.6 16.0 12.4 63.2 65.9 59.0 54.1 62.6 56.9 49.0 41.9 36.9 41.7 44.2 10.0 10.2 15.4 17.9 15.2 17.0 17.5 13.7 9.8 13.5 15.9 18.7 14.9 5.0 5.5 17.2 20.3 18.8 14.7 14.0 13.2 13.1 12.8 13.2 18.0 11.9 Number of unintentional injury deaths per 100,000 American Indian populationa (17.5 per 100,000); (36.0 per 100,000) Number of deaths caused by motor vehicle crashes per 100,000 American Indian populationa (16 per 100,000); (12.4 per 100,000) 2.6 Number of suicides per 100,000 American Indian population a (10 per 100,000); (10.2 per 100,000) 2.7 Number of homicides per 100,000 American Indian population a (5 per 100,000); (5.5 per 100,000) Number of deaths due to diabetes reported as the underlying or multiple 2.8 cause of death per 100,000 American Indian population a (45 per 100,000); (65.8 per 100,000) Number of deaths due to chronic liver disease and cirrhosis reported as the 2.9 underlying cause of death per 100,000 American Indian population a (3 per 100,000); (8.2 per 100,000) Number of deaths due to cancer of the uterine cervix reported as the 2.10 underlying cause of death per 100,000 American Indian female population a (2 per 100,000); (2.2 per 100,000) Note: 14 a 45.0 65.8 134.4 155.7 118.7 125.4 138.9 100.2 107.2 108.1 111.4 130.4 105.3 3.0 8.2 39.1 40.5 38.8 51.0 51.2 43.6 36.8 40.7 54.0 64.6 43.6 2.0 2.2 5.4 4.7 4.2 2.0 3.4 5.8 2.3 4.8 4.1 3.0 3.1 Age-adjusted to the 2000 US standard population. Health Status Profile of American Indians in Arizona, 2011 Data Book III. TRENDS IN SELECTED HEALTH PROBLEMS AND HEALTH RISKS AMONG AMERICAN INDIANS IN ARIZONA Health Status Profile of American Indians in Arizona, 2011 Data Book 15 TRENDS IN SELECTED HEALTH PROBLEMS AND HEALTH RISKS AMONG AMERICAN INDIANS IN ARIZONA 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Median Age at Death from all Causes All Arizonans 76 76 76 76 77 76 76 77 76 77 77 American Indians 56 57 56 58 59 57 59 59 59 58 60 All Arizonans 39.4 40.2 41.2 41.9 42.8 43.9 45.0 45.1 45.2 44.7 44.3 American Indians 70.1 69.7 72.4 73.1 72.9 74.8 75.9 75.8 76.9 77.7 77.1 73.9 68.9 63.5 70.1 81.9 95.3 78.7 52.8 49.3 50.8 71.4 115.5 107.7 103.1 142.7 142.6 125.7 94.4 73.3 50.0 85.1 162.8 All Arizonans 7.0 6.8 7.1 7.2 6.9 7.1 7.1 7.1 7.1 7.1 7.0 American Indians 7.3 6.5 6.8 7.2 7.3 7.4 6.6 6.7 6.4 7.0 6.9 All Arizonans 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 American Indians 0.2 0.4 0.0 0.5 0.2 0.6 0.2 0.0 0.5 0.3 0.0 All Arizonans 13.8 13.1 12.9 12.7 12.5 12.7 12.6 12.3 11.8 10.8 9.9 American Indians 19.0 18.7 19.4 18.7 19.1 19.1 20.1 18.6 19.0 17.0 16.9 All Arizonans 1.3 1.3 1.0 1.0 1.0 0.9 0.8 0.9 0.6 0.6 1.1 American Indians 1.9 2.2 1.3 1.6 1.5 1.2 1.4 0.9 0.8 0.6 1.4 All Arizonans 26.3 25.2 28.0 28.8 30.9 28.8 31.0 35.3 36.1 39.1 41.9 American Indians 57.1 46.0 57.1 54.4 58.2 58.8 57.9 58.9 55.4 61.2 62.8 All Arizonans 16.0 18.1 20.2 21.7 20.4 19.5 29.8 39.5 35.7 38.2 36.1 American Indians 59.7 51.0 54.8 54.6 56.1 66.2 67.6 72.5 71.8 59.5 59.9 22.2 23.4 21.4 24.5 29.7 31.6 34.3 38.9 38.7 41.8 46.4 61.8 65.5 60.0 75.7 82.5 72.0 80.4 82.0 82.2 77.9 93.3 Births to Unmarried Mothers a Incidence of Gonorrhea b All Arizonans American Indians Low-Birthweight Births a Fetal Alcohol Syndrome c Births to Teenage Mothers a Birth Defects (Congenital Anomilies) a Pregnancy-associated Hypertension c Anemia during Pregnancy c Diabetes during Pregnancy c All Arizonans American Indians a Notes: Per 100 live births; 16 b Per 100,000 population; c Per 1,000 births. Health Status Profile of American Indians in Arizona, 2011 Data Book IV. CHARACTERISTICS OF AMERICAN INDIAN NEWBORNS AND MOTHERS GIVING BIRTH BY PLACE OF RESIDENCE IN ARIZONA IN 2011 Health Status Profile of American Indians in Arizona, 2011 Data Book 17 SOCIODEMOGRAPHIC CHARACTERISTICS Health Status Profile of American Indians in Arizona, 2011 Data Book 19 4.1 MATERNAL AGE (2011 STATUS) 290† 680† 1,920† 1,460† 900† 460† 90† 0† Ak-Chin Indian Community 10† 0 * * * * 0 0 0 0 Cocopah Tribe 10† 0 0 0 8 * * * 0 0 Colorado River Indian Tribe 30† 0 * * 11 12 * * 0 0 Fort McDowell Yavapai Nation Reservation 20† 0 * * * * * 0 0 0 Fort Mojave Indian Tribe 10† 0 0 0 * * * * 0 0 Gila River Indian Community 70† * 7 11 26 14 8 * * 0 Havasupai Tribe 10† 0 0 * * * 0 * 0 0 200† 0 13 39 69 39 25 15 * 0 Hualapai Tribe 40† 0 0 * 16 10 8 0 0 0 Navajo Nation 1,460† * 65 159 442 355 251 155 32 * 60† 0 7 11 20 11 9 * * 0 Salt River Pima-Maricopa Indian Community 120† * 6 14 32 35 24 7 0 0 San Carlos Apache Tribe 280† * 29 40 103 66 25 16 * 0 Tohono O'Odham Nation 160† 0 9 24 57 31 19 11 * 0 White Mountain Apache Tribe 310† * 29 40 105 70 43 16 * 0 10† 0 0 0 * 0 * * 0 0 0† 0 0 * * 0 0 * 0 0 2,803 10† 170† 350† 910† 660† 420† 230† 50† 0† 1,490† * 49 157 483 395 265 120 19 * 366 0 14 41 129 104 47 25 6 0 ---in Coconino County 310† 0 16 21 104 89 53 25 * 0 ---elsewhere in Arizona 860† * 45 107 298 213 115 58 19 * 3,027 10† 124 326 1,014 801 480 228 50† 0† Hopi Tribe Pascua Yaqui Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe TOTAL Resided off reservation ---in Maricopa County ---in Pima County TOTAL 45+ 35-39 10† 40-44 30-34 Resided on reservation 25-29 18-19 5,830† ALL AMERICAN INDIAN RESIDENTS OF ARIZONA <15 15-17 TOTAL BIRTHS 20-24 Mother's age group Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 20 Health Status Profile of American Indians in Arizona, 2011 Data Book 4.2 EDUCATIONAL ATTAINMENT OF MOTHER (2011 STATUS) TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation <8 8 9-11 12 13-16 Unknown 17+ 5,830 30† 110† 1,400† 2,340† 1,720† 160† 60† Ak-Chin Indian Community 10† 0 0 * * * 0 0 Cocopah Tribe 10† 0 0 7 6 * 0 0 Colorado River Indian Tribe 30† 0 0 8 18 * * 0 Fort McDowell Yavapai Nation Reservation 20† 0 0 * 7 * * * Fort Mojave Indian Tribe 10† 0 0 * 6 * 0 0 Gila River Indian Community 70† * 12 35 18 6 0 * Havasupai Tribe 10† 0 * * * 0 0 0 200† 0 * 35 119 44 * * Hualapai Tribe 40† 0 * 17 17 * 0 0 Navajo Nation 1,464 8 13 240 623 532 42 6 60† 0 * 26 22 10 * 0 Salt River Pima-Maricopa Indian Community 120† * * 43 43 19 * 7 San Carlos Apache Tribe 280† * * 108 114 52 * 0 Tohono O'Odham Nation 160† * * 60 59 24 * * White Mountain Apache Tribe 310† 0 * 118 130 55 * 0 10† 0 0 * * 0 0 0 0† 0 0 * * 0 0 0 TOTAL 2,803 20† 40† 720† 1,200† 760† 60† 20† ---in Maricopa County 1,491 6 41 307 493 580 55 9 ---in Pima County 370† * 13 84 133 110 21 * ---in Coconino County 310† * * 51 138 101 12 * 860 6 15 239 380 173 18 29 3,027 20† 70† 681 1,144 964 106 40† Hopi Tribe Pascua Yaqui Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe Resided off reservation Mother's education ---elsewhere in Arizona TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 21 4.3 MARITAL STATUS OF MOTHER (2011 STATUS) Marital status TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation Unmarried Other 5,830 1,260† 4,490† 80† Ak-Chin Indian Community 10† * 7 0 Cocopah Tribe 10† * 13 0 Colorado River Indian Tribe 30† * 30 0 Fort McDowell Yavapai Nation Reservation 20† * 12 0 Fort Mojave Indian Tribe 10† * 9 0 74 8 66 0 9 0 9 0 200† 29 173 * Hualapai Tribe 36 6 30 0 Navajo Nation 1,464 292 1,150 22 60† * 58 0 Salt River Pima-Maricopa Indian Community 120† 20 97 * San Carlos Apache Tribe 280† 57 221 * Tohono O'Odham Nation 160† 16 138 * White Mountain Apache Tribe 310† 77 228 * 10† * 6 0 0† 0 * 0 TOTAL 2,803 520† 2,250† 30† ---in Maricopa County 1,491 364 1,095 32 ---in Pima County 370† 83 278 * ---in Coconino County 310† 87 218 * 860 200 653 7 3,027 734 2,244 50† Gila River Indian Community Havasupai Tribe Hopi Tribe Pascua Yaqui Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe Resided off reservation Married ---elsewhere in Arizona TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 22 Health Status Profile of American Indians in Arizona, 2011 Data Book 4.4 RACE/ETHNICITY OF FATHER (2011 STATUS) Father's race/ethnicity TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation Ak-Chin Indian Community Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Unknown 5,830 340† 690† 150† 3,380† 50† 1,220† 10† 0 * 0 * 0 * Cocopah Tribe 10† * * * 8 0 * Colorado River Indian Tribe 30† * * * 16 0 12 Fort McDowell Yavapai Nation Reservation 20† 0 * 0 7 0 6 Fort Mojave Indian Tribe 10† 0 * * * 0 * Gila River Indian Community 70† * 10 * 39 * 21 Havasupai Tribe 10† 0 0 0 * 0 * 200† * 0 0 169 0 33 Hualapai Tribe 40† * 0 * 25 0 9 Navajo Nation 1,460† 17 10 * 1,185 7 240 60† 0 11 * 22 0 26 Salt River Pima-Maricopa Indian Community 120† * 17 * 70 * 26 San Carlos Apache Tribe 280† * * * 197 0 78 Tohono O'Odham Nation 160† * * 0 91 * 58 White Mountain Apache Tribe 310† 9 * * 247 0 45 10† 0 * * * 0 * 0† 0 * 0 * 0 * TOTAL 2,803 40† 70† 20† 2,090† 10† 570† ---in Maricopa County 1,491 167 369 95 557 21 282 366 33 97 14 108 8 106 310† 27 20 8 201 * 52 860 74 130 17 423 7 209 3,027 301 616 134 1,289 40† 649 Hopi Tribe Pascua Yaqui Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe Resided off reservation White nonHispanic ---in Pima County ---in Coconino County ---elsewhere in Arizona TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 23 4.5 AGE OF FATHER (2011 STATUS) ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation 0† 120† 330† 1,320† 1,210† 850† 520† 220† Unknown 55+ 50-54 45-49 40-44 35-39 30-34 25-29 20-24 30† 10† 1,150† 10† 0 * * * * 0 0 0 0 0 0 * Cocopah Tribe 10† 0 0 * * 7 * 0 0 0 0 0 * Colorado River Indian Tribe 30† 0 * * * 8 * * * 0 0 0 11 Fort McDowell Yavapai Nation Reservation 20† 0 0 * * * * 0 * 0 0 0 6 Fort Mojave Indian Tribe 10† 0 0 0 * * * * * 0 0 0 * Gila River Indian Community 70† 0 7 * 18 11 6 * * 0 0 * 21 Havasupai Tribe 10† 0 0 0 * * 0 * * 0 0 0 * 200† 0 10 14 62 35 29 18 * * 0 * 31 Hualapai Tribe 40† 0 0 * 9 11 * * * * 0 0 8 Navajo Nation 1,460† 0 19 87 317 309 229 161 78 23 12 * 225 Pascua Yaqui Tribe 60† 0 * * 7 12 * * * 0 0 0 26 Salt River Pima-Maricopa Indian Community 120† 0 * 8 34 19 17 10 * 0 0 * 26 San Carlos Apache Tribe 280† * 9 15 78 48 26 11 8 * * 0 77 Tohono O'Odham Nation 160† 0 * 15 23 24 17 8 * * 0 0 58 White Mountain Apache Tribe 310† 0 17 24 89 61 33 21 12 * 0 0 44 10† 0 0 0 * * 0 0 0 0 * 0 * 0† 0 0 0 * 0 0 0 0 0 0 0 * 2,803 0† 70† 180† 660† 550† 380† 240† 120† 40† 20† 10† 550† 1,490† 0 16 70 332 350 259 138 51 14 * 0 257 ---in Pima County 370† 0 6 12 75 73 60 28 * * 0 0 103 ---in Coconino County 310† 0 10 12 66 67 54 37 10 * 0 * 48 ---elsewhere in Arizona 860† 0 17 56 183 165 104 76 38 14 11 * 194 3,027 0 49 150 656 655 477 279 100† 40† 20† 0† 602 Yavapai-Apache Nation Yavapai-Prescott Indian Tribe TOTAL Resided off reservation 18-19 80† Ak-Chin Indian Community Hopi Tribe 5,830 <15 TOTAL BIRTHS 15-17 Father's age group ---in Maricopa County TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 24 Health Status Profile of American Indians in Arizona, 2011 Data Book 4.6 SOURCE OF PAYMENT FOR LABOR AND DELIVERY (2011 STATUS) TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation Private insurance IHS AHCCCSa Self Unknown 5,830 3,440† 1,570† 730† 50† 50† Ak-Chin Indian Community 10† 11 0 * 0 0 Cocopah Tribe 10† 9 * 0 * 0 Colorado River Indian Tribe 30† 13 15 * * * Fort McDowell Yavapai Nation Reservation 20† * 0 11 * 0 Fort Mojave Indian Tribe 10† 6 * * 0 0 Gila River Indian Community 70† 48 13 10 * 0 Havasupai Tribe 10† * * * * 0 200† 66 134 * 0 * Hualapai Tribe 40† 22 * 8 * 0 Navajo Nation 1,460† 736 674 48 * * 60† 50 10 * 0 0 Salt River Pima-Maricopa Indian Community 120† 82 16 19 * * San Carlos Apache Tribe 280† 64 204 10 * * Tohono O'Odham Nation 155 100 29 26 0 0 310† 217 79 8 0 * 10† 6 0 * 0 0 0† * 0 * 0 0 2,803 1,440† 1,190† 150† 20† 10† 1,490† 976 145 348 18 * ---in Pima County 370† 241 45 74 * * ---in Coconino County 310† 209 56 43 0 * 860 579 134 108 11 28 3,027 2,005 380 573 30† 40† Hopi Tribe Pascua Yaqui Tribe White Mountain Apache Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe TOTAL Resided off reservation Payee for births ---in Maricopa County ---elsewhere in Arizona TOTAL a Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; The Arizona Health Care Cost Containment System (AHCCCS) is the State's Medicaid program. Health Status Profile of American Indians in Arizona, 2011 Data Book 25 MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Health Status Profile of American Indians in Arizona, 2011 Data Book 27 4.7 MATERNAL WEIGHT GAIN DURING PREGNANCY (2011 STATUS) TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation 1-15 pounds None 16-20 pounds 21-24 pounds 25-30 pounds 31+ pounds Unknown 5,830 190† 1,100† 780† 440† 1,200† 1,940† 180† Ak-Chin Indian Community 10† * * * * * * 0 Cocopah Tribe 10† 0 * * * * * * Colorado River Indian Tribe 30† * 17 * * * * 0 Fort McDowell Yavapai Nation Reservation 20† 0 * * 0 * 9 0 Fort Mojave Indian Tribe 10† 0 * * 0 0 * 0 Gila River Indian Community 70† * 13 7 * 20 23 * Havasupai Tribe 10† * * * 0 * * 0 200† 14 44 33 10 46 54 * Hualapai Tribe 40† * 11 10 * 9 * 0 Navajo Nation 1,464 42 355 195 131 268 419 54 60† 8 14 * * 15 15 0 Salt River Pima-Maricopa Indian Community 120† * 23 17 15 14 43 * San Carlos Apache Tribe 280† * 37 55 16 81 88 * Tohono O'Odham Nation 160† 10 33 19 15 24 49 * White Mountain Apache Tribe 306 9 50 44 24 63 82 34 Yavapai-Apache Nation 10† * 0 * 0 * * 0 0† 0 0 * 0 * * 0 TOTAL 2,803 100† 610† 400† 230† 560† 800† 110† ---in Maricopa County 1,491 30 232 197 111 295 592 34 366 22 64 42 22 74 135 7 310† 7 34 48 22 87 110 * 860 35 165 90 53 184 305 28 3,027 94 495 377 208 640 1,142 70† Hopi Tribe Pascua Yaqui Tribe Yavapai-Prescott Indian Tribe Resided off reservation Weight gain ---in Pima County ---in Coconino County ---elsewhere in Arizona TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 28 Health Status Profile of American Indians in Arizona, 2011 Data Book 4.8 MEDICAL RISK FACTORS OF PREGNANCY (2011 STATUS) Resided on reservation 60† 40† 10† Other Incompetent cervix Uterine bleeding RH sensitization Renal disease Previous SGA infant Previous infant 4000+g Eclampsia Pregnancy associated hypertension Chronic hypertension Hemoglobinopathy Hydramnios Genital herpes Diabetes Lung disease Cardiac disease 2,590† 350† 10† 70† 540† 40† 110† 0† 70† 370† 80† 1 30† 1 1,730† Ak-Chin Indian Community 13 6 * 0 * * * 0 0 0 * 0 0 0 0 0 * 0 * Cocopah Tribe 11 * * 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 * Colorado River Indian Tribe 28 6 * 0 0 * 0 0 0 * * 0 0 0 0 0 0 0 * Fort McDowell Yavapai Nation Reservation 15 10 * 0 0 * 0 0 0 * 0 0 0 0 0 0 0 0 9 Fort Mojave Indian Tribe 7 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * Gila River Indian Community 59 32 * 0 * 6 * * 0 * * 0 0 0 0 0 0 0 19 Havasupai Tribe 16 * 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 * Hopi Tribe 226 56 7 * 0 14 0 * 0 0 12 * * 0 0 0 0 0 27 Hualapai Tribe 24 * 0 0 0 * 0 0 0 * 0 * 0 0 0 0 0 0 0 Navajo Nation 1,460 651 87 * 7 144 * 28 * 21 97 10 23 17 * 0 7 0 373 41 38 0 0 0 7 0 * 0 0 11 6 0 0 0 0 0 0 33 Pascua Yaqui Tribe Salt River Pima-Maricopa Indian Community 117 79 10 0 * 24 0 * 0 * 10 * 7 0 0 0 0 0 59 San Carlos Apache Tribe 271 120 28 0 * 19 * * 0 * 23 * 0 * 0 0 * 0 86 Tohono O'Odham Nation 166 94 * 0 0 15 0 * 0 * 12 12 0 0 0 0 0 0 81 White Mountain Apache Tribe 327 139 11 * * 26 * * 0 * 16 0 0 0 * 0 * 0 103 2 * 0 0 0 * 0 0 0 0 * 0 0 0 0 0 0 0 * * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 10† 0 800† Yavapai-Apache Nation Yavapai-Prescott Indian Tribe Resided off reservation 5,830 Anemia Births with medical risk factors TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Medical risk factorsa 5 TOTAL 2,803 ---in Maricopa County 1,240† 150† 0† 20† 260† 10† 50† 0† 40† 190† 40† 40† 20† 10† 1,498 792 141 6 28 160 21 43 0 24 89 15 20 19 0 0 8 * 578 ---in Pima County 350 213 17 0 0 33 * 7 0 * 27 16 0 0 0 0 * 0 173 ---in Coconino County 288 76 * 0 * 26 * * 0 * 31 * 0 0 0 0 0 0 21 268 32 * 23 63 7 9 0 6 31 * * * 0 * * 0 160 282 30† 60† 0 0† 10† 0† 932 ---elsewhere in Arizona TOTAL 891 3,027 1,349 190† 10† 50† Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; factors as each birth may be associated with multiple medical risk factors. Health Status Profile of American Indians in Arizona, 2011 Data Book a 0 30† 178 40† 20† 20† Medical risk factors do not sum to the number of births with medical risk 29 4.9 SUBSTANCE USE DURING PREGNANCY (2011 STATUS) Substance use TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation Ak-Chin Indian Community Smoker, nondrinker Smoker and drinker Nonsmoker and nondrinker 5,815 50† 110† 30† 5,640† 12 0 0 0 12 10† 0 * 0 12 Colorado River Indian Tribe 32 0 0 0 32 Fort McDowell Yavapai Nation Reservation 15 0 0 0 15 Fort Mojave Indian Tribe 10 0 0 0 10 70† * * * 71 9 0 0 0 9 200† * 0 0 202 Hualapai Tribe 40† * 0 0 35 Navajo Nation 1,464 7 14 6 1,437 60† 0 0 * 60 Salt River Pima-Maricopa Indian Community 120† * * * 114 San Carlos Apache Tribe 280† 7 * * 266 Tohono O'Odham Nation 160† * * 0 152 White Mountain Apache Tribe 310† 13 6 * 283 10† * * 0 * 0† * 0 0 * TOTAL 2,803 40† 30† 20† 2,720† ---in Maricopa County 1,491 10 40 10 1,431 ---in Pima County 370† * 8 * 355 ---in Coconino County 310† * * 0 305 ---elsewhere in Arizona 860† * 23 * 828 3,027 20† 80† 20† 2,919 Cocopah Tribe Gila River Indian Community Havasupai Tribe Hopi Tribe Pascua Yaqui Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe Resided off reservation Drinker, nonsmoker TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 30 Health Status Profile of American Indians in Arizona, 2011 Data Book Utilization of Medical Services Health Status Profile of American Indians in Arizona, 2011 Data Book 31 4.10 TRIMESTER OF PREGNANCY PRENATAL CARE BEGAN (2011 STATUS) TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation 1st trimester No care 2nd trimester 3rd trimester Unknown 5,830† 140† 4,000† 1,290† 350† 40† Ak-Chin Indian Community 10† 0 11 * 0 0 Cocopah Tribe 10† * * 6 * 0 Colorado River Indian Tribe 30† 0 18 10 * 0 Fort McDowell Yavapai Nation Reservation 20† * 7 * * * Fort Mojave Indian Tribe 10† 0 8 * * 0 Gila River Indian Community 70† * 57 8 * 0 Havasupai Tribe 10† 0 8 * 0 0 200† * 132 58 10 0 Hualapai Tribe 40† 0 31 * 0 0 Navajo Nation 1,460† 30 1,004 337 91 * 60† * 47 7 * 0 Salt River Pima-Maricopa Indian Community 120† * 61 39 10 * San Carlos Apache Tribe 280† 13 156 79 31 * Tohono O'Odham Nation 155 8 88 48 11 0 310† * 191 85 22 * 10† 0 * 0 * 0 0† 0 * * 0 0 2,800† 70† 1,830† 690† 190† 20† 1,491 30 1,103 276 76 6 ---in Pima County 370† 12 242 84 25 * ---in Coconino County 310† * 251 50 6 0 860 25 576 193 52 14 3,027 70† 2,172 603 159 20† Hopi Tribe Pascua Yaqui Tribe White Mountain Apache Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe TOTAL Resided off reservation Prenatal care ---in Maricopa County ---elsewhere in Arizona TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 32 Health Status Profile of American Indians in Arizona, 2011 Data Book 4.11 NUMBER OF PRENATAL VISITS (2011 STATUS) TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation No visits 1-4 visits 5-8 visits 9-12 visits 13+ visits Unknown 5,830 140† 530† 1,460† 2,510† 1,150† 40† Ak-Chin Indian Community 10† 0 0 * 9 * 0 Cocopah Tribe 10† * * * * * 0 Colorado River Indian Tribe 30† 0 6 10 6 9 * Fort McDowell Yavapai Nation Reservation 20† * * * * * * Fort Mojave Indian Tribe 10† 0 0 * * * 0 Gila River Indian Community 70† * * 13 44 8 0 Havasupai Tribe 10† 0 * * * * 0 200† * 17 63 77 43 0 Hualapai Tribe 36 0 6 8 14 8 0 Navajo Nation 1,460† 30 120 353 643 315 * 60† * * 14 23 16 0 Salt River Pima-Maricopa Indian Community 120† * 17 31 43 19 * San Carlos Apache Tribe 280† 13 65 91 76 33 * Tohono O'Odham Nation 155 8 19 58 50 20 0 310† * 47 118 111 22 * 10† 0 * 0 * * 0 0† 0 0 * * * 0 TOTAL 2,803 70† 320† 770† 1,120† 500† 20† ---in Maricopa County 1,491 30 104 315 708 327 7 ---in Pima County 370† 12 34 113 136 67 * ---in Coconino County 310† * 20 66 142 79 0 860 25 51 192 407 174 11 3,027 70† 209 686 1,393 647 20† Hopi Tribe Pascua Yaqui Tribe White Mountain Apache Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe Resided off reservation Prenatal visits ---elsewhere in Arizona TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 33 4.12 OBSTETRIC PROCEDURES (2011 STATUS) 5,240† 1,110† 970† 50† 4,040† 540† Resided on reservation Ak-Chin Indian Community 12 0 12 * * 0 12 8 Cocopah Tribe 14 0 14 * * 0 14 0 Colorado River Indian Tribe 32 0 30 * 0 * 13 * Fort McDowell Yavapai Nation Reservation 15 0 15 * * 0 12 0 Fort Mojave Indian Tribe 10 0 9 * * 0 10 0 Gila River Indian Community 74 * 70 12 11 0 52 22 Havasupai Tribe Other Tocolysis 9 0 9 * * 0 0 0 204 * 189 31 41 * 82 * Hualapai Tribe 36 0 36 13 17 0 * 0 Navajo Nation 1,464 8 1,365 265 237 13 788 64 61 0 60 14 * 0 61 12 Salt River Pima-Maricopa Indian Community 119 * 115 13 26 0 113 * San Carlos Apache Tribe 282 * 203 29 32 13 99 49 Tohono O'Odham Nation 155 0 144 28 6 0 142 43 White Mountain Apache Tribe 306 * 204 48 56 * 293 * Yavapai-Apache Nation 7 0 6 * * 0 7 0 Yavapai-Prescott Indian Tribe * 0 * * * 0 * 0 TOTAL 2,803 20† 2,480† 480† 440† 30† 1,710† 210† ---in Maricopa County 1,498 30 1,401 307 310 15 1,158 97 ---in Pima County 350 * 356 76 30 * 344 79 ---in Coconino County 288 * 288 85 99 0 240 * ---elsewhere in Arizona 891 6 708 167 94 * 589 150 3,027 40† 2,753 635 533 20† 2,331 330† Hopi Tribe Pascua Yaqui Tribe Resided off reservation Ultrasound 60† ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Stimulation of labor Induction of labor 5,830 TOTAL BIRTHS Amniocentesis Electronic Fetal Monitor Obstetric proceduresa TOTAL a Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; Obstetric procedures do not sum to the number of total births as each birth may be associated with multiple obstetric procedures. 34 Health Status Profile of American Indians in Arizona, 2011 Data Book Resided on reservation 10† Other 20† Fetal distress Anesthetic complic. Cord prolapse 80† 190† 150† Cephalopelvic disp. 0† 110† Breech malpresentation Dysfunctional labor Prolonged labor 60† Precipitous labor 20† Seizures Other bleeding Rupture of membrane Meconium 30† 0† 280† 740† Ak-Chin Indian Community 12 * 0 0 0 0 0 * 0 * 0 0 0 0 0 0 * * Cocopah Tribe 14 7 0 * * 0 0 * 0 * 0 0 0 0 0 0 0 * Colorado River Indian Tribe 32 6 0 * 0 0 0 * 0 0 0 0 * 0 0 0 * * Fort McDowell Yavapai Nation Reservation 15 * * * 0 0 0 0 0 * 0 0 * 0 0 0 * 0 Fort Mojave Indian Tribe 10 * 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 * Gila River Indian Community 74 29 * 6 0 0 * * 0 * * 0 * 0 0 0 10 14 Havasupai Tribe 9 * 0 0 0 0 0 * 0 * 0 0 0 0 0 0 0 0 204 65 6 14 6 0 0 7 0 6 7 18 8 * * 0 12 13 Hualapai Tribe 36 * 0 * 0 0 0 0 0 0 0 0 * 0 0 0 * 0 Navajo Nation 1,464 473 38 49 82 15 6 22 0 38 30 104 50 7 * 0 40 149 Hopi Tribe Pascua Yaqui Tribe Resided off reservation 1,730 110† 220† 180† Placenta previa 5,830 Abruptio placenta ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Complications of labor and/or deliverya Febrile TOTAL BIRTHS Births with complications of labor and or delivery 4.13 COMPLICATIONS OF LABOR AND DELIVERY (2011 STATUS) 61 22 0 * * * * 0 0 * 0 * * 0 0 0 * 15 Salt River Pima-Maricopa Indian Community 119 23 * * 0 0 * * 0 * 0 * * 0 0 0 * 7 San Carlos Apache Tribe 282 100 * 9 * * 0 * 0 13 * 0 6 * * 0 20 53 Tohono O'Odham Nation 155 50 * 8 * 0 0 0 0 * * * * 0 0 0 * 36 White Mountain Apache Tribe 306 86 0 * * 0 0 * * 0 * 0 6 0 0 0 * 75 Yavapai-Apache Nation 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Yavapai-Prescott Indian Tribe * * 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 * TOTAL 2,803 880† 50† 100† 100† 20† 10† 40† 0† 70† 40† 130† 90† 10† 0† ---in Maricopa County 0 110† 370† 1,498 463 37 75 48 * * 10 * 20 20 47 35 7 * * 106 162 ---in Pima County 350 122 * 16 7 * 0 * 0 * * 6 * * 0 0 9 83 ---in Coconino County 288 56 * 13 12 * * * 0 * 8 * 7 * 0 0 7 9 ---elsewhere in Arizona 891 212 16 18 18 * * 7 0 9 * 11 13 * * 0 55 112 3,027 853 60† 122 85 10† 10† 20† 0† 40† 40† 70† 60† 10† 10† 0† 177 366 TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; of labor and/or delivery as each birth may be associated with multiple complications. Health Status Profile of American Indians in Arizona, 2011 Data Book a Complications of labor and/or delivery do not sum to the sum of births with complications 35 4.14 METHOD OF DELIVERY (2011 STATUS) TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation Vaginal after C-Section Vaginal Primary C- Repeat CSection Section Forceps Vacuum 5,830 4,350† 130† 670† 680† 30† 100† Ak-Chin Indian Community 12 8 0 0 * 0 0 Cocopah Tribe 14 11 0 * * 0 0 Colorado River Indian Tribe 32 17 * 6 8 0 0 Fort McDowell Yavapai Nation Reservation 15 10 0 * * * * Fort Mojave Indian Tribe 10 6 0 * * 0 * Gila River Indian Community 74 53 0 13 8 * 0 9 * 0 0 * * 0 204 159 8 22 12 * * Hualapai Tribe 36 30 0 * * 0 * Navajo Nation 1,464 1,138 66 135 123 * 15 61 50 * 8 * 0 * Salt River Pima-Maricopa Indian Community 119 78 * 17 22 * * San Carlos Apache Tribe 282 205 * 31 43 * 11 Tohono O'Odham Nation 155 129 * 12 12 0 * White Mountain Apache Tribe 306 239 * 19 46 6 19 Yavapai-Apache Nation 7 * 0 * * 0 0 Yavapai-Prescott Indian Tribe * * 0 * 0 0 * 2,800† 2,140† 80† 270† 300† 20† 60† 1,491 1,078 29 200 184 6 21 ---in Pima County 366 272 7 49 38 * 6 ---in Coconino County 310 250 6 30 24 * * ---elsewhere in Arizona 860 603 * 115 137 * 10 3,027 2,203 50† 394 383 10† 40† Havasupai Tribe Hopi Tribe Pascua Yaqui Tribe TOTAL Resided off reservation Method of deliverya ---in Maricopa County TOTAL a Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; Method of delivery does not sum to the number of total births as each birth may be associated with multiple methods of delivery. 36 Health Status Profile of American Indians in Arizona, 2011 Data Book 4.15 ATTENDANT AT BIRTH (2011 STATUS) TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation C.N.M Midwife D.O. Unknown Other 5,830 3,650† 1,580† 40† 540† 20† 0† Ak-Chin Indian Community 10† 8 * 0 * 0 0 Cocopah Tribe 10† 13 * 0 0 0 0 32 13 0 0 19 0 0 Fort McDowell Yavapai Nation Reservation 20† 13 0 0 * 0 0 Fort Mojave Indian Tribe 10† 8 0 0 * 0 0 Gila River Indian Community 70† 62 * 0 11 0 0 Havasupai Tribe 10† 6 * 0 * 0 0 200† 87 106 * 6 0 0 Hualapai Tribe 36 24 0 0 12 0 0 Navajo Nation 1,464 443 938 19 58 6 0 61 49 12 0 0 0 0 Salt River Pima-Maricopa Indian Community 120† 96 19 * * 0 * San Carlos Apache Tribe 280† 191 * 0 84 6 0 Tohono O'Odham Nation 160† 152 * 0 0 0 0 White Mountain Apache Tribe 310† 218 * 0 84 * 0 7 7 0 0 0 0 0 0† * 0 0 0 0 0 2,803 1,390† 1,090† 30† 280† 10† 0† 1,490† 1,052 343 * 92 * 0 ---in Pima County 370† 336 28 * * 0 0 ---in Coconino County 310† 240 43 * 21 0 * ---elsewhere in Arizona 860† 627 83 9 139 * 0 3,027 2,255 497 20† 250† 0† 0† Colorado River Indian Tribe Hopi Tribe Pascua Yaqui Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe TOTAL Resided off reservation M.D. ---in Maricopa County TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 37 Newborn’s Health Health Status Profile of American Indians in Arizona, 2011 Data Book 39 4.16 GESTATIONAL AGE (2011 STATUS) Length of gestation TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation 37-41 weeks 42+ weeks Unknown 5,830 530† 5,240† 50† 10† Ak-Chin Indian Community 10† * 11 0 0 Cocopah Tribe 10† * 13 0 0 Colorado River Indian Tribe 30† * 28 0 * Fort McDowell Yavapai Nation Reservation 20† * 11 0 * 10 0 10 0 0 70† * 70 0 0 9 0 9 0 0 200† 16 183 * 0 Hualapai Tribe 36 6 30 0 0 Navajo Nation 1,460† 103 1,335 23 * 61 9 52 0 0 Salt River Pima-Maricopa Indian Community 120† 17 100 * * San Carlos Apache Tribe 280† 40 240 * * Tohono O'Odham Nation 155 18 137 0 0 310† 38 264 * * 10† * 6 0 0 0† 0 * 0 0 TOTAL 2,803 260† 2,500† 30† 10† ---in Maricopa County 1,491 139 1,341 11 0 ---in Pima County 370† 24 340 * * ---in Coconino County 310† 27 279 * 0 ---elsewhere in Arizona 860† 77 781 * 0 3,027 267 2,741 20† 0† Fort Mojave Indian Tribe Gila River Indian Community Havasupai Tribe Hopi Tribe Pascua Yaqui Tribe White Mountain Apache Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe Resided off reservation <37 weeks TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 40 Health Status Profile of American Indians in Arizona, 2011 Data Book 4.17 WEIGHT AT BIRTH (2011 STATUS) TOTAL BIRTHS ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation <1,000 grams 1,0001,499 1,5002,499 2,5003,999 4000+ Unknown 5,830 40† 40† 330† 4,890† 540† 0† Ak-Chin Indian Community 10† 0 0 * 9 * 0 Cocopah Tribe 10† * 0 0 13 0 0 Colorado River Indian Tribe 30† 0 * * 24 * 0 Fort McDowell Yavapai Nation Reservation 20† 0 * * 11 * 0 Fort Mojave Indian Tribe 10† 0 0 0 8 * 0 Gila River Indian Community 70† 0 0 * 62 8 0 9 0 0 0 9 0 0 200† 0 * 15 176 11 0 Hualapai Tribe 40† * * * 29 * 0 Navajo Nation 1,460† 8 * 75 1,268 109 0 Pascua Yaqui Tribe 60† 0 * 6 47 6 0 Salt River Pima-Maricopa Indian Community 119 0 0 7 89 23 0 San Carlos Apache Tribe 280† * * 16 237 25 0 Tohono O'Odham Nation 155 0 0 11 129 15 0 310† * * 32 254 13 0 10† 0 0 * * * 0 0† 0 0 0 * 0 0 TOTAL 2,803 20† 20† 170† 2,370† 220† 0 ---in Maricopa County 1,491 8 10 73 1,235 165 0 ---in Pima County 370† * * 14 307 41 0 ---in Coconino County 310† * * 22 259 24 0 ---elsewhere in Arizona 860† 9 * 48 716 81 * 3,030† 20† 20† 157 2,517 311 0† Havasupai Tribe Hopi Tribe White Mountain Apache Tribe Yavapai-Apache Nation Yavapai-Prescott Indian Tribe Resided off reservation Weight at birth TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 41 ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation Other Newborn seizures Assisted vent. >30 min. Assisted vent.<30 min Meconium aspiration Membrane disease Fetal Alcohol Syndrome Birth injury 5,830 411 0† 0† 0 10† 10† 20† 10† 10† 370† Ak-Chin Indian Community 12 * 0 0 0 0 0 0 0 0 * Cocopah Tribe 14 * 0 0 0 0 0 0 * 0 * Colorado River Indian Tribe 32 * 0 0 0 * 0 * 0 0 * Fort McDowell Yavapai Nation Reservation 15 * 0 0 0 0 0 0 0 0 * Fort Mojave Indian Tribe 10 * 0 0 0 0 0 0 * 0 0 Gila River Indian Community 74 16 0 0 0 0 * 0 0 0 15 9 0 0 0 0 0 0 0 0 0 0 Havasupai Tribe Hopi Tribe 204 7 * 0 0 0 * * * 0 * Hualapai Tribe 36 * 0 0 0 0 * 0 0 0 * Navajo Nation 1,464 35 * * 0 * * * * * 23 Pascua Yaqui Tribe Resided off reservation Abnormal conditionsa Anemia TOTAL BIRTHS Births with abnormal conditions of the newborn 4.18 ABNORMAL CONDITIONS OF THE NEWBORN (2011 STATUS) 61 6 0 0 0 0 0 0 0 0 6 Salt River Pima-Maricopa Indian Community 119 0 0 0 0 0 0 0 0 0 0 San Carlos Apache Tribe 282 31 * 0 0 0 0 * * 0 28 Tohono O'Odham Nation 155 7 0 0 0 0 0 0 0 0 7 White Mountain Apache Tribe 306 36 0 0 0 0 0 0 0 0 36 Yavapai-Apache Nation 7 0 0 0 0 0 0 0 0 0 0 Yavapai-Prescott Indian Tribe * 0 0 0 0 0 0 0 0 0 0 TOTAL 2,803 150† 0† 0† 0 0† 0† 10† 10† 0† 130† ---in Maricopa County 1,491 125 * 0 0 * * * * 0 118 ---in Pima County 366 16 0 0 0 0 * * 0 0 15 ---in Coconino County 310 * 0 0 0 0 0 0 0 0 * ---elsewhere in Arizona TOTAL 860 114 0 0 0 * * 8 * * 103 3,027 260† 0† 0 0 10† 10† 10† 0† 0† 240† Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; a Abnormal conditions do not sum to the number of births with abnormal conditions of the newborn as each birth may be associated with multiple abnormal conditions. 42 Health Status Profile of American Indians in Arizona, 2011 Data Book 4.19 CONGENITAL ANOMALIES / BIRTH DEFECTS (2011 STATUS) a ALL AMERICAN INDIAN RESIDENTS OF ARIZONA 5,830 84 0 0† 0 0† 12 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 Colorado River Indian Tribe 32 0 0 0 0 0 0 Fort McDowell Yavapai Nation Reservation 15 * 0 0 0 0 Fort Mojave Indian Tribe 10 * 0 0 0 0 Gila River Indian Community 74 * 0 0 0 9 0 0 0 0 Resided on Ak-Chin Indian Community reservation Cocopah Tribe Havasupai Tribe Hopi Tribe 0 10† 10† 0† 0† 0† 0† 0 0† 10† 10† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† 10† Other Other chromosomal Down's syndrome Other muscosceletal Diaphragmatic hernia Club foot Cleft lip/palate 0† Polydactyly/ syndactyly/ adactyly Other urogenital Renal agenesis Malformed genitalia Other gastrointestinal Tracheo-esophageal fistula / esophageal Omphalocele/ gastroschisis Rectal atresia/ stenosis Other respiratory/ circulatory Heart malformations Other CNS anomaly Microcephalus Hydrocephalus Spina bifida/ meningocele Anencephalus TOTAL BIRTHS Births with congenital anomalies Congenital anomalies 0† 0 0† 50† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 * 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 204 * 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 * Hualapai Tribe 36 * 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Navajo Nation 1,464 23 0 * 0 0 0 * * * 0 0 0 0 0 0 * * * 0 0 * * 13 Pascua Yaqui Tribe Salt River Pima-Maricopa Indian Community San Carlos Apache Tribe 61 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 * 119 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 282 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * Tohono O'Odham Nation 155 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * White Mountain Apache Tribe 306 8 0 0 0 0 0 * * 0 0 * 0 0 0 0 * 0 0 0 0 0 0 * 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0† 0† 0 0† 0 0† 0 0 10† 0† 0† 0 0† 0† Yavapai-Apache Nation Yavapai-Prescott Indian Tribe * 0 0 0 0 0 2,800† 20 0 0† 0 0† Resided off ---in Maricopa County reservation ---in Pima County 1,491 17 0 0 0 0 0 0 * * * 0 * 0 0 * 0 * 0 0 * * 0 10 366 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 9 ---in Coconino County 310 * 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 * 860 11 0 0 0 0 0 0 * 0 0 * 0 0 0 0 * * 0 0 0 0 0 6 3,027 40† 0 0 0 0 0 0 10† 0† 0† 0† 0† 0 0 0† 0† 0† 0 0 0† 0† TOTAL ---elsewhere in Arizona TOTAL Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; congenital anomalies as each birth may be associated with multiple congenital anomalies. Health Status Profile of American Indians in Arizona, 2011 Data Book a 0† 30† 0 30† Congenital anomalies do not sum to the number of births with 43 4.20 CAUSES OF INFANT DEATHS AMONG AMERICAN INDIAN RESIDENTS, ARIZONA, 2011 10† 10† 30† 10† 0† 0† 2 10† 20† * * * 0 * * * * 20† * 0 0 0 0† Maternal complications 0† 0 0 0 0 * 0 0 0 0† * 0 0 0 0† Complications of placenta, cord and membrane 0† 0 0 0 0 0 0 0 * 0† 0 0 0 0 0 7 * 0 0 0 * * * * 10† 0 0 0 0 0 0† 0 0 0 0 0 0 * 0 0† 0 0 0 0 0 10† 0 0 0 0 * 0 0 0 0† * * 0 0 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 of brain, spinal cord or nervous system 0† 0 0 0 0 * 0 0 0 0† 0 0 0 0 0 other malformation 0† 0 0 0 0 * 0 0 0 0† 0 0 0 0 0 Sudden infant death syndrome 0† 0 0 0 0 * 0 0 0 0† 0 0 * 0 0† Accidents (unintentional injury) 0† 0 0 0 * 0 0 0 * 0† * 0 0 0 0† Influenza and pneumonia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Diseases of the digestive system 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Infectious and parasitic diseases 0† 0 0 0 0 * 0 0 0 0† 0 0 0 0 0 Diseases of the nervous system 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Choked on food 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Mechanical suffocation 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Drug poisoning, undetermined intent 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Certain conditions originating in the perinatal period Short gestation and low birth weight Bacterial sepsis of newborn Congenital malformations of circulatory system Navajo Nation Hualapai Tribe Cocopah Tribe Total 0† ---elsewhere in Arizona 20† ---in Pima County 0† Salt River PimaMaricopa Indian Community San Carlos Apache Tribe 0† Pascua Yaqui Tribe 0† Havasupai Tribe 0† Total, all causes Gila River Indian Community 43 TOTAL STATE ---in Maricopa County ---in Coconino County Resided off reservation Total Resided on reservation Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 44 Health Status Profile of American Indians in Arizona, 2011 Data Book Total births Mother's age group 50† 1,690† Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee 200† 110† 0† 90† 980† 578 380† 0 50† * * 0 0 0 * 0 * 0 * 0 0 0 293 30 0 45 23 8 0 * 60 * 65 30 21 0 * * 60† 18-19 680 90 0 74 27 16 0 7 184 * 135 76 58 0 * * 20-24 1,924 262 7 255 74 38 0 18 540 37 307 205 136 0 21 24 25-29 1,463 215 * 205 41 31 * 16 446 27 220 144 97 0 * 15 30-34 899 152 * 115 17 9 0 * 297 11 154 74 47 0 8 9 35-39 461 97 * 68 10 6 0 * 132 * 73 38 17 0 * * 40-44 92 20 0 6 * * 0 0 20 0 22 11 * 0 * 0 * * 0 0 0 0 0 0 * 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 AHCCCS 3,444 454 8 353 57 20 * 21 1,099 58 636 389 277 0 29 42 IHS 1,565 369 * 344 127 83 0 25 171 * 301 83 46 0 * * 726 21 7 69 11 * 0 * 388 17 32 100 55 0 12 8 Self 49 * 0 * * * 0 * 22 * 0 * * 0 * * Unknown 46 23 0 * * * 0 * * * 10 * * 0 0 0 0 <8 34 * 0 * * * 0 * 9 0 * * * 0 0 114 * 0 7 * 0 0 0 56 * 8 19 13 0 0 * 9-11 1,396 116 * 135 77 38 0 17 379 27 259 168 152 0 10 17 12 2,340 357 7 362 75 50 0 22 558 41 446 214 150 0 26 32 13-16 1,721 332 6 232 39 19 * 8 608 15 243 142 60 0 10 6 161 33 * 22 * * 0 * 57 0 13 25 * 0 * * 0 8 17+ Unknown 64 23 0 7 0 0 0 * 18 * 7 6 0 0 0 Married 1,255 187 11 184 34 26 0 * 395 17 209 101 71 0 10 7 Unmarried 4,494 672 * 575 161 81 * 48 1,255 65 759 472 311 0 37 52 Otherb 81 11 0 11 * * 0 0 35 * 11 * * 0 0 0 192 20 0 30 * * 0 * 36 * 36 40 17 0 * * 1,100 230 * 125 23 17 0 25 267 21 202 111 63 0 * 9 781 138 * 105 38 19 0 * 221 17 120 65 37 0 8 6 6 None 1-15 pounds 16-20 pounds 21-24 pounds 435 81 * 56 16 * 0 * 128 * 73 41 23 0 0 25-30 pounds 1,198 127 6 197 55 32 * * 327 14 214 113 89 0 12 6 31+ pounds 1,944 235 * 241 63 34 0 11 663 25 279 197 146 0 19 26 * Unknown Substance use Graham 770† 0 Private insurance Weight gain Gila 20† * Unknown Marital status Coconino 870† 14 45+ Mother's education Cochise 5,815 <15 15-17 Payee for births Apache Total State 4.21 COMPARISON OF SELECTED CHARACTERISTICSa OF AMERICAN INDIAN NEWBORNS AND WOMEN GIVING BIRTH BY COUNTY OF RESIDENCE, ARIZONA, 2011 180 39 0 16 * * 0 * 43 0 55 11 8 0 * Drinker, nonsmoker 54 6 0 * * * 0 0 13 * 18 * * 0 * 0 Smoker, nondrinker 107 9 * 6 * * 0 0 44 * 12 8 11 0 * * 0 12 0 6 * * 0 0 0 51 1,616 81 943 564 366 0 43 54 Smoker and drinker Nonsmoker and nondrinker 33 * 0 * * * 0 5,636 851 15 762 186 103 * Health Status Profile of American Indians in Arizona, 2011 Data Book 45 Length of gestation Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa 0 0 0 8 * 9 * * 0 0 * * 0 * 11 * 8 * * 0 0 0 329 43 * 49 13 * * * 85 * 74 30 23 0 * * 4,890 755 14 657 165 96 0 69 829 480 311 0 42 46 535 64 0 57 16 9 0 7 195 10 58 62 45 0 * 9 1,000-1,499 * * 0 0 0 0 0 0 0 0 * 0 0 0 0 0 1,500-2,499 527 60 * 58 30 11 * 9 164 10 91 50 34 0 * * 2,500-3,999 41 1,507 53 <1,000 grams 40 1,386 * 5,243 805 15 695 166 97 0 75 871 526 348 0 44 4000+ 50 * 0 16 * 0 0 0 12 0 14 * * 0 0 * Unknown 10 * 0 * 0 * 0 * * 0 * * 0 0 0 0 * No care 144 17 * 15 7 6 0 39 * 12 23 15 0 0 * 1st trimester 4,002 554 10 577 109 61 0 30 1,218 67 652 373 298 0 33 20 2nd trimester 1,292 225 * 150 54 33 * 14 324 11 239 139 62 0 8 29 3rd trimester 353 65 * 27 25 8 0 6 90 * 68 40 8 0 * 6 39 9 0 * * * 0 0 14 0 8 * 0 0 * 0 144 17 * 15 7 6 0 * 39 * 12 23 15 0 0 * No visits 1-4 visits 526 78 * 54 42 27 * 11 127 8 96 57 6 0 6 11 5-8 visits 1,459 224 * 167 58 41 0 16 360 16 302 184 59 0 9 21 9-12 visits 2,509 368 7 343 57 27 0 11 789 34 403 207 227 0 19 17 13+ visits 1,151 176 * 189 30 7 0 11 355 23 161 103 74 0 12 6 41 7 0 * * * 0 * 15 0 * * * 0 * 0 * 107 8 37 26 19 0 0 * 46 1,578 77 941 551 364 0 47 55 0 Yes No 253 16 0 16 11 * 0 5,574 854 16 753 186 105 * * 0 0 * 0 0 0 0 0 0 * * 0 0 0 59 * 0 6 * 0 0 * 34 * 8 * * 0 0 0 Electronic Fetal Monitoring 5,237 740 6 725 169 49 0 48 1,587 81 802 556 370 0 45 59 Induction of labor 1,110 144 * 177 25 6 0 * 336 32 165 117 74 0 19 10 972 106 * 190 27 7 0 * 349 25 179 37 29 0 9 9 49 8 0 * 10 * 0 * 15 * * * 0 0 0 0 4,037 457 15 480 48 67 * 22 1,321 38 588 543 355 0 43 59 Amniocentesis Tocolysis Ultrasound Other 46 La Paz * * Stimulation of labor Method of delivery Greenlee * 0 Unknown Obstetric procedures Graham * * Unknown Newborn intensive care Gila * 37 Unknown Prenatal visits Coconino 37 37-41 weeks Unknown Prenatal care Cochise <37 weeks 42+ weeks Weight at birth Apache Total State 4.21 (continued) COMPARISON OF SELECTED CHARACTERISTICSa OF AMERICAN INDIAN NEWBORNS AND WOMEN GIVING BIRTH BY COUNTY OF RESIDENCE, ARIZONA, 2011 535 45 0 8 * 56 * 4,347 685 8 627 148 77 0 Vaginal after C-Section 130 45 0 17 * * 0 * 30 Primary C-Section 667 77 * 61 20 12 * 12 229 Repeat C-Section 678 60 6 65 28 18 0 12 213 13 Vaginal 111 0 22 133 154 0 * 0 26 1,211 * 62 729 449 255 0 32 38 0 22 10 * 0 0 * 10 104 68 54 0 9 8 121 51 73 0 6 12 Forceps 30 * 0 * * 0 0 0 9 * 11 * 0 0 0 0 Vacuum 95 7 0 * 6 * 0 0 23 * 32 9 * 0 * 0 Health Status Profile of American Indians in Arizona, 2011 Data Book Births with medical risk factors Total Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise 2,593 327 3 222 85 31 1 12 882 4 360 282 163 1 24 12 348 53 0 30 21 8 0 * 155 0 37 20 21 0 0 * Cardiac disease 13 * 0 * 0 0 0 0 6 0 * 0 * 0 0 0 Lung disease 73 * 0 * * 0 0 0 32 0 10 0 21 0 0 0 544 73 0 72 9 10 0 * 190 * 89 55 29 0 * 7 42 * 0 * * 0 0 0 22 0 * * 7 0 0 0 107 17 0 8 * 0 0 0 47 0 12 13 6 0 0 0 * 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 Anemia Diabetes Genital herpes Hydramnios Hemoglobinopathy Chronic hypertension Pregnancy associated hypertension 70 7 0 9 * * 0 * 31 * 10 * * 0 0 * 366 49 0 60 19 6 0 * 101 0 57 50 17 0 * * Eclampsia 75 * 0 9 * * 0 * 19 * * 33 * 0 * 0 Previous infant 4000+g 56 12 0 6 0 0 0 0 27 0 10 0 * 0 0 0 Previous SGA infant 41 13 0 * * 0 0 0 19 0 * 0 * 0 0 0 7 * 0 * 0 0 0 0 0 0 * 0 0 0 0 0 RH sensitization * 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 Uterine bleeding 27 * * * * 0 0 0 8 0 7 * * 0 0 0 * 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 1,732 227 * 92 59 33 0 7 661 * 253 285 86 0 12 8 411 40 3 26 18 15 0 4 92 1 103 32 60 0 8 11 Anemia * * 0 * * 0 0 0 * 0 0 0 0 0 0 0 Birth injury * * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Fetal Alcohol Syndrome 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Membrane disease 10 0 0 * * 0 0 * * * 0 0 * 0 0 0 Meconium aspiration 10 * 0 0 0 0 0 0 * * * * * 0 0 0 Assisted vent.<30 min 24 0 0 * * * 0 8 * * * * 0 0 0 0 Assisted vent.>30 min. 12 * 0 * * 0 0 0 * * * 0 0 0 0 * * * 0 0 0 0 0 0 0 0 * 0 0 0 0 0 367 16 * 9 13 16 * * 132 * 51 27 83 0 * 7 84 4 0 4 4 0 0 0 3 2 7 10 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Spina bifida/meningocele * 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 Hydrocephalus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Microcephalus * 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 Other CNS anomaly 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Heart malformations * * 0 * 0 0 0 0 * 0 * 0 0 0 0 0 Other respiratory/circulatory 7 0 0 * 0 0 0 0 * 0 * 0 * 0 0 0 Rectal atresia/stenosis * 0 0 * 0 0 0 0 * 0 0 0 0 0 0 0 Renal disease Incompetent cervix Other Abnormal conditions of the newborn Apache Total State 4.21 (continued) COMPARISON OF SELECTED CHARACTERISTICSa OF AMERICAN INDIAN NEWBORNS AND WOMEN GIVING BIRTH BY COUNTY OF RESIDENCE, ARIZONA, 2011 Total Newborn seizures Other Births with congenital Total anomalies Anencephalus Health Status Profile of American Indians in Arizona, 2011 Data Book 47 Tracheo-esophageal fistula/esophageal atresia Omphalocele/gastroschisis Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 * 0 * 0 0 0 Other gastrointestinal * 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 Malformed genitalia * 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 Renal agenesis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Other urogenital * 0 0 * 0 0 0 0 * 0 0 0 0 0 0 0 10 * 0 * 0 0 0 0 * * * 0 0 0 0 0 * * 0 0 0 0 0 0 * * 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 51 1,685 85 979 578 383 0 47 59 Polydactyly/syndactyly/adactyly Club foot * 0 0 * 0 0 0 5,830 870 16 770 197 109 * Other muscosceletal * 0 0 0 0 0 0 0 * * 0 * 0 0 0 0 Down's syndrome * * 0 0 0 0 0 0 * 0 * * 0 0 0 0 Other chromosomal * * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 7 0 8 * * 0 0 11 * 8 11 0 0 0 0 1,730 232 6 185 76 30 0 6 499 6 282 162 99 0 21 22 Febrile 111 18 0 21 * 0 0 0 40 0 9 6 15 0 0 0 Meconium 222 27 0 32 11 0 0 * 86 * 23 27 10 0 0 * Rupture of membrane 184 51 * 35 * * 0 0 48 * 24 11 8 0 0 * Abruptio placenta 29 10 0 * * * * * * * * * * 0 0 0 Placenta previa 19 * 0 * * 0 0 0 7 * * * * 0 0 0 Other bleeding 60 17 0 13 * 0 0 * 12 0 10 * * 0 0 * 0 Diaphragmatic hernia Other Total Seizures * 0 0 0 0 0 0 0 * 0 * 0 0 0 0 106 16 * 21 11 * 0 0 26 0 15 * 7 0 0 * 79 14 * 20 * 0 0 0 21 0 13 * * 0 0 0 Dysfunctional labor 192 56 0 36 0 0 0 0 48 0 36 9 * 0 * 0 Breech malpresentation 146 29 * 21 * * 0 * 42 * 23 8 * 0 * * 24 * 0 * * * 0 0 7 * * * 0 0 0 0 8 * 0 * * 0 0 0 * 0 * 0 0 0 0 0 Precipitous labor Prolonged labor Cephalopelvic disproportion. Cord prolapse Anesthetic complications Infant mortalityc Cochise * Cleft lip/palate Births with complications Apache Total State 4.21 (continued) COMPARISON OF SELECTED CHARACTERISTICSa OF AMERICAN INDIAN NEWBORNS AND WOMEN GIVING BIRTH BY COUNTY OF RESIDENCE, ARIZONA, 2011 * 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 Fetal distress 282 22 0 17 18 * 0 * 119 * 32 16 45 0 0 * Other 737 95 * 38 25 34 0 * 179 * 152 134 46 0 13 11 Total 43 10† 0 10† 10† 0† 0 0† 10† 0† 10† 0† 0 0 0 0† Neonatal 19 * 0 * * * 0 0 * * * * 0 0 0 * Postneonatal 24 * 0 * * 0 0 * * * 7 * 0 0 0 0 Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; a Obstetric procedures, method of delivery, births with medical risk factors, abnormal conditions of the newborn, births with congenital anomalies, and births with complications may not sum to their respective totals as each birth may be associated with multiple occurrences of each of these indicators; 48 b 'Refused', 'Yes, divorced', 'Unknown'; c Total infant mortality includes unknown county of residence. Health Status Profile of American Indians in Arizona, 2011 Data Book V. PATTERNS OF MORTALITY AMONG AMERICAN INDIANS BY PLACE OF RESIDENCE IN ARIZONA IN 2011 Health Status Profile of American Indians in Arizona, 2011 Data Book 49 AGE-SPECIFIC MORTALITY Health Status Profile of American Indians in Arizona, 2011 Data Book 51 5.1 AGE-SPECIFIC MORTALITY AMONG AMERICAN INDIANS IN 2011 25-34 35-44 45-54 55-64 65-74 75-84 85+ 1,703 40† 10† 10† 100† 130† 170† 240† 250† 260† 260† 230† 0† 0 0 0 0 0 * * * 0 0 0 Cocopah Tribe 10† * 0 0 0 0 * * * 0 0 0 Colorado River Indian Tribe 10† 0 0 0 0 0 0 * * * * * Fort McDowell Yavapai Nation Reservation 10† 0 0 0 * * * * * * 0 * 0† * 0 0 0 0 0 0 0 0 0 0 20† 0 0 0 0 * * * 6 * * * 0† 0 0 0 0 * 0 0 * * 0 0 100† * * * * * * 16 11 13 20 23 Hualapai Tribe 10† * 0 0 0 0 * * * * 0 * Navajo Nation 650† 16 * * 44 45 59 73 76 97 122 109 Pascua Yaqui Tribe 10† 0 0 0 0 * * * * * 0 * Salt River Pima-Maricopa Indian Community 50† * 0 0 * * * 9 10 11 * * San Carlos Apache Tribe 80† 6 * 0 * * 10 13 10 13 15 7 Tohono O'Odham Nation 70† 0 * 0 * 7 9 11 15 15 7 6 110† * * * 13 17 7 14 14 7 16 11 0† 0 0 0 0 0 0 * * * 0 * 1,140† 30† 10† 10† 70† 90† 100† 150† 160† 170† 190† 170† 180† 6 * * * 13 30 27 39 36 11 15 ---in Pima County 90† * 0 * * * 8 10 19 17 12 9 ---in Coconino County 50† * 0 0 11 6 6 9 * * 10 * ---elsewhere in Arizona 240† * * * 11 21 24 47 31 33 37 34 TOTAL 560† 10† 0† 0† 30† 40† 68 93 90† 90† 70 60† ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Resided on reservation Ak-Chin Indian Community Fort Mojave Indian Tribe Gila River Indian Community Havasupai Tribe Hopi Tribe White Mountain Apache Tribe Yavapai-Apache Nation TOTAL Resided off reservation ---in Maricopa County 1-4 <1 TOTAL 5-14 15-24 Age group Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 52 Health Status Profile of American Indians in Arizona, 2011 Data Book 5.2 AGE-SPECIFIC MORTALITY AMONG AMERICAN INDIAN MALES IN 2011 80† 90† 120† 150† 140† 130† 100† Ak-Chin Indian Community 0† 0 0 0 0 0 * * 0 0 0 0 Cocopah Tribe 0† 0 0 0 0 0 * * 0 0 0 0 Colorado River Indian Tribe 0† 0 0 0 0 0 0 * * 0 0 0 Fort McDowell Yavapai Nation Reservation 0† 0 0 0 * * * 0 0 0 0 0 Fort Mojave Indian Tribe 0† * 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 0 0 * * * * 0 0 0† 0 0 0 0 * 0 0 * 0 0 0 Hopi Tribe 60† * * 0 * * * 10 9 7 9 11 Hualapai Tribe 10† * 0 0 0 0 * * * * 0 0 Navajo Nation 370† * * * 35 29 46 48 46 58 52 46 0† 0 0 0 0 * 0 * * 0 0 0 Salt River Pima-Maricopa Indian Community 20† 0 0 0 * * * 8 * * 0 0 San Carlos Apache Tribe 40† * * 0 * * * * 6 * 7 * Tohono O'Odham Nation 40† 0 * 0 * * * * 9 6 * * White Mountain Apache Tribe 50† * * 0 7 12 * * * * 7 * 0† 0 0 0 0 0 0 * * 0 0 0 TOTAL 610† 10† 10† 0† 60† 60† 70† 90† 90† 90† 80† 70† ---in Maricopa County 110† * * * * 11 21 17 22 15 * 6 ---in Pima County 40† * 0 * * * * 6 10 10 * * ---in Coconino County 30† * 0 0 8 * * 7 * * * * ---elsewhere in Arizona 130† 0 * * 8 15 16 30 16 19 13 10 TOTAL 310† 0† 0† 0† 20† 30† 50† 60 50† 50† 20† 20† Pascua Yaqui Tribe Yavapai-Apache Nation Resided off reservation 85+ 10† Havasupai Tribe 75-84 25-34 10† Gila River Indian Community 65-74 15-24 Resided on reservation 55-64 5-14 20† ALL AMERICAN INDIAN RESIDENTS OF ARIZONA 45-54 1-4 923 TOTAL 35-44 <1 Age group 90† Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 53 5.3 AGE-SPECIFIC MORTALITY AMONG AMERICAN INDIAN FEMALES IN 2011 0† 30† 40† 50† 90† 110† 120† 150† 140† Ak-Chin Indian Community 0† 0 0 0 0 0 * 0 * 0 0 0 Cocopah Tribe 0† * 0 0 0 0 0 0 * 0 0 0 10† 0 0 0 0 0 0 * * * * * 0† 0 0 0 0 0 0 * * * 0 * 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 0 * 0 * * * * * 0† 0 0 0 0 0 0 0 0 * 0 0 Hopi Tribe 40† 0 0 * * * * 6 * 6 11 12 Hualapai Nation 10† 0 0 0 0 0 0 * * 0 0 * 280† 12 * * 9 16 13 25 30 39 70 63 Pascua Yaqui Tribe 10† 0 0 0 0 0 * 0 * * 0 * Salt River Pima-Maricopa Indian Community 30† * 0 0 * * * * 7 8 * * San Carlos Apache Tribe 50† * 0 0 0 * 7 8 * 9 8 * Tohono O'Odham Nation 40† 0 0 0 0 * * 6 6 9 * * White Mountain Apache Tribe 60† * 0 * 6 * * 9 10 * 9 7 0† 0 0 0 0 0 0 0 0 * 0 * 530† 10† 10† 10† 10† 10† 10† 10† 10† 10† 10† 10† ---in Maricopa County 80† * 0 0 0 * 9 10 17 21 7 9 ---in Pima County 40† * 0 0 * * * * 9 7 9 6 ---in Coconino County 20† 0 0 0 * * * * 0 * 6 * 110† * 0 0 * 6 8 17 15 14 24 24 251 10† 0 0 10† 10† 20† 30† 41 40† 46 40† Fort McDowell Yavapai Nation Reservation Fort Mojave Indian Tribe Gila River Indian Community Havasupai Tribe Navajo Nation Yavapai-Apache Nation TOTAL Resided off reservation ---elsewhere in Arizona TOTAL 1-4 <1 85+ 0† Colorado River Indian Tribe 75-84 45-54 Resided on reservation 65-74 35-44 30† ALL AMERICAN INDIAN RESIDENTS OF ARIZONA 55-64 25-34 780† TOTAL 5-14 15-24 Age group Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 54 Health Status Profile of American Indians in Arizona, 2011 Data Book CAUSE-SPECIFIC MORTALITY Health Status Profile of American Indians in Arizona, 2011 Data Book 55 5.4 DEATHS BY GENDER FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Cause of death (Tenth Revision, International Statistical Classification of Diseases) Total, all causes MALE FEMALE 1,703 1,015 766 Salmonella infections 0 0 0 Shigellosis and amebiasis 0 0 0 10† * 8 10† * 6 0† * * Certain other intestinal infections Enterocolitis due to Clostridium difficile Tuberculosis Respiratory tuberculosis 0† * * 0 0 0 Whooping cough 0 0 0 Scarlet fever and erysipelas 0 0 0 Meningococcal infection 0 0 0 34 13 21 Syphilis 0 0 0 Acute poliomyelitis 0 0 0 Arthropod-borne encephalitis 0 0 0 Measles 0 0 0 0† * * Human immunodeficiency virus (HIV) disease 6 6 0 Malaria 0 0 0 Other and unspecified infectious and parasitic diseases 10† 7 * Malignant neoplasms 202 98 104 Other tuberculosis Septicemia Viral hepatitis Malignant neoplasm of lip, oral cavity and pharynx 0† * 0 Malignant neoplasm of esophagus 0† * * Malignant neoplasm of stomach 18 8 10 Malignant neoplasm of colon, rectum and anus 22 14 8 Malignant neoplasm of liver and intrahepatic bile ducts 26 18 8 20† * 12 0† 0 * 10† 10 * 0† * 0 Malignant neoplasm of pancreas Malignant neoplasm of larynx Malignant neoplasm of trachea, bronchus and lung Malignant melanoma of skin Malignant neoplasm of breast 9 0 9 Malignant neoplasm of cervix uteri 0† 0 * Malignant neoplasm of corpus uteri and uterus, part unspecified 0† 0 * Malignant neoplasm of ovary 10 0 10 0 Malignant neoplasm of prostate 56 TOTAL 11 11 Malignant neoplasm of kidney and renal pelvis 10† 8 * Malignant neoplasm of bladder 10† * * Health Status Profile of American Indians in Arizona, 2011 Data Book 5.4 (continued) DEATHS BY GENDER FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Cause of death (Tenth Revision, International Statistical Classification of Diseases) Malignant neoplasm of meninges, brain and other parts of CNS TOTAL MALE FEMALE 0† * * 10† * 8 Hodgkin's disease 0† * 0 Non-Hodgkin's lymphoma 0† 0 * 10† * * 0† * * Malignant neoplasm of lymphoid, hematopoietic and related tissue Leukemia Multiple myeloma and immunoproliferative neoplasms Other and unspecified malignant neoplasms of lymphoid tissue 0 0 0 27 11 16 In situ neoplasms 0† * * Anemias 0† 0 * Diabetes 129 50 79 0† * * 0† * * 0 0 0 All other and unspecified malignant neoplasm Nutritional deficiencies Malnutrition Other nutritional deficiencies Obesity Meningitis Parkinson's disease Alzheimer's disease Major cardiovascular diseases Diseases of heart Acute rheumatic fever and chronic rheumatic heart disease Hypertensive heart disease Hypertensive heart and renal disease 10† * * 0† 0 * 20† 10 * 26 8 18 282 146 136 215 122 93 0† 0 * 10† 6 * 0† * * 146 93 53 Acute myocardial infarction 46 33 13 Other acute ischemic heart disease 0† * * Other forms of chronic ischemic heart disease 98 59 39 30 24 6 Ischemic heart disease Atherosclerotic cardiovascular disease All other forms of chronic ischemic heart disease 68 35 33 58 22 36 Acute and subacute endocarditis 0† * 0 Diseases of pericardium and acute myocarditis 0† 0 * 20† * 10 25 Other heart diseases Heart failure All other forms of heart disease Essential (primary) hypertension and hypertensive renal disease Cerebrovascular diseases Health Status Profile of American Indians in Arizona, 2011 Data Book 41 16 10† * 11 49 18 31 57 5.4 (continued) DEATHS BY GENDER FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Cause of death (Tenth Revision, International Statistical Classification of Diseases) MALE FEMALE Atherosclerosis 0† * Other diseases of circulatory system 0† * * 0 0 0 Aortic aneurysm and dissection Other disease of arteries, arterioles and capillaries 0 0† * * Other disorders of circulatory system 0† * 0 Influenza and pneumonia 49 33 16 Influenza 0† * 0 Pneumonia 47 31 16 Other acute lower respiratory infections 0 0 0 Acute bronchiolitis 0 0 0 Unspecified acute lower respiratory infection 0 0 0 25 10 15 Bronchitis, chronic and unspecified 0 0 0 Emphysema 0 0 0 Asthma 0† * * Other chronic lower respiratory diseases 22 9 13 0† * 0 Chronic lower respiratory diseases Pneumoconioses and chemical effects Pneumonitis due to solids and liquids 10† * 7 Other disease of respiratory system 30 12 18 Peptic ulcer 0† * * Diseases of appendix 0† * 0 Hernia 0† 0 * 122 63 59 101 56 45 21 7 14 Chronic liver disease and cirrhosis Alcoholic liver disease Other chronic liver disease and cirrhosis Cholelithiasis and other disorders of gallbladder Nephritis, nephrotic syndrome and nephrosis Acute and rapidly progressive nephritic and nephrotic syndrome Chronic glomerulonephritis 10† * * 29 15 14 0 0 0 0 0 0 29 15 14 0 0 0 0 0 0 0† * 0 Inflammatory diseases of female pelvic organs 0 0 0 Pregnancy, childbirth and the puerperium 0 0 0 Renal failure Others disorders of kidney Infections of kidney Hyperplasia of prostate 58 TOTAL Health Status Profile of American Indians in Arizona, 2011 Data Book 5.4 (continued) DEATHS BY GENDER FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Cause of death (Tenth Revision, International Statistical Classification of Diseases) TOTAL MALE FEMALE Pregnancy with abortive outcome 0 0 Other complications of pregnancy, childbirth and the puerperium 0 0 0 17 8 9 Perinatal conditions Congenital anomalies, deformations and chromosomal abnormalities 0 10† * 6 47 31 16 299 214 85 153 112 41 147 107 40 Other land transport accidents 0† * 0 Water, air, space 0† * * 146 102 44 Symptoms, signs, abnormal findings Total accidents Transport accidents Motor vehicle accidents Nontransport accidents Falls 29 14 15 Accidental discharge of firearms 0 0 0 Accidental drowning and submersion 7 7 0 Accidental exposure to smoke, fire and flames 0† * 0 Accidental poisoning 75 54 21 10† * * 0 Excessive natural heat Excessive natural cold 9 9 34 26 8 56 45 11 By discharge of firearms 13 13 0 By other means 43 32 11 Other and unspecified nontransport accidents Intentional self-harm (suicide) Assault (homicide) 43 34 9 By discharge of firearms 20† 13 * By other means 30† 21 * Legal intervention 0 0 0 Events of undetermined intent Discharge of firearms Other and unspecified events of undetermined intent Operations of war Complications of medical and surgical care INJURY BY FIREARMS DRUG-INDUCED DEATHS ALCOHOL-INDUCED DEATHS 10† * 8 0† * 0 10† * 8 0† * 0 0 0 0 30† 28 * 32 19 13 191 123 68 Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 59 Total, all causes 85+ 75-84 65-74 55-64 45-54 35-44 25-34 15-24 5-14 1-4 1,703 47 14 9 102 147 170 301 269 255 253 214 Salmonella infections 0 0 0 0 0 0 0 0 0 0 0 0 Shigellosis and amebiasis 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 0 0 0 * * * * * 10† 0 0 0 0 0 0 * * 0 * 0 0† 0 0 0 0 0 * 0 * 0 0 0 0† 0 0 0 0 0 * 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Whooping cough 0 0 0 0 0 0 0 0 0 0 0 0 Scarlet fever and erysipelas 0 0 0 0 0 0 0 0 0 0 0 0 Meningococcal infection 0 0 0 0 0 0 0 0 0 0 0 0 30† * 0 0 0 0 * 6 8 6 * 6 Syphilis 0 0 0 0 0 0 0 0 0 0 0 0 Acute poliomyelitis 0 0 0 0 0 0 0 0 0 0 0 0 Arthropod-borne encephalitis 0 0 0 0 0 0 0 0 0 0 0 0 Measles 0 0 0 0 0 0 0 0 0 0 0 0 Certain other intestinal infections Enterocolitis due to Clostridium difficile Tuberculosis Respiratory tuberculosis Other tuberculosis Septicemia Viral hepatitis Human immunodeficiency virus (HIV) disease Malaria Other and unspecified infectious and parasitic diseases Malignant neoplasms 0† 0 0 0 0 0 * 0 0 0 0 0 10† 0 0 0 0 * * * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† * * 0 0 * * 0 * 0 0 * 200† 0 0 * * * * 26 42 57 42 25 Malignant neoplasm of lip, oral cavity and pharynx 0† 0 0 0 0 0 0 0 * 0 0 0 Malignant neoplasm of esophagus 0† 0 0 0 0 0 0 0 * * * * Malignant neoplasm of stomach 20† 0 0 0 0 0 0 * * 9 * * Malignant neoplasm of colon, rectum and anus 20† 0 0 0 0 0 0 6 * 9 0 * Malignant neoplasm of liver and intrahepatic bile ducts 30† 0 0 0 0 * 0 * 9 8 * 0 Malignant neoplasm of pancreas 20† 0 0 0 0 0 0 * * * 7 * 0† 0 0 0 0 0 0 0 0 * 0 0 10† 0 0 0 0 0 0 * * * 6 * 0† 0 0 0 0 0 0 0 0 0 * 0 10† 0 0 0 0 0 * * * * * 0 Malignant neoplasm of cervix uteri 0† 0 0 0 0 0 0 * 0 0 * 0 Malignant neoplasm of corpus uteri and uterus, part unspecified 0† 0 0 0 0 * 0 * 0 0 * 0 Malignant neoplasm of ovary 10† 0 0 0 0 0 0 * * * 0 0 Malignant neoplasm of prostate 10† 0 0 0 0 0 0 0 * * * * Malignant neoplasm of larynx Malignant neoplasm of trachea, bronchus and lung Malignant melanoma of skin Malignant neoplasm of breast 60 <1 Cause of death (Tenth Revision, International Statistical Classification of Diseases) TOTAL 5.5 DEATHS BY AGE GROUP FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Health Status Profile of American Indians in Arizona, 2011 Data Book 85+ 75-84 65-74 55-64 45-54 35-44 25-34 15-24 5-14 1-4 <1 Cause of death (Tenth Revision, International Statistical Classification of Diseases) TOTAL 5.5 (continued) DEATHS BY AGE GROUP FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Malignant neoplasm of kidney and renal pelvis 10† 0 0 0 0 0 0 0 * 6 * * Malignant neoplasm of bladder 10† 0 0 0 0 0 0 0 * * * * 0† 0 0 * 0 0 * 0 * 0 0 * 10† 0 0 0 * * * * 0 * * * 0† 0 0 0 0 0 0 0 0 0 * 0 Malignant neoplasm of meninges, brain and other parts of CNS Malignant neoplasm of lymphoid, hematopoietic and related tissue Hodgkin's disease Non-Hodgkin's lymphoma 0† 0 0 0 0 * 0 0 0 0 0 0 10† 0 0 0 * * * * 0 * * * 0† 0 0 0 0 0 0 * 0 * * 0 0 0 0 0 0 0 0 0 0 0 0 0 30† 0 0 0 0 * 0 * * 8 * 8 In situ neoplasms 0† 0 0 0 0 0 0 0 * * 0 * Anemias 0† 0 0 0 0 0 0 * 0 0 0 0 Diabetes 130† 0 0 0 0 * 10 20 24 38 18 15 0† 0 0 0 0 0 0 0 0 * * * 0† 0 0 0 0 0 0 0 0 * * * 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 * * * * * 0 0 0 0† 0 * 0 0 0 0 0 0 0 0 0 20† 0 0 0 0 0 0 0 * * * * Leukemia Multiple myeloma and immunoproliferative neoplasms Other and unspecified malignant neoplasms of lymphoid tissue All other and unspecified malignant neoplasm Nutritional deficiencies Malnutrition Other nutritional deficiencies Obesity Meningitis Parkinson's disease Alzheimer's disease Major cardiovascular diseases Diseases of heart Acute rheumatic fever and chronic rheumatic heart disease Hypertensive heart disease Hypertensive heart and renal disease Ischemic heart disease Acute myocardial infarction Other acute ischemic heart disease 30† 0 0 0 0 0 0 0 0 * 10 12 280† * 0 * * * 15 29 47 58 77 46 220† * 0 0 * * 11 24 41 41 57 32 0† 0 0 0 0 0 0 * 0 0 0 0 10† 0 0 0 * 0 0 * * * 0 * 0† 0 0 0 0 0 0 0 0 * 0 * 150† 0 0 0 0 * 8 14 33 27 42 20 50† 0 0 0 0 * * * 11 12 12 * 0† 0 0 0 0 0 * 0 * 0 0 0 100† 0 0 0 0 0 * 12 21 15 30 16 Atherosclerotic cardiovascular disease 30† 0 0 0 0 0 * * 9 * 10 * All other forms of chronic ischemic heart disease 70† 0 0 0 0 0 * 7 12 12 20 15 Other forms of chronic ischemic heart disease Other heart diseases 60† * 0 0 * * * 7 7 10 15 10 Acute and subacute endocarditis 0† 0 0 0 0 0 * 0 0 0 0 0 Diseases of pericardium and acute myocarditis 0† 0 0 0 0 0 0 * 0 0 0 0 Heart failure 20† 0 0 0 0 0 0 0 * * 7 * All other forms of heart disease 40† * 0 0 * * * 6 * 7 8 7 Health Status Profile of American Indians in Arizona, 2011 Data Book 61 85+ 75-84 65-74 55-64 45-54 35-44 25-34 15-24 5-14 1-4 Essential (primary) hypertension and hypertensive renal disease 10† 0 0 0 0 0 * * * 7 * * Cerebrovascular diseases 50† 0 0 * 0 0 * * * 9 19 12 Atherosclerosis 0† 0 0 0 0 0 0 * 0 0 0 0 Other diseases of circulatory system 0† 0 0 0 0 0 0 0 * * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Aortic aneurysm and dissection Other disease of arteries, arterioles and capillaries Other disorders of circulatory system Influenza and pneumonia Influenza 0† 0 0 0 0 0 0 0 * * 0 0† 0 0 0 0 0 * 0 0 0 0 0 50† 0 0 0 * * * * * 7 8 20 0† 0 0 0 0 * 0 0 0 * 0 0 50† 0 0 0 * 0 * * * 6 8 20 Other acute lower respiratory infections 0 0 0 0 0 0 0 0 0 0 0 0 Acute bronchiolitis 0 0 0 0 0 0 0 0 0 0 0 0 Unspecified acute lower respiratory infection 0 0 0 0 0 0 0 0 0 0 0 0 30† 0 * 0 0 0 0 0 6 * 6 8 Bronchitis, chronic and unspecified 0 0 0 0 0 0 0 0 0 0 0 0 Emphysema 0 0 0 0 0 0 0 0 0 0 0 0 Pneumonia Chronic lower respiratory diseases Asthma Other chronic lower respiratory diseases Pneumoconioses and chemical effects 0† 0 * 0 0 0 0 0 * 0 * 0 20† 0 0 0 0 0 0 0 * * * 8 0 0† 0 0 0 0 0 0 0 0 0 * Pneumonitis due to solids and liquids 10† 0 0 0 0 0 0 0 * * * * Other disease of respiratory system 30† * 0 0 0 * 0 * * 7 * 10 Peptic ulcer 0† 0 0 0 0 0 0 * 0 * * 0 Diseases of appendix 0† 0 0 0 0 0 0 0 0 0 * 0 Hernia 0† 0 0 0 0 0 * 0 0 0 0 * 120† 0 0 0 * 13 27 39 28 7 * * 100† 0 0 0 * 12 25 33 24 * * 0 20† 0 0 0 0 * * 6 * * * * Cholelithiasis and other disorders of gallbladder 10† 0 0 0 0 0 0 * 0 * * * Nephritis, nephrotic syndrome and nephrosis 30† 0 0 0 0 0 * * 8 7 8 * Acute and rapidly progressive nephritic and nephrotic syndrome 0 0 0 0 0 0 0 0 0 0 0 0 Chronic glomerulonephritis 0 0 0 0 0 0 0 0 0 0 0 0 30† 0 0 0 0 0 * * 8 7 8 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 0 0 0 0 0 * Chronic liver disease and cirrhosis Alcoholic liver disease Other chronic liver disease and cirrhosis Renal failure Others disorders of kidney Infections of kidney Hyperplasia of prostate 62 <1 Cause of death (Tenth Revision, International Statistical Classification of Diseases) TOTAL 5.5 (continued) DEATHS BY AGE GROUP FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Health Status Profile of American Indians in Arizona, 2011 Data Book 85+ 75-84 65-74 55-64 45-54 35-44 25-34 15-24 5-14 1-4 <1 Cause of death (Tenth Revision, International Statistical Classification of Diseases) TOTAL 5.5 (continued) DEATHS BY AGE GROUP FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Inflammatory diseases of female pelvic organs 0 0 0 0 0 0 0 0 0 0 0 0 Pregnancy, childbirth and the puerperium 0 0 0 0 0 0 0 0 0 0 0 0 Pregnancy with abortive outcome 0 0 0 0 0 0 0 0 0 0 0 0 Other complications of pregnancy, childbirth and the puerperium 0 0 0 0 0 0 0 0 0 0 0 0 17 17 0 0 0 0 0 0 0 0 0 0 Congenital anomalies, deformations and chromosomal abnormalities 10† * 0 * 0 * * * 0 0 0 0 Symptoms, signs, abnormal findings 50† 6 0 * * * 10 8 * * * 9 300† * * * 51 61 47 48 34 21 17 9 150† * * * 34 40 20 21 14 9 6 * 150† * * * 34 39 19 21 13 8 * * 0† 0 0 0 0 0 0 0 * * * 0 0 Perinatal conditions Total accidents Transport accidents Motor vehicle accidents Other land transport accidents Water, air, space Nontransport accidents Falls Accidental discharge of firearms Accidental drowning and submersion Accidental exposure to smoke, fire and flames 0† 0 0 * 0 * * 0 0 0 0 150† * * 0 17 21 27 27 20 12 11 8 30† * 0 0 * 0 * * * 6 8 6 0 0 0 0 0 0 0 0 0 0 0 0 10† * 0 0 0 * * * * 0 0 0 0† 0 0 0 0 0 0 0 * 0 0 0 80† 0 * 0 12 13 19 17 9 * 0 0 Excessive natural heat 10† 0 0 0 0 * * 0 * 0 0 * Excessive natural cold 10† 0 0 0 * * * * * 0 * 0 Other and unspecified nontransport accidents 30† 0 0 0 * 7 * 6 6 * * * 60† 0 0 * 25 9 13 6 * 0 0 0 By discharge of firearms 10† 0 0 0 7 * * * 0 0 0 0 By other means 40† 0 0 * 18 7 10 * * 0 0 0 Accidental poisoning Intentional self-harm (suicide) Assault (homicide) 40† * * 0 10 10 11 7 * 0 0 0 By discharge of firearms 20† * 0 0 * * 6 * * 0 0 0 By other means 30† * * 0 7 6 * * 0 0 0 0 Legal intervention 0 0 0 0 0 0 0 0 0 0 0 0 10† * 0 0 * * * * * 0 0 0 0† 0 0 0 0 * 0 * 0 0 0 0 10† * 0 0 * * * * * 0 0 0 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Events of undetermined intent Discharge of firearms Other and unspecified events of undetermined intent Operations of war Complications of medical and surgical care INJURY BY FIREARMS 30† * 0 0 10 7 9 * * 0 0 0 DRUG-INDUCED DEATHS 30† 0 0 0 * 8 9 6 * 0 0 0 190† 0 0 0 10 27 46 56 37 11 * 0 ALCOHOL-INDUCED DEATHS Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 63 5.6 DEATHS BY RESIDENCE FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Total, all causes 0† 10† 10† 10† 0† 20† 0† 100† 10† 650† 10† 50† 80† 70† 110† Total elsewhere in Arizona in Coconino County in Pima County in Maricopa County Total Yavapai-Apache Nation Salt River Pima Maricopa Indian San Carlos Apache Tribe Tohono O'Odham Nation White Mountain Apache Tribe Pascua Yaqui Tribe Navajo Nation Hualapai Tribe Hopi Tribe Havasupai Tribe Cocopah Tribe Colorado River Indian Tribe Fort McDowell Yavapai Nation Reservation Fort Mohave Indian Tribe Gila River Indian Community Ak-Chin Indian Community 1,703 Resided off reservation 0† 1,140† 180† 90† 50† 240† 563 Salmonella infections 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Shigellosis and amebiasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 * 0 0 0 * 0 * 0 0 0 0 0 0 10† * 0 * * 0† 10† 0 0 0 * 0 0 0 * 0 * 0 0 0 0 0 0 0† * 0 * * 0† 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† * 0 0 0 0† 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† * 0 0 0 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Whooping cough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Scarlet fever and erysipelas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Meningococcal infection 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30† 0 * 0 0 0 0 0 * * 15 * * * * * 0 30† * 0 0 * 10† Syphilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Acute poliomyelitis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Arthropod-borne encephalitis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Measles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0† Human immunodeficiency virus (HIV) disease 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 * * 10† Malaria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Other and unspecified infectious and parasitic diseases 10† 0 * 0 0 0 0 0 0 0 * 0 0 * 0 * 0 10† * * 0 * 0† Malignant neoplasms Certain other intestinal infections Enterocolitis due to Clostridium difficile Tuberculosis Respiratory tuberculosis Other tuberculosis Septicemia Viral hepatitis 0 202 0 0 * * 0 * 0 16 0 70 * * 15 8 11 0 130† 28 13 * Malignant neoplasm of lip, oral cavity and pharynx 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0† Malignant neoplasm of esophagus 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 0 * * 0† 20† 0 0 0 0 0 0 0 * 0 9 0 0 * 0 * 0 20† * * 0 * 0† 22 0 0 0 0 0 0 0 * 0 6 0 0 * 0 * 0 10† 8 * 0 * 10† Malignant neoplasm of liver and intrahepatic bile ducts 26 0 0 * 0 0 0 0 * 0 7 0 * * * 0 0 10† * * 0 * 10† Malignant neoplasm of pancreas 16 0 0 0 0 0 0 0 * 0 6 0 0 * 0 0 0 10† * * 0 * 10† Malignant neoplasm of larynx 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 10† 0 0 * * 0 0 0 0 0 6 0 0 0 0 * 0 10† * 0 * * 10† Malignant neoplasm of stomach Malignant neoplasm of colon, rectum and anus Malignant neoplasm of trachea, bronchus and lung Malignant melanoma of skin 26 70† 0† 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 10† 0 0 0 0 0 0 0 * 0 * 0 0 * 0 0 0 10† * * 0 * 0† Malignant neoplasm of cervix uteri 0† 0 0 0 0 0 0 0 0 0 * 0 0 * 0 * 0 0† 0 0 0 0 0 Malignant neoplasm of corpus uteri and uterus, part unspecified 0† 0 0 0 0 0 * 0 0 0 * 0 0 0 0 0 0 0† 0 * 0 0 0† Malignant neoplasm of breast 64 ALL AMERICAN INDIAN RESIDENTS OF ARIZONA Cause of death (Tenth Revision, International Statistical Classification of Diseases) Resided on reservation Malignant neoplasm of ovary 10† 0 0 0 * 0 0 0 * 0 0 0 0 * 0 * 0 10† * 0 0 * 0† Malignant neoplasm of prostate 10† 0 0 0 0 0 0 0 * 0 6 0 0 0 0 0 0 10† * * 0 * 0† Malignant neoplasm of kidney and renal pelvis 10† 0 0 0 0 0 * 0 * 0 * * * 0 * 0 0 10† 0 0 0 * 0† Health Status Profile of American Indians in Arizona, 2011 Data Book Malignant neoplasm of bladder Malignant neoplasm of meninges, brain and other parts of CNS Malignant neoplasm of lymphoid, hematopoietic and related tissue Hodgkin's disease Non-Hodgkin's lymphoma Leukemia Multiple myeloma and immunoproliferative neoplasms Other and unspecified malignant neoplasms of lymphoid tissue All other and unspecified malignant neoplasm Total elsewhere in Arizona in Coconino County in Pima County Total in Maricopa County Resided off reservation Salt River Pima Maricopa Indian San Carlos Apache Tribe Tohono O'Odham Nation White Mountain Apache Tribe Yavapai-Apache Nation Pascua Yaqui Tribe Navajo Nation Hualapai Tribe Hopi Tribe Havasupai Tribe Cocopah Tribe Colorado River Indian Tribe Fort McDowell Yavapai Nation Fort Mohave Indian Tribe Gila River Indian Community Resided on reservation Ak-Chin Indian Community Cause of death (Tenth Revision, International Statistical Classification of Diseases) ALL AMERICAN INDIAN RESIDENTS OF ARIZONA 5.6 (continued) DEATHS BY RESIDENCE FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 10† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 * 0 0† * 0 0 * 0† 0† 0 0 0 0 0 0 0 0 0 * 0 0 * 0 0 0 0† * * 0 0 0† 10† 0 0 * 0 0 0 0 0 0 * 0 0 * 0 * 0 10† * * 0 * 10† 0† 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0† 0 0 0 0 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 0 0 0 0 10† 0 0 * 0 0 0 0 0 0 * 0 0 0 0 * 0 0† * 0 0 * 0† 0† 0 0 0 0 0 0 0 0 0 * 0 0 * 0 0 0 0† 0 * 0 * 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30† 0 0 * 0 0 0 0 * 0 11 * 0 * * * 0 20† * * 0 * 0† In situ neoplasms 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * * 0† Anemias 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 0 0 0 0 Diabetes 129 0 0 * * 0 0 0 * 0 31 * 9 6 6 9 * 70† 26 8 * 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 0 0 * 0† 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 0 0 * 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 0 0 * 0 0 0 0 0 * 0 0 * 0 0† * * * * 0† Nutritional deficiencies Malnutrition Other nutritional deficiencies Obesity Meningitis Parkinson's disease Alzheimer's disease Major cardiovascular diseases Diseases of heart Acute rheumatic fever and chronic rheumatic heart disease Hypertensive heart disease Hypertensive heart and renal disease 22 60† 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 0 0 0 0 20† 0 0 0 0 0 0 0 0 0 11 0 0 * * 0 0 10† * 0 0 * 0† 0 26 0 0 0 0 0 * 0 0 6 0 0 * * * 0 10† 6 * * 282 * * * 0 0 * * 17 * 113 * 7 9 12 16 * 190† 19 18 9 45 * 10† 91 215 0 0 * 0 0 * 0 14 * 87 * * 9 8 14 * 150† 13 14 8 32 67 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0† 0 0 0 0 0 10† 0 0 0 0 0 0 0 0 * * 0 0 0 0 0 0 0† 0 * * * 0† 0 0† 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * * 146 0 0 * 0 0 * 0 10 0 54 * * 7 * 7 * 90† 11 9 * Acute myocardial infarction 46 0 0 0 0 0 0 0 6 0 19 0 * * * * 0 30† * * 0 7 10† Other acute ischemic heart disease 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 * Other forms of chronic ischemic heart disease 98 0 0 * 0 0 * 0 * 0 35 * * * * * * 60† 8 6 * Atherosclerotic cardiovascular disease 30 0 0 * 0 0 * 0 * 0 11 0 0 * 0 0 * 20† * 0 * 6 10† All other forms of chronic ischemic heart disease 68 0 0 * 0 0 * 0 * 0 24 * * * * * 0 40† * 6 * 13 30† Ischemic heart disease Other heart diseases 27 50† 0† 19 40† 58 0 0 * 0 0 0 0 * 0 30 0 * * * 6 0 50† * * * * 10† Acute and subacute endocarditis 0† 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0† 0 0 0 0 0 Diseases of pericardium and acute myocarditis 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 Heart failure 15 0 0 0 0 0 0 0 * 0 11 0 0 * * 0 0 20† 0 0 0 0 0 All other forms of heart disease 41 0 0 * 0 0 0 0 * 0 19 0 * * * 6 0 30† * * * * 10† Health Status Profile of American Indians in Arizona, 2011 Data Book 65 Total elsewhere in Arizona in Coconino County in Pima County in Maricopa County Total Salt River Pima Maricopa Indian San Carlos Apache Tribe Tohono O'Odham Nation White Mountain Apache Tribe Yavapai-Apache Nation Pascua Yaqui Tribe Navajo Nation Hualapai Tribe Hopi Tribe Havasupai Tribe Cocopah Tribe Colorado River Indian Tribe Fort McDowell Yavapai Nation Fort Mohave Indian Tribe Gila River Indian Community Resided off reservation Essential (primary) hypertension and hypertensive renal disease 14 0 0 0 0 0 0 0 0 0 * 0 * 0 * * 0 10† * * 0 * 10† Cerebrovascular diseases 49 * * 0 0 0 0 * * * 22 0 * 0 * * * 30† * * * 10 20† Atherosclerosis 0† 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 Other diseases of circulatory system 0† 0 0 0 0 0 0 0 * 0 * 0 0 0 * 0 0 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 0 0 * 0 * 0 0 0 * 0 0 0† 0 0 0 0 0 Other disorders of circulatory system 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0† Influenza and pneumonia 49 0 0 0 0 0 0 0 * 0 29 0 * * * * 0 40† * * * * 10† Influenza 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† * 0 0 0 Pneumonia 47 0 0 0 0 0 0 0 * 0 28 0 * * * * 0 40† 0 * * * 10† Other acute lower respiratory infections 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Acute bronchiolitis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Unspecified acute lower respiratory infection 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 * 0 0 * 10 0 * 0 * * 0 20† * * 0 * 10† Bronchitis, chronic and unspecified 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Emphysema 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Asthma 0† 0 0 0 0 0 0 0 0 * * 0 0 0 0 0 0 0† * 0 0 0 0† Other chronic lower respiratory diseases 22 0 0 0 0 0 * 0 0 0 9 0 * 0 * * 0 10† * * 0 * 10† 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 * 0 0 10† 0 0 0 0 0 0 0 * 0 * 0 0 * * * 0 10† * * 0 * 10† Other disease of respiratory system 30 0 0 0 0 0 0 0 * 0 16 0 * * 0 0 0 20† * 0 * * 10† Peptic ulcer 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 * 0 0 0† * 0 0 0 0† Diseases of appendix 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 Hernia 0† 0 0 0 0 0 0 0 0 0 0 0 0 * * 0 0 0† 0 0 0 0 0 122 * 0 * * 0 * 0 * * 39 * * 8 * 10 0 80† 15 6 * 22 50† 101 0 0 * * 0 * 0 * * 33 * * 8 * 8 0 70† 11 * * 19 40† 21 * 0 0 0 0 0 0 0 0 6 0 0 0 * * 0 10† * * 0 * 10† 10† 0 0 0 0 0 0 0 0 0 * * 0 0 0 0 0 0† * * 0 0 29 * 0 0 0 0 0 0 * 0 10 * * * * * 0 20† * * 0 * 10† Acute and rapidly progressive nephritic and nephrotic syndrome 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Chronic glomerulonephritis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 * 0 0 0 0 0 0 * 0 10 * * * * * 0 20† * * 0 * 10† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Aortic aneurysm and dissection Other disease of arteries, arterioles and capillaries Chronic lower respiratory diseases Pneumoconioses and chemical effects Pneumonitis due to solids and liquids Chronic liver disease and cirrhosis Alcoholic liver disease Other chronic liver disease and cirrhosis Cholelithiasis and other disorders of gallbladder Nephritis, nephrotic syndrome and nephrosis Renal failure Others disorders of kidney Infections of kidney 66 Resided on reservation Ak-Chin Indian Community Cause of death (Tenth Revision, International Statistical Classification of Diseases) ALL AMERICAN INDIAN RESIDENTS OF ARIZONA 5.6 (continued) DEATHS BY RESIDENCE FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 0† 0 0† 0† Health Status Profile of American Indians in Arizona, 2011 Data Book Hyperplasia of prostate Total elsewhere in Arizona in Coconino County in Pima County Total in Maricopa County Resided off reservation Salt River Pima Maricopa Indian San Carlos Apache Tribe Tohono O'Odham Nation White Mountain Apache Tribe Yavapai-Apache Nation Pascua Yaqui Tribe Navajo Nation Hualapai Tribe Hopi Tribe Havasupai Tribe Cocopah Tribe Colorado River Indian Tribe Fort McDowell Yavapai Nation Fort Mohave Indian Tribe Gila River Indian Community Resided on reservation Ak-Chin Indian Community Cause of death (Tenth Revision, International Statistical Classification of Diseases) ALL AMERICAN INDIAN RESIDENTS OF ARIZONA 5.6 (continued) DEATHS BY RESIDENCE FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 0 0 0 0 Inflammatory diseases of female pelvic organs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Pregnancy, childbirth and the puerperium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Pregnancy with abortive outcome 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Other complications of pregnancy, childbirth and the puerperium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Perinatal conditions Congenital anomalies, deformations and chromosomal abnormalities Symptoms, signs, abnormal findings 20† 0 * 0 0 * 0 0 * 0 * 0 * * 0 * 0 20† * 0 0 0 0† 10† 0 0 0 0 0 0 0 0 0 * 0 0 * 0 0 0 10† * * 0 * 0† 47 0 0 0 0 0 0 0 * 0 Total accidents 299 0 * 0 * 0 * * 19 Transport accidents 22 0 0 * 0 * 0 30† 7 * * 8 20† * 119 * 9 8 15 23 0 210† 36 * 12 42 90† 153 0 0 0 0 0 * * 9 0 66 0 7 * 10 11 0 110† 13 * 6 21 40† 147 0 0 0 0 0 * * 9 0 63 0 7 * 9 11 0 110† 12 * 6 20 40† Other land transport accidents 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† * 0 0 0 0† Water, air, space 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 * 0 0 0† 0 0 0 * 0† 146 0 * 0 * 0 0 0 10 * 53 * * * * 12 0 100† 23 * 6 29 0 0 0 0 0 0 0 6 * 11 0 0 0 0 * 0 20† * 0 * * 10† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 0 0 0 0 0 * 0 0 0 0 * * 0 0† * 0 0 * 0† Accidental exposure to smoke, fire and flames 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† 0 0 0 0 0 Accidental poisoning 75 0 * 0 * 0 0 0 * * 25 * * * * 9 0 50† 13 * * 8 30† Excessive natural heat 10† 0 0 0 0 0 0 0 0 0 * * 0 0 0 0 0 0† 0 0 0 * 0† Excessive natural cold 10† 0 0 0 0 0 0 0 0 0 * 0 0 * 0 * 0 10† 0 0 * * 0† 34 0 0 0 0 0 0 0 0 0 16 * 0 * * * 0 20† * 0 * 7 10† Motor vehicle accidents Nontransport accidents Falls Accidental discharge of firearms Accidental drowning and submersion Other and unspecified nontransport accidents Intentional self-harm (suicide) By discharge of firearms By other means Assault (homicide) 21 50† 56 0 0 0 * 0 0 0 * 0 30 0 0 * * * 0 40† * * * 6 10† 10† 0 0 0 * 0 0 0 0 0 9 0 0 * 0 0 0 10† * 0 * 0 43 0 0 0 0 0 0 0 * 0 21 0 0 * * * 0 30† * * * 6 10† 0† 43 0 0 0 0 0 * 0 * 0 15 0 * * * * 0 30† * * * 7 20† By discharge of firearms 18 0 0 0 0 0 0 0 * 0 7 0 0 * * 0 0 10† * 0 0 * 10† By other means 25 0 0 0 0 0 * 0 * 0 8 0 * * * * 0 20† * * * * 10† Legal intervention 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 0 0 0 0 * 0 * 0 0 0 * * 0 10† 0 * * * 0† 0† Events of undetermined intent Discharge of firearms 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0† 0 0 0 * 10† 0 0 0 0 0 0 0 * 0 * 0 0 0 * * 0 10† 0 * * 0 0† 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 INJURY BY FIREARMS 33 0 0 0 * 0 0 0 * 0 16 0 0 * * 0 0 20† * 0 * * 10† DRUG-INDUCED DEATHS 32 0 0 0 * 0 0 0 * * 8 * * 0 * * 0 20† 9 * 0 * 20† 191 * * * * 0 * * * * 70 * 8 15 * 20 0 130† 19 * 6 29 60† Other and unspecified events of undetermined intent Operations of war Complications of medical and surgical care ALCOHOL-INDUCED DEATHS Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 67 Total, all causes Unknown Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise 1,700† 420 * 214 79 12 0 21 255 24 357 161 102 0 17 13 27 Salmonella infections 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Shigellosis and amebiasis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† * 0 * 0 0 0 0 * 0 * 0 0 0 0 0 0 10† 0 0 * 0 0 0 0 * 0 * 0 0 0 0 0 0 0† * 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0† * 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Whooping cough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Scarlet fever and erysipelas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Meningococcal infection 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30† 11 0 6 * 0 0 0 * * * * * 0 0 * * Syphilis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Acute poliomyelitis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Arthropod-borne encephalitis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Measles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 10† 0 0 * 0 0 0 0 * 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† * 0 0 * 0 0 0 * 0 * * 0 0 0 * * Certain other intestinal infections Enterocolitis due to Clostridium difficile Tuberculosis Respiratory tuberculosis Other tuberculosis Septicemia Viral hepatitis Human immunodeficiency virus (HIV) disease Malaria Other and unspecified infectious and parasitic diseases Malignant neoplasms 200† 56 0 15 14 * 0 * 35 * 39 21 11 0 0 0 * Malignant neoplasm of lip, oral cavity and pharynx 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 Malignant neoplasm of esophagus 0† * 0 * 0 0 0 0 0 0 * 0 * 0 0 0 0 Malignant neoplasm of stomach 20† 6 0 * * 0 0 0 * 0 * * 0 0 0 0 0 Malignant neoplasm of colon, rectum and anus 20† 6 0 * * 0 0 0 8 0 * * * 0 0 0 0 Malignant neoplasm of liver and intrahepatic bile ducts 30† 6 0 * * 0 0 * * 0 * * * 0 0 0 * Malignant neoplasm of pancreas 20† * 0 * 0 * 0 0 * * * * * 0 0 0 0 0† * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† * 0 * 0 0 0 * * 0 * 0 * 0 0 0 0 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 10† * 0 * 0 * 0 0 * * * * 0 0 0 0 0 Malignant neoplasm of cervix uteri 0† * 0 0 * 0 0 0 0 0 * 0 0 0 0 0 0 Malignant neoplasm of corpus uteri and uterus, part unspecified 0† * 0 0 0 0 0 0 * 0 0 * 0 0 0 0 0 Malignant neoplasm of ovary 10† * 0 0 * 0 0 0 * 0 * 0 0 0 0 0 0 Malignant neoplasm of prostate 10† * 0 * 0 0 0 0 * 0 * * 0 0 0 0 0 Malignant neoplasm of kidney and renal pelvis 10† * 0 * * 0 0 0 * 0 * * 0 0 0 0 0 Malignant neoplasm of bladder 10† * 0 * 0 0 0 0 * 0 * 0 * 0 0 0 0 Malignant neoplasm of larynx Malignant neoplasm of trachea, bronchus and lung Malignant melanoma of skin Malignant neoplasm of breast 68 Apache Cause of death (Tenth Revision, International Statistical Classification of Diseases) ARIZONA 5.7 DEATHS BY COUNTY OF RESIDENCE FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Health Status Profile of American Indians in Arizona, 2011 Data Book Malignant neoplasm of meninges, brain and other parts of CNS Unknown Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise Apache Cause of death (Tenth Revision, International Statistical Classification of Diseases) ARIZONA 5.7 (continued) DEATHS BY COUNTY OF RESIDENCE FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 0† * 0 0 * 0 0 0 * 0 0 * 0 0 0 0 0 10† * 0 * * 0 0 * * 0 * * * 0 0 0 0 Hodgkin's disease 0† 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 Non-Hodgkin's lymphoma 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 10† 0 0 * 0 0 0 * * 0 * 0 * 0 0 0 0 0† * 0 0 * 0 0 0 0 0 0 * * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30† 11 0 * * 0 0 * * 0 6 * 0 0 0 0 * In situ neoplasms 0† * 0 * 0 0 0 0 0 0 0 0 * 0 0 0 0 Anemias 0† * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Diabetes 130† 27 0 * 6 0 0 * 37 0 21 15 9 0 * 0 * 0† * 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0† * 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 * 0 0 0 0 * 0 * * * 0 0 0 0 0† 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 Parkinson's disease 20† * 0 * * 0 0 0 * 0 * * 0 0 * 0 0 Alzheimer's disease 30† * 0 * * * 0 0 7 0 6 * * 0 0 0 * 280† 60 0 36 8 * 0 6 29 6 79 29 15 0 * * 6 220† 49 0 25 8 * 0 6 20 * 59 22 12 0 * 0 * 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 10† * 0 * 0 0 0 0 0 * * * * 0 0 0 0 0† 0 0 * 0 0 0 0 0 0 0 * 0 0 0 0 0 150† 33 0 13 6 * 0 * 16 * 38 14 10 0 * 0 * 50† 15 0 * * 0 0 * * * 14 * 0 0 0 0 * 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 * 100† 18 0 10 * * 0 * 12 * 24 9 10 0 * 0 * 0 Malignant neoplasm of lymphoid, hematopoietic and related tissue Leukemia Multiple myeloma and immunoproliferative neoplasms Other and unspecified malignant neoplasms of lymphoid tissue All other and unspecified malignant neoplasm Nutritional deficiencies Malnutrition Other nutritional deficiencies Obesity Meningitis Major cardiovascular diseases Diseases of heart Acute rheumatic fever and chronic rheumatic heart disease Hypertensive heart disease Hypertensive heart and renal disease Ischemic heart disease Acute myocardial infarction Other acute ischemic heart disease Other forms of chronic ischemic heart disease Atherosclerotic cardiovascular disease 30† 6 0 6 * 0 0 * * 0 * 0 * 0 * 0 All other forms of chronic ischemic heart disease 70† 12 0 * * * 0 * 7 * 20 9 7 0 0 0 * 60† 14 0 10 * 0 0 * * 0 19 6 * 0 0 0 * Acute and subacute endocarditis 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 Diseases of pericardium and acute myocarditis 0† 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 Heart failure 20† 8 0 * * 0 0 0 0 0 * * 0 0 0 0 0 All other forms of heart disease 40† 6 0 9 * 0 0 * * 0 15 * * 0 0 0 * Other heart diseases Essential (primary) hypertension and hypertensive renal disease 10† * 0 0 0 0 0 0 * 0 * * * 0 0 * 0 Cerebrovascular diseases 50† 10 0 11 0 0 0 0 * * 14 * * 0 * * * Health Status Profile of American Indians in Arizona, 2011 Data Book 69 Unknown Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise Atherosclerosis 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 Other diseases of circulatory system 0† 0 0 0 0 0 0 0 0 0 * * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† 0 0 0 0 0 0 0 0 0 * * 0 0 0 0 0 Aortic aneurysm and dissection Other disease of arteries, arterioles and capillaries Other disorders of circulatory system 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 50† 18 0 8 0 * 0 0 * 0 12 * * 0 0 0 * 0† 0 0 * 0 0 0 0 * 0 0 0 0 0 0 0 0 50† 18 0 7 0 * 0 0 * 0 12 * * 0 0 0 * Other acute lower respiratory infections 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Acute bronchiolitis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Unspecified acute lower respiratory infection 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30† 6 0 * 0 0 0 0 7 * * * * 0 0 0 0 Bronchitis, chronic and unspecified 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Emphysema 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† * 0 0 0 0 0 0 * * 0 0 0 0 0 0 0 20† * 0 * 0 0 0 0 6 * * * * 0 0 0 0 Influenza and pneumonia Influenza Pneumonia Chronic lower respiratory diseases Asthma Other chronic lower respiratory diseases Pneumoconioses and chemical effects 0† * 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 Pneumonitis due to solids and liquids 10† * 0 * * 0 0 0 * 0 6 * 0 0 0 0 0 Other disease of respiratory system 30† 7 0 8 * 0 0 0 * 0 6 0 * 0 * 0 * Peptic ulcer 0† * 0 0 0 0 0 0 * 0 0 * 0 0 0 0 0 Diseases of appendix 0† 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 * 0 Hernia Chronic liver disease and cirrhosis Alcoholic liver disease Other chronic liver disease and cirrhosis 0† 0 0 0 * 0 0 0 0 0 0 * 0 0 0 0 120† 25 0 9 9 0 0 * 22 * 26 12 13 0 0 0 * 100† 21 0 8 9 0 0 * 18 * 22 7 10 0 0 0 * 20† * 0 * 0 0 0 0 * 0 * * * 0 0 0 0 Cholelithiasis and other disorders of gallbladder 10† * 0 0 0 0 0 0 * 0 0 * 0 0 0 0 0 Nephritis, nephrotic syndrome and nephrosis 30† * * * 6 0 0 0 * 0 * 6 * 0 0 0 0 Acute and rapidly progressive nephritic and nephrotic syndrome 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Chronic glomerulonephritis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30† * * * 6 0 0 0 * 0 * 6 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Inflammatory diseases of female pelvic organs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Pregnancy, childbirth and the puerperium 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Renal failure Others disorders of kidney Infections of kidney Hyperplasia of prostate Pregnancy with abortive outcome 70 Apache Cause of death (Tenth Revision, International Statistical Classification of Diseases) ARIZONA 5.7 (continued) DEATHS BY COUNTY OF RESIDENCE FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 Health Status Profile of American Indians in Arizona, 2011 Data Book Other complications of pregnancy, childbirth and the puerperium Perinatal conditions Unknown Yuma Yavapai Santa Cruz Pinal Pima Navajo Mohave Maricopa La Paz Greenlee Graham Gila Coconino Cochise Apache Cause of death (Tenth Revision, International Statistical Classification of Diseases) ARIZONA 5.7 (continued) DEATHS BY COUNTY OF RESIDENCE FOR SELECTED CAUSES AMONG AMERICAN INDIANS, ARIZONA, 2011 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20† * 0 0 * * 0 0 * * 6 0 0 0 0 * 0 Congenital anomalies, deformations and chromosomal abnormalities 10† * 0 * * 0 0 0 * 0 * * * 0 0 0 0 Symptoms, signs, abnormal findings 50† 14 0 8 * 0 0 0 7 0 10 * * 0 * 0 0 300† 76 0 45 7 * 0 * 49 7 66 19 17 0 * * * 150† 42 0 25 * * 0 * 23 0 33 12 10 0 0 * * 150† 42 0 22 * * 0 * 22 0 33 11 10 0 0 * * 0† 0 0 * 0 0 0 0 * 0 0 0 0 0 0 0 0 0† 0 0 * 0 0 0 0 0 0 0 * 0 0 0 * 0 150† 34 0 20 6 0 0 0 26 7 33 7 7 0 * * * Total accidents Transport accidents Motor vehicle accidents Other land transport accidents Water, air, space Nontransport accidents Falls 30† 8 0 6 * 0 0 0 * * 6 0 * 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 0 0 0 0 * * * * * 0 0 0 0 0† * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80† 11 0 10 * 0 0 0 16 * 23 * * 0 * * * Excessive natural heat 10† * 0 * 0 0 0 0 0 * 0 * 0 0 0 0 * Excessive natural cold 10† * 0 * * 0 0 0 0 0 * 0 * 0 0 0 0 Other and unspecified nontransport accidents 30† 14 0 * * 0 0 0 * * * * * 0 0 0 * 0 Accidental discharge of firearms Accidental drowning and submersion Accidental exposure to smoke, fire and flames Accidental poisoning Intentional self-harm (suicide) 60† 22 0 9 * * 0 0 * * 12 * * 0 0 0 By discharge of firearms 10† * 0 * * 0 0 0 * 0 * 0 0 0 0 0 0 By other means 40† 18 0 6 0 * 0 0 * * 9 * * 0 0 0 0 Assault (homicide) 40† 8 0 9 * 0 0 * 7 0 * * * 0 * 0 0 By discharge of firearms 20† * 0 * * 0 0 0 * 0 * * * 0 * 0 0 By other means 30† * 0 6 * 0 0 * * 0 * * * 0 0 0 0 Legal intervention 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 * 0 0 0 0 0 0 * * * 0 0 0 0 Events of undetermined intent Discharge of firearms 0† 0 0 0 0 0 0 0 0 0 * 0 * 0 0 0 0 10† 0 0 * 0 0 0 0 0 0 * * 0 0 0 0 0 0† 0 0 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 INJURY BY FIREARMS 30† 8 0 6 * 0 0 0 * 0 * * * 0 * 0 0 DRUG-INDUCED DEATHS 30† * 0 * 0 0 0 0 11 * * * * 0 * 0 0 190† 44 0 21 15 * 0 * 29 * 48 9 13 0 * * * Other and unspecified events of undetermined intent Operations of war Complications of medical and surgical care ALCOHOL-INDUCED DEATHS Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 71 5.8 DEATHS FROM MOTOR VEHICLE-RELATED INJURIES AMONG AMERICAN INDIANS BY PLACE OF RESIDENCE, GENDER, AND AGE GROUP, ARIZONA, 2011 TOTAL M F ALL AGES <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ ALL AGES <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ ALL AGES <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 75-84 147 0† 0† 0† 34 39 19 20† 10† 10† 10† 0† 107 0† 0† 0† 28 24 14 20† 10† 10† 0† 0† 40 0† 0† 10† 20† 10† 10† 0† 0† 0† 0† 0 0 0 0 * * 0 * * 0 0 0† 0 0 0 0 0 * 0 * 0 0 0 0† 0 0 0 * 0 0 0 * 0 0† 0 0 0 0 0 0 0 * 0 0 0 0† 0 0 0 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 * 0 * * 0 * * 0 * 0 10† 0 * 0 * * 0 * * 0 * 0 0† 0 0 * 0 0 0 0 0 0 60† 0 0 * 19 18 6 7 * * * * 50† 0 0 * 16 9 * 6 * * * * 20† 0 0 * 9 * * 0 0 * 10† 0 0 0 * * 0 * 0 0 0 0 10† 0 0 0 * * 0 * 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0† 0 0 0 * * 0 * 0 0 0 0 0† 0 0 0 * 0 0 0 0 0 0 0 0† 0 0 0 * 0 * 0 0 0 10† 0 0 0 0 * * * * * 0 0 10† 0 0 0 0 * * * * 0 0 0 0† 0 0 0 0 * 0 * * 0 10† * 0 * * * 0 * 0 0 * 0 10† * 0 0 * * 0 0 0 0 * 0 0† * * 0 0 0 * 0 0 0 110† 0† 0† 0† 30† 30† 10† 20† 10† 10† 10† 0† 80† 0† 0† 0† 20† 20† 10† 10† 10† 0† 0† 0† 30† 0† 0† 0† 10† 0† 0† 0† 0† 0† 10† 0 0 0 0 * * * * 0 0 0 10† 0 0 0 0 * * * * 0 0 0 0† 0 0 0 * 0 0 * 0 0 0† 0 0 0 * 0 0 0 0 * 0 0 0† 0 0 0 * 0 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0 0 10† 0 0 0 * * * 0 0 0 0 0 0† 0 0 0 * 0 * 0 0 0 0 0 0† 0 0 * * 0 0 0 0 0 20† 0 * 0 * * * * * * 0 0 10† 0 * 0 * * * * * * 0 0 10† 0 0 * * * * 0 0 0 TOTAL ---elsewhere in Arizona ---in Coconino County ---in Pima County ---in Maricopa County TOTAL White Mountain Apache Tribe Resided off reservation Tohono O'Odham Nation San Xavier San Carlos Apache Tribe Pasqua Yaqui Tribe Navajo Nation Hopi Tribe Ak-Chin Indian Community TOTAL Resided on reservation 40† 0† 0† 0† 10† 10† 10† 10† 0† 0† 0† 0† 30† 0† 0† 0† 10† 10† 10† 0† 0† 0† 0† 0† 10† 0† 0† 0† 0† 0† 0† 0† 0† 0† Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 72 Health Status Profile of American Indians in Arizona, 2011 Data Book 5.9 INTENTIONAL SELF-HARM (SUICIDE) AMONG AMERICAN INDIANS BY PLACE OF RESIDENCE, GENDER, AND AGE GROUP, ARIZONA, 2011 TOTAL M F TOTAL ---elsewhere in Arizona ---in Coconino County ---in Pima County ---in Maricopa County TOTAL Tohono O'Odham Nation Resided off reservation San Xavier San Carlos Apache Tribe Navajo Nation Hopi Tribe TOTAL Salt River PimaMaricopa Indian Community Resided on reservation ALL AGES 56 0† 0† 30† 0† 0† 10† 40† 0† 0† 0† 10† 10† 5-14 0† 0 0 0 0 0 * 0† 0 0 0 0 0 15-24 25 * * 11 * 0 * 20† * * * * 10† 25-34 10† 0 0 * 0 * * 10† * 0 * 0 0† 35-44 10† 0 0 9 0 0 0 9 * * 0 * 0† 45-54 10† 0 * * 0 0 0 10† 0 0 0 * 0† 55-64 0† 0 * * 0 0 0 0† 0 0 0 0 0 ALL AGES 45 0† 0† 30† 0† 0† 0† 30† 0† 0 0† 10† 10† 15-24 20 * * 10 * 0 0 10† * 0 * * 10† 25-34 10† 0 0 * 0 * * 10† * 0 * 0 0† 35-44 10† 0 0 8 0 0 0 8 * 0 0 * 0† 45-54 10† 0 * * 0 0 0 0† 0 0 0 * 0† 55-64 0† 0 * * 0 0 0 0† 0 0 0 0 0 ALL AGES 11 0 0 0† 0 0 0† 10† 0 0† 0 0† 0† 5-14 0† 0 0 0 0 0 * 0† 0 0 0 0 0 15-24 10† 0 0 * 0 0 * 0† 0 * 0 0 0† 25-34 0† 0 0 * 0 0 0 0† 0 0 0 0 0 35-44 0† 0 0 * 0 0 0 0† 0 * 0 * 0† 45-54 0† 0 0 * 0 0 0 0† 0 0 0 0 0 Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. Health Status Profile of American Indians in Arizona, 2011 Data Book 73 5.10 ASSAULT (HOMICIDE) AMONG AMERICAN INDIANS BY PLACE OF RESIDENCE, GENDER, AND AGE GROUP, ARIZONA, 2011 TOTAL M F TOTAL ---elsewhere in Arizona ---in Coconino County ---in Pima County TOTAL San Xavier ---in Maricopa County Resided off reservation San Carlos Apache Tribe Salt River PimaMaricopa Indian Community Navajo Nation Hopi Tribe Colorado River Indian Tribe TOTAL Gila River Indian Community Resided on reservation ALL AGES 43 0† 0† 20† 0† 0† 0† 0† 30† 0† 0† 0† 10† 20† <1 0† 0 0 * 0 0 0 0 0† 0 0 0 * 0† 1-4 0† 0 0 * 0 0 0 0 0† 0 0 0 0 0 15-24 10† 0 * * 0 0 * 0 10† * * * 0 0† 25-34 10† 0 * * 0 * 0 * 10† * * 0 * 10† 35-44 10† * * * 0 * 0 0 10† * 0 0 * 0† 45-54 10† * * * * * 0 0 10† 0 0 0 * 0† 55-64 0† 0 0 0 0 0 0 0 0 0 0 0 * 0† ALL AGES 34 0† 0† 10† 0† 0† 0† 0† 20† 0† 0† 0† 10† 10† 1-4 0† 0 0 * 0 0 0 0 0† 0 0 0 0 0 15-24 10† 0 * * 0 0 * 0 10† * * * 0 0† 25-34 10† 0 * * 0 * 0 * 10† * * 0 * 10† 35-44 10† * * * 0 * 0 0 10† * 0 0 * 0† 45-54 0† * 0 * * 0 0 0 0† 0 0 0 * 0† 9 0 0† 0† 0 0† 0 0 10† 0 1 0 0† 0† <1 0† 0 0 * 0 0 0 0 0† 0 0 0 * 0† 15-24 0† 0 0 0 0 0 0 0 0 0 * 0 0 0† 35-44 0† 0 0 * 0 0 0 0 0† 0 0 0 0 0 45-54 0† 0 * * 0 * 0 0 0† 0 0 0 0 0 55-64 0† 0 0 0 0 0 0 0 0 0 0 0 * 0† ALL AGES Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 74 Health Status Profile of American Indians in Arizona, 2011 Data Book 5.11 (correction) DIABETES-RELATED DEATHS AMONG AMERICAN INDIANS BY PLACE OF RESIDENCE, GENDER, AND AGE GROUP, ARIZONA, 2011 TOTAL M TOTAL ---elsewhere in Arizona ---in Coconino County ---in Pima County ---in Maricopa County TOTAL Yavapai-Apache Nation White Mountain Apache Tribe Tohono O'Odham Nation San Carlos Apache Tribe Salt River PimaMaricopa Indian Community Pascua Yaqui Tribe Navajo Nation Hualapai Tribe Hopi Tribe Havasupai Tribe Fort McDowell Yavapai Nation Reservation Colorado River Indian Tribe Resided off reservation ALL AGES 248 0† 0† 0† 0† 0† 10† 0† 60† 0† 20† 10† 10† 20† 0† 146 40† 20† 10† 50† 25-34 10† 0 0 0 * 0 0 0 0 0 * 0 0 * 0 0† * * 0 * 0† 35-44 17 0 * 0 0 0 0 0 * 0 * 0 * * 0 10† * * * * 10† 45-54 37 * 0 0 0 0 0 0 12 0 * * * * 0 20† * * * 9 20† 55-64 55 0 0 * 0 0 * * 9 * 7 * * 7 0 30† 10 * 0 10 20† 65-74 66 0 0 * 0 * * * 20 0 * * * * * 40† 11 * 0 9 20† 75-84 44 0 0 * 0 0 * 0 15 0 * * * * 0 30† * * * 8 20† 85+ 22 0 0 0 * 0 * 0 * 0 * 0 0 * * 10† * * 0 * 10† 111 0† 0† 0† 0† 0 10† 0† 40† 0 10† 0† 0† 10† 0 70 10† 10† 0† 20† 41 25-34 0† 0 0 0 * 0 0 0 0 0 0 0 0 0 0 0† * 0 0 * 0† 35-44 10† 0 * 0 0 0 0 0 * 0 * 0 0 * 0 0† * * * * 10† 45-54 24 * 0 0 0 0 0 0 11 0 * * * * 0 20† * * * * 10† 55-64 27 0 0 * 0 0 * * * 0 * * 0 * 0 20† * * 0 * 10† 65-74 25 0 0 0 0 0 * * 11 0 * * * 0 0 20† * * 0 * 10† 75-84 20† 0 0 0 0 0 * 0 6 0 0 * * * 0 10† * 0 0 * 10† 6 0 0 0 0 0 * 0 * 0 0 0 0 * 0 10† 0 0 0 0 0 137 0 0 0† 0† 0† 10† 0 20† 0† 20† 10† 10† 10† 0† 76 20† 10† 0† 30† 61 ALL AGES 85+ F Cocopah Tribe TOTAL Ak-Chin Indian Community Resided on reservation ALL AGES 102 25-34 0† 0 0 0 0 0 0 0 0 0 * 0 0 * 0 0† 0 * 0 * 0† 35-44 10† 0 0 0 0 0 0 0 * 0 * 0 * 0 0 0† * 0 * * 0† 45-54 10† 0 0 0 0 0 0 0 * 0 * * * 0 0 10† * 0 * * 10† 55-64 28 0 0 0 0 0 0 0 * * * * * * 0 20† * * 0 7 10† 65-74 41 0 0 * 0 * * 0 9 0 * * * * * 30† 9 * 0 * 20† 75-84 28 0 0 * 0 0 * 0 9 0 * * 0 * 0 20† * * * * 10† 85+ 16 0 0 0 * 0 * 0 0 0 * 0 0 * * 10† * * 0 * 10† Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; Diabetes-related: deaths due to diabetes reported as multiple cause of death (any mention of diabetes on the death certificate). The number of deaths due to diabetes as the underlying cause of death (129 in 2011) is shown in Tables 5.4 - 5.7. Health Status Profile of American Indians in Arizona, 2011 Data Book 75 5.12 ALCOHOL-INDUCED DEATHS AMONG AMERICAN INDIANS BY PLACE OF RESIDENCE, GENDER, AND AGE GROUP, ARIZONA, 2011 F ---elsewhere in Arizona Yavapai Apache Nation White Mountain Apache Tribe 70† 0† 10† 20† 0† 20† 10† 10† 30† 60† 0 * 0 * 0 0 6 10† 0 0 * 0 0† 25-34 27 0 0 0 * 0 * 0 0 8 0 * * 0 8 20† 0 0 * 6 10† 35-44 46 * * 0 0 0 0 * 0 18 * * * * * 30† * * * * 10† 45-54 56 0 0 * 0 * 0 * * 21 0 * * * * 30† 7 * * 11 20† 55-64 37 0 0 0 0 * 0 * * 15 0 * * * * 30† * 0 0 * 10† 65-74 10† 0 0 0 0 * 0 0 0 * 0 0 0 0 0 10† * * 0 * 10† ALL AGES 20† 130† ---in Pima County Salt River PimaMaricopa Indian Community Navajo Nation Hopi Tribe TOTAL 0† 0 ---in Coconino County 10† 0 ---in Maricopa County 0† 0 TOTAL 0† 0 75-84 M Tohono O'Odham Nation 0† 0 San Xavier 0† 0 Pascua Yaqui Tribe Gila River Indian Community 0† 0 Hualapai Nation Fort McDowell Yavapai Nation Reservation 0† 10† ALL AGES Havasupai Tribe Colorado River Indian Tribe 190† 15-24 TOTAL TOTAL Resided off reservation San Carlos Apache Tribe Resided on reservation 0† 0 0 0 0 0 0 0 0 * 0 0 * 0 0 0† 0 0 0 0 0 120† 0† 0† 0 0† 0† 0† 0† 0 50† 0 0† 10† 0† 10† 80† 10† 0† 10† 20† 40† 15-24 10† 0 0 0 0 0 0 0 0 0 0 0 0 0 * 10† 0 0 * 0 0† 25-34 18 0 0 0 * 0 * 0 0 * 0 0 * 0 * 10† 0 0 * * 10† 35-44 32 * * 0 0 0 0 * 0 15 0 * * 0 * 20† * * * * 10† 45-54 34 0 0 0 0 0 0 0 0 13 0 * * 0 * 20† * 0 * 9 20† 55-64 22 0 0 0 0 * 0 0 0 11 0 0 * * 0 20† * 0 0 * 10† 65-74 10† 0 0 0 0 * 0 0 0 * 0 0 0 0 0 0† * * 0 * 0† 75-84 0† 0 0 0 0 0 0 0 0 * 0 0 * 0 0 0† 0 0 0 0 0 70† 0 0 0† 0 0† 0 0† 0† 20† 0† 10† 10† 0† 10† 50† 10† 0† 0 10† 20† 15-24 0† 0 0 0 0 0 0 0 0 * 0 * 0 0 * 0† 0 0 0 0 0 25-34 10† 0 0 0 0 0 0 0 0 * 0 * 0 0 * 10† 0 0 0 * 0† 35-44 10† 0 0 0 0 0 0 * 0 * * 0 * * * 10† * 0 0 * 0† 45-54 22 0 0 * 0 * 0 * * 8 0 0 0 * * 20† * * 0 * 10† 55-64 20† 0 0 0 0 0 0 * * * 0 * * 0 * 10† * 0 0 * 0† 65-74 0† 0 0 0 0 0 0 0 0 * 0 0 0 0 0 0† 0 0 0 * 0† 75-84 0† 0 0 0 0 0 0 0 0 0 0 0 * 0 0 0† 0 0 0 0 0 ALL AGES Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6. 76 Health Status Profile of American Indians in Arizona, 2011 Data Book COMPARATIVE CAUSE-SPECIFIC MORTALITY Health Status Profile of American Indians in Arizona, 2011 Data Book 77 5.13 Temporal Changesa in the Selected Leading Causes of Death among American Indian Residents of Arizona, 1991-2011 Notes: a Based on age-adjusted mortality rates: Number of deaths per 100,000 population age-adjusted to the 2000 U.S. standard. See Table 2B-3 in the “Arizona Health Status and Vital Statistics 2011” report. 78 Health Status Profile of American Indians in Arizona, 2011 Data Book 5.14 Five Leading Causes of Deatha by Gender among American Indian Residents of Arizona in 2011 Rank Female Both Male 1 Diseases of heart 92.7 Diseases of heart 111.1 Unintentional injury 146.7 2 Cancer 90.9 Cancer 100.8 Diseases of heart 131.1 3 Diabetes 68.8 Unintentional injury 100.6 Cancer 116.3 4 Unintentional injury 58.0 Diabetes 61.3 Diabetes 50.7 5 Chronic liver disease and cirrhosis 40.4 Chronic liver disease and cirrhosis 43.6 Chronic liver disease and cirrhosis 46.7 Notes: a Based on age-adjusted mortality rates: Number of deaths per 100,000 population age-adjusted to the 2000 U.S. standard. See Table 2B-4 in the “Arizona Health Status and Vital Statistics 2011” report. Health Status Profile of American Indians in Arizona, 2011 Data Book 79 5.15 Five Leading Causes of Deatha among American Indians by Gender and Residence On or Off Reservation, Arizona, 2011 Rank Female, resided on reservation Female, resided off reservation Male, resided on reservation Male, resided off reservation 1 Diseases of heart 12.7 Cancer 15.1 Unintentional injury 24.5 Unintentional injury 20.5 2 Cancer 12.5 Diabetes 14.7 Diseases of heart 13.3 Diseases of heart 13.1 3 Unintentional injury 10.6 Unintentional injury 11.6 Cancer 11.0 Cancer 9.9 4 Diabetes 7.9 Diseases of heart 10.4 Chronic liver disease and cirrhosis 6.2 Chronic liver disease and cirrhosis 8.0 5 Chronic liver disease and cirrhosis 7.4 Chronic liver disease and cirrhosis 8.0 Suicide 5.6 Diabetes 6.4 Note: 80 a Percent of total deaths in specified group. Health Status Profile of American Indians in Arizona, 2011 Data Book 5.16 Proportional Mortalitya by Type of Cancer and Gender among American Indians and all Residents of Arizona, 2001-2011 Rank Arizona male b American Indian Male Arizona female b American Indian female 1 Trachea, bronchus, lung 27.9 Lymphoma 11.5 Trachea, bronchus, lung 25.5 Breast 12.5 2 Lymphoma 10.8 Prostate 11.0 Breast 15.4 Lymphoma 11.0 3 Prostate 10.4 Liver 9.7 Colon, rectum, anus 9.5 Ovary 8.1 4 Colon, rectum, anus 9.3 Trachea, bronchus, lung 9.3 Lymphoma 9.4 Trachea, bronchus, lung 7.7 5 Pancreas 5.9 Kidney 9.0 Pancreas 6.2 Colon, rectum, anus 6.9 6 Leukemia 4.4 Colon, rectum, anus 8.8 Ovary 6.0 Liver 6.4 7 Non-Hodgkin's lymphoma 4.0 Stomach 8.4 Non-Hodgkin's lymphoma 3.9 Pancreas 6.2 8 Liver 4.0 Pancreas 6.5 Leukemia 3.5 Stomach 5.7 9 Esophagus 3.8 Leukemia 4.1 Brain 2.5 Cervix uteri 4.5 10 Bladder 3.5 Esophagus 3.7 Liver 2.4 Kidney 4.0 Notes: a Percent of cancer deaths in specified group in 2001-2011. All race/ethnic groups combined. See Table 5-18 for percentages based on frequency counts. b Health Status Profile of American Indians in Arizona, 2011 Data Book 81 5.17 Proportional Mortalitya by Mechanism of Unintentional Injury and Gender among American Indians and all Residents of Arizona, 2001-2011 Rank Arizona maleb American Indian Male Arizona femaleb American Indian female 1 Motor vehicle-related 37.5 Motor vehicle-related 53.9 Falls 33.0 Motor vehicle-related 61.8 2 Poisoning by drugs 22.9 Poisoning by drugs 8.9 Motor vehicle-related 29.1 Falls 11.8 3 Falls 16.9 Falls 6.8 Poisoning by drugs 20.6 Poisoning by drugs 8.6 4 Accidental drowning 3.6 Poisoning by gases 6.2 Misadventures to patients 2.2 Poisoning by gases 3.7 5 Poisoning by gases 2.0 Exposure to cold 5.3 Choked on objects other than food 2.2 Misadventures to patients 1.9 6 Exposure to heat 1.9 Accidental drowning 3.0 Accidental drowning 2.1 Exposure to cold 1.8 7 Choked on objects other than food 1.5 Railway accidents 1.5 Fire, flames, smoke 1.5 Choked on objects other than food 1.4 8 Fire, flames, smoke 1.4 Mechanical suffocation 1.5 Chocked on food 1.4 Accidental drowning 1.3 9 Chocked on food 1.2 Fire, flames, smoke 1.5 Exposure to heat 1.1 Fire, flames, smoke 1.2 10 Mechanical suffocation 1.2 Exposure to heat 1.4 Poisoning by gases 1.1 Railway accidents 0.8 Notes: 82 a Percent of unintentional injury deaths in specified group in 2001-2011. All race/ethnic groups combined. See Table 5-19 for percentages based on frequency counts. b Health Status Profile of American Indians in Arizona, 2011 Data Book 5.18 (correction) COMPARISON OF MORTALITY BY SPECIFIC TYPE OF CANCER BY GENDER AMONG AMERICAN INDIANS AND ALL RESIDENTSa OF ARIZONA, 2001-2011 ALL RESIDENTS OF ARIZONA TOTAL Malignant neoplasms, total MALE AMERICAN INDIANS OR ALASKA NATIVES FEMALE TOTAL MALE FEMALE 107,765 57,807 49,955 2,111 1,010 1,100 Malignant neoplasm of lip, oral cavity and pharynx 1,413 1,006 407 26 18 8 Malignant neoplasm of esophagus 2,754 2,218 536 48 37 11 Malignant neoplasm of stomach 2,113 1,274 839 148 85 63 10,108 5,381 4,726 165 89 76 Malignant neoplasm of liver and intrahepatic bile ducts 3,546 2,330 1,216 168 98 70 Malignant neoplasm of pancreas 6,497 3,398 3,099 134 66 68 635 504 131 10† * * 28,880 16,131 12,749 179 94 85 Malignant melanoma of skin 1,904 1,323 581 10† 8 * Malignant neoplasm of breast 7,763 83 7,680 140† * 138 Malignant neoplasm of colon, rectum and anus Malignant neoplasm of larynx Malignant neoplasm of trachea, bronchus and lung 713 0 713 49 0 49 Malignant neoplasm of corpus uteri and uterus, part unspecified Malignant neoplasm of cervix uteri 1,170† * 1,166 35 0 35 Malignant neoplasm of ovary 2,990† * 2,989 89 0 89 Malignant neoplasm of prostate 6,015 6,008 7 111 111 0 Malignant neoplasm of kidney and renal pelvis 2,651 1,712 939 135 91 44 Malignant neoplasm of bladder 2,776 2,021 754 24 12 12 Malignant neoplasm of meninges, brain and other parts of central nervous system 2,729 1,503 1,226 34 20 14 10,943 6,235 4,707 238 116 121 219 133 86 0† * 0 Non-Hodgkin's lymphoma 4,265 2,337 1,927 79 36 42 Leukemia 4,289 2,519 1,770 85 41 44 Multiple myeloma and immunoproliferative neoplasms 2,163 1,242 921 72 37 35 10† * * 0 0 0 12,168 6,678 5,490 370 158 212 Malignant neoplasm of lymphoid, hematopoietic and related tissue Hodgkin's disease Other and unspecified malignant neoplasms of lymphoid tissue All other and unspecified malignant neoplasms a Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; All race/ethnic groups combined. Health Status Profile of American Indians in Arizona, 2011 Data Book 83 5.19 (correction) UNINTENTIONAL INJURY DEATHS BY MECHANISM AND GENDER AMONG AMERICAN INDIANS AND ALL RESIDENTSa OF ARIZONA, 2001-2011 ALL RESIDENTS OF ARIZONA TOTAL 5.19 Railway accidents Motor vehicle -related Water transport accident Accident involving aircraft Poisoning by drugs/medicaments Poisoning by gases and vapors Falls Fire, flames, smoke MALE AMERICAN INDIANS OR ALASKA NATIVES FEMALE TOTAL MALE FEMALE 31,055 19,793 11,256 2,971 2,133 838 107 92 15 40 33 7 10,694 7,414 3,280 1,668 1,150 518 35 25 10 0 0 0 230 194 36 0† * 0 6,856 4,541 2,315 262 190 72 526 405 121 163 132 31 7,056 3,343 3,712 244 145 99 436 269 167 41 31 10 Excessive natural heat 497 368 129 35 29 6 Excessive natural cold 229 189 40 129 114 15 Contact with venomous snakes and lizards 10† * * 0† * 0 Contact with venomous spiders 0† * * 0 0 0 Contact with scorpions 0† * * 0 0 0 10† * * 0 0 0 15 7 8 0† * 0 Lightning 10† 10 * 0† * 0 Storms and floods 10† 9 * 0† * 0 Accidental drowning and submersion 941 703 237 75 64 11 Contact with hornets, wasps, bees Bitten or struck by dog Choked on food 393 239 154 27 20 7 Choked on other objects 551 305 246 37 25 12 Mechanical suffocation 336 235 101 39 32 7 Accidental discharge of firearms 160 129 31 20† 16 * Exposure to electric current 77 77 0 10† * 0 Overexertion 0† * 0 0† * 0 Adverse effects of drugs in therapeutic use Misadventures to patients during medical/surgical care 68 27 41 0† * 0 488 235 253 25 9 16 a Notes: * Cell suppressed due to non-zero count less than 6; † Sum rounded to nearest tens unit due to non-zero addend less than 6; All race/ethnic groups combined. 84 Health Status Profile of American Indians in Arizona, 2011 Data Book TECHNICAL NOTES Health Status Profile of American Indians in Arizona, 2011 Data Book 85 Sources of Data Very low-birthweight - Any neonate whose weight at birth is 1,500 grams or less (less than 3 pounds 5 ounces). The tables in Sections I and II are based on rates and ratios published in the Arizona Health Status and Vital Statistics annual report. Medical Terms Used on the Birth Certificate Information on live births and deaths in Sections III and IV is compiled from the original documents filed with the Arizona Department of Health Services' Office of Vital Records, and from transcripts of original certificates filed in other states but affecting Arizona residents (copies of certificates for births and deaths occurring to Arizona residents outside the United States are not sent to Arizona). Medical risk factors for this pregnancy Definitions Rates Rate is a measure of the frequency of some event in relation to a unit of population during a specified time period such as a year; events in the numerator of the year occur to individuals in the denominator. Rates express the likelihood (or risk) of the event in the specified population during a particular time and are generally expressed as units of population in the denominator (per 1,000, per 100,000, and so forth). Terms Related to Reproductive Health Birth or Live Birth - The complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy which, after such expulsion or extraction, breaths or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. Birth weight - The weight of a neonate determined immediately after delivery or as soon thereafter as possible. Infant death - Any death at any time from birth up to, but not including, the first year of age (364 days, 23 hours, 59 minutes from the moment of birth). Infant mortality rate - Number of infant deaths per 1,000 live births. Low-birthweight - any neonate weighing less than 2,500 grams at birth (less than 5 pounds 8 ounces). Neonatal death - Death of a liveborn neonate before the neonate becomes 28 days old (up to and including 27 days, 23 hours, 59 minutes from the moment of birth). Neonatal mortality rate - Number of neonatal deaths per 1,000 live births. Postneonatal death - Any death of a liveborn infant at least 28 days of age but less than one year of age. Postneonatal mortality rate - Number of postneonatal deaths per 1,000 live births. Health Status Profile of American Indians in Arizona, 2011 Data Book Anemia - Hemoglobin level of less than 10.0 g/dL during pregnancy, or hematocrit of less than 30 percent during pregnancy. Cardiac disease - Disease of the heart. Acute or chronic lung disease - Disease of the lungs during pregnancy. Diabetes - Metabolic disorder characterized by excessive discharge of urine and persistent thirst; includes juvenile onset, adult onset, and gestational diabetes during pregnancy. Genital herpes - Infection of the skin of the genital area by herpes simplex virus. Hydramnios/Oligohydramnios - Any noticeable excess (hydramnios) or lack (oligohydramnios) of amniotic fluid. Hemoglobinopathy - A blood disorder caused by alteration in the genetically determined molecular structure of hemoglobin (for example, sickle cell anemia). Hypertension, chronic - Blood pressure persistently greater than 140/90, diagnosed prior to onset of pregnancy or before the 20th week of gestation. Hypertension, pregnancy-associated - An increase in blood pressure of at least 30 mm hg systolic or 15 mm hg diastolic on two measurements taken 6 hours apart after the 20th week of gestation. Eclampsia - The occurrence of convulsions and/or coma unrelated to other cerebral conditions in women with signs and symptoms of preeclampsia. Incompetent cervix - Characterized by painless dilation of the cervix in the second trimester or early in the third trimester of pregnancy, with premature expulsion of membranes though cervix and ballooning of the membranes into vagina, followed by rupture of the membrane and subsequent expulsion of the fetus. Previous infant 4,000+ grams - The birthweight of a previous live-born child was over 4,000 grams (8lbs.14oz.). Previous preterm or small-for-gestational-age-infant - Previous birth of an infant prior to term (before 37 completed weeks of gestation) or of an infant weighing less than the 10th percentile for gestational age using a standard weight for age chart. Renal disease - Kidney disease. Rh Sensitization - The process or state of becoming sensitized to the Rh factor as when an Rh-negative woman is pregnant with an Rh-positive fetus. Uterine bleeding - Any clinically significant bleeding during the pregnancy taking into consideration the stage of pregnancy; any second or third trimester bleeding or third trimester bleeding of the uterus prior to the onset of labor. 87 Complications of labor and/or delivery Abnormal conditions of the newborn Febrile - A fever greater than 100 degrees F. or 38 degrees C. occurring during labor and/or delivery. Anemia - Hemoglobin level of less than 13.0 g/dL, or a hematocrit of less than 39 percent. Meconium, moderate/heavy - Meconium consists of undigested debris from swallowed amniotic fluid, various products of secretion and shedding by the gastrointestinal tract, moderate to heavy amounts of meconium in the amniotic fluid noted during labor and/or delivery. Birth injury - Impairment of the infant's body function or structure due to adverse influences that occurred at birth. Premature rupture of membranes (more than 12 hours) - Rupture of membranes at any time during pregnancy and more than 12 hours before the onset of labor. Abruptio placenta - Premature separation of normally implanted placenta from the uterus. Placenta previa - Implantation of the placenta over or near the internal opening of the cervix. Other excessive bleeding - The loss of significant amount of blood from conditions other than abruptio placenta or placenta previa. Seizures during labor - Maternal seizures occurring during labor from any cause. Precipitous labor (less than 3 hours) - Extremely rapid labor and delivery lasting less than3 hours. Prolonged labor (more than 20 hours) - Abnormally slow progress of labor lasting more than 20 hours. Dysfunctional labor - Failure to progress in a normal pattern of labor. Breech/Malpresentation - At birth, the presentation of the fetal buttocks, rather than the head or other malpresentation. Cephalopelvic disproportion - The relationship of the size, presentation, and position of the fetal head to the maternal pelvis, which prevents dilation of the cervix and/or descent of the fetal head. Cord prolapse - Premature expulsion of the umbilical cord in labor before the fetus is delivered. Anesthetic complications - Any complication during labor and/or delivery brought on by an anesthetic agent or agents. Fetal distress - Signs indicating fetal hypoxia (deficiency in amount of oxygen reaching fetal tissues). 88 Fetal alcohol syndrome - A syndrome of altered prenatal growth and development occurring in infants born of women who consumed excessive amounts of alcohol during pregnancy. Hyaline membrane disease/RDS - A disorder primarily of prematurity, manifested clinically by respiratory distress and pathologically by pulmonary hyaline membranes and incomplete expansion of the lungs at birth. Meconium aspiration syndrome - Aspiration of meconium by the fetus or newborn, affecting the lower respiratory system. Assisted ventilation (less than 30 minutes) - A mechanical method of assisting respiration for newborns with respiratory failure. Assisted ventilation (30 minutes or more) - Newborn placed on assisted ventilation for 30 minutes or longer. Seizures - A seizure of any etiology. Congenital anomalies of child Anencephalus – Absence of the cerebral hemispheres. Spina bifida/meningocele – Developmental anomaly characterized by defective closure of the bony encasement of the spinal cord, through which the cord and meninges may or may not protrude. Hydrocephalus – Excessive accumulation of cerebrospinal fluid within the ventricles of the brain with consequent enlargement of cranium. Microcephalus – A significantly small head. Other central nervous system anomalies – Other specified anomalies of the brain, spinal cord, and nervous system. Heart malformations – Congenital anomalies of heart. Other circulatory/respiratory anomalies – Other specified anomalies of the circulatory and respiratory systems. Health Status Profile of American Indians in Arizona, 2011 Data Book Rectal atresia/stenosis – Congenital absence, closure, or narrowing of the rectum. Tracheo-esophageal fistula/Esophageal atresia – An abnormal passage between the trachea and the esophagus; esophageal atresia is the congenital absence or closure of the esophagus. Omphalocele/Gastroschisis – An omphalocele is a protrusion of variable amounts of abdominal viscera from a midline defect at the base of the umbilicus. In gastroschisis, the abdominal viscera protrude through an abdominal wall defect, usually on the right side of the umbilical cord insertion. Other gastrointestinal anomalies – Other specified congenital anomalies of the gastrointestinal system. Malformed genitalia – Congenital anomalies of the reproductive organs. Renal agenesis – One or both kidneys are completely absent. Other urogenital anomalies – Other specified congenital anomalies of the organs concerned in the production and excretion of the urine, together with organs of reproduction. Cleft lip/palate – Cleft lip is a fissure or elongated opening of the lip; cleft palate is a fissure in the roof of the mouth. These are failures of embryonic development. Down’s syndrome – The most common chromosomal defect with most cases resulting from an extra chromosome (trisomy 21). Other chromosomal anomalies – All other chromosomal aberrations. Polydactyly/Syndactyly/Adactyly– Polydactyly is the presence of more than five digits on either hands and/or feet; syndactyly is having fused or webbed fingers and/or toes; adactyly is the absence of fingers and/or toes. Club foot – Deformities of the foot, which is twisted out of shape or position. Diaphragmatic hernia – Herniation of the abdominal contents through the diaphragm into the thoracic cavity usually resulting in respiratory distress. Other muscoskeletal/integumental anomalies – Other specified congenital anomalies of the muscles, skeleton, or skin. Terms Related to Mortality Age-adjusted mortality rates - Because mortality from most causes of death occurs predominately among the elderly, a population group with a larger proportion of older persons would have a higher mortality rate. The "ageadjustment" removes the effect of the age differences among sub-populations (or in the same population over time) by placing them all in a population with a standard age distribution. All age-adjusted mortality rates in this report were computed by the direct method, that is by weighting the age-specific rates for a given year by the age distribution of a standard population. The weighted agespecific rates are then added to produce the summary rate for all ages combined. Health Status Profile of American Indians in Arizona, 2011 Data Book Beginning with the 2000 data year, a new population standard for the age adjustment of mortality rates has replaced the standard based on the 1940 population and used since 1943. The new standard uses the age composition of the 2000 U.S. projected population. The standard is expressed in terms of a ”standard million”: the relative distribution of the 2000 population of the United States totaling 1 million in 10-year age groups: Age group A <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ 2011 population of American Indians 2011 deaths among American Indians Age-specific rates for American Indians in 2011 B C D (C/B)*100000 614.9 34.6 16.5 149.2 241.1 385.4 583.5 954.7 1852.8 3985.0 11198.4 6,993 28,868 66,849 69,012 53,923 44,633 41,645 26,185 13,871 6,399 2,036 360,414 43 10 11 103 130 172 243 250 257 255 228 1703 Ageadjusted rate for American Indians In 2011 F D*E 8.5 1.9 2.4 20.7 32.7 62.7 78.7 83.3 122.4 178.7 173.7 2000 standard E .013818 .055317 .145565 .138646 .135573 .162613 .134834 .087247 .066037 .044842 .015508 TOTAL ∑ 765.5 Age-specific mortality - Number of deaths in a specific age group during a calendar year. Cause of death - For the purpose of national mortality statistics, every death is attributed to one underlying condition, based on information reported on the death certificate and utilizing the international rules for selecting the underlying cause of death from the reported conditions. Cause-specific mortality - Number of deaths from a specified cause during a calendar year. Classification of causes of death - The cause of death used in this report is the underlying cause classified according to the International Classification of Diseases (ICD). Beginning with the 2000 data year in Arizona (1999 nationally), a new revision of the International Classification of Diseases was implemented. The Tenth Revision (ICD-10) has replaced the Ninth Revision (ICD-9), which was in effect since 1979. Drug-induced deaths – This category was expanded in 2003. Causes of death attributable to drug-related mortality include mental and behavioral disorders due to psychoactive substance use, accidental poisoning by and exposure to drugs, suicide by drugs, homicide by drugs and poisoning by drugs, undetermined intent. Firearm mortality – Causes of death attributable to firearm mortality include accidental discharge of firearms, suicide by firearms, homicide by firearms, legal intervention involving discharge of firearms, terrorism involving firearms and discharge of firearms, undetermined intent. 89 Our Web site at http://www.azdhs.gov/plan provides instantaneous access to a wide range of statistical information about health status of Arizonans. The Arizona Health Status and Vital Statistics annual report examines trends in natality, mortality, and morbidity towards established health objectives. Additional reports and studies include Differences in the Health Status Among Race/Ethnic Groups, Advance Vital Statistics by County of Residence, Mortality from Alzheimer's Disease, Injury Mortality among Arizona Residents (accidents, suicides, homicides, legal intervention, firearm-related fatalities, drug-related deaths, drowning deaths, falls among Arizonans 65 years or older), hospital inpatient and emergency room statistics for mental disorders, asthma, diabetes, influenza and pneumonia, and substance abuse, Community Vital Statistics, Teenage Pregnancy, Selected Characteristics of Newborns and Mothers Giving Birth by Census Tract in Maricopa County, Pima County and South Phoenix Area, Health Status Profile of American Indians in Arizona, Deaths from Exposure to Excessive Natural Heat Occurring in Arizona, Obesity in Arizona: Prevalence, Hospital Care Utilization, Mortality, Marital Status, and Health, Heart Disease vs. Cancer: An Epidemiologic Transition in Mortality Risks. Population Health and Vital Statistics Section Bureau of Public Health Statistics PUBLIC HEALTH SERVICES ARIZONA DEPARTMENT OF HEALTH SERVICES