HEALTH STATUS PROFILE OF AMERICAN INDIANS IN ARIZONA 1999 DATA BOOK by Christopher K. Mrela, Ph.D., Assistant Registrar of Vital Statistics Trentham Coe, Senior Research Data Analyst May 2001 HEALTH STATUS PROFILE OF AMERICAN INDIANS IN ARIZONA 1999 DATA BOOK TABLE OF CONTENTS Introduction .....................................................................................................................................................1 I. 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 Comparison of American Indians’ Standing in Arizona in 1999 With Respect to Selected Health Objectives for the Year 2000 ......................................................... 3 Early Prenatal Care.................................................................................................................................. 5 Infant Mortality ....................................................................................................................................... 6 Postneonatal Mortality ............................................................................................................................ 7 Mortality from Unintentional Injuries ...................................................................................................... 8 Mortality from Motor Vehicle-Related Injuries......................................................................................... 9 Suicide Mortality.................................................................................................................................... 10 Homicide Mortality ................................................................................................................................ 11 Mortality of Children 1-14 Years Old...................................................................................................... 12 Mortality of Adolescents and Young Adults 15-24 Years Old ................................................................. 13 Mortality of Adults 25-64 Years of Age .................................................................................................. 14 II. An Overview of Selected Health Problems and Health Risks Among American Indians and All Residents of Arizona in 1999 .................................................................. 15 2.1 Causes From Which American Indians Were More Likely of Less Likely to Die Relative to All Arizona Residents in 1999 ........................................................................................ 17 2.2 Average Age At Death From All Causes Among American Indians and All Arizona Residents ................ 18 2.3 Nonmarital Births .................................................................................................................................. 19 2.4 Low Birthweight Births.......................................................................................................................... 20 2.5 The Incidence of Fetal Alcohol Syndrome .............................................................................................. 21 2.6 Births to Teenage Mothers..................................................................................................................... 22 2.7 Low Birthweight Births to Mothers 30 Years or Older as a Percentage of All Low Birthweight Births .... 23 2.8 The Incidence of Pregnancy Associated Hypertension........................................................................... 24 2.9 The Incidence of Anemia During Pregnancy .......................................................................................... 25 2.10 The Incidence of Diabetes During Pregnancy ........................................................................................ 26 Health Status Profile of American Indians in Arizona, 1999 Data Book ii III. Characteristics of American Indian Newborns and Mothers Giving Birth By Place of Residence in Arizona in 1999........................................................................................ 27 SOCIODEMOGRAPHIC CHARACTERISTICS 3.1 3.2 3.3 3.4 3.5 3.6 Maternal Age ......................................................................................................................................... 31 Educational Attainment of Mother ......................................................................................................... 32 Marital Status of Mother ........................................................................................................................ 33 Race/Ethnicity of Father........................................................................................................................ 34 Age of Father......................................................................................................................................... 35 Source of Payment for Labor and Delivery............................................................................................. 36 MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS 3.7 3.8 3.9 Maternal Weight Gain During Pregnancy ............................................................................................... 39 Medical Risk Factors for Pregnancy ....................................................................................................... 40 Substance Use During Pregnancy .......................................................................................................... 41 UTILIZATION OF MEDICAL SERVICES 3.10 3.11 3.12 3.13 3.14 3.15 Trimester of Pregnancy Prenatal Care Began ........................................................................................ 45 Number of Prenatal Visits...................................................................................................................... 46 Obstetric Procedures ............................................................................................................................. 47 Complications of Labor and Delivery ..................................................................................................... 48 Method of Delivery ................................................................................................................................ 49 Attendant at Birth.................................................................................................................................. 50 3.16 3.17 3.18 3.19 3.20 NEWBORN’S HEALTH Gestational Age ..................................................................................................................................... 53 Weight At Birth...................................................................................................................................... 54 Abnormal Conditions of the Newborn .................................................................................................... 55 Congenital Anomalies (Birth Defects).................................................................................................... 56 Causes of Infant Death .......................................................................................................................... 57 IV. Patterns of Mortality Among American Indians By Place of Residence in Arizona in 1999 .............. 59 AGE-SPECIFIC MORTALITY 4.1 4.2 4.3 Age-Specific Mortality ........................................................................................................................... 63 Age-Specific Mortality Among Males...................................................................................................... 64 Age-Specific Mortality Among Females.................................................................................................. 65 CAUSE-SPECIFIC MORTALITY 4.4 4.5 4.6 4.7 Deaths From Causes Selected As Indicators for Monitoring Progress Toward The Year 2000 Objectives ......................................................................................................... 69 Leading Causes of Death ....................................................................................................................... 70 Leading Causes of Death Among Males.................................................................................................. 71 Leading Causes of Death Among Females.............................................................................................. 72 LEADING CAUSES OF DEATH BY AGE GROUP FOR SELECTED INDIAN NATIONS 4.8 4.9 4.10 4.11 4.12 4.13 4.14 Leading Causes of Death by Age Group Among Resident of NAVAJO Tribal Communities ...................... 75 Leading Causes of Death by Age Group Among Residents of HOPI Tribal Communities......................... 76 Leading Causes of Death by Age Group Among Residents of FORT APACHE Tribal Communities ........... 77 Leading Causes of Death by Age Group Among Residents of GILA RIVER Tribal Communities .............. 78 Leading Causes of Death by Age Group Among Resident of SALT RIVER Tribal Communities ................ 79 Leading Causes of Death by Age Group Among Residents of SAN CARLOS Tribal Communities ............. 80 Leading Causes of Death by Age Group Among Residents of TOHONO O’ODHAM Tribal Communities ................................................................................................. 81 4.15 Leading Causes of Death by Age Group Among American Indians Who Resided Off Reservation in Arizona................................................................................................ 82 Technical Notes .............................................................................................................................................. 83 Sources of Data ..................................................................................................................................... 85 Definitions ............................................................................................................................................. 85 Rates ............................................................................................................................................ 85 Terms Related to Reproductive Health ......................................................................................... 85 Terms Related to Mortality ........................................................................................................... 85 Medical Terms Used on the Birth Certificate ................................................................................. 86 Communities on Indian Reservations in Arizona ............................................................................................ 89 Health Status Profile of American Indians in Arizona, 1999 Data Book iii INTRODUCTION The report Health Status Profile of American Indians in Arizona: 1999 Data Book is the sixth annual update of populationlevel data on trends and patterns in natality and mortality among American Indian residents of Arizona. It should be noted that tribal identity is very poorly recorded on birth or death certificates. Tabulations of births and deaths in this publication are by place of residence in Arizona and not by tribe. 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 Health Status Profile of American Indians in Arizona are grouped into four major sections: 1) a section focused on American Indians' standing in 1999 with respect to selected health objectives for the year 2000; 2) a section presenting an overview of selected health problems and health risks among American Indian and all residents of Arizona in 1999; 3) a four-part section concerned with the characteristics of American Indian newborns and mothers giving birth who were residents of specified tribal communities on reservations, and those who resided off reservation in Arizona in 1999; 4) a three-part section focused on patterns of mortality among American Indians by age group, gender and place of residence in Arizona in 1999. Detailed mortality profiles are given for the seven largest tribal communities: Navajo, Hopi, Fort Apache, Tohono O'Odham, Gila River, Salt River and San Carlos. These sections are followed by the Technical Notes which provide definitions of terms used in the report, as well as information about the sources of data and a detailed classification of communities on Indian reservations in Arizona. Health Status Profile of American Indians in Arizona was intended as a data book: a basic reference for some of the most frequently requested statistics. The four sections of the report were computer-generated and contain information with no accompanying narrative. Health Status Profile of American Indians in Arizona, 1999 Data Book I. COMPARISON OF AMERICAN INDIANS’ STANDING IN ARIZONA IN 1999 WITH RESPECT TO SELECTED HEALTH OBJECTIVES FOR THE YEAR 2000 Health Status Profile of American Indians in Arizona, 1999 Data Book 3 1.1 Early Prenatal Care National Year 2000 Objective: Increase to 90 percent the proportion of women giving birth who receive prenatal care in the first trimester of pregnancy 100.0 OBJECTIVE 90.0 % American Indian women giving birth in Arizona who received early prenatal care 80.0 , , 64.1 , 60.0 , , 58.7 , 57.0 54.9 , , 53.5 50.2 1989 46.4 40.0 , 46.8 50.0 51.8 60.0 61.2 70.0 , , 1990 1991 1992 1993 1994 Health Status Profile of American Indians in Arizona, 1999 Data Book 1995 1996 1997 1998 1999 5 Health Status Profile of American Indians in Arizona, 1999 Data Book 6 1.2 Infant Mortality National Year 2000 Objective: Reduce the rate of infant deaths among American Indians to no more than 8.5 per 1,000 live births 14.5 , , , 9.4 , 9.7 9.8 , 11.5 , 10.5 , 11.2 12.0 11.8 10.5 11.5 , 8.5 8.5 8.4 , , OBJECTIVE , Number of infant deaths per 1,000 live births among American Indian residents of Arizona by year 5.5 1989 O B J E C T I V E 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 1.3 Postneonatal Mortality National Year 2000 Objective: Reduce postneonatal mortality among American Indians to no more than 4 per 1,000 live births 8.5 Number of postneonatal deaths per 1,000 live births among American Indian residents of Arizona by year 7.0 4.9 OBJECTIVE , 1990 1991 1992 1993 , 3.5 1989 , 5.0 , 3.7 2.5 6.3 6.0 6.0 , 4.0 , , 5.0 5.4 , , 5.8 5.5 , 6.5 , 1994 Health Status Profile of American Indians in Arizona, 1999 Data Book 1995 1996 1997 1998 1999 7 Health Status Profile of American Indians in Arizona, 1999 Data Book 8 1.4 Mortality From Unintentional Injuries National Year 2000 Objective: Reduce unintentional injury deaths among American Indians to no more than 66.1 per 100,000 (age-adjusted) 198.3 121.5 , 127.2 , 146.0 143.0 136.8 & 130.5 132.2 , , 66.1 , OBJECTIVE Number of unintentional injury deaths per 100,000 American Indian population (age-adjusted to 1940 standard) 0.0 1990 1995 1996 1997 1998 1999 1.5 Mortality From Motor Vehicle-Related Injuries National Year 2000 Objective: Reduce motor vehicle-related injury deaths among American Indians to no more than 39.2 per 100,000 (age-adjusted) 117.6 , , , 71.5 79.6 84.3 97.3 83.3 81.6 78.4 & , , 39.2 OBJECTIVE Number of motor vehicle-related deaths per 100,000 American Indian population (age-adjusted to 1940 standard) 0.0 1990 Health Status Profile of American Indians in Arizona, 1999 Data Book 1995 1996 1997 1998 1999 9 Health Status Profile of American Indians in Arizona, 1999 Data Book 10 1.6 Suicide Mortality National Year 2000 Objective: Reduce suicides among American Indians to no more than 12.8 per 100,000 (age-adjusted) 38.4 , 18.2 , 19.1 21.3 , 17.5 20.8 & 21.0 25.6 , , 12.8 OBJECTIVE Number of suicides per 100,000 American Indian population (age-adjusted to 1940 standard) 0.0 1990 1995 1996 1997 1998 1999 1.7 Homicide Mortality National Year 2000 Objective: Reduce homicides among American Indians to no more than 11.3 per 100,000 (age-adjusted) 28.5 33.9 , , 21.9 , 22.1 20.2 22.4 & 19.6 22.6 , , 11.3 OBJECTIVE Number of homicides per 100,000 American Indian population (age-adjusted to 1940 standard) 0.0 1990 Health Status Profile of American Indians in Arizona, 1999 Data Book 1995 1996 1997 1998 1999 11 Health Status Profile of American Indians in Arizona, 1999 Data Book 12 1.8 Mortality of Children 1-14 Years Old National Year 2000 Objective: Reduce death rates for children 1-14 years of age to no more than 28 per 100,000 , 72.9 72.2 & 83.4 84.0 , 39.2 , 50.1 55.4 56.0 , , 28.0 OBJECTIVE Number of deaths per 100,000 American Indian children 1-14 years old 0.0 1990 1995 1996 1997 1998 1999 1.9 Mortality of Adolescents and Young Adults 15-24 Years Old National Year 2000 Objective: Reduce death rates for adolescents and young adults 15-24 years of age to no more than 185 per 100,000 370.0 195.9 , 212.8 , 243.9 266.5 257.1 231.9 & , , , 185.0 OBJECTIVE Number of deaths per 100,000 American Indian adolescents and young adults 15-24 years old 0.0 1990 Health Status Profile of American Indians in Arizona, 1999 Data Book 1995 1996 1997 1998 1999 13 Health Status Profile of American Indians in Arizona, 1999 Data Book 14 1.10 Mortality of Adults 25-64 Years of Age National Year 2000 Objective: Reduce death rates for adults 25-64 years of age to no more than 340 per 100,000 1020.0 , , 666.8 690.0 , 714.9 , 662.9 660.4 & 612.0 680.0 , 340.0 OBJECTIVE Number of deaths per 100,000 American Indian children 1-14 years old 0.0 1990 1995 1996 1997 1998 1999 II. AN OVERVIEW OF SELECTED HEALTH PROBLEMS AND HEALTH RISKS AMONG AMERICAN INDIANS AND ALL RESIDENTS OF ARIZONA IN 1999 Health Status Profile of American Indians in Arizona, 1999 Data Book 15 2.1 Causes From Which American Indians Were More Likely (+) or Less Likely (-) to Die Relative to All Arizona Residents in 1999 PERCENTAGE DIFFERENCE IN AGE-ADJUSTED MORTALITY RATES FOR 1999 PERCENT LESS LIKELY - PERCENT MORE LIKELY + 487 Alcoholism 354 Diabetes 205 Unintentional injury Infectious & Parasitic Diseases* 188 119 Homicide 80 Influenza & Pneumonia 25 Suicide Diseases of heart -5 Cerebrovascular Disease -7 Prostate cancer -49 Breast cancer -57 Chronic Obstructive Pulmonary Disease -59 Lung cancer -75 Alzheimer's Disease -76 -600 -500 -400 -300 -200 -100 0 100 200 300 400 500 600 *Excluding HIV infection Health Status Profile of American Indians in Arizona, 1999 Data Book 17 Health Status Profile of American Indians in Arizona, 1999 Data Book 18 2.2 Average Age At Death From All Causes Among American Indians and All Arizona Residents Age At Death 75.0 70.0 65.0 60.0 71.0 71.2 71.7 69.6 68.7 68.6 68.5 68.5 68.4 68.4 68.2 55.0 50.0 53.0 51.4 52.3 52.8 51.9 52.0 52.2 52.9 55.4 56.5 55.7 45.0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 American Indians All Arizonans 2.3 Nonmarital Births Per 100 births 80.0 60.0 57.8 59.9 62.1 62.8 64.8 66.4 67.5 67.8 68.4 68.2 69.2 40.0 30.7 20.0 32.6 35.0 36.2 37.8 38.2 38.2 38.8 37.7 38.4 38.8 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 All Arizonans Health Status Profile of American Indians in Arizona, 1999 Data Book American Indians 19 Health Status Profile of American Indians in Arizona, 1999 Data Book 20 2.4 Low-Birthweight Births 8.0 Per 100 births ! 7.5 7.0 ! & 6.5 & 6.0 & & ! ! & ! & & & ! & & ! & ! 1997 1998 ! ! ! 5.5 5.0 1989 1990 1991 ! 1992 1993 1994 American Indians 1995 & 1996 All Arizonans 1999 2.5 The Incidence of Fetal Alcohol Syndrome 2.7 3.0 Per 1,000 live births 2.5 2.0 1.7 1.7 1.9 2.0 1996 1997 American Indians Health Status Profile of American Indians in Arizona, 1999 Data Book 1998 0.1 0.2 1995 0.6 0.2 1994 0.1 0.1 1993 0.6 0.2 1992 0.1 1991 0.2 1990 0.4 0.3 0.4 0.0 1989 0.6 0.7 1.0 0.5 1.3 1.2 1.5 1999 All Arizonans 21 Health Status Profile of American Indians in Arizona, 1999 Data Book 22 2.6 Births to Teenage Mothers* 20.0 Per 100 births 18.0 16.0 ! 14.0 ! ! ! ! ! ! ! ! 12.0 10.0 1989 1990 1991 1992 1993 1994 American Indians *19 or younger 1995 ! 1996 All Arizonans 1997 ! 1998 ! 1999 2.7 Low-Birthweight Births to Mothers 30 Years or Older as a Percentage of All Low-Birthweight Births 36.0 % of all LBW births ! ! ! 32.0 28.0 ! ! ! ! ! ! 1990 1991 1992 ! ! 24.0 20.0 1989 1993 1994 American Indian mothers 1995 ! 1996 1997 1998 1999 All Arizona mothers Source: Tables 1B-3 and 1B-15 in Arizona Health Status and Vital Statistics 1998 Health Status Profile of American Indians in Arizona, 1999 Data Book 23 Health Status Profile of American Indians in Arizona, 1999 Data Book 24 2.8 The Incidence of Pregnancy Associated Hypertension Per 1,000 births 70.0 60.0 50.0 40.0 65.3 53.0 56.0 54.0 50.0 53.0 46.0 48.0 53.3 56.0 55.7 30.0 28.0 26.0 27.0 26.0 28.0 29.0 24.0 25.1 26.0 27.7 28.5 20.0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 All Arizona mothers American Indian mothers 2.9 The Incidence of Anemia During Pregnancy Per 1,000 births 70.0 60.0 50.0 66.0 40.0 30.0 53.0 65.0 57.0 55.0 45.0 41.0 44.7 44.0 43.2 50.6 20.0 10.0 19.0 17.0 21.0 17.0 21.0 21.0 16.0 14.4 14.4 18.6 20.7 0.0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 All Arizona mothers Health Status Profile of American Indians in Arizona, 1999 Data Book American Indian mothers 25 Health Status Profile of American Indians in Arizona, 1999 Data Book 26 2.10 The Incidence of Diabetes During Pregnancy Per 1,000 births 80.0 70.0 60.0 50.0 40.0 30.0 62.0 50.0 50.0 48.0 55.0 63.0 65.0 70.2 75.3 67.6 66.3 20.0 10.0 25.2 23.5 21.8 20.0 21.0 23.0 22.0 21.0 24.0 24.0 23.8 0.0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 All Arizona mothers American Indian mothers III. CHARACTERISTICS OF AMERICAN INDIAN NEWBORNS AND MOTHERS GIVING BIRTH BY PLACE OF RESIDENCE IN ARIZONA IN 1999 Health Status Profile of American Indians in Arizona, 1999 Data Book 27 Note: The data in Tables 3.1 – 3.19 are by self-reported (and not validated) place of mother’s residence. Certain tribal communities may not be present (or, may be underrepresented) in the tabulated data. SOCIODEMOGRAPHIC CHARACTERISTICS Health Status Profile of American Indians in Arizona, 1999 Data Book 29 3.1 MATERNAL AGE (1999 STATUS) 25-29 30-34 35-39 40-44 Resided on reservation 300 552 1664 1310 849 476 121 3 1 17 1 1 3 5 3 4 0 0 0 0 229 1 26 29 53 60 35 20 5 0 0 1 0 0 0 0 0 1 0 0 0 0 GILA RIVER 149 0 14 15 54 31 21 9 5 0 0 HAVASUPAI 10 0 0 0 1 1 5 3 0 0 0 HOPI 89 0 4 13 30 23 12 6 1 0 0 HUALAPAI 21 0 2 0 7 5 5 2 0 0 0 1671 3 67 143 477 416 313 196 55 0 1 SALT RIVER 48 0 5 3 18 10 9 3 0 0 0 SAN CARLOS 188 1 15 23 62 43 29 12 3 0 0 TOHONO O'ODHAM 142 1 15 16 39 30 27 12 2 0 0 TOTAL 2565 7 149 245 746 622 461 263 71 0 1 ---in Maricopa County 1397 5 70 145 482 374 183 113 23 2 0 ---in Pima County 385 5 31 47 132 84 47 33 6 0 0 ---in Coconino County 317 0 15 28 107 87 52 22 5 1 0 ---elsewhere in Arizona 631 2 35 87 197 143 106 45 16 0 0 2730 12 151 307 918 688 388 213 50 3 0 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO Resided off reservation Unknown 20-24 19 TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 45+ 18-19 5295 ALL ETHNIC GROUPS <15 15-17 TOTAL Mother's age group 31 Health Status Profile of American Indians in Arizona, 1999 Data Book 32 3.2 EDUCATIONAL ATTAINMENT OF MOTHER (1999 STATUS) TOTAL ALL ETHNIC GROUPS Resided on reservation Mother's education 9-11 12 13-16 8 17+ Unknown 5295 81 180 1536 1966 1305 82 145 17 1 0 4 6 4 1 1 229 6 3 90 76 40 3 11 1 0 0 1 0 0 0 0 GILA RIVER 149 3 14 66 45 18 1 2 HAVASUPAI 10 0 0 3 4 2 1 0 HOPI 89 1 0 29 38 21 0 0 HUALAPAI 21 1 1 12 2 5 0 0 1671 24 35 435 687 382 24 84 48 0 3 21 13 8 1 2 SAN CARLOS 188 2 7 53 78 44 1 3 TOHONO O'ODHAM 142 2 9 60 55 16 0 0 TOTAL 2565 40 72 774 1004 540 32 103 ---in Maricopa County 1397 27 53 392 452 425 27 21 ---in Pima County 385 6 24 117 132 95 7 4 ---in Coconino County 317 0 6 66 123 108 13 1 ---elsewhere in Arizona 631 8 25 187 255 137 3 16 2730 41 108 762 962 765 50 42 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO SALT RIVER Resided off reservation <8 TOTAL 3.3 MARITAL STATUS OF MOTHER (1999 STATUS) TOTAL ALL ETHNIC GROUPS Resided on reservation Unknown 5295 1565 3666 64 17 5 12 0 229 74 153 2 1 0 1 0 GILA RIVER 149 25 123 1 HAVASUPAI 10 9 1 0 HOPI 89 17 71 1 HUALAPAI 21 8 12 1 1671 510 1138 23 48 20 27 1 SAN CARLOS 188 51 135 2 TOHONO O'ODHAM 142 15 125 2 TOTAL 2565 734 1798 33 ---in Maricopa County 1397 419 962 16 ---in Pima County 385 95 287 3 ---in Coconino County 317 118 196 3 ---elsewhere in Arizona 631 199 423 9 2730 831 1868 31 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO SALT RIVER Resided off reservation Marital status Unmarried Married TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 33 Health Status Profile of American Indians in Arizona, 1999 Data Book 34 3.4 RACE/ETHNICITY OF FATHER (1999 STATUS) NonHispanic white Hispanic 5295 301 375 79 2816 28 1696 17 1 2 0 7 0 7 229 2 2 0 169 0 56 1 0 1 0 0 0 0 GILA RIVER 149 2 7 2 75 0 63 HAVASUPAI 10 0 1 0 9 0 0 HOPI 89 0 0 0 65 0 24 HUALAPAI 21 2 4 0 9 0 6 1671 25 20 5 1170 5 446 48 4 5 1 27 0 11 SAN CARLOS 188 4 1 1 108 0 74 TOHONO O'ODHAM 142 1 0 0 55 0 86 TOTAL 2565 41 43 9 1694 5 773 ---in Maricopa County 1397 145 186 45 551 13 457 ---in Pima County 385 31 69 12 100 4 169 ---in Coconino County 317 19 17 4 188 1 88 ---elsewhere in Arizona 631 65 60 9 283 5 209 2730 260 332 70 1122 23 923 TOTAL ALL ETHNIC GROUPS Resided on reservation COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO SALT RIVER Resided off reservation TOTAL American Indian Black Asian Unknown 3.5 AGE OF FATHER (1999 STATUS) 25-29 30-34 35-39 40-44 45-49 50-54 74 206 962 962 707 451 201 70 14 11 1636 17 1 0 0 2 2 3 2 0 1 0 0 6 229 0 7 11 50 45 36 20 5 1 0 0 54 1 0 0 0 0 0 1 0 0 0 0 0 0 GILA RIVER 149 0 3 8 25 18 17 4 11 2 0 0 61 HAVASUPAI 10 0 0 0 1 3 0 3 1 1 1 0 0 HOPI 89 0 2 5 18 19 13 5 3 0 0 0 24 HUALAPAI 21 0 1 0 10 1 1 1 1 0 0 0 6 1671 0 16 56 274 311 250 194 91 29 6 6 438 SALT RIVER 48 0 1 1 12 9 5 5 2 2 0 0 11 SAN CARLOS 188 0 1 8 40 32 22 8 5 0 1 0 71 TOHONO O'ODHAM 142 0 5 5 15 15 9 4 3 0 1 1 84 TOTAL 2565 1 36 94 447 455 357 246 122 36 9 7 755 ---in Maricopa County 1397 0 15 55 258 280 197 91 40 16 3 1 441 ---in Pima County 385 0 5 19 74 62 31 22 7 3 2 2 158 ---in Coconino County 317 0 8 11 71 56 44 26 12 3 0 0 86 ---elsewhere in Arizona 631 0 10 27 112 109 78 66 20 12 0 1 196 2730 0 38 112 515 507 350 205 79 34 5 4 881 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO Resided off reservation Unknown 20-24 1 TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 55+ 18-19 Resided on reservation <15 5295 ALL ETHNIC GROUPS 15-17 TOTAL Father's age group 35 Health Status Profile of American Indians in Arizona, 1999 Data Book 36 3.6 SOURCE OF PAYMENT FOR LABOR AND DELIVERY (1999 STATUS) TOTAL ALL ETHNIC GROUPS Resided on reservation IHS Self Unknown 5295 2710 1463 843 65 214 17 9 2 5 0 1 229 94 109 10 0 16 1 0 0 1 0 0 GILA RIVER 149 76 13 55 1 4 HAVASUPAI 10 9 0 0 1 0 HOPI 89 13 66 2 0 8 HUALAPAI 21 16 0 4 1 0 1671 765 726 90 1 89 SALT RIVER 48 24 6 14 1 3 SAN CARLOS 188 30 140 8 6 4 TOHONO O'ODHAM 142 94 24 15 5 4 TOTAL 2565 1130 1086 204 16 129 ---in Maricopa County 1397 782 166 372 28 49 ---in Pima County 385 199 51 115 11 9 ---in Coconino County 317 212 51 44 3 7 ---elsewhere in Arizona 631 387 109 108 7 20 2730 1580 377 639 49 85 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO Resided off reservation AHCCCS Payee for birth Private insurance TOTAL MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Health Status Profile of American Indians in Arizona, 1999 Data Book 37 3.7 MATERNAL WEIGHT GAIN DURING PREGNANCY (1999 STATUS) TOTAL None 16-20 pounds 5295 82 895 572 638 807 1605 696 17 1 3 2 6 1 1 3 229 6 28 28 7 19 67 74 1 0 0 1 0 0 0 0 GILA RIVER 149 3 22 27 16 41 30 10 HAVASUPAI 10 0 1 1 2 3 3 0 HOPI 89 2 18 7 14 10 12 26 HUALAPAI 21 0 5 4 0 4 8 0 1671 30 398 188 218 197 389 251 48 1 4 9 7 8 10 9 SAN CARLOS 188 2 29 18 19 30 47 43 TOHONO O'ODHAM 142 0 19 19 20 36 43 5 TOTAL 2565 45 527 304 309 349 610 421 ---in Maricopa County 1397 19 200 134 169 227 509 139 ---in Pima County 385 6 53 36 47 78 141 24 ---in Coconino County 317 1 27 21 53 59 140 16 ---elsewhere in Arizona 631 11 88 77 60 94 205 96 2730 37 368 268 329 458 995 275 ALL ETHNIC GROUPS Resided on reservation COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO SALT RIVER Resided off reservation Weight gain 21-25 25-30 pounds pounds 1-16 pounds TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 31+pounds Unknown 39 Health Status Profile of American Indians in Arizona, 1999 Data Book 40 3 16 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 9 0 1 1 1 0 2 2 14 1 2 0 0 0 0 0 0 1 2 No medical risk factors Other 14 0 0 0 0 0 0 0 12 0 0 0 12 1 0 0 1 2 Incompetent cervix 37 0 0 0 0 0 0 0 24 0 3 0 27 5 0 2 3 10 Uterine bleeding 81 38 0 0 2 3 0 0 2 0 0 0 1 0 0 0 16 29 3 0 5 2 3 0 32 34 22 2 13 1 2 1 12 0 49 4 RH sensitization 295 1 28 0 6 1 9 0 112 1 15 9 182 38 15 32 28 113 Renal disease 46 1 2 0 2 0 3 0 19 2 3 1 33 8 1 0 4 13 Previous SGA infant 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Previous infant 4000+g Pregnancy associated Hypertension 18 112 1 0 0 0 0 0 0 0 0 0 0 2 0 0 5 68 1 1 1 3 0 3 8 77 6 17 1 0 0 10 3 8 10 35 Eclampsia Chronic hypertension 351 0 22 0 19 2 5 0 122 4 10 8 192 91 15 20 33 159 Hemoglobinopathy 8 0 3 0 0 0 0 0 1 0 1 0 5 0 0 0 3 3 Hydramnios 10 0 0 0 0 0 0 0 5 0 0 0 5 2 0 0 3 5 Genital herpes 268 1 9 0 8 0 4 0 76 4 5 0 107 132 11 6 12 161 Diabetes Lung disease 2081 9 128 0 40 3 33 1 644 21 73 38 990 651 137 124 179 1091 Cardiac disease 5295 17 229 1 149 10 89 21 1671 48 188 142 2565 1397 385 317 631 2730 Medical risk factors Anemia Births with medical risk factors TOTAL BIRTHS Resided on COLORADO RIVER reservation FORT APACHE FORT McDOWELL GILA RIVER HAVASUPAI HOPI HUALAPAI NAVAJO SALT RIVER SAN CARLOS TOHONO O'ODHAM TOTAL Resided off ---in Maricopa County reservation ---in Pima County ---in Coconino County ---elsewhere in Arizona TOTAL TOTAL BIRTHS 3.8 MEDICAL RISK FACTORS OF PREGNANCY (1999 STATUS) 1 1277 3215 0 6 8 0 97 101 0 0 1 0 14 109 0 2 7 0 13 56 0 1 20 0 276 1028 0 19 27 0 39 115 0 17 104 0 484 1576 1 509 746 0 109 248 0 73 193 0 102 452 1 793 1639 3.9 SUBSTANCE USE DURING PREGNANCY (1999 STATUS) Substance use TOTAL Drinker, nonsmoker Smoker, nondrinker Smoker and drinker Nonsmoker and nondrinker 5295 99 127 58 5011 17 0 1 0 16 229 17 6 18 188 1 0 1 0 0 GILA RIVER 149 3 1 0 145 HAVASUPAI 10 0 0 0 10 HOPI 89 1 1 0 87 HUALAPAI 21 1 3 0 17 1671 33 17 9 1612 SALT RIVER 48 1 1 1 45 SAN CARLOS 188 5 4 7 172 TOHONO O'ODHAM 142 6 2 1 133 TOTAL 2565 67 37 36 2425 ---in Maricopa County 1397 18 46 16 1317 ---in Pima County 385 6 16 3 360 ---in Coconino County 317 1 5 0 311 ---elsewhere in Arizona 631 7 23 3 598 2730 32 90 22 2586 ALL ETHNIC GROUPS Resided on reservation COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO Resided off reservation TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 41 UTILIZATION OF MEDICAL SERVICES Health Status Profile of American Indians in Arizona, 1999 Data Book 43 3.10 TRIMESTER OF PREGNANCY PRENATAL CARE BEGAN (1999 STATUS) TOTAL ALL ETHNIC GROUPS Resided on reservation 5295 128 3395 1257 392 123 17 1 12 3 0 1 229 11 120 68 23 7 1 0 1 0 0 0 GILA RIVER 149 5 107 25 3 9 HAVASUPAI 10 0 1 2 6 1 HOPI 89 2 61 19 3 4 HUALAPAI 21 0 13 4 2 2 1671 36 1096 394 118 27 SALT RIVER 48 1 28 13 3 3 SAN CARLOS 188 9 104 51 12 12 TOHONO O'ODHAM 142 6 86 29 21 0 TOTAL 2565 71 1629 608 191 66 ---in Maricopa County 1397 20 865 360 108 44 ---in Pima County 385 8 255 90 29 3 ---in Coconino County 317 5 248 53 10 1 ---elsewhere in Arizona 631 24 398 146 54 9 2730 57 1766 649 201 57 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO Resided off reservation No care Prenatal care 1st 2nd 3rd Unknown trimester trimester trimester TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 45 Health Status Profile of American Indians in Arizona, 1999 Data Book 46 3.11 NUMBER OF PRENATAL VISITS (1999 STATUS) TOTAL ALL ETHNIC GROUPS Resided on reservation 13+ visits Unknown 5295 128 511 1327 2106 1039 184 17 1 3 2 7 3 1 229 11 42 82 64 15 15 1 0 0 0 0 1 0 GILA RIVER 149 5 6 20 90 19 9 HAVASUPAI 10 0 6 2 1 0 1 HOPI 89 2 8 28 39 10 2 HUALAPAI 21 0 5 8 6 0 2 1671 36 162 483 620 343 27 48 1 5 10 21 8 3 SAN CARLOS 188 9 41 52 57 12 17 TOHONO O'ODHAM 142 6 11 36 57 31 1 TOTAL 2565 71 289 723 962 442 78 ---in Maricopa County 1397 20 106 290 587 313 81 ---in Pima County 385 8 36 91 138 101 11 ---in Coconino County 317 5 18 53 167 71 3 ---elsewhere in Arizona 631 24 62 170 252 112 11 2730 57 222 604 1144 597 106 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO SALT RIVER Resided off reservation No visits Prenatal visits 5-8 9-12 visits visits 1-4 visits TOTAL 3.12 OBSTETRIC PROCEDURES (1999 STATUS) Resided on reservation Other Ultrasound Tocolysis Stimulation of labor 5068 74 4349 998 623 124 3670 652 17 0 15 3 0 0 7 1 217 5 191 62 58 16 166 46 1 0 1 0 1 0 1 0 GILA RIVER 144 4 138 25 10 6 139 78 HAVASUPAI 10 0 10 2 2 0 2 0 HOPI 82 3 77 24 12 1 47 2 HUALAPAI 21 0 21 1 0 0 1 0 1600 20 1498 328 151 19 1066 69 47 2 36 11 2 1 40 11 SAN CARLOS 177 3 127 33 38 9 144 24 TOHONO O'ODHAM 137 2 60 13 2 0 125 1 TOTAL 2453 39 2174 502 276 52 1738 232 ---in Maricopa County 1328 22 1132 233 193 60 1074 305 ---in Pima County 378 5 249 55 38 0 297 25 ---in Coconino County 313 1 299 82 35 4 117 4 ---elsewhere in Arizona 596 7 495 126 81 8 444 86 2615 35 2175 496 347 72 1932 420 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO SALT RIVER Resided off reservation Induction of labor Amniocentesis TOTAL ALL ETHNIC GROUPS Electronic Fetal Monitoring Obstetric procedures TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 47 Health Status Profile of American Indians in Arizona, 1999 Data Book 48 TOTAL BIRTHS Births with complications Meconium Rupture of Membrane Abruptio Placenta Placenta Previa Other bleeding Seizures Precipitous Labor Prolonged labor Dysfunctional Labor Breech Malpresentation Cephalopelvic Disp. Cord Prolapse Anesthetic Complic. Fetal distress Other 3.13 COMPLICATIONS OF LABOR AND DELIVERY (1999 STATUS) 5295 1760 57 260 175 36 12 66 6 71 100 82 158 51 5 2 122 985 3534 17 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 16 229 104 0 13 3 1 0 11 1 1 5 4 13 5 1 0 6 67 125 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 GILA RIVER 149 27 0 4 2 1 1 1 0 1 0 1 6 4 0 0 0 12 122 HAVASUPAI 10 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9 HOPI 89 30 1 4 5 0 0 4 0 1 7 4 3 0 0 0 3 8 59 HUALAPAI 21 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 20 1671 535 23 75 87 14 3 33 3 48 60 49 49 12 1 2 33 179 1136 SALT RIVER 48 19 0 6 0 0 0 1 0 0 1 0 0 0 0 0 2 16 29 SAN CARLOS 188 62 0 6 6 2 0 4 0 1 4 1 5 4 0 0 11 35 126 TOHONO O'ODHAM 142 18 0 1 0 0 1 0 0 1 0 0 2 1 0 0 3 10 124 TOTAL 2565 799 24 109 104 18 6 54 4 53 77 59 79 26 2 2 58 330 1766 ---in Maricopa County TOTAL BIRTHS Resided on COLORADO RIVER reservation FORT APACHE FORT McDOWELL NAVAJO Resided off reservation No complications Febrile Complications of labor and/or delivery 1397 549 20 92 39 8 5 5 1 10 9 7 33 9 1 0 34 418 847 ---in Pima County 385 92 5 11 6 4 0 0 0 3 1 2 9 6 0 0 13 56 293 ---in Coconino County 317 99 3 18 5 2 0 3 0 0 4 4 10 1 1 0 2 59 218 ---elsewhere in Arizona 631 221 5 30 21 4 1 4 1 5 9 10 27 9 1 0 15 122 410 2730 961 33 151 71 18 6 12 2 18 23 23 79 25 3 0 64 655 1768 TOTAL 3.14 METHOD OF DELIVERY (1999 STATUS) ALL ETHNIC GROUPS Resided on reservation Vacuum Forceps Repeat C-Section Primary C-Section Vaginal after C-Section 5295 4332 166 489 308 41 123 17 12 0 3 2 0 0 229 183 8 28 10 5 14 1 1 0 0 0 0 0 GILA RIVER 149 123 0 15 11 0 0 HAVASUPAI 10 7 0 1 2 0 0 HOPI 89 78 3 7 1 0 0 HUALAPAI 21 17 0 0 4 0 0 1671 1409 74 123 65 7 15 SALT RIVER 48 39 2 3 4 2 2 SAN CARLOS 188 141 6 20 21 3 5 TOHONO O'ODHAM 142 112 4 10 16 2 2 TOTAL 2565 2122 97 210 136 19 38 ---in Maricopa County 1397 1145 37 138 77 13 51 ---in Pima County 385 299 9 46 31 2 8 ---in Coconino County 317 265 8 22 22 2 10 ---elsewhere in Arizona 631 501 15 73 42 5 16 2730 2210 69 279 172 22 85 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO Resided off reservation Vaginal TOTAL Method of delivery TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 49 Health Status Profile of American Indians in Arizona, 1999 Data Book 50 3.15 ATTENDANT AT BIRTH (1999 STATUS) TOTAL ALL ETHNIC GROUPS Resided on reservation Attendant Midwife D.O. C.N.M Other Unknown 5295 3045 1838 2 299 31 80 17 15 1 0 1 0 0 229 185 3 0 41 0 0 1 1 0 0 0 0 0 GILA RIVER 149 102 11 0 36 0 0 HAVASUPAI 10 7 0 0 3 0 0 HOPI 89 41 48 0 0 0 0 HUALAPAI 21 16 0 0 5 0 0 1671 467 1088 0 39 10 67 SALT RIVER 48 33 11 0 4 0 0 SAN CARLOS 188 179 6 1 0 1 1 TOHONO O'ODHAM 142 136 3 0 0 3 0 TOTAL 2565 1182 1171 1 129 14 68 ---in Maricopa County 1397 900 422 1 65 9 0 ---in Pima County 385 299 74 0 6 5 1 ---in Coconino County 317 230 64 0 20 2 1 ---elsewhere in Arizona 631 434 107 0 79 1 10 2730 1863 667 1 170 17 12 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO Resided off reservation M.D. TOTAL NEWBORN’S HEALTH Health Status Profile of American Indians in Arizona, 1999 Data Book 51 3.16 GESTATIONAL AGE (1999 STATUS) TOTAL ALL ETHNIC GROUPS Resided on reservation Unknown 5295 526 381 4365 2 21 17 1 2 14 0 0 229 33 19 177 0 0 1 1 0 0 0 0 GILA RIVER 149 22 7 120 0 0 HAVASUPAI 10 2 0 8 0 0 HOPI 89 6 8 74 0 1 HUALAPAI 21 1 4 16 0 0 1671 130 104 1431 1 5 48 2 5 41 0 0 SAN CARLOS 188 30 17 141 0 0 TOHONO O'ODHAM 142 17 13 111 1 0 TOTAL 2565 245 179 2133 2 6 ---in Maricopa County 1397 141 101 1146 0 9 ---in Pima County 385 47 36 300 0 2 ---in Coconino County 317 34 22 260 0 1 ---elsewhere in Arizona 631 59 43 526 0 3 2730 281 202 2232 0 15 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO SALT RIVER Resided off reservation Length of gestation 38-43 43+ 37 weeks weeks weeks <37 weeks TOTAL Health Status Profile of American Indians in Arizona, 1999 Data Book 53 Health Status Profile of American Indians in Arizona, 1999 Data Book 54 3.17 WEIGHT AT BIRTH (1999 STATUS) TOTAL TOTAL BIRTHS Resided on reservation 1,0001,499 Weight at birth 1,5002,5002,499 3,999 4000+ grams Unknown 5295 35 37 329 4377 471 46 17 0 0 0 15 2 0 229 2 3 23 179 20 2 1 0 0 0 1 0 0 GILA RIVER 149 1 1 10 116 21 0 HAVASUPAI 10 0 0 2 5 3 0 HOPI 89 1 0 7 77 4 0 HUALAPAI 21 0 0 1 18 2 0 1671 5 10 95 1427 128 6 48 1 0 2 40 5 0 SAN CARLOS 188 0 3 15 143 25 2 TOHONO O'ODHAM 142 1 1 8 121 9 2 TOTAL 2565 11 18 163 2142 219 12 ---in Maricopa County 1397 15 13 76 1121 150 22 ---in Pima County 385 2 4 28 316 31 4 ---in Coconino County 317 2 0 23 268 22 2 ---elsewhere in Arizona 631 5 2 39 530 49 6 2730 24 19 166 2235 252 34 COLORADO RIVER FORT APACHE FORT McDOWELL NAVAJO SALT RIVER Resided off reservation <1,000 grams TOTAL TOTAL BIRTHS Resided on COLORADO RIVER reservation FORT APACHE FORT McDOWELL GILA RIVER HAVASUPAI HOPI HUALAPAI NAVAJO SALT RIVER SAN CARLOS TOHONO O'ODHAM TOTAL Resided off ---in Maricopa County reservation ---in Pima County ---in Coconino County ---elsewhere in Arizona TOTAL 5295 17 229 1 149 10 89 21 1671 48 188 142 2565 1397 385 317 631 2730 487 4 70 0 6 1 0 1 75 5 30 4 196 176 46 14 55 291 8 0 0 0 0 0 0 0 3 0 1 0 4 2 0 2 0 4 11 0 6 0 1 0 0 0 2 0 0 0 9 1 1 0 0 2 Health Status Profile of American Indians in Arizona, 1999 Data Book 3 0 0 0 0 0 0 0 3 0 0 0 3 0 0 0 0 0 11 1 2 0 0 0 0 0 4 0 0 0 7 3 0 0 1 4 12 0 0 0 0 0 0 0 6 0 1 0 7 4 0 0 1 5 70 0 20 0 0 0 0 0 5 0 0 1 26 4 25 1 14 44 45 0 20 0 0 0 0 1 8 0 1 0 30 5 0 0 10 15 7 0 0 0 0 0 0 0 3 0 0 0 3 1 3 0 0 4 363 3 36 0 5 1 0 0 52 5 27 3 132 165 18 11 37 231 No abnormal conditions Other Seizures Assisted vent. >30 min. Assisted vent. <30 min. Meconium aspiration Membrane disease Fetal Alcohol Syndrome Birth injury Abnornal conditions Anemia Abnornal conditions of the newborn TOTAL BIRTHS 3.18 ABNORMAL CONDITIONS OF THE NEWBORN (1999 STATUS) 4808 13 159 1 143 9 89 20 1596 43 158 138 2369 1221 339 303 576 2439 55 Health Status Profile of American Indians in Arizona, 1999 Data Book 56 Hydrocephalus Microcephalus Other CNS Anomaly Heart Malformations Other Resp./Circulatory Rectal Atresia Fistula/Esoph.Atresia Omphalocele Other Gatrointestinal Malformed Genitalia Renal Agenesis Other Urogenital Cleft Lip/Palate Polydactyly Club Foot Diaphragmatic Hernia Other Muscosceletal Down's Syndrome Other Chromosomal Other 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 3 0 1 0 0 0 0 0 1 0 0 0 2 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 1 1 2 1 0 0 0 1 3 0 1 0 0 0 0 0 2 0 0 0 3 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 ** 1 9 0 0 0 0 0 71 0 4 0 85 27 3 1 20 51 No congenital anomalies Spina Bifida 5295 151 17 1 229 10 1 0 149 0 10 0 89 0 21 0 1671 77 48 0 188 5 142 2 2565 95 1397 29 385 4 317 1 631 22 2730 56 Congenital anomalies Anencephalus TOTAL BIRTHS Resided on COLORADO RIVER reservation FORT APACHE FORT McDOWELL GILA RIVER HAVASUPAI HOPI HUALAPAI NAVAJO SALT RIVER SAN CARLOS TOHONO O'ODHAM TOTAL Resided off ---in Maricopa County reservation ---in Pima County ---in Coconino County ---elsewhere in Arizona TOTAL Births with congenital anomalies TOTAL BIRTHS 3.19 CONGENITAL ANOMALIES (BIRTH DEFECTS) (1999 STATUS) 5137 16 214 1 149 10 89 21 1594 48 183 140 2465 1367 381 316 608 2672 TABLE 3.20 CAUSES OF INFANT DEATH AMONG AMERICAN INDIAN RESIDENTS OF ARIZONA, 1999 Resided off reservation FORT APACHE GILA RIVER NAVAJO SALT RIVER SAN CARLOS TOHONO O'ODHAM TOTAL --in Maricopa County --in Pima County --in Coconino County --elsewhere in Arizona TOTAL TOTAL 49 2 2 2 14 2 1 1 24 13 4 1 7 25 Perinatal Conditions 18 0 2 1 5 0 1 0 9 6 0 1 2 9 -Low birthweight/short gestation 3 0 0 0 2 0 0 0 2 1 0 0 0 1 -Other respiratory condition 3 0 0 0 0 0 0 0 0 2 0 0 1 3 -Maternal complications 3 0 0 1 0 0 1 0 2 1 0 0 0 1 -Other perinatal conditions 9 0 2 0 3 0 0 0 5 2 0 1 1 4 CONGENITAL ANOMALIES 9 1 0 0 2 1 0 1 5 3 1 0 0 4 -Heart and/or circulatory system 1 0 0 0 1 0 0 0 1 0 0 0 0 0 -Respiratory system 1 0 0 0 0 0 0 0 0 1 0 0 0 1 -Brain, spinal cord or nervous system 1 0 0 0 0 0 0 0 0 0 1 0 0 1 -Other anomalies 6 1 0 0 1 1 0 1 4 2 0 0 0 2 SUDDEN INFANT DEATH SYNDROME (SIDS) 5 1 0 1 2 1 0 0 5 0 0 0 0 0 Unintentional injury 3 0 0 0 0 0 0 0 0 0 2 0 1 3 Pneumonia/Influenza 2 0 0 0 1 0 0 0 1 1 0 0 0 1 TOTAL COLORADO RIVER Resided on reservation Health Status Profile of American Indians in Arizona, 1999 Data Book 57 IV. PATTERNS OF MORTALITY AMONG AMERICAN INDIANS BY PLACE OF RESIDENCE IN ARIZONA IN 1999 Health Status Profile of American Indians in Arizona, 1999 Data Book 59 AGE-SPECIFIC MORTALITY Health Status Profile of American Indians in Arizona, 1999 Data Book 61 4.1 AGE-SPECIFIC MORTALITY IN 1999 TOTAL TOTAL Resided on reservation 1-4 5-14 15-24 Age group 25-34 35-44 45-54 55-64 65+ 1566 49 21 22 94 123 201 203 221 632 5 0 0 0 1 1 0 2 0 1 COLORADO RIVER 22 2 0 0 0 1 5 6 3 5 FORT APACHE 50 2 1 1 4 4 8 7 9 14 7 0 0 0 1 2 1 0 1 2 GILA RIVER 85 2 0 0 7 10 10 16 13 27 HAVASUPAI 3 0 0 0 0 0 0 1 0 2 61 0 0 0 3 5 3 6 7 37 HUALAPAI 5 0 0 0 0 1 1 1 1 1 KAIBAB 2 0 0 0 1 0 1 0 0 0 NAVAJO 496 14 8 6 27 31 65 46 50 249 SALT RIVER 25 2 1 0 0 4 2 4 6 6 SAN CARLOS 54 1 0 2 8 3 7 8 8 17 SAN XAVIER 9 0 0 0 0 0 1 2 1 5 87 1 3 2 4 8 13 9 20 27 TOTAL 911 24 13 11 56 70 117 108 119 393 ---in Maricopa County 269 13 4 4 13 25 37 51 38 84 ---in Pima County 102 4 1 1 5 9 10 15 17 40 26 1 0 1 0 1 8 3 7 5 ---elsewhere in Arizona 258 7 3 5 20 18 29 26 40 110 TOTAL 655 25 8 11 38 53 84 95 102 239 AK CHIN FORT McDOWELL HOPI TOHONO O'ODHAM Resided off reservation <1 ---in Coconino County Health Status Profile of American Indians in Arizona, 1999 Data Book 63 Health Status Profile of American Indians in Arizona, 1999 Data Book 64 4.2 AGE-SPECIFIC MORTALITY AMONG MALES IN 1999 TOTAL TOTAL Resided on reservation 1-4 5-14 15-24 Age group 25-34 35-44 45-54 55-64 65+ 866 24 14 8 75 85 137 122 117 284 4 0 0 0 1 1 0 1 0 1 COLORADO RIVER 14 1 0 0 0 0 2 5 3 3 FORT APACHE 27 0 0 1 4 3 3 5 3 8 6 0 0 0 1 1 1 0 1 2 GILA RIVER 46 1 0 0 5 8 5 9 8 10 HAVASUPAI 3 0 0 0 0 0 0 1 0 2 35 0 0 0 1 5 2 4 5 18 HUALAPAI 2 0 0 0 0 1 1 0 0 0 KAIBAB 2 0 0 0 1 0 1 0 0 0 NAVAJO 282 5 5 2 25 22 48 33 31 111 SALT RIVER 11 0 1 0 0 4 2 0 1 3 SAN CARLOS 31 0 0 0 6 2 6 5 5 7 SAN XAVIER 4 0 0 0 0 0 1 0 1 2 AK CHIN FORT McDOWELL HOPI TOHONO O'ODHAM Resided off reservation <1 48 1 2 1 3 6 9 5 10 11 TOTAL 515 8 8 4 47 53 81 68 68 178 ---in Maricopa County 146 9 2 1 11 14 26 28 19 36 ---in Pima County 44 2 1 0 4 4 3 9 6 15 ---in Coconino County 14 1 0 1 0 1 5 2 2 2 ---elsewhere in Arizona 147 4 3 2 13 13 22 15 22 53 TOTAL 351 16 6 4 28 32 56 54 49 106 4.3 AGE-SPECIFIC MORTALITY AMONG FEMALES IN 1999 TOTAL TOTAL Resided on reservation 1-4 5-14 15-24 Age group 25-34 35-44 45-54 55-64 65+ 699 24 7 14 19 38 64 81 104 348 AK CHIN 1 0 0 0 0 0 0 1 0 0 COLORADO RIVER 8 1 0 0 0 1 3 1 0 2 23 2 1 0 0 1 5 2 6 6 1 0 0 0 0 1 0 0 0 0 GILA RIVER 39 1 0 0 2 2 5 7 5 17 HOPI 26 0 0 0 2 0 1 2 2 19 3 0 0 0 0 0 0 1 1 1 213 8 3 4 2 9 17 13 19 138 SALT RIVER 14 2 0 0 0 0 0 4 5 3 SAN CARLOS 23 1 0 2 2 1 1 3 3 10 SAN XAVIER 5 0 0 0 0 0 0 2 0 3 39 0 1 1 1 2 4 4 10 16 TOTAL 395 15 5 7 9 17 36 40 51 215 ---in Maricopa County 123 4 2 3 2 11 11 23 19 48 ---in Pima County 58 2 0 1 1 5 7 6 11 25 ---in Coconino County 12 0 0 0 0 0 3 1 5 3 ---elsewhere in Arizona 111 3 0 3 7 5 7 11 18 57 TOTAL 304 9 2 7 10 21 28 41 53 133 FORT APACHE FORT McDOWELL HUALAPAI NAVAJO TOHONO O'ODHAM Resided off reservation <1 Health Status Profile of American Indians in Arizona, 1999 Data Book 65 CAUSE-SPECIFIC MORTALITY Health Status Profile of American Indians in Arizona, 1999 Data Book 67 4.4 DEATHS FROM CAUSES SELECTED* AS INDICATORS FOR MONITORING PROGRESS TOWARD THE YEAR 2000 OBJECTIVES (1999 STATUS) TOTAL TOTAL Resided on reservation - Motor Vehicle -Related - Lung Cancer - Female Breast Homicide Suicide Cancer Workrelated injury** 1566 302 170 15 9 49 43 2 5 1 0 0 0 0 1 0 COLORADO RIVER 22 9 0 0 0 0 0 0 FORT APACHE 50 9 4 2 0 0 2 1 7 1 0 0 0 0 1 0 GILA RIVER 85 16 14 0 0 5 2 1 HAVASUPAI 3 1 0 0 0 0 0 0 61 11 4 0 0 1 2 0 HUALAPAI 5 1 1 0 0 0 0 0 KAIBAB 2 0 0 0 0 0 0 0 NAVAJO 496 92 64 1 5 12 14 0 SALT RIVER 25 3 1 0 0 2 1 0 SAN CARLOS 54 12 10 1 0 1 0 0 SAN XAVIER 9 1 0 1 0 0 0 0 87 11 11 1 0 3 3 0 TOTAL 911 168 109 6 5 24 26 2 ---in Maricopa County 269 53 20 5 0 12 5 0 ---in Pima County 102 18 6 2 1 2 5 0 26 8 2 0 1 1 0 0 ---elsewhere in Arizona 258 55 33 2 2 10 7 0 TOTAL 655 134 61 9 4 25 17 0 AK CHIN FORT McDOWELL HOPI TOHONO O'ODHAM Resided off reservation Cardiovascular Disease ---in Coconino County * Centers for Disease Control: Consensus set of health status indicators for the general assessment of community health, United States. MMWR 40(27): 449-51, 1991 ** Non-motor vehicle. Health Status Profile of American Indians in Arizona, 1999 Data Book 69 Health Status Profile of American Indians in Arizona, 1999 Data Book 70 4.5 LEADING CAUSES OF DEATH IN 1999 2 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 99 64 5 3 64 44 34 17 24 12 14 18 21 0 17 9 3 6 4 5 0 25 3 1 1 1 1 0 2 4 0 2 1 2 1 0 1 1 1 0 0 0 0 54 12 10 0 1 8 9 1 6 2 1 0 2 2 1 1 0 0 0 1 1 1 9 0 0 0 0 0 3 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 87 14 11 0 0 10 5 17 5 3 3 3 1 3 0 2 3 1 2 0 0 0 269 102 42 18 20 6 4 2 4 0 41 14 25 13 16 12 18 3 16 6 12 2 5 5 8 3 14 4 5 0 5 1 2 0 5 2 2 2 0 0 7 0 3 0 ---elsewhere in Arizona 5 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 ---in Coconino County KAIBAB 61 9 4 2 0 8 8 9 3 4 1 2 3 1 0 1 4 0 1 0 0 0 ---in Pima County HUALAPAI 3 2 0 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ---in Maricopa County HOPI 85 18 14 1 1 12 2 12 6 2 5 2 2 1 0 1 2 0 0 0 1 1 TOHONO O'ODHAM HAVASUPAI 7 0 0 0 0 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 SAN XAVIER GILA RIVER 50 8 4 0 0 7 7 0 5 5 0 2 2 1 0 1 1 0 0 0 2 0 SAN CARLOS FORT McDOWELL 22 0 0 0 0 9 0 0 3 1 0 0 0 0 0 0 2 1 1 0 0 0 SALT RIVER FORT APACHE 5 1 0 1 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 NAVAJO COLORADO RIVER TOTAL 1566 Unintentional injury 281 - Motor Vehicle-Related 170 - Falls 20 - Drowning 12 Diseases of Heart 225 Malignant Neoplasms 154 Diabetes 121 Alcoholism 81 Pneumonia/Influenza 74 Homicide 49 Suicide 43 Cerebrovascular Disease 49 Infectious & Parasitic Diseases 56 - HIV Infection 8 - Septicemia 34 Ill Defined Conditions 30 Congenital Anomalies 15 Chronic Obstructive Pulmonary Disease 22 Diseases of Arteries 8 Perinatal Conditions 19 Atherosclerosis 8 Resided off reservation AK CHIN TOTAL Resided on reservation 26 6 2 1 0 7 6 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 258 48 33 3 0 41 32 16 8 10 10 7 7 7 2 3 5 2 8 2 2 3 4.6 LEADING CAUSES OF DEATH AMONG MALES IN 1999 Health Status Profile of American Indians in Arizona, 1999 Data Book ---elsewhere in Arizona TOTAL 2 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ---in Coconino County 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 ---in Pima County 35 7 3 1 0 5 5 4 1 1 1 2 1 0 0 0 3 0 1 0 0 0 ---in Maricopa County KAIBAB 3 2 0 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL HUALAPAI 46 12 9 0 1 6 0 5 3 1 4 1 0 1 0 1 2 0 0 0 0 0 TOHONO O'ODHAM HOPI 6 0 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 SAN XAVIER HAVASUPAI 27 7 4 0 0 4 5 0 4 2 0 1 1 1 0 1 0 0 0 0 0 0 SAN CARLOS GILA RIVER 14 0 0 0 0 7 0 0 2 1 0 0 0 0 0 0 1 0 0 0 0 0 SALT RIVER FORT McDOWELL 4 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 Resided off reservation NAVAJO FORT APACHE 866 197 120 12 9 133 75 45 57 40 32 34 20 28 7 15 21 7 7 2 9 3 COLORADO RIVER TOTAL Unintentional injury - Motor Vehicle-Related - Falls - Drowning Diseases of Heart Malignant Neoplasms Diabetes Alcoholism Pneumonia/Influenza Homicide Suicide Cerebrovascular Disease Infectious & Parasitic Diseases - HIV Infection - Septicemia Ill Defined Conditions Congenital Anomalies Chronic Obstructive Pulmonary Disease Diseases of Arteries Perinatal Conditions Atherosclerosis AK CHIN TOTAL Resided on reservation 282 73 49 4 2 43 15 19 14 10 8 13 7 10 0 9 8 1 0 1 1 0 11 3 1 1 1 0 0 0 2 0 2 1 1 0 0 0 0 0 0 0 0 0 31 7 6 0 1 5 6 0 4 0 1 0 2 1 1 0 0 0 0 1 0 0 4 0 0 0 0 0 2 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 48 8 5 0 0 6 3 6 3 2 2 3 0 2 0 1 2 1 1 0 0 0 515 121 78 7 7 78 36 35 35 18 18 23 12 15 1 12 17 2 2 2 1 0 146 28 15 3 2 20 13 4 12 11 7 3 4 9 5 1 1 3 1 0 5 1 44 8 3 0 0 6 5 2 3 4 1 3 1 1 0 1 0 1 2 0 0 0 14 4 1 0 0 4 3 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 147 36 23 2 0 25 18 4 7 7 5 5 3 3 1 1 3 1 2 0 2 2 351 76 42 5 2 55 39 10 22 22 14 11 8 13 6 3 4 5 5 0 8 3 71 Health Status Profile of American Indians in Arizona, 1999 Data Book 72 4.7 LEADING CAUSES OF DEATH AMONG FEMALES IN 1999 5 39 395 0 4 44 0 6 46 0 6 31 0 0 3 0 0 1 1 2 42 0 11 42 0 1 24 0 2 17 0 1 18 0 1 16 0 0 0 0 1 13 0 1 5 0 1 6 0 0 4 0 0 3 1 0 4 0 1 8 0 0 8 0 0 2 123 21 14 5 1 2 12 12 5 6 4 5 0 4 1 5 2 2 0 1 2 2 58 8 10 3 2 0 8 10 2 0 2 3 0 0 0 1 1 2 0 0 0 0 TOTAL TOTAL TOHONO O'ODHAM SAN XAVIER SAN CARLOS SALT RIVER NAVAJO 3 213 14 23 1 21 1 3 0 26 0 5 0 15 0 4 0 1 0 0 0 1 0 0 0 29 0 3 1 15 2 1 0 14 0 2 0 3 2 2 0 11 1 0 0 11 1 1 0 0 0 0 0 8 1 1 0 0 1 0 0 4 0 0 0 2 1 0 0 1 0 0 0 3 0 0 0 6 0 0 0 4 0 1 0 0 0 1 ---elsewhere in Arizona 1 39 26 0 6 3 0 6 2 0 5 1 0 1 1 0 0 0 0 2 3 0 7 5 0 1 3 1 3 2 0 2 2 0 0 1 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 HUALAPAI HOPI GILA RIVER FORT McDOWELL FORT APACHE COLORADO RIVER 8 23 2 3 0 1 0 0 0 0 0 0 0 2 0 0 0 3 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 1 0 0 2 0 0 ---in Coconino County 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 ---in Pima County 699 92 84 50 8 3 79 76 34 24 29 28 1 19 8 17 8 9 6 15 10 5 Resided off reservation ---in Maricopa County TOTAL Diseases of Heart Unintentional injury - Motor Vehicle-Related - Falls - Drowning Malignant Neoplasms Diabetes Pneumonia/Influenza Alcoholism Cerebrovascular Disease Infectious & Parasitic Diseases - HIV Infection - Septicemia Ill Defined Conditions Homicide Congenital Anomalies Suicide Diseases of Arteries Chronic Obstructive Pulmonary Disease Perinatal Conditions Atherosclerosis AK CHIN TOTAL Resided on reservation 12 3 2 1 1 0 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 111 16 12 10 1 0 14 12 3 1 4 4 1 2 2 5 1 2 2 6 0 1 304 48 38 19 5 2 37 34 10 7 11 12 1 6 3 11 4 6 2 7 2 3 LEADING CAUSES OF DEATH BY AGE GROUP FOR SELECTED INDIAN NATIONS Health Status Profile of American Indians in Arizona, 1999 Data Book 73 4.8 LEADING CAUSES OF DEATH BY AGE GROUP AMONG RESIDENTS OF NAVAJO TRIBAL COMMUNITIES IN 1999 TOTAL TOTAL <1 1-4 5-14 Age group 15-24 25-34 35-44 45-54 55-64 65+ 496 14 8 6 27 31 65 46 50 249 Unintentional injury 99 0 6 2 18 14 27 13 7 12 - Motor Vehicle-Related 64 0 3 1 17 10 20 7 2 4 - Falls 5 0 0 0 1 1 0 0 1 2 - Drowning 3 0 1 0 0 0 0 1 1 0 Diseases of Heart 64 0 1 0 1 0 3 6 10 43 Malignant Neoplasms 44 0 1 0 1 0 3 4 8 27 Diabetes 34 0 0 0 0 0 2 4 8 20 Alcoholism 17 0 0 0 0 2 10 1 3 1 Pneumonia/Influenza 24 1 0 0 1 0 1 1 1 19 Homicide 12 0 0 0 0 4 4 3 0 1 Suicide 14 0 0 1 2 5 3 2 1 0 Cerebrovascular Disease 18 1 0 0 0 1 0 0 1 15 Infectious & Parasitic Diseases 21 2 0 1 0 0 2 3 3 10 - Septicemia 17 1 0 1 0 0 2 2 2 9 Ill Defined Conditions 9 2 0 0 2 0 0 2 1 2 Congenital Anomalies 3 2 0 0 0 0 0 0 0 1 Chronic Obstructive Pulmonary Disease 6 0 0 0 0 0 0 1 1 4 Diseases of Arteries 4 0 0 0 0 0 0 0 0 4 Perinatal Conditions 5 5 0 0 0 0 0 0 0 0 Health Status Profile of American Indians in Arizona, 1999 Data Book 75 Health Status Profile of American Indians in Arizona, 1999 Data Book 76 4.9 LEADING CAUSES OF DEATH BY AGE GROUP AMONG RESIDENTS OF HOPI TRIBAL COMMUNITIES IN 1999 TOTAL TOTAL 15-24 Age group 35-44 45-54 25-34 55-64 65+ 61 3 5 3 6 7 37 Unintentional injury 9 2 1 0 1 2 3 - Motor Vehicle -Related 4 2 0 0 1 0 1 - Falls 2 0 0 0 0 0 2 Diseases of Heart 8 0 0 0 0 1 7 Malignant Neoplasms 8 0 0 1 1 1 5 Diabetes 9 0 0 0 0 2 7 Alcoholism 3 0 1 1 1 0 0 Pneumonia/Influenza 4 0 0 0 0 1 3 Homicide 1 0 0 0 1 0 0 Suicide 2 0 2 0 0 0 0 Cerebrovascular Disease 3 1 0 0 0 0 2 Infectious & Parasitic Diseases 1 0 0 0 0 0 1 - Septicemia 1 0 0 0 0 0 1 Ill Defined Conditions 4 0 1 0 0 0 3 Chronic Obstructive Pulmonary Disease 1 0 0 0 0 0 1 4.10 LEADING CAUSES OF DEATH BY AGE GROUP AMONG RESIDENTS OF FORT APACHE TRIBAL COMMUNITIES IN 1999 TOTAL TOTAL <1 1-4 5-14 Age group 25-34 35-44 15-24 45-54 55-64 65+ 50 2 1 1 4 4 8 7 9 14 Unintentional injury 8 0 0 0 4 1 0 2 1 0 - Motor Vehicle-Related 4 0 0 0 4 0 0 0 0 0 Diseases of Heart 7 0 0 0 0 0 0 1 1 5 Malignant Neoplasms 7 0 0 1 0 0 0 0 3 3 Alcoholism 5 0 0 0 0 1 1 1 2 0 Pneumonia/Influenza 5 0 0 0 0 0 1 2 0 2 Suicide 2 0 0 0 0 1 1 0 0 0 Cerebrovascular Disease 2 0 0 0 0 0 0 0 1 1 Infectious & Parasitic Diseases 1 0 0 0 0 0 1 0 0 0 - Septicemia 1 0 0 0 0 0 1 0 0 0 Ill Defined Conditions 1 0 0 0 0 0 0 0 0 1 Perinatal Conditions 2 2 0 0 0 0 0 0 0 0 Health Status Profile of American Indians in Arizona, 1999 Data Book 77 Health Status Profile of American Indians in Arizona, 1999 Data Book 78 4.11 LEADING CAUSES OF DEATH BY AGE GROUP AMONG RESIDENTS OF GILA RIVER TRIBAL COMMUNITIES IN 1999 TOTAL <1 15-24 Age group 35-44 25-34 45-54 55-64 65+ TOTAL 85 2 7 10 10 16 13 27 Unintentional injury 18 0 4 7 2 4 1 0 - Motor Vehicle -Related 14 0 4 4 2 3 1 0 - Falls 1 0 0 0 0 1 0 0 - Drowning 1 0 0 1 0 0 0 0 12 0 0 0 0 1 1 10 2 0 0 0 0 0 0 2 12 0 0 0 0 2 2 8 Alcoholism 6 0 0 0 3 0 3 0 Pneumonia/Influenza 2 0 0 0 0 0 1 1 Homicide 5 0 1 2 2 0 0 0 Suicide 2 0 0 1 1 0 0 0 Cerebrovascular Disease 2 0 0 0 0 0 1 1 Infectious & Parasitic Diseases 1 0 0 0 0 1 0 0 - Septicemia 1 0 0 0 0 1 0 0 Ill Defined Conditions 2 1 0 0 0 1 0 0 Perinatal Conditions 1 1 0 0 0 0 0 0 Atherosclerosis 1 0 0 0 0 0 0 1 Diseases of Heart Malignant Neoplasms Diabetes 4.12 LEADING CAUSES OF DEATH BY AGE GROUP AMONG RESIDENTS OF SALT RIVER TRIBAL COMMUNITIES IN 1999 TOTAL TOTAL <1 1-4 Age group 35-44 25-34 45-54 55-64 65+ 25 2 1 4 2 4 6 6 Unintentional injury 3 0 1 1 0 0 0 1 - Motor Vehicle-Related 1 0 0 1 0 0 0 0 - Falls 1 0 0 0 0 0 0 1 - Drowning 1 0 1 0 0 0 0 0 Diseases of Heart 1 0 0 0 0 1 0 0 Diabetes 2 0 0 0 0 0 2 0 Alcoholism 4 0 0 0 1 1 1 1 Homicide 2 0 0 2 0 0 0 0 Suicide 1 0 0 1 0 0 0 0 Cerebrovascular Disease 2 0 0 0 1 0 0 1 Infectious & Parasitic Diseases 1 0 0 0 0 0 1 0 - Septicemia 1 0 0 0 0 0 1 0 Ill Defined Conditions 1 1 0 0 0 0 0 0 Congenital Anomalies 1 1 0 0 0 0 0 0 Health Status Profile of American Indians in Arizona, 1999 Data Book 79 Health Status Profile of American Indians in Arizona, 1999 Data Book 80 4.13 LEADING CAUSES OF DEATH BY AGE GROUP AMONG RESIDENTS OF SAN CARLOS TRIBAL COMMUNITIES IN 1999 TOTAL <1 5-14 Age group 25-34 35-44 15-24 45-54 55-64 65+ TOTAL 54 1 2 8 3 7 8 8 17 Unintentional injury 12 0 2 7 1 1 0 0 1 - Motor Vehicle-Related 10 0 2 7 0 1 0 0 0 - Drowning 1 0 0 0 1 0 0 0 0 Diseases of Heart 8 0 0 0 0 1 1 1 5 Malignant Neoplasms 9 0 0 0 1 1 1 2 4 Diabetes 1 0 0 0 0 0 0 1 0 Alcoholism 6 0 0 0 1 2 1 2 0 Pneumonia/Influenza 2 0 0 0 0 0 0 0 2 Homicide 1 0 0 1 0 0 0 0 0 Cerebrovascular Disease 2 0 0 0 0 0 2 0 0 Infectious & Parasitic Diseases 2 0 0 0 0 0 1 1 0 - HIV Infection 1 0 0 0 0 0 1 0 0 - Septicemia 1 0 0 0 0 0 0 1 0 Diseases of Arteries 1 0 0 0 0 0 0 0 1 Perinatal Conditions 1 1 0 0 0 0 0 0 0 Atherosclerosis 1 0 0 0 0 0 0 0 1 4.14 LEADING CAUSES OF DEATH BY AGE GROUP AMONG RESIDENTS OF TOHONO O'ODHAM TRIBAL COMMUNITIES IN 1999 TOTAL <1 1-4 5-14 15-24 Age group 25-34 35-44 45-54 55-64 65+ TOTAL 87 1 3 2 4 8 13 9 20 27 Unintentional injury 14 0 2 2 2 1 4 1 1 1 - Motor Vehicle-Related 11 0 2 2 2 1 2 1 1 0 Diseases of Heart 10 0 0 0 0 0 0 2 0 8 5 0 0 0 0 1 1 0 1 2 17 0 0 0 0 0 2 2 3 10 Alcoholism 5 0 0 0 0 0 0 3 1 1 Pneumonia/Influenza 3 0 0 0 0 0 1 0 2 0 Homicide 3 0 0 0 1 2 0 0 0 0 Suicide 3 0 0 0 1 2 0 0 0 0 Cerebrovascular Disease 1 0 0 0 0 0 0 0 0 1 Infectious & Parasitic Diseases 3 0 0 0 0 0 1 1 1 0 - Septicemia 2 0 0 0 0 0 1 0 1 0 Ill Defined Conditions 3 0 0 0 0 1 1 0 1 0 Congenital Anomalies 1 1 0 0 0 0 0 0 0 0 Chronic Obstructive Pulmonary Disease 2 0 0 0 0 0 0 0 1 1 Malignant Neoplasms Diabetes Health Status Profile of American Indians in Arizona, 1999 Data Book 81 Health Status Profile of American Indians in Arizona, 1999 Data Book 82 4.15 LEADING CAUSES OF DEATH BY AGE GROUP AMONG AMERICAN INDIANS WHO RESIDED OFF RESERVATION IN 1999 TOTAL 45-54 55-64 TOTAL 655 25 8 11 38 53 84 95 102 239 Unintentional injury 114 3 5 6 17 20 20 21 10 12 - Motor Vehicle-Related 61 0 2 4 12 12 10 9 8 4 - Falls 10 0 0 0 1 1 1 1 1 5 4 0 1 0 0 1 0 2 0 0 103 2 0 0 1 3 8 10 25 54 Malignant Neoplasms 76 0 0 1 0 2 7 12 13 41 Diabetes 44 0 0 0 0 1 4 4 13 22 Alcoholism 29 0 0 0 0 0 9 11 5 4 Pneumonia/Influenza 32 1 0 1 2 3 6 3 3 13 Homicide 25 0 1 0 6 7 4 5 1 1 Suicide 17 0 0 0 5 4 2 3 2 1 Cerebrovascular Disease 19 0 0 0 0 1 2 2 3 11 Infectious & Parasitic Diseases 25 1 0 0 1 1 10 4 4 4 - HIV Infection 7 0 0 0 0 1 4 2 0 0 - Septicemia 9 1 0 0 0 0 2 1 3 2 Ill Defined Conditions 7 3 1 0 0 0 2 0 0 1 Congenital Anomalies 9 4 1 1 1 0 0 1 1 0 12 0 0 0 0 0 1 0 3 8 Diseases of Arteries 2 0 0 1 0 0 0 0 0 1 Perinatal Conditions 10 9 0 1 0 0 0 0 0 0 6 0 0 0 0 0 0 1 0 5 - Drowning -Diseases of Heart Chronic Obstructive Pulmonary Disease Atherosclerosis <1 1-4 5-14 Age group 15-24 25-34 35-44 65+ TECHNICAL NOTES Health Status Profile of American Indians in Arizona, 1999 Data Book 83 Sources of Data The charts in Sections I and II are based on rates and ratios published in the Arizona Health Status and Vital Statistics annual report. 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). Population denominators for American Indians by place of residence in Arizona were not available for 1999. 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 - Prior to 1990: any neonate whose weight at birth is 2,500 grams or less. Beginning in 1990: 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. Very Low-Birthweight - Any neonate whose weight at birth is 1,500 grams or less (less than 3 pounds 5 ounces). 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 "age-adjustment" removes the effect of the age differences among sub-populations 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 applying the age-specific death rates to the standard population distributed by age. The total U.S. population as enumerated in 1940 was used as the standard. The age-adjusted mortality rates in this report are based on the following nine age groups: *See "Standard Terminology for Reporting Reproductive Health in the United States". Public Health Reports, Vol.103, No.5. September-October 1988. Health Status Profile of American Indians in Arizona, 1999 Data Book 85 Health Status Profile of American Indians in Arizona, 1999 Data Book Age All ages Population per million 1,000,000 Under 1 year 1-4 years 5-14 years 15-24 years 25-34 years 35-44 years 45-54 years 55-64 years 65 years and over 15,343 64,718 170,335 181,677 162,066 139,237 117,811 80,294 68,499 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, Injuries and Causes of Death. Listed below are categories and International Classification of Diseases (ICD) codes for selected causes of mortality presented in this report. Alcoholism: 291, 303, 571.0-571.3 Alzheimer's Disease: 331.0 Breast Cancer in women: 174 Cerebrovascular Disease (Stroke): 430-438 Chronic Obstructive Pulmonary Disease (COPD): 490-496 Cirrhosis: 571 Diabetes Mellitus: 250 Diseases of Heart: 390-398, 402, 404-429 Drowning: 830, 832, 910 HIV Infection: 042-044 Homicide and legal intervention: 960-978 Infectious and parasitic diseases: 001-139 Injuries Not Related to Motor Vehicles: 800-807, 826-949 Injuries, Unintentional: 800-949 86 Lung Cancer: 162.2-162.9 Malignant Neoplasms (cancers): 140-208 Motor Vehicle-Related Injuries: 810-825 Pneumonia and Influenza: 480-487 Septicemia: 038 Suicide: 950-959 Medical Terms Used on the Birth Certificate Medical risk factors for this pregnancy 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. Complications of labor and/or delivery Febrile - A fever greater than 100 degrees F. or 38 degrees C. occurring during labor and/or delivery. 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. 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. Health Status Profile of American Indians in Arizona, 1999 Data Book 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). Abnormal conditions of the newborn Anemia - Hemoglobin level of less than 13.0 g/dL, or a hematocrit of less than 39 percent. Birth injury - Impairment of the infant's body function or structure due to adverse influences that occurred at birth. 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. 87 COMMUNITIES ON INDIAN RESERVATIONS IN ARIZONA Health Status Profile of American Indians in Arizona, 1999 Data Book 89 COMMUNITIES ON INDIAN RESERVATIONS IN ARIZONA RESERVATION COUNTY AK CHIN PINAL CAMP VERDE YAVAPAI COCOPAH COLORADO RIVER YUMA LA PAZ FORT APACHE APACHE GILA NAVAJO COMMUNITY CODE* 11059 11060 13079 13080 14024 15003 15023 15024 15025 15026 01024 01025 01026 01027 04031/04036/04037 04032 04033 04034 04035 04038 09063/09064 09065 09066/09079 09067 09068 09069 09070 09071 09072 09073 09074 09075 Health Status Profile of American Indians in Arizona, 1999 Data Book COMMUNITY NAME AK CHIN AK CHIN INDIAN RESERVATION/NOS** CAMP VERDE INDIAN RESERVATION/NOS MIDDLE VERDE COCOPAH INDIAN RESERVATION PARKER COLORADO RIVER INDIAN RESERVATION/NOS POSTON PARKER VALLEY MOHAVE TRIBAL CEMETERY FORT APACHE INDIAN RESERVATION/NOS HAWLEY LAKE MAVERICK MCNARY FORT APACHE INDIAN RESERVATION/NOS AMOS WASH CANYON DAY CARRIZO CEDAR CREEK WARRIOR CANYON FORT APACHE INDIAN RESERVATION/NOS CHINO SPRINGS CIBECUE DEER SPRINGS DIAMOND CREEK EAST FORK FORT APACHE INDIAN PINE HONDAH MCNARY NORTH FORK SEVEN MILE 91 Health Status Profile of American Indians in Arizona, 1999 Data Book 92 COMMUNITIES ON INDIAN RESERVATIONS IN ARIZONA RESERVATION COUNTY FORT APACHE (CONTINUED) FORT MCDOWELL MARICOPA FORT MOHAVE FORT YUMA GILA RIVER MOHAVE YUMA MARICOPA PINAL COMMUNITY CODE* 09076 09077 09078 07107 07108 08048 14023 07021 07103 07104 07105 07106 11061/11065 11062 11063 11064 11066 11067 11068 11069 11070 11071 11072 11073 11074 11075 11076 11077 11078 11079 11081 11083 COMMUNITY NAME WHITERIVER RAINBOW CITY CASTLE BUTTE FORT MCDOWELL FORT MCDOWELL INDIAN RESERVATION/NOS FORT MOHAVE FORT YUMA FIREBIRD LAKE GILA RIVER INDIAN RESERVATION/NOS GILA CROSSING SAINT JOHNS KOMATKE GILA RIVER INDIAN RESERVATION/NOS BAPCHULE BLACKWATER CASA BLANCA LOWER SANTAN OLBERG PROGRESSIVE COLONY SACATON SANTAN SOUTH GOODYEAR STOTONIC UPPER SANTAN SNAKETOWN LONG BUTTE WETCAMP WEST CHANDLER SWEETWATER GILA RIVER INDIAN COMMUNITY (GRIC) COCLEBURR JACKRABBIT COMMUNITIES ON INDIAN RESERVATIONS IN ARIZONA RESERVATION COUNTY HAVASUPAI COCONINO HOPI COCONINO NAVAJO HUALAPAI COCONINO MOHAVE KAIBAB COCONINO MOHAVE COMMUNITY CODE* 03059 03060 03061 03071 03083 09026 09027/09028 09035 09037 09040 09042 09043/09094 09044 09045 09047 09050 09051/09052/09056 09053/09054 09055 09058 09060 03057 03058 08054 08055 08059 08060 03056 08049 08051 08052 08053 Health Status Profile of American Indians in Arizona, 1999 Data Book COMMUNITY NAME SUPAI HAVASUPAI INDIAN RESERVATION/NOS HOPI INDIAN RESERVATION/NOS MOENCOPI MOENAVE HOPI INDIAN RESERVATION/NOS BACAVI HANO HOTEVILLA KEAMS CANYON MISHONGNOVI KYKOTSMOVI VILLAGE OLD ORAIBI ORAIBI POLACCA SECOND MESA SHIPAULOVI SHONGOPOVI SICHOMOVI SNOWBIRD WALPI HUALAPAI INDIAN RESERVATION/NOS FRAZIERS WELL PEACH SPRINGS INDIAN RESERVATION/NOS PEACH SPRINGS VALENTINE INDIAN RESERVATION/NOS VALENTINE KAIBAB INDIAN RESERVATION/NOS KAIBAB INDIAN RESERVATION/NOS KAIBAB MOCCASIN SIX MILE 93 Health Status Profile of American Indians in Arizona, 1999 Data Book 94 COMMUNITIES ON INDIAN RESERVATIONS IN ARIZONA RESERVATION NAVAJO COUNTY APACHE COMMUNITY CODE* 01018 01020 01022 01028 01029 01030 01031 01032/01042 01033 01034 01035 01036 01037 01038 01039 01040 01041 01043 01044 01045 01046 01047 01048/01062 01049 01050 01051 01052 01053 01054 01055 01056 01057 COMMUNITY NAME NAVAJO PINON PAINTED DESERT FORT DEFIANCE CHINLE SAWMILL WINDOW ROCK TSAILEE KINLICHEE GANADO NAZLINI STEAMBOAT MANY FARMS COTTONWOOD ROCK POINT DENNEHOTSO HUNTER'S POINT LUKACHUKAI ROUND ROCK BLUE GAP ROUGH ROCK BLUE CANYON ST. MICHAELS WHEATFIELDS SALINA SPRINGS KLAGETOH TOYEI WIDE RUINS HOUCK TEEC NOS POS LUPTON RED VALLEY COMMUNITIES ON INDIAN RESERVATIONS IN ARIZONA RESERVATION COUNTY NAVAJO (CONTINUED) COCONINO COMMUNITY CODE* 01058 01059 01060 01061 01063 01064 01065 01066 01067 01068 01069 01070 01071 01072 01073 03018 03062 03063 03064 03065 03067 03068 03069 03070 03072 03073 03074 03075 03076 03077 03078 03079 Health Status Profile of American Indians in Arizona, 1999 Data Book COMMUNITY NAME COVE CORNFIELDS CANYON DEL MUERTO NAVAJO STATION WOODSPRINGS SWEETWATER ALLENTOWN TEC NEZ IAH OAK SPRINGS RED MESA WHIPPORWILL GREASEWOOD SUNRISE CROSS CANYON PINE SPRINGS GREY MOUNTAIN COW SPRINGS DINNEBITO ELEPHANT'S FEET HOWELL MESA RED LAKE TONALEA TUBA CITY BITTER SPRINGS KAIBETO LEUPP CEDAR RIDGE INSCRIPTION THE GAP CAMERON NAVAJO MOUNTAIN INSCRIPTION HOUSE 95 Health Status Profile of American Indians in Arizona, 1999 Data Book 96 COMMUNITIES ON INDIAN RESERVATIONS IN ARIZONA RESERVATION NAVAJO (CONTINUED) COUNTY COMMUNITY CODE* 03080 03081 03082 03084 03085 03086 03087 03088 NAVAJO 09029 09036 09038/09039 09041 09046 09059 09061 09080 09081 09082 09083 09084 09085/09090 09086 09087 09088 09089 09091 09093 09095 09031/09032/09034/09049/09092 COMMUNITY NAME LECHEE FOREST LAKES TOLANI LAKE WHITE MESA COALMINE SAND SPRINGS RARE METALS COPPERMINE BIG MOUNTAIN HARD ROCKS JEDDITO LOW MOUNTAIN PINON TACHEE WHIPPORWILL TEESTO (TEESTOH) KAYENTA WHITECONE SHONTO GREASEWOOD DILCON CHILCHINBETO BURNTCORN BLACK MESA BIRD SPRINGS INDIAN WELLS KITSEEL SEBA DAIKAL OTHER/UNKNOWN PLACE COMMUNITIES ON INDIAN RESERVATIONS IN ARIZONA RESERVATION PASCUA YAQUI SALT RIVER SAN CARLOS COUNTY PIMA MARICOPA GILA GRAHAM SAN XAVIER TOHONO O'ODHAM PIMA MARICOPA PIMA PINAL * ** COMMUNITY CODE* 10059 07109 04040 04041 04042 04043 04044 05030 05031 05032 05033 10047 07099 07100 07101/07102 10048 10049 10050 10051 10052 10053 10054 10055 10056/10060 10057 11055 11056 11057 01105 COMMUNITY NAME PASCUA YAQUI INDIAN RESERVATION SALT RIVER INDIAN RESERVATION SAN CARLOS INDIAN RESERVATION/NOS COOLIDGE DAM CUTTER PERIDOT SAN CARLOS SAN CARLOS INDIAN RESERVATION/NOS BYLAS CALVA SAN CARLOS LAKE SAN XAVIER INDIAN RESERVATION/NOS TOHONO O'ODHAM INDIAN RESERVATION/NOS KAKA GILA BEND INDIAN COMMUNITY/SAN LUCY VILLAGE TOHONO O'ODHAM SANTA ROSA HICKIWAN PISINEMO IRON STAND VILLAGE LITTLE TUCSON SELLS TOPAWA MENEGER'S DAM QUEEN'S WELL TOHONO O'ODHAM INDIAN RESERVATION/NOS CHUICHU KOHATK NORTH KOMELIK THE CITY/TOWN/PLACE CODES USED BY THE OFFICE OF VITAL RECORDS OF THE ARIZONA DEPARTMENT OF HEALTH SERVIES. NOT OTHERWISE SPECIFIED. Health Status Profile of American Indians in Arizona, 1999 Data Book 97