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Rosalyn Singleton, MD, MPH; Steve Holve, MD; Amy Groom, MPH; Brian J. McMahon, MD; Mathu Santosham, MD, MPH; George Brenneman, MD; Katherine L. O’Brien, MD, MPH

Arch Pediatr Adolesc Med. 2009;163(5):446-453.

American Indian and Alaska Native (AI/AN) people have suffered disproportionately from infectious diseases compared with the general US population. As recently as 25 years ago, rates of hepatitis A and B virus, Haemophilus influenzae type b, and Streptococcus pneumoniae infections were as much as 10 times higher among AI/AN children compared with the general US child population. In the past quarter century, routine use of childhood immunizations for hepatitis A and B viruses has eliminated disease disparities for these pathogens in AI/AN children, and significant decreases have been demonstrated for H influenzae type b, S pneumoniae, and pertussis. Nevertheless, certain infectious diseases continue to occur at higher rates in AI/AN children. The reason for continued disparities is most likely related to adverse living conditions such as household crowding, lack of indoor plumbing, poverty, and poor indoor air quality. Although tremendous strides have been made in eliminating disparities in infectious disease among AI/AN children, further gains will require addressing disparities in adverse living conditions.

Author Affiliations: Alaska Native Tribal Consortium (Dr Singleton) and Arctic Investigations Program, National Center for Preparedness, Detection, and Control of Infectious Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention (Drs Singleton and McMahon), Anchorage, Alaska; Tuba City Indian Medical Center, Tuba City, Arizona (Dr Holve); National Center for Immunization and Respiratory Diseases, Immunization Services Division, Program Operations Branch, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Groom); Indian Health Service, Division of Epidemiology and Disease Prevention, Albuquerque, New Mexico (Ms Groom); Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Santosham and O’Brien); and Indian Health Service, Aberdeen Area, Aberdeen, South Dakota (Dr Brenneman).

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