American Indian alcohol use has received scrutiny in recent decades, but data derived from samples that permit direct comparisons to other US epidemiological studies have been less commonly reported. This brief places rates of the quantity and frequency of alcohol use in 2 tribally defined reservation samples in such a comparative epidemiological context.
PROBLEM/CONDITION: From 1986 through 1990, an epidemic of syphilis occurred throughout the United States. In 1991, the number of reported cases of primary and secondary (P&S) syphilis in the United States declined for the first time since 1985. REPORTING PERIOD COVERED: To examine how this decline reflected sex-specific, race/ethnicity-specific, and regional patterns of syphilis morbidity, we analyzed data for syphilis cases reported to CDC from 1984 through 1991. DESCRIPTION OF SYSTEM: Summary data for cases of syphilis reported to state health departments were sent quarterly and annually to CDC. The quarterly data from each state included total number of syphilis cases by sex, stage of disease (primary, secondary, early latent, and late latent), and source of report (public or private). The annual data from each state included total number of P&S syphilis cases by sex, racial/ethnic group (white, not of Hispanic origin; black, not of Hispanic origin; Hispanic; Asian/Pacific Islander; or American Indian/Alaskan Native), 5-year age group, and source of report. RESULTS: The decline in both the number and rate of reported syphilis cases in 1991 occurred in every racial group in the United States and in both sexes. This decline also occurred in every region of the United States except the Midwest, where the total P&S syphilis rate increased 37.3% from 1990 through 1991. Despite the increase in syphilis rates in the Midwest, the highest rates of P&S syphilis in 1991 were reported from the South. INTERPRETATION: The reasons for the decline in syphilis are unclear. No data exist to conclusively identify which STD control program activities affected the level of syphilis morbidity or to what extent those activities may have contributed to the decline. Changes in drug use and limited immunity to Treponema pallidum may have accounted for some of the decrease in syphilis incidence. Higher levels of poverty in the South and poor access to health-care services associated with poverty probably contributed to continued high levels of disease transmission in the South. ACTIONS TAKEN: Better evaluation of STD control program activities will be necessary to help determine the most effective strategies for preventing and controlling syphilis in different high-risk populations.
Measles is a highly infectious, acute viral illness that can cause severe pneumonia, diarrhea, encephalitis, and death. To characterize the epidemiology of measles in the United States during 2001-2003, CDC analyzed data reported by state and local health departments. This report summarizes the results of that analysis, which indicated that no endemic measles virus is circulating in the United States; however, imported measles cases continue to occur and can result in limited indigenous transmission. Maintaining immunity through high vaccination coverage levels is essential to limit the spread of measles from imported cases and prevent measles from becoming endemic.
In 1994, suicides were committed by 31,142 persons in the United States (crude rate: 12.0 suicides per 100,000 population), and suicide was the ninth leading cause of death. Although rates of suicide have varied by geographic region (e.g., rates have consistently been higher in western states, reasons for these regional variations are unknown but may reflect regional differences in certain demographic variables. For example, suicide rates have been higher for males, for the elderly, and for certain racial/ethnic groups (e.g., non-Hispanic whites and American Indians/Alaskan Natives). CDC examined U.S. suicide rates from 1990 through 1994 to determine whether regional variations in suicide rates are affected by differences in age, race/Hispanic-ethnicity, and sex and to examine whether method-specific rates varied by region. This report summarizes the results of that analysis, which indicate that, despite adjustments for certain demographic variables, regional differences persist.
BACKGROUND: High rates of alcohol use and alcohol-related morbidity and mortality among American Indians (AI) are major public health concerns. The purpose of this paper is to describe patterns of alcohol consumption among three distinct samples of American Indians (AIs) compared to a U.S reference population. METHODS: Data were drawn from two epidemiologic studies: 1) a study of 2,927 AIs living on or near reservations from two culturally distinct tribes in the Southwest (SW-AI) and Northern Plains (NP-AI); and 2) the National Longitudinal Alcohol Epidemiologic Study (NLAES), which included data from a geographically dispersed sample of AIs (n = 780) as well as the US reference population (all-race excluding AIs, n = 30,063). Multivariate analyses were used to assess drinking patterns. RESULTS: After controlling for demographic characteristics, the prevalence of drinking during the past year was similar among males in the NP-AI, NLAES-AI, and the US populations. SW-AI males and females were significantly less likely to drink during the past year (Odds Ratios of 0.74 and 0.41, respectively), while the odds of NP-AI females being current drinkers were twice that of US females. Among those who drank during the past year, the AIs consumed a larger quantity of alcohol per drinking day than the US reference population. However, the reservation-based AIs consumed alcohol less frequently (Odds Ratios between 0.18-0.40, p