Fort Peck Tribes Tribal Health Initiative. Death Data Analysis

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1 Fort Peck Tribes Tribal Health Initiative Death Data Analysis An analysis of deaths among members of the Fort Peck Assiniboine and Sioux Tribes in 2012 and 2013

2 Methodology and Overview This analysis is derived from official death certificates from the Fort Peck Assiniboine and Sioux Tribes. Death records were accessed by RADM Kermit C. Smith, D.O., M.P.H., (USPHS, Ret) on January 8th, 9th and 10th with permission from the Tribe granted through a resolution from the Fort Peck Tribal Council. All names and other identifiers were removed from the data set for analysis. Summary of number, mean and median age of deaths In 2012 and 2013 there were 112 deaths among members of the Assiniboine and Sioux Tribes, including 48 in 2012 and 64 in The deaths were split almost equally between gender, with 57 (51%) deaths among male tribal members and 55 (49%) of deaths among females. The average age of death was 51.5 and the median age of death was The median age of death for both women and men of the Assiniboine and Sioux Tribes was lower than the median for white males and females in Montana in 2012 as well as all American Indian males and females in Montana in (See Figure 1). The health disparities in life expectancy are striking. The median age of death for members of the Assiniboine and Sioux tribes is 25 and 22 years lower than whites in Montana, for men and women respectively Montana Vital Statistics Annual Report 2

3 Demographics Marital Status and Tribal Affiliation Of the 112 deaths, the marital status of 108 individuals was listed on the death certificate. Table 1. Marital status among Assiniboine and Sioux Tribal members who died in Single Married Divorced Widowed 42 (39%) 26 (24%) 26 (24%) 14 (13%) Ninety two of the 112 death certificates had the tribal affiliation of the individual listed. Almost half of deaths were among individuals with Sioux as their tribal affiliation. Table 2. Tribal affiliation listed on death certificate of Assiniboine and Sioux Tribal members, Assiniboine Sioux Assiniboine Sioux Not listed 15 (16%) 42 (46%) 34 (38%) 20 3

4 Geography Many members of the Assiniboine and Sioux Tribes live on the Fort Peck Reservation in northeast Montana. The Fort Peck Reservation is 110 miles (east to west) by 40 miles (north to south) and encompasses 2,093,318 acres or approximately 3,200 square miles in northeastern Montana. There are 8,291 Indian people on the Fort Peck Indian reservation. The Sioux divisions of the Sisseton/Wahpetons, Yantonais, Teton Hunkpapa and the Assiniboine bands of the Canoe Paddler and Red Bottom are the primary membership of the Tribes. Fort Peck is comprised of six small communities, Brockton, Fort Kipp and Poplar on the eastside of the reservation and Wolf Point, Oswego and Frazier on the west side. Figure 2 shows the number of deaths among residents living on and off the reservation (in east and west side communities) and the median age of deaths for Assiniboine and Sioux tribal members living in these areas. Even though 57% (n=64) of the deaths occurred among tribal members residing on the reservation, only 42% (n=47) of deaths occurred on the reservation. Of the 64 deaths among tribal members living on the reservation, 27% (n=17) of deaths occurred off the reservation. Only 3 (6%) of the 48 deaths of individuals residing off the reservation occurred on the reservation. 4

5 Cause of Death Death certificates list up to six causes of death for each individual. The figures below indicate what number and percent of the deaths include the specified disease state categories as one of the causes of death. Some deaths are represented twice on this chart, for instance a person with Lung Cancer listed on his or her death certificate would be represented under Lung Disease and Cancer. Sixty nine of the 112 deaths (62%) had one ore more of the above causes listed on the death certificate. Definitions: Cancer included: Esophageal Cancer, Hepatocellular Carcinoma, Metastatic Cancer, Metastatic Cervical Cancer, Lung Cancer, Renal Cell Cancer-metastasis to bone, liver, lung, and Pancreatic Cancer Diabetes included: Diabetes and Diabetes Mellitus Kidney Disease included: Kidney Failure, Complications of Renal Insufficiency, Stage V Chronic Kidney Disease, Chronic Kidney Disease Anemia, Acute Renal Failure, Hepatorenal failure Lung disease included: Interstitial Lung Disease, Pneumonia (including Pseudomal and Community Acquired), Pulmonary Vascular Disease, Chronic Obstructive Pulmonary Disease, Chronic Respiratory Failure, Lung Cancer, Interstitial Lung Failure, Pulmonary Amnesia and Intact Ventricular Septum but EXCLUDED Cardiopulmonary Arrest Liver disease included: End Stage Liver Disease, Cirrhosis of the Liver, Liver Failure, Fatty Liver, Hepatic Encephalopathy, Acute Renal Failure, Hepatorenal syndrome Heart disease included Myocardial Infarction (and probable MI), Cardiovascular Disease, Hypertension, Ischemia (and Myocardial Ischemia), Coronary Artery Disease, Stroke (and Brainstem and Cerebellar Stroke), Congestive Heart Failure, Advanced Cardiovascular Disease, Hypertensive Cardiovascular Disease, Arteriosclerotic Cardiovascular Disease, Atherosclerotic Cardiovascular Disease, Cardiovascular Accident, Dilatel Cardiomyopathy, Cardiac Cirrhosis but EXCLUDED Cardiopulmonary or Cardiac Arrest 5

6 Cause of Death The following figure lists the number and percent of deaths where alcohol or drug use was specifically noted as an underlying cause of death, along with suicide, violence automobile accidents and other accidental deaths. Almost one in ten deaths in the data set was listed with either an undetermined cause of death or with the cause of death pending. Of note, more than one in five deaths among Assiniboine and Sioux Tribal members lists alcohol use as an underlying cause. Adding in drug use, at least one in four deaths among Assiniboine and Sioux tribal members can be attributed at least in part to substance abuse. The average age of death where alcohol was an underlying cause is Males account for 61% of the deaths attributed to alcohol. Suicide and violence are also a concern, associated with almost one out of every 10 deaths. 80% of the deaths in this category were among males. Suicide victims particularly tended to be younger, with an average age of death of 30.5 for the 6 deaths specifically attributed to suicide. 6

7 Contact information Fort Peck Health Promotion Disease Prevention Program P.O. Box G Street East Poplar, Montana Phone: (406) Fax: (406) Kenny Smoker Director Wellness Program krsmoker@yahoo.com 7