Document Type

Master's Culminating Experience

Publication Date



Objectives. This ecological study evaluates the association between community characteristics and death rates from pneumonia/influenza, tuberculosis, and infectious diseases in 196 Alaska Native villages.

Methods. Ecological variables studied included percentage of Natives in the population, age distribution, latitude, average household size, socioeconomic status, percentage of homes with complete plumbing and/or kitchens, type of heating fuel used, community alcohol restrictions, level of healthcare access, and residence in specific regions of Alaska. These data come from the 2000 U.S. Census, the Alaska Alcohol Beverage Control Board, and the Alaska Native Tribal Health Consortium. A stepwise analysis of variance using the Proc GLM procedure in SAS® was performed for these variables and for the death rates with least significant difference used to separate the means.

Results. Significantly higher rates of pneumonia/influenza death were associated with high average household size and low household income. Higher rates of death from tuberculosis were associated with residence in specific regions of Alaska and with the type of heating fuel used. Death rates from infectious disease were associated with a high percentage of Natives in the population, high average household size, low percentages of the population below poverty, and a lack of healthcare within the village.

Conclusions. This study linked multiple community characteristics with the risk of death from several types of infectious diseases in Alaska Native villages. This and other ecological studies can be used to identify the risk factors associated with higher death rates from infection for defined populations such as the residents of Alaska Native villages. Understanding the specific cause or cause of illness is essential in order to best direct efforts to eliminate disparity and to curtail disease and death.