RT Journal Article SR Electronic T1 Trends and disparities in American Indian/Alaska Native unintentional injury mortality from 1999 to 2016 JF Injury Prevention JO Inj Prev FD BMJ Publishing Group Ltd SP 435 OP 441 DO 10.1136/injuryprev-2020-043951 VO 27 IS 5 A1 Kerr, William C A1 Ye, Yu A1 Williams, Edwina A1 Mulia, Nina A1 Cherpitel, Cheryl J YR 2021 UL http://injuryprevention.bmj.com/content/27/5/435.abstract AB Introduction Alcohol and drug use are significant problems in the US, and American Indian/Alaska Native (AI/AN) communities and individuals are known to be among the most affected. This study evaluates disparities in unintentional injury mortality causes since 1999.Methods Analyses in 2020 of unintentional injury mortality rate disparities between AI/ANs and white population over the 1999–2016 period with attention to motor vehicle crashes, alcohol poisoning, drug poisoning and all other cause types. Rates in each of the 10 states with the largest AI/AN populations were also investigated to account for geographical concentration.Results Motor vehicle mortality rates declined for both AI/AN and white groups, but a large racial disparity was maintained. Conversely, poisoning mortality rates rose substantially in both groups, with a jump in rates in 2007 due to a coding change, resulting in a large disparity that was maintained through 2016. Comparison of alcohol and drug poisonings showed that the AI/AN alcohol poisoning rate was about eight times the white rate, whereas drug poisoning rates were similar. For ‘all other’ unintentional injuries, the highest rates were seen for AI/AN men, with rates generally rising over the study period. State-specific analyses found substantial variation in AI/AN rates, with few or no disparities in New York and Texas.Conclusions Results indicate substantial and persisting disparities in unintentional injury mortality, with especially large differences in alcohol poisoning. The absence of disparities in New York and Texas suggest the importance of situational factors.The data are avilable by request with a data use agreement if NCHS agrees with the request.