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Objectives: We describe methods used to mitigate the effect of race misclassification in mortality records and the data sets used to improve mortality estimates for American Indians and Alaska Natives (AI/ANs)., Methods: We linked US National Death Index (NDI) records with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN deaths. Analyses excluded decedents of Hispanic origin and focused on Contract Health Service Delivery Area (CHSDA) counties. We compared death rates for AI/AN persons and Whites across 6 US regions., Results: IHS registration records merged to 176,137 NDI records. Misclassification of AI/AN race in mortality data ranged from 6.3% in the Southwest to 35.6% in the Southern Plains. From 1999 to 2009, the all-cause death rate in CHSDA counties for AI/AN persons varied by geographic region and was 46% greater than that for Whites. Analyses for CHSDA counties resulted in higher death rates for AI/AN persons than in all counties combined., Conclusions: Improving race classification among AI/AN decedents strengthens AI/AN mortality data, and analyzing deaths by geographic region can aid in planning, implementation, and evaluation of efforts to reduce health disparities in this population.

Dr. Bill Richards was a noted psychiatrist who worked with Alaska Native people for many years. This paper was taken from notes he used for a slide presentation at a conference. In it, he discussed the possible relationship between rapid social change and the increasing rates of suicide among northern people. He summarized the limitations in the existing suicide data, including its essentially descriptive nature, the short time periods of study, small numbers of observations and lack of complete health service use information which could help anticipate a suicidal event. Richards noted the importance of suicide as an indicator condition that could be used to link social survey and health information data bases. He closed his paper with a discussion of the transition from an era of "rights" to one of "entitlements," and described his observations of growing overt anger and hostile dependency upon government programs. Last, Richards related his concerns over the collection of health service use and epidemiological data associated with a suicidal event.

A number of "behavioral health" exchange activities between Alaska and the Russian Far East took place during 1992-93. These included visits by a psychiatrist running one of the first "private polyclinics" in Magadan and by a narcologist to discuss the latest developments in alcohol services; a Behavioral Health Conference where Native health workers from Russia and Alaska shared experiences; beginning a multi-year epidemiology project; and a project to assess needs for a fetal alcohol syndrome (FAS) prevention program in Magadan.

This report provides a brief overview of the July, 1991 mental health team visit to the Magadan and Chukotka regions. A previous trip to the region was made by a mental health team in the summer of 1990. The sites covered were Anadyr, Magadan, Yagodnoye and Sinegorye. There are several follow-up activities and projects currently underway, such as a Fetal Alcohol Syndrome project, alcohol treatment comparisons, and Native Elder exchanges. The Soviet economy has had a marked effect in the type of treatments available in hospitals and clinics for all the types of physical and mental health problems. Because of the openness and cooperation of the Soviet medical personnel, much data and information has been gathered and will be used to determine the areas to be addressed for joint study and application.