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This Article Extract Full Text (PDF) All Versions of this Article: AJPH.2005.076497v1 96/1/8    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Baker, T. Search for Related Content PubMed PubMed Citation Articles by Baker, T. Related Collections Injury/Emergency Care/Violence Native Americans

Timothy Baker, MD, MPH

Correspondence: Requests for reprints should be sent to Timothy Baker, MD, MPH, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205 (e-mail: tbaker{at}jhsph.edu).

In the excellent May issue featuring Native American health problems, I was particularly interested in "Disparities in Indigenous Health: a Cross-Country Comparison Between New Zealand and the United States."¹ Bramley et al. call attention to the fact that for many health measures, the gaps between Maoris and the European population of New Zealand are wider than the gaps between Native Americans and Whites in the United States. They refer to "the success of the United States in eliminating disparities."^1(p849) However, in the case of infant mortality rates, male life expectancy, and homicide, the indigenous peoples’ rates are considerably worse in the United States than in New Zealand. For homicide, the gap between American Indians/Alaska Natives and US Whites is much greater than the gap between Maoris and New Zealanders of European descent.

Perhaps the United States could learn from New Zealand ways to lower the homicide rate for all races. For example, in the same issue of the Journal, the article "Employer Policies Toward Guns and the Risk of Homicide in the Workplace"² suggests a possible course of corrective action for the United States. The easy availability of guns is clearly a factor in the unacceptably high US homicide rate.

Why were unintentional injuries excluded from Bramley and colleagues’ Table 2 when injury death rates are higher than the rates for diabetes, suicide, HIV, and homicide? Years of potential life lost owing to death before the age of 75 years (YPLL-75) is a far more useful measure of the real burden of disease and injury than simple age-adjusted death rates. In the United States, external causes of death (unintentional and intentional injuries) are the most important cause of disease burden.³ It would be interesting to compare the differences in YPLL-75 between the United States and New Zealand for the various causes of death.

Bramley et al. have called attention to the need to reduce health disparities between Maoris and Europeans in New Zealand. There is also an urgent need to reduce homicide deaths for all races in the United States.

References

1. Bramley D, Hebert P, Tuzzio L, Chassin M. Disparities in indigenous health: a cross-country comparison between New Zealand and the United States. Am J Public Health. 2005:95:844–850.[Abstract/Free Full Text]

2. Loomis D, Marshall SW, Ta ML. Employer policies toward guns and the risk of homicide in the work-place. Am J Public Health. 2005:830–832.

3. National Center for Health Statistics. Health, United States, 2004, With Chartbook on Trends in the Health of Americans. Hyattsville, Md: National Center for Health Statistics; 2004:151.

This Article Extract Full Text (PDF) All Versions of this Article: AJPH.2005.076497v1 96/1/8    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Baker, T. Search for Related Content PubMed PubMed Citation Articles by Baker, T. Related Collections Injury/Emergency Care/Violence Native Americans