The IHS Director described increased diversity in how services are delivered by IHS and tribal and urban Indian communities. The neonatal mortality rates in IHS service areas are indicators of the health of a community. There are considerable differences in neonatal mortality rates among the 12 IHS Service Areas. The California IHS Service Area had the lowest rate with 2.2 per 1,000 live births in 1990, which is only about half the U.S. rate, while the Aberdeen IHS Service Area had the highest rate of 8.0 per 1,000 live births. When examined by age and gender, homicide, suicide, and unintentional injury death rates peak among adolescents and young adults and among the elderly.
Males have considerably higher rates than females.
These patterns lead to strategies tailored to those at highest risk. The Cherokee Nation shared materials about their efforts utilizing Healthy People 2000 objectives tailored to the needs of their community. The National Indian Council on Aging emphasized the need to ensure that achievement of Healthy People 2000 objectives translates into quality of life for the elderly. Motor vehicle crash deaths dropped from the 1987 baseline of 37.7 per 100,000 to 32 per 100,000 in 1992 and met the year 2000 target. Unintentional injury deaths and suicide also declined, but remain at levels higher than the total population.