Reduce reported rate of hepatitis C-related deaths among non-Hispanic American Indian/Alaska Native persons by 30% or more

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Reduce reported rate of hepatitis C-related deaths among non-Hispanic American Indian and Alaska Native persons by 30% or more
National Progress Report 2025 Goal
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Source: CDC, National Vital Statistics System.1
* Rates are per 100,000 population and age-adjusted to the 2000 US Standard Population.
† Cause of death is defined as the underlying cause of death or one of the multiple causes of death and is based on the International Classification of Disease, 10th Revision (ICD-10) codes B17.1 or B18.2.2
‡ Excludes those reporting Hispanic or Latino origin.

Summary of Findings

Compared to the overall population, non-Hispanic American Indian/Alaska Native (AI/AN) persons had a much higher age-adjusted hepatitis C-related death rate in 2021 (3.18 vs. 9.99 per 100,000, respectively). Although the death rate among non-Hispanic AI/AN persons decreased slightly from 10.24 per 100,000 population in the 2017 baseline year, the rate of 9.99 in 2021 remains above the target rate of 8.19. The overall increase in US deaths due to the COVID-19 pandemic during 2020 and 2021 may have affected the hepatitis C-related death rates in these two years; therefore, 2020 and 2021 data should be interpreted with caution.

Reduction needed to meet 2025 goal:

A 28% reduction from the 2021 rate of hepatitis C-related deaths among non-Hispanic AI/AN persons is needed to meet the 2025 goal of 7.17 deaths per 100,000 population.

This reduction can best be achieved by:

  • Increasing access to hepatitis C testing for non-Hispanic AI/AN persons.
  • Increasing access to care and appropriate treatment for non-Hispanic AI/AN persons.
  • Developing trainings, technical assistance, and tools for primary care and other healthcare providers to support implementation of hepatitis C testing and referral, specifically for non-Hispanic AI/AN patients.
  • Using digital technology and telemedicine models to expand access to specialty healthcare providers to all populations, including non-Hispanic AI/AN persons.
  • Implementing continuing education and educational campaigns to encourage testing and dispel myths about who is at increased risk for hepatitis C virus infection.

Technical Notes

Data Sources:
CDC, National Vital Statistics System (NVSS)

Numerator:
Number of death records among non-Hispanic AI/AN persons with a report of hepatitis C listed as the underlying or one of the multiple causes of death

Denominator:
Total US Census population of non-Hispanic AI/AN persons 

Indicator Notes:
Death certificates are completed for all deaths registered in the United States.1 Information for death certificates is provided to funeral directors or cremation organizations by attending physicians, medical examiners, and coroners. Death certificates are filed in vital statistics offices within each state and the District of Columbia. Through the NVSS, information from death certificates is compiled by CDC to produce national Multiple Cause of Death data; causes of death are coded in accordance with the International Classification of Diseases, 10th Revision.2 National Multiple Cause of Death data from NVSS were obtained and analyzed, and those death records with a report of hepatitis C (ICD-10: B17.1 or B18.2) listed as the underlying or one of the multiple (i.e., contributing) causes of death in the record were enumerated. Rates were calculated as the number of deaths related to hepatitis C among non-Hispanic AI/AN persons who were US residents in the 50 states and District of Columbia divided by the total US Census population of non-Hispanic AI/AN persons in these jurisdictions using the postcensal estimates of the July 1 resident population. Rates were standardized to the age distribution of the 2000 US Standard Population.3

Goal Setting:
The 2025 goal of 7.17 hepatitis C-related deaths among non-Hispanic AI/AN persons per 100,000 population is consistent with CDC’s Division of Viral Hepatitis 2025 Strategic Plan and the US Department of Health and Human Services’ 2021–2025 Viral Hepatitis National Strategic Plan. Annual targets assume a constant (linear) rate of change from the observed baseline (2017 data year) to the 2025 goal (2023 data year).

Limitations:
Death data must be interpreted with caution due to the potential for misclassification of ICD-10 codes on the death record, underrepresentation of certain racial/ethnic populations in US Census data, and underreporting of viral hepatitis as a cause of death on death certificates.

References
  1. Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2021 on CDC WONDER Online Database. Data are compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Released 2022. Accessed January 13, 2023.
  2. World Health Organization. International Classification of Diseases. Geneva: World Health Organization.
  3. Centers for Disease Control and Prevention. Viral Hepatitis Surveillance – United States, 2021. Published August 2023. Accessed [date].
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