Hepatitis C Virus – Reduce Deaths Among Non-Hispanic AI/AN

At a glance

  • National Progress Report 2025 Goal: Reduce reported rate of hepatitis C-related deaths among non-Hispanic American Indian/Alaska Native persons by 30% or more.
  • Status: Moving toward annual target, but annual target was not fully met.
Moving toward annual target of reducing deaths among non-hispanic AIAN

Age-adjusted rate* of hepatitis C-related deaths† among American Indian/Alaska Native persons‡ and annual targets for the United States by year

Source: National Vital Statistics System (NVSS) data in this report are from the 2018–Present Provisional Multiple Cause of Death Data files in the CDC WONDER online database as of November 12, 2023.1
*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 2022 (2.89 vs. 9.08 deaths per 100,000, respectively). Although the death rate among non-Hispanic AI/AN persons decreased in 2022, the rate of 9.08 remains above the target rate of 7.68. The impact of the COVID-19 pandemic on overall mortality during 2020–2022 might have affected hepatitis C-related death rates; therefore, 2020–2022 data should be interpreted with caution.

Reduction needed to meet 2025 goal

21%

A 21% reduction from the 2022 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.
  • Reducing stigma around hepatitis C.
  • Developing trainings, technical assistance, and tools for primary care and other health care providers to improve hepatitis C testing and referral for non-Hispanic AI/AN patients.
  • Building the capacity of the health care system to identify and link persons with hepatitis C to care (such as through electronic health record solutions and telemedicine).
  • Supporting continuing medical education and implementing local educational campaigns to encourage universal hepatitis C testing among non-Hispanic AI/AN adults.

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 United States Census population of non-Hispanic AI/AN persons

Indicator notes: Death certificates are completed for all deaths registered in the US.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 (ICD-10).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 (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 per 100,000 population among non-Hispanic AI/AN persons 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 and/or ethnic populations in US Census data, and underreporting of viral hepatitis as a cause of death on death certificates.4

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Content Source:
Division of Viral Hepatitis
  1. Centers for Disease Control and Prevention, National Center for Health Statistics. 2018–Present Provisional Multiple Cause of Death on CDC WONDER Online Database. Data are compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed November 12, 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, 2022. Published March 2024. Accessed [date].
  4. Centers for Disease Control and Prevention, National Center for Health Statistics. Provisional Mortality Statistics by Multiple Cause of Death and by Single Race for 2018 through Present. Accessed January 31, 2024.