Almost 12% of the deaths among American Indians and Alaska Natives are alcohol-related — more than three times the percentage in the general population.

Dwayne Jarman, a CDC epidemiologist who works for the Indian Health Service and is one of the study's authors, said it is the first national survey that measures American Indian deaths due to alcohol.

The two leading causes of alcohol-related deaths among Indians were traffic accidents and alcoholic liver disease, each of which cause more than a quarter of the 1,514 alcohol-related deaths over the four-year period.

The greatest number of tribal alcohol-related deaths — about a third of the total — occurred in the Northern Plains, where reservations are remote and often destitute. The lowest number of deaths were in Alaska.

The study said more than 68% of the Indians whose deaths were attributed to alcohol were men, and 66% were people younger than 50 years old. Seven percent were less than 20 years old.