Alaska Progress Report

Alaska's death rate middle of the pack

Bad news: you will die at age 78.2. Unless you're female, in which case you'll probably hit 80, but if you're male, don't buy green bananas after age 75. That's just the way it is, according to the latest NCHS data brief, Deaths in the United States, 2009:

"Hawaii has the lowest age-adjusted death rate (619.8 deaths per 100,000 population) of all the states, 16.4 percent lower than the average rate for the United States (741.0). West Virginia had the highest state age-adjusted death rate in 2009, 28.2 percent higher than the average U.S. rate."

Alaska's rate was 754.3, slightly above the average US rate of 741.0 and in the middle quintile: "In general, states in the Southeast region have higher rates than those in other regions of the country. Louisiana, for example, is typical of the region and has an age-adjusted death rate of 887.5 deaths per 100,000 population. States in other regions of the country, such as Illinois in the Midwest (743.0 deaths per 100,000 population) and Oregon in the West (733.1 deaths per 100,000 population), have rates that are more comparable with the average U.S. rate."

Alaska ranks 30th on obesity, 2nd on breastfeeding

You gotta love a report titled, "F as in Fat." Published annually by the Trust for America's Health (burp!) the report ranks states on a number of obesity-related measures:

• 25.9% of Alaskans are obese, and 64.9% are overweight or obese compared to 68% nationwide.
• In Alaska 23.9% of men and 28.1% of women are obese.
• 5.9% of Alaskan adults have diabetes, tied with Colorado for the lowest rate.
• 22.8% of Alaskan adults are physically inactive, rank 33rd.
• 24.3% of Alaskans have hypertension, ranked 48th.

These are mixed numbers to be sure, and they vary considerably by race although the margin of error for the minority samples in Alaska are very high. Policies and programs are looked at as well, and Alaska is generally portrayed in the study as lacking most best-practice efforts to curb obesity and related health problems.

On a very positive note, the report says that although only 13.3% of mothers in America are breastfeeding through six months, in Alaska that rate was 23.7% in 2007, the second highest rate in the nation, just behind Oregon.

Alaska ranks first for chlamydia, second for gonorrhea

From the Good News Folks at the state epidemiology shop: "Alaska had the highest chlamydia rate in the country in 2010, and the second highest rate of gonorrhea. Alaska has consistently had the first or second highest rates of chlamydia since 2000. The Department of Health and Social Services noted a rapid increase in new cases of gonorrhea in most regions of the state in 2009.

"...According to the bulletins published today, 6,026 cases of chlamydia were reported to the section in 2010, a 13 percent increase over 2009. In 2010, 1,273 cases of gonorrhea were reported, representing a 23 percent increase in the gonorrhea infection rate over 2009.

"Susan Jones, Alaska’s HIV/STD program manager, said it’s important that people understand that the symptoms of gonorrhea and chlamydia can be mild for some patients, so many people may not even know they have the sexually transmitted diseases. Left untreated, the diseases are the leading causes of infertility in women, she said."

Providers are required to report these diseases by law: "To find a place in your community to get tested, call the local public health nursing center, family planning or Planned Parenthood Center, the Alaska Native Regional Health Corporation in your area, or go to the website at https://www.iknowmine.org."

Alaska among states lacking comprehensive smoke-free law

What? You don't read the Morbidity and Mortality Weekly Report? You don't know what you're missing, but fret not, we're about to tell you. In volume 60 number 15 is the article State Smoke-Free Laws for Worksites, Restaurants and Bars - United States 2000-2010.

Basically, second-hand smoke is nasty, killing about 50,000 Americans every year, and a lot of people can't avoid it if they want to work in a restaurant, bar or casino. Half of all states have implemented statewide comprehensive smoke-free laws since 2002. Alaska is not one of them, and in fact is one of the most permissive states when it comes to this issue.

That's not the entire story, because communities in Alaska do enact such laws, including a comprehensive one in Anchorage. See the Alaska Tobacco Control Alliance for details.

Older Alaskans have lowest rates of critical screenings, immunizations

An ounce of prevention is worth a pound of cure, the saying goes. Alaskans, apparently, prefer to pay by the pound. A new CDC report on the use of preventive services by Americans age 65 plus shows that Alaskans have the lowest rates of two of four recommended screenings, and the lowest rate of one of two recommended immunizations.

The exact data is in appendix B of the report. Alaskans age 65 plus have the worst rates of any state for immunizations for influenza (37.9% not receiving), and for screenings for breast cancer (27.5% not receiving) and cholesterol (10% not receiving). Alaska has the 9th worst rate of screenings for colorectal cancer (40.8% not receiving), the 12th worst rate of vaccinations for pneumococcal 33.7% not receiving), and - the only "bright" spot - the 20th worst rate for diabetes screenings (30.8% not receiving).

Asthma in Alaska

New data is available from the Asthma Call-back Survey, an in-depth asthma survey developed and funded by the Air Pollution and Respiratory Health Branch in the National Center for Environmental Health. It is conducted with Behavioral Risk Factor Surveillance System Survey respondents who report an asthma diagnosis.

Asthma surveillance data at the state level includes adult and child asthma prevalence and in-depth state and local asthma data. A 2006 state report on Asthma in Alaska has good background reading, and the Alaska Asthma Coalition has even more information on the burden of asthma:

"More than 72,000 Alaskans report that they have suffered from asthma at some point in their lives, and more than 46,100 report a current diagnosis. Approximately 8 percent of children in Alaska have asthma. Rural Alaska Natives have some of the highest documented rates for respiratory diseases, suggesting the same may be true for asthma. Uncertainty about true asthma rates among rural Alaskans is due to a lack of consistency in the diagnosis and treatment of asthma, despite the existence of well-established national guidelines. Between July 2002 and June 2003 there were over $8.6 million spent by Medicaid for asthma in Alaska."

HIV infection in Alaska, 1982-2010

From the State of Alaska Epidemiology Bulletin: From January 1, 1982 through December 31, 2010, 1,394 cases of human immunodeficiency virus (HIV) infection were reported to the Alaska Section of Epidemiology (SOE), 488 (35%) of which were in persons who are known to have subsequently died. During 2010, 77 cases of HIV infection were reported to SOE, two of which were in persons who are known to have died as of December 31, 2010. Of those 77 cases, 38 (49%) were initially diagnosed in 2010. An initial diagnosis of HIV might not mean that acquisition of HIV infection is recent; in fact, of the 38 persons with a new diagnosis of HIV in 2010, 14 also had a diagnosis of AIDS suggesting a more long-standing infection.

Of the 1,394 cases reported from 1982–2010,

• 1118 (80%) were male;
• 795 (57%) were White (Figure 1);
• 1,107 (79%) had their initial diagnosis in Alaska; of those, 781 (71%) were diagnosed in the Anchorage/Matanuska-Susitna area (Figure 2);
• the most common exposure category (48%) was men having sex with men (MSM; Figure 3);
• the median age was 34 years (range: <1–75 years; Figure 4);
• 955 (69%) had a diagnosis of acquired immune deficiency syndrome (AIDS).

Of the 77 cases reported in 2010,

• 61 (79%) were male;
• 34 (44%) were White, 13 (17%) were Alaska Native/American Indian, and 10 (13%) were Black;
• 45 (58%) had their initial diagnosis in Alaska; of those, 33 (73%) were diagnosed in the Anchorage/Matanuska-Susitna area;
• 47 (61%) were MSM, five of whom were MSM with a history of injection drug use (MSM/IDU);
• the median age was 34 years (range: 16–70 years);
• 34 (44%) had a diagnosis of AIDS;
• 38 were newly diagnosed; of those, 45% were White, 26% were Alaska Native/American Indian, and 63% were MSM.

Alaska below average on children's health systems

From Securing a Healthy Future: The Commonwealth Fund State Scorecard on Child Health System Performance, 2011. Alaska is ranked 30th overall on twenty indicators in three broad areas: access and affordability (34th); prevention and treatment (38th); potential to lead healthy lives (40th); and equity (8th).

In the rate of children age 0-18 who are uninsured, Alaska ranks 6th worst with 12.4%. Even though we have the lowest rate of low-birthweight babies in the nation, we're still middle of the pack on infant mortality, and our chubby babies seem to become chubbier children: 34% of Alaska children age 10-17 were overweight or obese in 2007, ranking us 40th among states.

In the only area where Alaska is in the top half, equity, we're ranked 12th on income equity, 7th on insurance coverage equity and 13th on racial/ethnic equity. Given the rate of suicide by Alaska Native youth it's hard to figure how we even managed that.

Two-thirds of Alaskans have weight problem

Oh come on, not right after the holidays! Et tu, Daily News? "The number of Alaskans joining the ranks of the overweight or obese has increased an average of about 1 percent a year since 1991, says a new analysis produced by the state Department of Health and Social Services. Adult Alaskans with weight problems grew from 49 percent being above normal weight in 1991 to 66 percent in 2007.

"The new state analysis gives details of some consequences of that weight gain:

• Obese adults are twice as likely as those with normal weight to be diagnosed with high blood pressure. More than a third of obese Alaskans get that diagnosis, versus 15 percent of normal-weight people.
• If you're obese, you are six times more likely to suffer from diabetes (other than the type pregnant women sometimes get) than normal-weight adults. Two percent of normal-weight Alaskans get diabetes compared with 13 percent of obese Alaskans.
• Obese Alaskans are twice as likely as normal-weight people to say their health is fair or poor instead of good or excellent.

"The state used body mass indexes -- a calculation taking into account weight and height -- to determine whether people are considered normal weight, overweight or obese. The report says some Alaskans are more likely to be overweight and obese than others. Among those with the highest levels of obesity are Alaska Natives, women with household incomes of $15,000 or less and women who don't finish high school.

"The only hopeful note for Alaska cited in the report is that the rate of students in the Anchorage School District who are overweight or obese has leveled off. The district collects height and weight measurements as part of its health screening, and the state has been monitoring the trends. The above-normal-weight percent peaked at 38 percent of students in 2002-2003, and by the 2007-2008 school year had dropped to 36 percent."

Alaska has above average rate of obesity

The Anchorage Daily News reports on the latest Centers for Disease Control obesity statistics: "...one of the skinniest places in the state is Anchorage, where "only" about one in four people are obese. he Dillingham Census area in Southwest Alaska is the heaviest region, with a nearly 37 percent obesity rate. The North Slope Borough and Bethel Census area round out the top three.

"State health officials say it's nice to have the new numbers, but warned against making direct comparisons among regions as Alaska's low population makes for a high margin of error. The report reveals a more important point, they say. When it comes to overall weight gain, Alaska's starting to look a lot like Appalachia and the southeastern United States. That's not good."