Skip directly to searchSkip directly to the site navigationSkip directly to the page's main content
Skip directly to searchSkip directly to the site navigationSkip directly to this page's context menuSkip directly to the page's main content
State of Alaska

Complete Health Indicator Report of Health Care - Cost as a Barrier (HA2020 Leading Health Indicator: 23)

Definition

Percentage of adults aged 18 years and older who responded "Yes" to the Behavioral Risk Factor Surveillance System (BRFSS) question: "Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?"

Numerator

Number of adults (18+) who responded "Yes" to the BRFSS question: "Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?"

Denominator

Number of adults (18+) with valid responses to the BRFSS question "Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?", excluding those with missing, "Don't know/Not sure" and "Refused" answers.

Why Is This Important?

Access to quality healthcare is influenced by a number of factors, including: having a usual source of care, having health insurance, and being able to afford care. Inadequate prenatal care--including late initiation of care, infrequent prenatal visits, or no care at all--is associated with poor infant and maternal outcomes, including low birth weight or preterm infants and for the mothers an increased risk for pregnancy-related mortality and complications of childbirth. Preventable hospitalizations are a set of conditions for which hospitalization could be avoided if patients had early access to good quality outpatient healthcare; this metric can be used to assess the effectiveness and accessibility of primary healthcare. A study using the National Hospital Discharge Survey found that 12% of all hospitalizations in 1990 (3.1 million) were for potentially preventable conditions.^1^[[br]] [[br]] {{class .SmallerFont # Pappas G, Hadden WC, Kozak LJ, Fisher GF. Potentially avoidable hospitalizations: inequalities in rates between US socioeconomic groups. Am J Public Health. 1997 May; 87(5): 811-816. }}

Healthy People Objective: Reduce the proportion of individuals who are unable to obtain or delay in obtaining necessary medical care, dental care, or prescription medicines: Individuals--medical care

U.S. Target: 4.2%

Other Objectives

Healthy Alaskans 2020 Target: 14.0% of adult (18+) who reported they were unable to receive needed health care in the past 12 months but could not because of cost.

How Are We Doing?

The crude percentage of Alaska adults (18+) who reported being unable to see a doctor in the past 12 months due to cost was 13.6% in 2014, below the goal of 14% for Healthy Alaskans 2020 (HA2020). However, the ability to afford health care is not evenly distributed throughout the population. Alaska adults with low incomes or less than a high school education were much more likely to report cost as a barrier to health care than those with higher incomes or educational attainment. Adult (18+) females consistently report more difficulty affording health care than males. Individuals between the ages of 25 and 44 are at increased risk of not being able to afford health care. Only Alaska Native people (13.7%) and non-Hispanic white individuals (12.9%) were below the HA2020 goal of 14%. Those who were never married (17.9%), divorced or separated (18.6%), or living with a partner (23.3%) had greater difficulty compared to those married (9.8%) or widowed (8.5%). Those adults who were unemployed or unable to work reported significantly higher rates of cost as a barrier than those who were employed. Not unexpectedly, those earning less than $50,000 more frequently reported cost as a barrier as did those in households that reported poor or near poor poverty thresholds. Prevalence rates for cost as a barrier to accessing health care from the BRFSS are initially presented for all Alaskans, Alaska Native people, and the median from states, District of Columbia, and territories for all available years. Subsequent analyses by demographic subpopulations (i.e., sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status) are limited to 2010 and later to allow for ease of assessing recent trends. Prevalence of cost as a burden by regions of Alaska are presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 6 Alaska Public Health Regions, 2) three-year averages by the 7 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) single-year for the 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) three-year averages for 29 boroughs and census areas, and 5) five-year averages for the 12 tribal health organization regions. These time intervals match those for the InstantAtlas health profiles for each of the geographic regionalizes of Alaska for those desiring longer time series.

How Do We Compare With the U.S.?

Since 2011, there has been a reduction in the prevalence of cost being a barrier to health care in both the United States and Alaska. In 2014, the median prevalence for the United States was 13.1% compared to 13.6% for all Alaskans and 11.8% for Alaska Native people.

What Is Being Done?

The Alaska Department of Health and Social Services administers programs to improve access to care, such as Medicaid, the Children's Health Insurance Program (CHIP), and primary care grants, and clinics for children with disabilities. Federally Qualified Health Centers provide preventive services such as immunizations and screenings at low or no cost to eligible persons who cannot afford them. Federally Qualified Health Centers and other providers strive to meet the needs of the medically underserved in Alaska.

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaska subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs.* '''Strategy 1:''' [[br]]Improve insurance coverage for Alaskans who have financial barriers to care. '''Evidence Base:''' [[br]]Inability to access health care can result in unmet health needs and delays in receiving appropriate care, financial hardship, and hospitalizations that could have been prevented. High health care costs present a significant barrier to care, and one approach to making health care more affordable from the patient's perspective is health insurance coverage. Insurance coverage helps people obtain preventive and screening services, prescription drug benefits, mental health and other services, and improves continuity of care. Numerous studies by leading health research organizations, such as the Institute of Medicine and the Agency for Healthcare Research and Quality, note the significance of health insurance coverage for overcoming financial barriers to health care access. '''Strategy 2:''' [[br]]Address underlying health care costs that drive higher insurance premiums in Alaska. '''Evidence Base:''' [[br]]The largest cost component of health insurance premiums is payment for covered health care services. The remaining cost components, administrative costs and profits, are limited under the Affordable Care Act. Studies by economists and health care actuaries have identified high prices for health care services relative to cost of living as the primary driver of health insurance premium price differences between Alaska and comparison states. Many factors contribute to reimbursement rates for physicians and hospitals, such as higher real costs experienced by providers in Alaska, accommodation for small markets, and compensation for providers. Higher health insurance premiums negatively affect affordability of insurance for individuals. Studies by economists and health care actuaries have documented the drivers of health care costs nationally and in Alaska. Numerous studies by leading health research organizations, such as the Institute of Medicine and the Agency for Healthcare Research and Quality, document opportunities for reducing health care costs through quality improvement and consumer engagement. '''Strategy 3:''' [[br]]Improve access to health care safety net services. '''Evidence Base:''' [[br]]The health care safety net consists of providers delivering care to low-income and other vulnerable populations. Safety net providers typically have either a legal mandate or an explicit policy to provide services regardless of a patient's ability to pay. Safety net providers are generally the only source of health care for uninsured, low-income individuals. Safety net providers, such as community health centers and community hospitals play an important role nationally and in Alaska by providing affordable health services for the uninsured and working poor individuals. * Sources for all strategies can be found at: [http://hss.state.ak.us/ha2020/assets/EBS/HA2020_EBS23_CostBarriersToHealthcare.pdf] A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_23_CostasBarrier.pdf].

Available Services

Alaska Medicaid Program: visit [http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx] or one of the regional centers: ANCHORAGE DISTRICT OFFICE 400 Gambell Street Anchorage, AK 99501 (907) 269-6599 - Phone (907) 269-6450 - Fax BETHEL DISTRICT OFFICE P.O. Box 365 Bethel, AK 99559 (907) 543-2686 - Phone (1-800-478-2686) (907) 543-5912 - Fax COASTAL FIELD OFFICE 3601 C Street, Suite 410 P.O. Box 240249 Anchorage, AK 99524 (907) 269-8950 - Phone 1-800-478-4372 (907) 562-1619 - Fax EAGLE RIVER JOB CENTER 11723 Old Glenn Highway, Sp. B-4 Eagle River, AK 99577-7595 (907) 694-7008 (907) 694-1490 - Fax FAIRBANKS DISTRICT OFFICE 675 7th Avenue, Station D Fairbanks, AK 99701 (907) 451-2850 - Phone (1-800-478-2850) (907) 451-2923 - Fax 1-877-451-2923 toll free fax HOMER DISTRICT OFFICE New address! Homer District Office 3670 Lake Street, # 200 Homer, AK 99603 (907) 226-3040 - Phone (907) 235-6176 - Fax JUNEAU FIELD OFFICE 10002 Glacier Hwy, Suite 200 Juneau, AK 99801 (907) 465-3537 - Phone (1-800-478-3537) (907) 465-4657 - Fax KENAI PENINSULA JOB CTR 11312 Kenai Spur Hwy, Suite #2 Kenai, AK 99611 (907) 283-2900 - Phone (1-800-478-9032) (907) 283-6619 - Fax KETCHIKAN DISTRICT OFFICE 2030 Sea Level Dr., Suite 301 Ketchikan, AK 99901 (907) 225-2135 - Phone (1-800-478-2135) (907) 247-2135 - Fax KODIAK DISTRICT OFFICE 211 Mission Road, Suite 101 Kodiak, AK 99615 (907) 486-3783 - Phone (1-888-480-3783) (907) 486-3116 - Fax KOTZEBUE DISTRICT OFFICE P.O. Box 1210 Kotzebue, AK 99752 (907) 442-3451 - Phone (907) 442-2151 - Fax MAT-SU DISTRICT OFFICE 855 W. Commercial Drive Wasilla, AK 99654 (907) 376-3903 - Phone (1-800-478-7778) (907) 373-1136 - Fax MULDOON DISTRICT OFFICE 1251 Muldoon Rd, Suite 111B Anchorage, AK 99504 (907) 269-0001 - Phone (907) 269-0070 - Fax NOME DISTRICT OFFICE P.O. Box 2110 Nome, AK 99762 (907) 443-2237 - Phone (1-800-478-2236) (907) 443-2307 - Fax SOUTHEAST ADULT PUBLIC ASSISTANCE & SPECIALIZED MED 10002 Glacier Hwy, Suite 200 Juneau, AK 99801 (907) 465-3537 - Phone (1-800-478-3537) (907) 465-4657 - Fax SITKA DISTRICT OFFICE 201 Katlian Street, Suite 107 Sitka, AK 99835 (907) 747-8234 - Phone (1-800-478-8234) (907) 747-8224 - Fax Denali KidCare is Alaska's Children's Health Insurance Program (CHIP): If you have questions or need further information, please call Denali KidCare: Within the Anchorage area, phone 269-6529. From other areas of the state, you may phone toll free 1-888-318-8890. If you prefer, you may fax your application to 1-855-769-0986. In Anchorage, our office is located at 3601 C Street, 1st floor of the Frontier Building. Outside of Anchorage, please view Public Assistance office locations. If you have questions about Denali KidCare or would like an application or renewal mailed to you, please email denali.kid.care@alaska.gov The Alaska Primary Care Association (APCA) is the primary care association for the state of Alaska. APCA members include Federally Qualified Health Centers (FQHC) and other providers who strive to meet the needs of the medically underserved. APCA and its member organizations are part of a statewide and national movement to reduce barriers to health care by enhancing primary care service delivery through prevention, health promotion, and community participation. Alaska Primary Care Association 903 W Northern Lights Blvd. Suite 200 Anchorage, AK 99503 Tel: 907.929.2722 Fax: 907.929.2734 Email: info@alaskapca.org


Related Indicators

Relevant Population Characteristics

Persons with low incomes are much more likely to report problems with access to care than persons with higher incomes. Young adults were more likely to report cost as a barrier to care than older adults.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Persons without health insurance are more likely to report cost as a barrier to care than those with health insurance coverage.

Health Status Outcomes

Persons without access to health care tend to delay getting care until a problem becomes too painful or dangerous to avoid dealing with it. At this point, health problems are often expensive to treat and sometimes have serious long term implications for the individual's health. The health status of these persons may suffer due to lack of appropriate care.

Related Health Status Outcomes Indicators:




Graphical Data Views

Percentage of adults (18+) reporting cost as a barrier to care in past year, all Alaskans, Alaska Natives, and U.S., 2000-2020

::chart - missing::
confidence limits

Alaska ComparisonsYearPecentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 53
All Alaskans200012.3%10.2%14.9%
All Alaskans2001**
All Alaskans2002**
All Alaskans200312.3%10.8%14.0%
All Alaskans200413.5%11.8%15.4%
All Alaskans200514.8%12.9%16.8%
All Alaskans200614.7%12.8%16.9%
All Alaskans200715.7%13.5%18.2%
All Alaskans200816.4%14.8%18.2%
All Alaskans200915.9%14.2%17.8%
All Alaskans201014.7%12.8%17.0%4473,211
All Alaskans201117.6%16.0%19.2%9056,080
All Alaskans201214.7%13.4%16.1%1,1918,306
All Alaskans201314.1%12.9%15.4%1,1769,145
All Alaskans201413.6%12.4%14.9%9648,979
Alaska Natives200012.6%9.2%17.0%
Alaska Natives2001**
Alaska Natives2002**
Alaska Natives200314.6%11.2%18.8%
Alaska Natives200414.9%11.3%19.3%
Alaska Natives200513.1%10.3%16.5%
Alaska Natives200617.7%14.0%22.1%
Alaska Natives200717.3%12.3%23.7%
Alaska Natives200817.1%14.2%20.4%
Alaska Natives200916.4%13.3%20.1%
Alaska Natives201013.2%10.1%17.1%103604
Alaska Natives201117.4%14.2%21.0%2221,175
Alaska Natives201215.3%12.7%18.3%3131,787
Alaska Natives201313.9%11.5%16.7%2501,567
Alaska Natives201411.8%9.5%14.6%1721,433
U.S.20009.9%
U.S.20018.3%
U.S.2002**
U.S.200312.0%
U.S.200412.8%
U.S.200513.3%
U.S.200612.4%
U.S.200712.5%
U.S.200813.5%
U.S.200913.7%
U.S.201013.4%
U.S.201116.1%
U.S.201215.2%
U.S.201315.3%
U.S.201413.1%
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Notes

** Data Not Available U.S. values are based upon the median value of the states, District of Columbia, and territories.

Data Sources

  • Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion
  • U.S. Data: National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS)


Percentage of adults (18+) reporting cost as a barrier to care in past year, by sex, all Alaskans, 2010-2020

::chart - missing::
confidence limits

HA: Males vs. FemalesYearPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 18
Males201011.4%9.0%14.3%1531,448
Males201114.6%12.5%17.0%3392,781
Males201212.3%10.6%14.3%4643,854
Males201311.5%9.9%13.2%4664,199
Males201411.5%9.9%13.2%3764,096
Females201018.4%15.4%21.9%2941,763
Females201120.7%18.4%23.2%5663,299
Females201217.3%15.3%19.4%7274,452
Females201316.9%15.0%18.9%7104,946
Females201415.9%14.0%18.0%5884,883
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by age, all Alaskans, 2010-2020

::chart - missing::
confidence limits

HA: Age Group: 18-24,25-34,35-44,45-64,65+YearPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 33
18-2420109.0%4.6%16.8%17140
18-24201116.0%11.5%21.7%54355
18-24201210.1%7.2%14.0%65577
18-24201312.6%9.2%17.0%81646
18-24201413.0%9.7%17.3%65492
25-34201017.4%12.5%23.6%74418
25-34201119.9%15.8%24.9%126797
25-34201217.1%14.0%20.8%1931,302
25-34201315.6%12.7%18.9%1931,259
25-34201419.1%15.6%23.3%1431,050
35-44201015.3%11.1%20.7%80549
35-44201123.0%19.2%27.3%1891,049
35-44201214.0%11.2%17.5%1931,308
35-44201315.8%12.7%19.6%2031,403
35-44201416.0%13.0%19.5%1771,323
45-64201017.4%14.3%21.0%2371,503
45-64201117.7%15.5%20.1%4462,693
45-64201218.7%16.3%21.3%6083,499
45-64201315.6%13.8%17.7%5943,948
45-64201413.3%11.7%15.1%4803,915
65+20104.8%3.0%7.7%30555
65+20116.6%4.9%8.9%741,105
65+20124.7%3.5%6.3%1161,518
65+20136.5%4.4%9.6%941,795
65+20143.2%2.3%4.4%862,054
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by race/ethnicity, all Alaskans, 2012-2014 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 8
Alaska Native (any mention)13.7%12.2%15.4%7354,787
Asian (non-Hispanic)17.9%12.9%24.4%68407
Black (non-Hispanic)24.3%18.0%31.9%63300
Native Hawaiian/Other Pacific Islander (non-Hispanic)21.8%12.8%34.6%20109
White (non-Hispanic)12.9%12.1%13.7%2,18319,263
Multiracial/Other (non-Hispanic)15.5%11.2%20.9%83461
Hispanic (alone or multi)20.5%16.2%25.6%124649
Healthy Alaskans Goal14.0%

Data Notes

Age-adjusted to U.S. 2000 standard population.

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by ethnicity, all Alaskans, 2010-2020

::chart - missing::
confidence limits

HA: Ethnicity - Hispanic/LatinoYearPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 18
Hispanic/Latino201021.8%10.6%39.4%1274
Hispanic/Latino201137.7%26.9%49.9%41172
Hispanic/Latino201223.9%16.5%33.3%58247
Hispanic/Latino201323.2%16.4%31.6%47263
Hispanic/Latino201414.7%9.4%22.3%40249
Not Hispanic/Latino201014.2%12.3%16.5%4283,096
Not Hispanic/Latino201116.5%14.9%18.1%8505,855
Not Hispanic/Latino201214.2%12.9%15.6%1,1248,004
Not Hispanic/Latino201313.5%12.3%14.8%1,1168,766
Not Hispanic/Latino201413.4%12.1%14.7%9008,588
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Notes

Ethnicity is defined independent of race.

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by marital status, all Alaskans, 2010-2020

::chart - missing::
confidence limits

HA: Marital StatusYearPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 33
Married201012.1%9.9%14.7%1961,837
Married201113.3%11.5%15.2%3933,360
Married201211.7%10.0%13.6%5214,474
Married201310.9%9.6%12.4%5114,948
Married20149.8%8.5%11.3%4185,007
Widowed201013.6%8.4%21.2%34243
Widowed201116.5%11.1%23.8%57430
Widowed201215.6%11.2%21.3%88623
Widowed201312.6%7.6%20.1%66677
Widowed20148.5%6.1%11.9%57699
Divorced/Separated201022.5%16.8%29.4%107510
Divorced/Separated201126.2%21.8%31.2%2141,066
Divorced/Separated201225.0%21.1%29.4%2801,370
Divorced/Separated201318.3%14.8%22.3%2621,531
Divorced/Separated201418.6%15.4%22.3%2201,482
Never Married201015.9%11.1%22.2%84475
Never Married201120.6%16.6%25.2%171917
Never Married201215.5%12.7%18.8%2281,430
Never Married201315.6%12.7%18.9%2361,517
Never Married201417.9%14.8%21.5%1921,350
Living with a Partner201024.6%14.6%38.3%25116
Living with a Partner201127.3%19.5%36.9%60253
Living with a Partner201217.5%12.6%23.8%71347
Living with a Partner201328.0%21.4%35.8%93405
Living with a Partner201423.3%16.5%31.7%69348
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (25+) reporting cost as a barrier to care in past year, by education, all Alaskans, 2010-2020

::chart - missing::
confidence limits

HA: Edu Level: < HS, HS, Some Coll, Coll GradYearPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 28
< HS201026.3%18.3%36.1%52203
< HS201131.2%24.0%39.4%104386
< HS201226.7%20.3%34.2%134522
< HS201326.3%19.8%34.0%94455
< HS201424.1%18.6%30.5%102451
HS201015.3%11.6%19.8%123834
HS201118.9%16.0%22.3%2581,577
HS201218.8%15.8%22.3%3382,031
HS201315.3%12.9%18.0%3392,164
HS201413.4%11.2%16.0%2512,011
Some Coll201015.4%12.0%19.6%131903
Some Coll201116.9%14.2%20.0%2521,604
Some Coll201214.4%12.1%17.0%3392,277
Some Coll201314.4%12.3%16.8%3502,532
Some Coll201415.1%12.6%18.0%2702,398
Coll Grad201010.6%8.0%13.9%1141,080
Coll Grad201113.2%10.8%16.0%2182,062
Coll Grad20129.9%8.2%12.1%2982,780
Coll Grad20139.2%7.8%10.9%2993,227
Coll Grad20149.0%7.5%10.8%2603,435
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Notes

Education is based upon education completed by or after 25 years of age. Individuals less than 25 years of age are excluded.

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by employment status, all Alaskans, 2010-2020

::chart - missing::
confidence limits

HA: EmploymentYearPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 28
Employed201013.0%10.6%15.8%2522,039
Employed201116.5%14.5%18.7%5023,708
Employed201214.8%13.1%16.7%6955,065
Employed201313.2%11.7%14.9%6715,472
Employed201413.1%11.6%14.8%5505,299
Unemployed201031.7%23.1%41.7%71219
Unemployed201132.3%25.9%39.3%149459
Unemployed201226.2%20.6%32.8%155602
Unemployed201327.4%21.6%34.1%167625
Unemployed201427.2%21.3%34.0%122479
Not In Work Force201011.8%8.5%16.1%79778
Not In Work Force201111.1%8.9%13.8%1651,577
Not In Work Force20129.2%7.4%11.3%2302,183
Not In Work Force20139.8%7.9%12.1%2132,524
Not In Work Force20149.0%7.0%11.5%1792,660
Unable to Work201028.3%18.1%41.3%41155
Unable to Work201131.5%23.4%40.8%86308
Unable to Work201222.9%17.4%29.6%109419
Unable to Work201324.6%18.2%32.3%107442
Unable to Work201421.7%16.4%28.1%101440
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by income, all Alaskans, 2010-2020

::chart - missing::
confidence limits

HA: Income: <$15k, $15k-$25k, $25k-$50k, $50-$75k, $75k+YearPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 33
<$15,000201028.1%19.1%39.3%62218
<$15,000201132.9%26.0%40.6%147447
<$15,000201227.0%21.6%33.1%183657
<$15,000201326.2%20.5%33.0%179712
<$15,000201425.5%20.4%31.3%151631
$15,000 - $24,999201022.6%16.6%30.0%78300
$15,000 - $24,999201134.4%28.1%41.2%176656
$15,000 - $24,999201227.5%22.6%33.0%253973
$15,000 - $24,999201324.4%20.1%29.2%2301,021
$15,000 - $24,999201430.2%25.1%25.9%186944
$25,000 - $49,999201021.0%16.2%26.8%116614
$25,000 - $49,999201119.9%16.4%23.9%2121,157
$25,000 - $49,999201218.2%15.1%21.8%2731,619
$25,000 - $49,999201318.7%15.8%22.1%3051,744
$25,000 - $49,999201417.6%14.7%20.9%2501,655
$50,000 - $74,999201011.6%7.3%17.9%52541
$50,000 - $74,999201115.7%12.3%19.8%131980
$50,000 - $74,999201215.3%11.8%19.6%1751,309
$50,000 - $74,999201314.0%11.2%17.4%1781,523
$50,000 - $74,99920148.5%6.4%11.3%1141,386
$75,000+20106.8%4.8%9.5%701,089
$75,000+20118.2%6.3%10.6%1152,019
$75,000+20124.2%3.2%5.5%1532,636
$75,000+20136.6%5.3%8.2%1913,280
$75,000+20146.2%5.0%7.8%1683,407
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by poverty threshold, all Alaskans, 2010-2020

::chart - missing::
confidence limits

Poverty thresholds are intended for use as a statistical yardstick, not as a complete description of what people and families need to live. Poverty thresholds are the dollar amounts assigned by the U.S. Census Bureau to determine poverty status. Poverty thresholds are assigned based upon the size of the family and the ages of the members (i.e., adults versus children). The same thresholds are used throughout the United States. Poverty thresholds were originally derived in the 1963-1964 using U.S. Department of Agriculture food budgets designed for families under economic stress and data about what proportion of their income families spent on food. The thresholds are updated annually for inflation using the Consumer Price Index for All Urban Consumers (CPI-U). How the Census Bureau Measures Poverty - U.S. Census Bureau [https://www.census.gov/hhes/www/poverty/about/overview/measure.html]
HA: Poverty ThresholdYearPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 23
Poor201025.6%17.5%35.7%62184
Poor201133.8%26.0%42.5%132405
Poor201227.6%22.3%33.6%199666
Poor201325.3%19.9%31.6%171647
Poor201425.8%20.7%31.8%151577
Near Poor201027.7%21.5%34.8%108424
Near Poor201123.6%19.3%28.5%182735
Near Poor201227.7%23.0%32.9%2901,175
Near Poor201323.8%20.1%28.0%2951,288
Near Poor201426.4%21.9%31.4%2091,094
Middle/High201010.3%8.3%12.7%2082,154
Middle/High201111.3%9.8%13.0%3943,839
Middle/High20129.8%8.5%11.3%5485,352
Middle/High201310.8%9.5%12.2%6176,345
Middle/High201410.0%8.8%11.4%5096,351
Healthy Alaskans Goal201314.0%
Healthy Alaskans Goal201414.0%
Healthy Alaskans Goal201514.0%
Healthy Alaskans Goal201614.0%
Healthy Alaskans Goal201714.0%
Healthy Alaskans Goal201814.0%
Healthy Alaskans Goal201914.0%
Healthy Alaskans Goal202014.0%

Data Notes

Poverty thresholds computed using the BRFSS assume that householders are less than 65 years of age as the ages of the household heads are not recorded. The maximum of the income range provided for the household is used to evaluate the proportion of the poverty threshold. This is a conservative approach as there are no errors of misclassification into the lowest poverty group. The category of Poor represents less than 100% of the poverty threshold. Near Poor is 100% through 199% of the poverty threshold. Middle/High income families are 200% or higher of the poverty threshold. How the Census Bureau Measures Poverty - U.S. Census Bureau [https://www.census.gov/hhes/www/poverty/about/overview/measure.html]

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by Alaska Public Health Regions, all Alaskans and Alaska Natives, 2014

::chart - missing::
confidence limits

Alaska ComparisonsAlaska Public Health RegionsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 13
All AlaskansAnchorage - Mat-Su13.9%12.0%15.9%3773,536
All AlaskansGulf Coast13.4%10.7%16.5%1561,372
All AlaskansInterior14.6%11.7%17.9%1961,807
All AlaskansNorthern8.6%5.0%14.5%30274
All AlaskansSoutheast11.3%8.5%15.0%1001,337
All AlaskansSouthwest16.3%11.5%22.5%105653
Alaska NativesAnchorage - Mat-Su10.3%6.2%16.7%26344
Alaska NativesGulf Coast9.8%4.9%18.6%15135
Alaska NativesInterior15.5%9.6%24.0%30220
Alaska NativesNorthern9.9%5.3%17.8%21170
Alaska NativesSoutheast9.0%4.7%16.7%17207
Alaska NativesSouthwest15.4%10.3%22.3%63357
Healthy Alaskans GoalHealthy Alaskans Goal14.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by metropolitan/micropolitan statistical areas, all Alaskans and Alaska Natives, 2012-2014 (3-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of AdultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 15
All AlaskansAnchorage13.8%12.5%15.3%6085,505
All AlaskansFairbanks North Star MSA14.4%12.6%16.4%5064,203
All AlaskansJuneau MicroSA12.0%9.4%15.1%1481,651
All AlaskansKetchikan Gateway MicroSA14.2%10.9%18.3%95855
All AlaskansKodiak Island MicroSA12.3%7.9%18.6%62557
All AlaskansMatanuska-Susistna Borough15.4%13.5%17.5%5353,792
All AlaskansRural (non-Metro/MicroSA)14.3%13.2%15.5%1,3779,867
Alaska NativesAnchorage10.5%7.4%14.6%58570
Alaska NativesFairbanks North Star MSA15.4%9.9%23.1%42342
Alaska NativesJuneau MicroSA6.2%2.9%12.8%15176
Alaska NativesKetchikan Gateway MicroSA11.1%6.0%19.8%16138
Alaska NativesKodiak Island MicroSA5.9%1.6%19.8%7102
Alaska NativesMatanuska-Susistna Borough10.9%7.1%16.4%37314
Alaska NativesRural (non-Metro/MicroSA)16.5%14.6%18.7%5603,145
Healthy Alaskans GoalHealthy Alaskans Goal14.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by behavioral health system assessment areas, all Alaskans and Alaska Natives, 2014

::chart - missing::
confidence limits

Alaska ComparisonsBehavioral Health System Assessment RegionsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 21
All AlaskansAnchorage Muncipality13.8%11.6%16.4%2132,154
All AlaskansFairbanks North Star Borough14.5%11.3%18.5%1441,437
All AlaskansCity and Borough of Juneau11.5%7.4%17.5%45564
All AlaskansKenai Peninsula Borough13.5%10.6%17.2%115994
All AlaskansMatanuska-Susitna Borough13.9%11.1%17.2%1641,382
All AlaskansNorthwest Region8.6%5.0%14.5%30274
All AlaskansOther Interior Region15.9%11.7%21.1%79561
All AlaskansOther Southeast Region11.2%7.6%16.2%55773
All AlaskansY-K Delta Region17.3%11.4%25.3%59306
All AlaskansSouthwest Region12.5%7.6%19.7%60534
Alaska NativesAnchorage Muncipality10.0%5.2%18.2%13214
Alaska NativesFairbanks North Star Borough14.9%7.4%27.7%15125
Alaska NativesCity and Borough of Juneau3.3%1.1%9.1%669
Alaska NativesKenai Peninsula Borough13.2%6.1%26.2%1081
Alaska NativesMatanuska-Susitna Borough11.4%5.9%20.9%13130
Alaska NativesNorthwest Region9.9%5.3%17.8%21170
Alaska NativesOther Interior Region13.7%7.5%23.8%17119
Alaska NativesOther Southeast Region11.9%5.8%22.8%11138
Alaska NativesY-K Delta Region18.1%11.2%28.0%44204
Alaska NativesSouthwest Region9.7%5.3%17.0%22183
Healthy Alaskans GoalHealthy Alaskans Goal14.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by boroughs and census areas, all Alaskans and Alaska Natives, 2012-2014 (3-year average)

::chart - missing::
confidence limits

Alaska ComparisonsBoroughs/Census AreasPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 59
All AlaskansAleutians East Borough14.7%7.7%26.2%28185
All AlaskansAleutians West Borough11.4%6.6%19.0%36290
All AlaskansAnchorage Municipality13.8%12.5%15.3%6085,505
All AlaskansBethel Census Area14.1%10.4%18.9%134865
All AlaskansBristol Bay Borough22.5%12.4%37.4%36184
All AlaskansDenali Borough11.5%6.8%18.9%28191
All AlaskansDillingham Census Area12.8%8.0%19.7%55401
All AlaskansFairbanks North Star Borough14.4%12.6%16.4%5064,203
All AlaskansHaines Borough11.8%6.3%21.0%25197
All AlaskansHoonah-Angoon Census Area18.0%8.5%34.0%11120
All AlaskansJuneau City and Borough12.0%9.4%15.1%1481,651
All AlaskansKenai Peninsula Borough14.0%12.1%16.2%3432,822
All AlaskansKetchikan Gateway Borough14.2%10.9%18.3%95855
All AlaskansKodiak Island Borough12.3%7.9%18.6%62557
All AlaskansKusilvak Census Area24.0%18.6%30.3%100346
All AlaskansLake and Peninsula Borough32.1%17.6%51.0%36180
All AlaskansMatanuska-Susitna Borough15.4%13.5%17.5%5353,792
All AlaskansNome Census Area15.4%11.1%21.0%77510
All AlaskansNorth Slope Borough7.3%4.6%11.4%41294
All AlaskansNorthwest Arctic Borough10.4%6.1%17.2%42324
All AlaskansPetersburg Borough11.6%4.4%27.5%16220
All AlaskansPrince of Wales-Hyder Census Area16.6%10.2%25.7%29291
All AlaskansSitka City and Borough8.9%5.2%14.9%33451
All AlaskansSkagway Municipality19.6%8.4%39.3%856
All AlaskansSoutheast Fairbanks Census Area12.5%9.2%16.7%87631
All AlaskansValdez-Cordova Census Area13.8%10.1%18.6%82578
All AlaskansWrangell City and Borough14.4%6.8%28.1%12130
All AlaskansYakutat City and Borough27.0%13.5%46.7%1257
All AlaskansYukon-Koyukuk Census Area20.0%15.0%26.1%106544
Alaska NativesAleutians East Borough9.0%4.8%16.2%14100
Alaska NativesAleutians West Borough20.3%7.6%43.9%1071
Alaska NativesAnchorage Municipality10.5%7.4%14.6%58570
Alaska NativesBethel Census Area15.3%10.9%21.0%108537
Alaska NativesBristol Bay Borough15.8%6.8%32.2%1274
Alaska NativesDenali Borough**12
Alaska NativesDillingham Census Area10.1%5.7%17.2%26190
Alaska NativesFairbanks North Star Borough15.4%9.9%23.1%42342
Alaska NativesHaines Borough**23
Alaska NativesHoonah-Angoon Census Area**33
Alaska NativesJuneau City and Borough2.6%2.9%12.8%15176
Alaska NativesKenai Peninsula Borough19.0%12.7%27.4%38241
Alaska NativesKetchikan Gateway Borough11.1%6.0%19.8%16138
Alaska NativesKodiak Island Borough5.9%1.6%19.8%7102
Alaska NativesKusilvak Census Area24.7%19.0%34.1%93308
Alaska NativesLake and Peninsula Borough26.0%15.2%40.7%21109
Alaska NativesMatanuska-Susitna Borough10.9%7.1%16.4%37314
Alaska NativesNome Census Area15.3%10.2%22.3%53313
Alaska NativesNorth Slope Borough8.5%4.8%14.6%26180
Alaska NativesNorthwest Arctic Borough12.7%7.2%21.5%37225
Alaska NativesPetersburg Borough**20
Alaska NativesPrince of Wales-Hyder Census Area18.1%8.1%34.7%9113
Alaska NativesSitka City and Borough15.8%4.7%41.7%467
Alaska NativesSkagway Municipality**4
Alaska NativesSoutheast Fairbanks Census Area16.4%7.4%32.5%1279
Alaska NativesValdez-Cordova Census Area22.2%10.4%41.2%1376
Alaska NativesWrangell City and Borough**24
Alaska NativesYakutat City and Borough**28
Alaska NativesYukon-Koyukuk Census Area24.9%17.9%33.4%71318
Healthy Alaskans GoalHealthy Alaskans Goal14.0%

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator.

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) reporting cost as a barrier to care in past year, by tribal health organization regons, all Alaskans and Alaska Natives, 2010-2014 (5-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 25
All AlaskansAleutians and Pribilofs12.6%9.0%17.2%83598
All AlaskansAnchorage/Mat-Su15.0%14.0%16.2%1,51411,706
All AlaskansArctic Slope8.5%5.4%13.0%46387
All AlaskansBristol Bay19.0%14.9%24.0%1761,008
All AlaskansCopper River/Prince William Sound13.6%10.6%17.2%126875
All AlaskansInterior14.9%13.5%16.4%9957,548
All AlaskansKenai Peninsula15.3%13.6%17.1%5334,046
All AlaskansKodiak Area11.3%7.7%16.4%87820
All AlaskansNorthwest Arctic15.4%10.9%21.4%73496
All AlaskansNorton Sound13.3%10.1%17.6%104706
All AlaskansSoutheast14.0%12.5%15.7%6045,840
All AlaskansYukon-Kuskokwim19.2%16.1%22.6%3421,691
Alaska NativesAleutians and Pribilofs16.1%10.0%24.9%34223
Alaska NativesAnchorage/Mat-Su10.9%8.4%13.9%1231,089
Alaska NativesArctic Slope10.5%6.1%17.5%28223
Alaska NativesBristol Bay15.9%11.9%20.9%89507
Alaska NativesCopper River/Prince William Sound16.7%8.7%29.6%19124
Alaska NativesInterior17.8%14.2%22.0%174898
Alaska NativesKenai Peninsula22.8%16.8%30.2%71369
Alaska NativesKodiak Area7.1%3.0%15.8%11145
Alaska NativesNorthwest Arctic18.0%12.4%25.5%62376
Alaska NativesNorton Sound12.7%9.0%17.5%69445
Alaska NativesSoutheast11.2%8.5%14.6%90898
Alaska NativesYukon-Kuskokwim19.9%16.6%23.6%2901,207
Healthy Alaskans GoalHealthy Alaskans Goal14.0%

Data Source

Alaska Data: Behavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

References and Community Resources

'''References:''' 1. Pappas G, Hadden WC, Kozak LJ, Fisher GF. Potentially avoidable hospitalizations: inequalities in rates between US socioeconomic groups. Am J Public Health. 1997 May; 87(5): 811-816.

More Resources and Links

Alaska and national goals may be found at the following sites:

Alaska health promotion resources may be found at the following site:

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Maps of health indicators for various subdivisions of Alaska may be found at the following site:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

AK-IBIS Web Citation

Use and reproduction of the information published on this website are encouraged and may be done without permission. The following citation should accompany information from this website whenever it is used, reproduced, or published:

AK-IBIS Indicator Citation:
"[Indicator name]. Retrieved on [insert date] from Alaska Department of Health and Social Services, Indicator-Based Information System for Public Health (AK-IBIS) website: http://ibis.dhss.alaska.gov/.

Example:
Diabetes Prevalence. Retrieved on March 25, 2016, from Alaska Department of Health and Social Services, Indicator-Based Information System for Public Health (AK-IBIS) website: http://ibis.dhss.alaska.gov/.

Page Content Updated On 01/26/2016, Published on 01/26/2016
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 06 May 2016 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Tue, 26 Jan 2016 08:44:56 AKST
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 06 May 2016 16:22:21 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 26 Jan 2016 08:44:56 AKST