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State of Alaska

Complete Health Indicator Report of Overweight - Adolescents (Grades 9-12) (HA2020 Leading Health Indicator: 5Ai)

Definition

Percentage of adolescents (students in grades 9-12) with a body mass index (BMI) at or above the sex- and age-specific 85th percentile and less than the 95th percentile based on the CDC Growth Charts.^1^ Weight status is computed on the Youth Risk Behavior survey (YRBS) using two questions: "How tall are you without your shoes on?" (responses in feet and inches) and "How much do you weigh without your shoes on?" (responses in pounds).[[br]] [[br]] 1. U.S. Centers for Disease Control and Prevention. National Center for Health Statistics. Growth Charts. [http://www.cdc.gov/growthcharts/clinical_charts.htm]

Numerator

Weighted number of adolescents (students in grades 9-12) responding on the YRBS with BMI at or above the sex- and age-specific 85th percentile and less than the 95th percentile based on the CDC Growth Charts.

Denominator

Weighted number of adolescents (students in grades 9-12) on the YRBS with complete and valid measurements for height, weight, age, and sex.

Data Interpretation Issues

Although the prevalence of overweight is presented independent of obesity in this report, interpretation of the overweight results should be conducted in the context of data on obesity prevalence. Subpopulations may have relatively low rates of overweight paired with relatively high rates of obesity. It is the combination of overweight and obesity prevalence that gives the most complete picture of risk for weight related health conditions. Alaska has conducted a statewide Youth Risk Behavior Survey in 1995 and biennially from 2003. Weighted data were not obtained in 2005 and therefore no statewide estimates are available for that year. A YRBS survey conducted in 1999 did not include the Anchorage School District and therefore was not considered a valid statewide estimate. No YRBS survey was conducted in Alaska in 1997 and 2001. Traditional high schools are sometimes called comprehensive high schools. They are public high schools that are distinct from alternative high schools, which serve students at risk of not graduating, charter schools, correspondence schools, and students enrolled in high school in correctional facilities. Responses are weighted to reflect youth attending public traditional high schools in Alaska. The ability to compute BMI has been present on the YRBS since 2003.

Why Is This Important?

Overweight and obesity affect a large proportion of the Alaska population and there has been an increase in the number of obese persons over the last decade. Many diseases and adverse health outcomes are associated with overweight and obesity, including high blood pressure, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and some types of cancer. An unhealthy diet and a lack of physical activity are both key contributors to rising obesity rates.^2^ It has been projected that, due to obesity, today's children may be the first generation to have a shorter life expectancy than their parents.^3^[[br]] [[br]] {{class .SmallerFont 2. U.S. Department of Health and Human Services. [http://www.ncbi.nlm.nih.gov/books/NBK44660/pdf/Bookshelf_NBK44660.pdf/ The Surgeon General's Vision for a Healthy and Fit Nation.] Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010. 3. Olshansky SJ, Passaro DJ, Hershow RC et al. A potential decline in life expectancy in the United States in the 21st century. NEJM 2005;352(11):1138-45. }}

Other Objectives

Healthy Alaskans 2020 Indicator 5.a.i: Reduce the percentage of adolescents (high school students in grades 9-12) who meet criteria for overweight (age- and sex-specific body mass index of >=85th and <95th percentile) to 12% by 2020.

How Are We Doing?

The rate of overweight has increased among all Alaska adolescents to 16.7% in 2015 from 14.4% in 2003 and similarly for Alaska Native adolescents to 16.9% in 2015 from 13.0% in 2003. The rates for the combined overweight and obese risk factor exhibit a similar pattern of being 30.8% in 2015 for all Alaskan adolescents compared to 25.5% in 2003, a 20% increase from 12 years earlier. The rate of overweight in Alaska adolescents in 2015 exceeds the Healthy Alaskans 2020 goal of 12%. The prevalence of being overweight has increased among most subgroups of Alaskan adolescents between 2013 and 2015. Prevalence rates of overweight from the YRBS are initially presented all Alaskans, Alaska Native people, and the mean of the national YRBS. The combined risk factor of being overweight or obese is then shown. Subsequent analyses display overweight rates by demographic subpopulations (i.e., sex, age, race/ethnicity, ethnicity, grade level, and academic achievement).

How Do We Compare With the U.S.?

In 2013, the latest period for which national data are available, the prevalence of overweight for all Alaskan adolescents of 13.7% was below the national average on the YRBS of 16.6%. There has been over a 10% increase in the rate of overweight for adolescents nationally between 2003 and 2013.

What Is Being Done?

The mission of the Obesity Prevention and Control Program is to prevent and reduce obesity among Alaskans though the promotion of physical activity and good nutrition. The program: [[br]]a) manages the Play Every Day campaign, Community Nutrition efforts, Early Care and Education (ECE) Obesity Prevention Partnerships, the Obesity Prevention School Partnerships and supports Healthy Futures; [[br]]b) serves as a credible source of information on the causes, health and economic consequences of obesity; [[br]]c) provides information to the public, health professionals, and the media; [[br]]d) maintain systematic collection, analysis, evaluation and reporting of obesity prevalence and related physical activity and nutrition behaviors; [[br]]e) identifies population groups at greatest risk for the health threats of obesity; [[br]]f) develops partnerships with and provides leadership to a wide variety of private and public agencies; [[br]]g) provides technical advice and support to partners in implementing obesity prevention strategies; [[br]]h) facilitates the Alaska Alliance for Healthy Kids that works to prevent childhood obesity; and [[br]]i) facilitates the Alaska Food Policy Council that works to strengthen Alaska's food systems to spur local economic development, increase food security, and improve nutrition and health.^4^[[br]] [[br]] {{class .SmallerFont 4. [https://akfoodpolicycouncil.wordpress.com/ Alaska Food Policy Council]. }}

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. '''Strategy 1:''' [[br]]Implement a comprehensive social marketing campaign promoting nutrition and physical activity. Choose campaign topics strategically; examples include limiting sugary drinks and the importance of family meals. '''Evidence Base:''' [[br]]Citing The Community Guide and other reviews, the CDC recommends community-wide campaigns as effective in increasing physical activity, a contributing factor to maintaining a healthy weight. '''Sources:''' [[br]]Centers for Disease Control and Prevention. Increasing physical activity: A report on recommendations of the Task Force on Community Preventive Services. MMWR. 2001; 50 (RR-18): 1-16. [http://www.thecommunityguide.org/pa/index.html The Community Guide] Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity: a systematic review. Am J Prev Med. 2002; 22(4s): 73-107. '''Strategy 2:''' [[br]]Increase the number of breastfeeding-friendly maternity facilities. '''Evidence Base:''' A systematic review from the Agency for Healthcare Research and Quality (AHRQ) concluded that infants who are not breastfed are more likely than breastfed infants to experience a number of poor health outcomes, including obesity (Ip et al., 2007). A Cochrane review of studies found that one effective approach for increasing breastfeeding initiation and duration rates is through support for institutional changes in maternity care practices (Fairbank et al., 2000). Specifically, the Baby-Friendly Hospital Initiative has been demonstrated to lead to improved breastfeeding rates (Philipp et al., 2001). '''Sources:''' Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess. 2007; (153): 1-186. Fairbank L, O'Meara S, Renfrew MJ, Woolridge M, Sowden AJ, Lister Sharp D. A systematic review to evaluate the effectiveness of interventions to promote the initiation of breastfeeding. Health Technol Assess. 2000; 4(25):1-171. Philipp BL, Merewood A, Miller LW, et al. Baby-friendly hospital initiative improves breastfeeding initiation rates in a US hospital setting. Pediatrics. 2001; 108(3):677-681. '''Strategy 3:''' Adopt and implement new school physical activity and nutrition policies, also known as "wellness policies". '''Evidence Base:''' Many of the evidence-based strategies to address childhood obesity (such as promoting quality PE and health education, and establishing a Safe Routes to School program) depend on the support of schools, communities, and parents to implement. Therefore a strategy recommended by the CDC, US DHHS and the IOM is to support the adoption and implementation of school physical activity and nutrition policies (also known as "wellness policies") by school districts. '''Sources:''' [http://www.cdc.gov/healthyyouth/npao/strategies.htm CDC School Health Guidelines] Institute of Medicine. Progress in preventing childhood obesity: How do we measure up? Koplan JP, Liverman CT, Kraak VI, Wisham, SL editors. Washington: National Academies Press; 2007. US Department of Health and Human Services. The Surgeon General's Vision for a Healthy and Fit Nation. Rockville, MD: US Department of Health and Human Services, Office of the Surgeon General, January 2010. USDA Healthy, Hunger-Free Kids Act of 2010 SEC. 204 [http://www.gpo.gov/fdsys/pkg/PLAW-111publ296/pdf/PLAW-111publ296.pdf Local School Wellness Policy Implementation] A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_5_Overweight_Youth.pdf].

Available Services

Additional information on current efforts to prevent overweight in Alaska: [http://www.hss.state.ak.us/dph/chronic/obesity/].


Related Indicators

Related Relevant Population Characteristics Indicators:


Related Health Care System Factors Indicators:


Related Risk Factors Indicators:


Related Health Status Outcomes Indicators:




Graphical Data Views

Percentage of adolescents (students in grades 9-12 in traditional high schools) who were overweight, all Alaskans, Alaska Natives, and U.S., 2003-2019

::chart - missing::
confidence limits

Alaska ComparisonsYearPercentage of adolescentsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 25
All Alaskans200314.4%12.4%16.8%2101,427
All Alaskans2005**
All Alaskans200716.2%13.7%19.0%2031,263
All Alaskans200914.3%12.3%16.6%1951,320
All Alaskans201114.4%12.4%16.6%1881,275
All Alaskans201313.7%11.4%16.5%1651,167
All Alaskans201516.7%14.7%19.0%2271,344
Alaska Natives200313.0%9.3%18.0%37281
Alaska Natives2005**
Alaska Natives200721.3%15.6%28.5%57239
Alaska Natives200916.6%12.4%21.9%50291
Alaska Natives201117.2%13.0%22.3%52292
Alaska Natives201313.6%9.2%19.7%36268
Alaska Natives201516.9%12.7%22.1%58340
U.S.200314.6%14.0%15.4%
U.S.200515.6%14.6%16.6%
U.S.200715.6%14.6%16.6%
U.S.200915.6%14.6%16.7%
U.S.201115.2%14.4%16.2%
U.S.201316.6%15.4%17.8%
U.S.2015**
Healthy Alaskans Goal201312.0%
Healthy Alaskans Goal201512.0%
Healthy Alaskans Goal201712.0%
Healthy Alaskans Goal201912.0%

Data Notes

** = Data Not Available

Data Sources

  • Alaska Youth Risk Behavior Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, YRBS Program
  • Youth Risk Behavior Surveillance System, Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention


Percentage of adolescents (students in grades 9-12 in traditional high schools) who were overweight or obese, all Alaskans and Alaska Natives, 2003-2019

::chart - missing::
confidence limits

The prevalence of overweight is presented combined with obesity because it is important to interpret the overweight results in the context of obesity prevalence. Subpopulations may have relatively low rates of overweight paired with relatively high rates of obesity. It is the combination of overweight and obesity prevalence that gives the most complete picture of risk for weight related health conditions.
Alaska ComparisonsYearPercentage of adolescentsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 14
All Alaskans200325.5%22.6%28.5%3581,427
All Alaskans2005**
All Alaskans200727.3%23.8%31.1%3471,263
All Alaskans200926.2%23.4%29.3%3461,320
All Alaskans201125.8%23.2%28.6%3401,275
All Alaskans201326.1%23.4%29.1%3101,167
All Alaskans201530.8%27.8%33.9%4171,344
Alaska Natives200326.7%19.7%35.0%742,281
Alaska Natives2005**
Alaska Natives200734.7%25.8%44.9%86239
Alaska Natives200928.0%22.5%34.1%81291
Alaska Natives201132.0%26.1%38.5%96292
Alaska Natives201329.7%23.8%36.3%82268
Alaska Natives201531.0%25.0%37.6%109340

Data Notes

Definition: Percentage of adolescents (students in grades 9-12) with a body mass index (BMI) at or above the sex- and age-specific 85th percentile based on the CDC Growth Charts.[1] BMI is computed on the Youth Risk Behavior survey (YRBS) using two questions: "How tall are you without your shoes on?" (responses in feet and inches) and "How much do you weigh without your shoes on?" (responses in pounds). Numerator: Weighted number of adolescents (students in grades 9-12) responding on the YRBS with BMI at or above the sex- and age-specific 85th percentile based on the CDC Growth Charts. Denominator: Weighted number of adolescents (students in grades 9-12) on the YRBS with complete and valid measurements for height, weight, age, and sex. ** = Data not available

Data Source

Alaska Youth Risk Behavior Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, YRBS Program


Percentage of adolescents (students in grades 9-12 in traditional high schools) who were overweight, by sex, all Alaskans, 2003-2019

::chart - missing::
confidence limits

HA: Males vs. FemalesYearPercentage of adolescentsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 18
Males200315.1%12.3%18.6%116738
Males2005**
Males200717.6%14.4%21.2%112636
Males200913.6%11.0%16.7%87621
Males201114.1%11.7%16.9%86622
Males201314.7%12.0%17.8%85562
Males201515.5%13.4%18.0%107678
Females200313.7%11.3%16.4%94689
Females2005**
Females200714.7%11.7%18.3%91627
Females200915.1%12.5%18.2%108699
Females201114.7%11.8%18.1%102653
Females201312.7%9.7%16.6%80605
Females201518.1%14.8%21.8%120666
Healthy Alaskans Goal201312.0%
Healthy Alaskans Goal201512.0%
Healthy Alaskans Goal201712.0%
Healthy Alaskans Goal201912.0%

Data Notes

** = Data not available

Data Source

Alaska Youth Risk Behavior Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, YRBS Program


Percentage of adolescents (students in grades 9-12 in traditional high schools) who were overweight, by age, all Alaskans, 2003-2019

::chart - missing::
confidence limits

HA: Adolescent Age GroupsYearPercentage of adolescentsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 39
14 or Younger200314.4%9.9%20.5%22138
14 or Younger2005**
14 or Younger200715.0%9.8%22.2%21139
14 or Younger200919.5%13.4%27.4%30137
14 or Younger201111.6%7.6%17.2%21162
14 or Younger201318.3%12.4%26.1%26137
14 or Younger201527.7%21.8%34.4%38137
15200314.0%10.6%18.2%57418
152005**
15200721.1%16.8%26.2%73344
15200915.5%12.3%19.5%53356
15201114.2%10.3%19.2%55369
15201314.7%11.1%19.2%47324
15201517.8%14.5%21.7%63344
16200315.8%12.4%19.9%54332
162005**
16200717.5%13.5%22.4%52286
16200916.5%12.5%21.5%58344
16201115.6%11.5%20.8%51342
16201311.4%8.6%14.9%32282
16201511.1%8.3%14.6%46377
17200314.2%10.4%19.2%45316
172005**
17200712.6%8.9%17.8%37301
1720099.9%7.4%13.1%31300
17201114.6%11.3%18.7%43259
17201314.9%10.7%20.3%42262
17201517.7%13.3%23.1%55315
18 or Older200313.4%9.7%18.3%32223
18 or Older2005**
18 or Older200711.5%7.1%18.1%20193
18 or Older200912.3%8.6%17.3%23183
18 or Older201114.0%9.7%19.8%18143
18 or Older201310.7%6.3%17.8%18162
18 or Older201514.6%10.4%20.2%25171
Healthy Alaskans Goal201312.0%
Healthy Alaskans Goal201512.0%
Healthy Alaskans Goal201712.0%
Healthy Alaskans Goal201912.0%

Data Notes

** = Data not available

Data Source

Alaska Youth Risk Behavior Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, YRBS Program


Percentage of adolescents (students in grades 9-12 in traditional high schools) who were overweight, by race, all Alaskans, 2003-2020

::chart - missing::
confidence limits

HA: Race: White, AK Native, OtherYearPercentage of adolescentsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 25
White200314.5%12.0%17.4%130883
White2005**
White200713.8%11.4%16.7%97733
White200912.6%10.2%15.5%78612
White201111.7%9.4%14.4%77645
White201313.4%10.7%16.7%80574
White201515.4%12.7%18.6%102650
Alaska Native200313.0%9.3%18.0%37281
Alaska Native2005**
Alaska Native200721.3%15.6%28.4%54239
Alaska Native200916.6%12.4%21.9%50291
Alaska Native201117.2%13.0%22.3%52292
Alaska Native201313.6%9.2%19.7%36268
Alaska Native201516.9%12.7%22.1%58340
Other races200316.5%10.7%24.6%30178
Other races2005**
Other races200717.9%13.4%23.4%50266
Other races200916.6%12.4%21.8%53320
Other races201117.4%13.3%22.5%54301
Other races201315.1%11.6%19.6%46295
Other races201518.4%14.5%23.1%55305
Healthy Alaskans Goal201312.0%
Healthy Alaskans Goal201512.0%
Healthy Alaskans Goal201712.0%
Healthy Alaskans Goal201912.0%

Data Notes

** = Data not available

Data Source

Alaska Youth Risk Behavior Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, YRBS Program


Percentage of adolescents (students in grades 9-12 in traditional high schools) who were overweight, by ethnicity, all Alaskans, 2003-2020

::chart - missing::
confidence limits

HA: Ethnicity - Hispanic/LatinoYearPercentage of adolescentsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 18
Hispanic/Latino2003**45
Hispanic/Latino2005**
Hispanic/Latino200716.2%10.5%24.2%16102
Hispanic/Latino200917.1%10.1%27.5%21124
Hispanic/Latino201120.2%14.5%27.6%28133
Hispanic/Latino201312.9%7.9%20.5%15114
Hispanic/Latino201521.3%14.7%29.9%25123
Not Hispanic/Latino200314.3%12.2%16.7%1891,297
Not Hispanic/Latino2005**
Not Hispanic/Latino200716.1%13.6%19.0%1851,151
Not Hispanic/Latino200914.3%12.3%16.7%1741,180
Not Hispanic/Latino201113.9%11.8%16.3%1571,121
Not Hispanic/Latino201313.8%11.5%16.4%1471,036
Not Hispanic/Latino201516.2%14.0%18.5%1931,191
Healthy Alaskans Goal201312.0%
Healthy Alaskans Goal201512.0%
Healthy Alaskans Goal201712.0%
Healthy Alaskans Goal201912.0%

Data Notes

Ethnicity is defined independent of race. ** = Data not available

Data Source

Alaska Youth Risk Behavior Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, YRBS Program


Percentage of adolescents (students in grades 9-12 in traditional high schools) who were overweight, by grade level, all Alaskans, 2003-2020

::chart - missing::
confidence limits

HA: Grade LevelYearPercentage of adolescentsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 32
9th200315.4%11.6%20.1%75
9th2005**
9th200719.8%15.4%25.0%78
9th200916.1%13.3%19.4%62
9th201114.7%11.2%18.9%60
9th201314.1%10.2%19.2%50
9th201519.3%15.6%23.6%61
10th200313.3%10.3%17.1%42305
10th2005**
10th200717.0%12.4%22.8%45245
10th200916.8%13.0%21.5%57328
10th201114.7%11.1%19.2%48340
10th201314.5%10.9%19.0%44308
10th201516.9%13.6%20.8%72409
11th200316.2%12.5%20.8%56353
11th2005**
11th200714.7%11.2%19.2%47325
11th200912.1%9.1%16.0%43356
11th201114.7%11.2%19.1%49302
11th201313.0%9.4%17.7%34268
11th201512.8%10.0%16.3%45347
12th200313.2%9.6%17.8%37265
12th2005**
12th200712.2%8.3%17.5%31273
12th200911.4%8.2%15.5%28243
12th201112.9%9.6%17.1%30221
12th201313.6%9.6%18.8%37252
12th201517.6%13.3%22.9%47265
Healthy Alaskans Goal201312.0%
Healthy Alaskans Goal201512.0%
Healthy Alaskans Goal201712.0%
Healthy Alaskans Goal201912.0%

Data Notes

** = Data not available

Data Source

Alaska Youth Risk Behavior Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, YRBS Program


Percentage of adolescents (students in grades 9-12 in traditional high schools) who were overweight, by academic performance, all Alaskans, 2003-2020

::chart - missing::
confidence limits

HA: Academic PerformanceYearPercentage of adolescentsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 18
Mostly As and Bs200314.2%11.9%16.8%139984
Mostly As and Bs2005**
Mostly As and Bs200715.6%12.8%18.9%127839
Mostly As and Bs200913.2%10.9%15.9%122884
Mostly As and Bs201112.7%10.6%15.2%113846
Mostly As and Bs201313.4%10.9%16.3%116836
Mostly As and Bs201516.6%14.2%19.3%157926
Not mostly As and Bs200315.1%11.4%19.7%69429
Not mostly As and Bs2005**
Not mostly As and Bs200716.9%12.0%23.4%74418
Not mostly As and Bs200916.8%13.6%20.6%73432
Not mostly As and Bs201117.9%14.5%21.8%75421
Not mostly As and Bs201314.7%11.1%19.2%48322
Not mostly As and Bs201517.1%13.6%21.3%68403
Healthy Alaskans Goal201312.0%
Healthy Alaskans Goal201512.0%
Healthy Alaskans Goal201712.0%
Healthy Alaskans Goal201912.0%

Data Notes

** = Data not available

Data Source

Alaska Youth Risk Behavior Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, YRBS Program

References and Community Resources

'''References:''' 1. U.S. Centers for Disease Control and Prevention. National Center for Health Statistics. Growth Charts. [http://www.cdc.gov/growthcharts/clinical_charts.htm] 2. U.S. Department of Health and Human Services. The Surgeon General's Vision for a Healthy and Fit Nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, January 2010. [http://www.ncbi.nlm.nih.gov/books/NBK44660/pdf/Bookshelf_NBK44660.pdf] 3. Olshansky SJ, Passaro DJ, Hershow RC et al. A potential decline in life expectancy in the United States in the 21st century. NEJM 2005;352(11):1138-45. 4. Alaska Food Policy Council. [https://akfoodpolicycouncil.wordpress.com/] '''Resources:''' Additional information on current efforts to prevent overweight and obesity in Alaska is available at: [http://www.hss.state.ak.us/dph/chronic/obesity/].

More Resources and Links

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

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

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

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.
Page Content Updated On 01/31/2016, Published on 01/31/2016
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 Wed, 10 February 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: Sun, 31 Jan 2016 16:55:33 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 Wed, 10 February 2016 23:31:59 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Sun, 31 Jan 2016 16:55:33 AKST