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State of Alaska

Complete Health Indicator Report of Health Care - No Prenatal Care in First Trimester (HA2020 Leading Health Indicator: 21)

Definition

The percentage of women delivering live births who have not received prenatal care in the first trimester of pregnancy.

Numerator

Number of women delivering lives births who reported not receiving prenatal care in the first trimester of pregnancy for a specific time period.

Denominator

Number of live births for a specific time period.

Data Interpretation Issues

The transition from the 1989 revision of the U.S. Standard Certificate of Live Birth to the 2003 revision has multiple implications for tracking rates of prenatal care in the United States. First, the timing of prenatal care item has changed. For data collected using the 1989 revision (for Alaska, all data prior to 2013), the item was recorded as the month of pregnancy that prenatal care began as reported by the mother. With the 2003 revision, the item was changed to request the date (day/month/year) of the first prenatal care visit, as recorded in the prenatal care or medical record. As a result of these modifications, rates of prenatal care timing and adequacy from the 2003 revision may not be comparable to data collected using earlier birth certificate revisions.^1^ Alaska implemented the 2003 revision of the birth certificate in 2013. Some states began the revision process in 2003, but full implementation in all states was phased in over several years. By 2016, all states were using the same version. [[br]] [[br]] ---- {{class .SmallerFont 1. Calculations | PeriStats | March of Dimes. [http://www.marchofdimes.org/peristats/calculationsp.aspx?id=23]. Accessed August 6, 2019. }}

Why Is This Important?

Utilization of quality healthcare is influenced by a number of factors, including: having health insurance, having access to care, and being able to afford care.^2^ 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.^3^ This report also includes data on early and adequate prenatal care using the Adequacy of Prenatal Care Utilization (APNCU) index that additionally accounts for the reported number of prenatal visits. [[br]] [[br]] ---- {{class .SmallerFont 2. DeVoe, Baez A, Angier H, Krois L, et al. Insurance plus Access Does not Equal Health Care: Typology of Barriers to Health Care Access for Low-Income Families. Ann Fam Med. 2007;5(6):511-518. [https://www.ncbi.nlm.nih.gov/pubmed/18025488] Accessed August 6, 2019. 3. Young MB, Perham-Hester KA, Kemberling MM. Alaska Maternal and Child Health Data Book 2011: Alaska Native Edition. Anchorage, AK: A collaboration of the Alaska Department of Health and Social Services, Division of Public Health, and the Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center. October 2011. [http://dhss.alaska.gov/dph/wcfh/Pages/mchepi/mchdatabook/2011.aspx] Accessed August 6, 2019. }}

Healthy People Objective: Prenatal care beginning in first trimester

U.S. Target: 77.9 percent (or 22.1 percent not beginning prenatal care in the first trimester)
State Target: Healthy Alaskans 2020 Target: 19.0% with no prenatal care in first trimester

Other Objectives

Healthy People Objective 10.2: Increase the proportion of pregnant women who receive early and adequate prenatal care. '''U.S. Target:''' 77.6 percent Healthy Alaskans 2020 Indicator 21: Reduce the percentage of women delivering live births who have not received prenatal care beginning in the first trimester of pregnancy to 19% by 2020.

How Are We Doing?

In 2018, Alaska's rate for this indicator (19.9%) approached the Healthy Alaskans 2020 objective of 19%. That same year, 24.6% of Alaska Native women who had delivered live births had not received prenatal care beginning in the first trimester - a 25.0% decrease since 2008 (32.8%). Thirty percent of women giving birth in the Southwest region did not receive prenatal care beginning in the first trimester for the 5-year period of 2014-2018. In reviewing the 10-year average for 2009-2018 by boroughs and census areas, areas with approximately one-third or higher rates of not receiving prenatal care in the first trimester consisted of Kusilvak census area (37.9%), North Slope Borough (36.5%), Southeast Fairbanks census area (35.7%), Aleutians West census area (34.8%), and Yukon-Koyukuk census area (34.0%). Alaska PRAMS surveyed women who recently delivered a live birth about their ability to obtain prenatal care when they wanted it, and asked them to list the corresponding reasons if they were unable to. During 2002-2011, the prevalence of Alaska women who received prenatal care as early as they wanted it increased from 80.4% to 85.0%. The most common reason that Alaska women gave for not getting prenatal care as early in their pregnancy as they wanted was because they didn't know they were pregnant (36.5%). Not having a Medicaid or Denali KidCare card (35.6%) or not being able to get an appointment when they wanted one (35.0%) were also common reasons given.^4^ The Adequacy of Prenatal Care Utilization (APNCU) index makes use of two types of prenatal care information obtained from birth certificate data: when prenatal care began (adequacy of initiation) and the number of prenatal visits from when prenatal care began until delivery (adequacy of received services). In 2018, 65.1% of Alaska women who had delivered a live birth were categorized as receiving adequate prenatal care. [[br]] [[br]] ---- {{class .SmallerFont 4. Newby-Kew AJ, DeLozier DP, Prince CB, Perham-Hester KA, Young MB. Alaska Maternal and Child Health Data Book 2014: Life Course Edition. Anchorage, AK. Maternal and Child Health Epidemiology Unit, Section of Women's, Children's, and Family Health, Division of Public Health, Alaska Department of Health and Social Services, September 2014. [http://dhss.alaska.gov/dph/wcfh/Documents/mchepi/pubs/databook/MCHDataBook2014toweb.pdf]. Accessed August 6, 2019. }}

How Do We Compare With the U.S.?

In 2018, 19.9% of Alaska women delivering lives births did not receive prenatal care in the first trimester of pregnancy, compared to 22.5% in the U.S.^5^ In 2016, 64.6% of Alaska women who had delivered a live birth were categorized as receiving early and adequate prenatal care (APNCU index), compared to 75.6% in the U.S.^6^ [[br]] [[br]] ---- {{class .SmallerFont 5. Hamilton BE, Martin JA, Osterman MJK, Rossen LM. Births: Provisional data for 2018. Vital Statistics Rapid Release; no 7. Hyattsville, MD: National Center for Health Statistics. May 2019. Available from [https://www.cdc.gov/nchs/data/vsrr/vsrr-007-508.pdf]. Accessed August 6, 2019. 6. Osterman MJK, Martin JA. Timing and adequacy of prenatal care in the United States, 2016. National Vital Statistics Reports, vol 67 no 3. Hyattsville, MD: National Center for Health Statistics. 2018 Available from [https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_03.pdf]. Accessed August 6, 2019. }}

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]]Increase the number of women of childbearing age who report having access to health care providers who support them to plan their pregnancies. '''Strategy 2:''' [[br]]Increase the number of women who have their pregnancies confirmed by a health care provider in the first trimester. '''Strategy 3:''' [[br]]Improve systems and services that care for women with addictions (alcohol, drugs, tobacco). '''Source:''' [[br]]Agency of Healthcare Research and Quality. Patient Safety.[http://www.ahrq.gov/research/findings/nhqrdr/nhqr08/Chap3.html] In National Healthcare Quality Report, 2008 (Chapter 3).

Health Program Information

A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_21_Prenatal.pdf]. Accessed August 6, 2019.


Related Indicators

Relevant Population Characteristics

Pregnant teens 15-19 years of age, mothers with low level of education, race other than White, Hispanic ethnicity, being unmarried, lower socio-economic status, and women who lack health insurance are less likely to get early prenatal care.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Having health insurance improves availability of prenatal care services. Lack of health insurance affects both the timing and frequency of prenatal care visits, resulting in poor pregnancy outcomes such as premature birth, low birth weight, and complicated delivery. Availability of family planning services is another system factor that reduces the risk of unintended pregnancy. If a pregnancy is planned, a woman is more likely to seek early and adequate prenatal care.

Related Health Care System Factors Indicators:


Risk Factors

The risk factors for late entry identified by the Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) and from the birth certificate are: - women less than 20 years of age - women with less than 12 years of education - non-White women - Hispanic women - unmarried women - women with an annual household income less than $15,000/year - unintended pregnancy - women who had no private insurance prior to conception

Health Status Outcomes

Prenatal care can improve birth outcomes and prevent medical complications and their costs associated with premature births, low birth weight births, and maternal and infant mortality and morbidity.



Graphical Data Views

Women who did not receive prenatal care beginning in first trimester of pregnancy, all Alaskans, Alaska Native people, and U.S., 2000-2018

::chart - missing::
confidence limits

The measure shown in the graph is women who reported receiving prenatal care beginning in the second or third trimester of pregnancy. Excludes live births with missing data on timing of first prenatal care.
Alaska ComparisonsYearPercentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 63
All Alaskans200019.7%18.8%20.6%1,9129,707
All Alaskans200119.4%18.6%20.3%1,8819,675
All Alaskans200219.8%18.9%20.7%1,8929,541
All Alaskans200320.2%19.3%21.1%1,9449,638
All Alaskans200419.3%18.4%20.2%1,8939,817
All Alaskans200519.7%18.8%20.6%2,01410,226
All Alaskans200619.0%18.2%19.8%2,03810,726
All Alaskans200720.0%19.1%20.8%2,14210,725
All Alaskans200820.6%19.8%21.5%2,26410,982
All Alaskans200919.8%19.0%20.7%2,04710,337
All Alaskans201021.3%20.4%22.2%2,24810,571
All Alaskans201122.5%21.6%23.4%2,45110,897
All Alaskans201223.4%22.5%24.3%2,46910,560
All Alaskans201321.5%20.6%22.4%2,34510,908
All Alaskans201422.4%21.5%23.3%2,46110,976
All Alaskans201521.1%20.2%21.9%2,31310,985
All Alaskans201620.4%19.6%21.3%2,25111,015
All Alaskans201719.2%18.4%20.1%1,96410,223
All Alaskans201819.9%19.1%20.8%1,9569,815
Alaska Native people200030.2%28.1%32.5%7292,411
Alaska Native people200128.5%26.4%30.7%6862,405
Alaska Native people200230.2%28.0%32.5%7012,321
Alaska Native people200329.5%27.3%31.7%7042,388
Alaska Native people200429.5%27.4%31.7%7332,487
Alaska Native people200528.6%26.6%30.7%7642,674
Alaska Native people200627.9%25.9%30.0%7382,646
Alaska Native people200730.6%28.6%32.8%8332,719
Alaska Native people200832.8%30.7%34.9%9302,838
Alaska Native people200927.1%25.2%29.1%7762,864
Alaska Native people201027.3%25.4%29.3%7662,805
Alaska Native people201125.3%23.5%27.3%6932,735
Alaska Native people201227.2%25.2%29.2%7382,717
Alaska Native people201324.8%23.0%26.7%7042,843
Alaska Native people201425.0%23.2%26.9%7162,865
Alaska Native people201524.3%22.5%26.2%6872,827
Alaska Native people201623.7%22.0%25.5%7042,968
Alaska Native people201722.4%20.7%24.3%6062,701
Alaska Native people201824.6%22.7%26.5%6552,665
U.S.200729.2%
U.S.200829.0%
U.S.200927.9%
U.S.201026.9%
U.S.201126.3%
U.S.201225.9%
U.S.201325.8%
U.S.201423.3%
U.S.201523.0%
U.S.201622.9%
U.S.201722.7%
Healthy Alaskans Goal200115.0%
Healthy Alaskans Goal200215.0%
Healthy Alaskans Goal200315.0%
Healthy Alaskans Goal200415.0%
Healthy Alaskans Goal200515.0%
Healthy Alaskans Goal200615.0%
Healthy Alaskans Goal200715.0%
Healthy Alaskans Goal200815.0%
Healthy Alaskans Goal200915.0%
Healthy Alaskans Goal201015.0%
Healthy Alaskans Goal201419.0%
Healthy Alaskans Goal201519.0%
Healthy Alaskans Goal201619.0%
Healthy Alaskans Goal201719.0%

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Data from before 2013 were obtained using the 1989 revision of the U.S. Standard Certificate of Live Birth in which only the month in which prenatal care began was collected. Data from before 2013 may not be comparable to the information from 2013 and later based upon the 2003 revision of the certificate that requested the date of the first prenatal care visit.

Data Sources

  • [http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Health Analytics and Vital Records Section (HAVRS)], Division of Public Health, Alaska Department of Health and Social Services
  • U.S. Center for Disease Control and Prevention, on-line data - CDC WONDER


Women who did not receive prenatal care beginning in first trimester of pregnancy, by race, Alaska, 2000-2018

::chart - missing::
confidence limits

The measure shown in the graph is women who reported receiving prenatal care beginning in the second or third trimester of pregnancy. Excludes live births with missing data on timing of first prenatal care.
Race: Alaska Native, Asian/Pacific Is, Black, WhiteYearPercentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 76
Alaska Native people200030.2%28.1%32.5%7292,411
Alaska Native people200128.5%26.4%30.7%6862,405
Alaska Native people200230.2%28.0%32.5%7012,321
Alaska Native people200329.5%27.3%31.7%7042,388
Alaska Native people200429.5%27.4%31.7%7332,487
Alaska Native people200528.6%26.6%30.7%7642,674
Alaska Native people200627.9%25.9%30.0%7382,646
Alaska Native people200730.6%28.6%32.8%8332,719
Alaska Native people200832.8%30.7%34.9%9302,838
Alaska Native people200927.1%25.2%29.1%7762,864
Alaska Native people201027.3%25.4%29.3%7652,805
Alaska Native people201125.3%23.5%27.3%6932,735
Alaska Native people201227.2%25.2%29.2%7382,717
Alaska Native people201324.8%23.0%26.7%7042,843
Alaska Native people201425.0%23.2%26.9%7162,865
Alaska Native people201524.3%22.5%26.2%6872,827
Alaska Native people201623.7%22.0%25.5%7042,968
Alaska Native people201722.4%20.7%24.3%6062,701
Alaska Native people201824.6%22.7%26.5%6552,665
Asian/Pacific Islander200022.6%18.9%26.7%134594
Asian/Pacific Islander200122.5%18.9%26.6%136604
Asian/Pacific Islander200222.6%19.0%26.6%142629
Asian/Pacific Islander200325.0%21.3%29.2%158632
Asian/Pacific Islander200426.7%23.0%30.9%183685
Asian/Pacific Islander200529.7%25.9%33.9%218735
Asian/Pacific Islander200622.9%19.8%26.5%189824
Asian/Pacific Islander200726.6%23.1%30.4%213802
Asian/Pacific Islander200826.8%23.4%30.5%226845
Asian/Pacific Islander200928.2%24.7%32.1%232823
Asian/Pacific Islander201031.2%27.7%35.0%287921
Asian/Pacific Islander201136.5%32.8%40.5%351962
Asian/Pacific Islander201234.8%31.3%38.7%3541,016
Asian/Pacific Islander201333.1%29.8%36.8%3531,066
Asian/Pacific Islander201431.4%28.3%34.9%3561,132
Asian/Pacific Islander201532.3%29.2%35.8%3781,169
Asian/Pacific Islander201629.1%26.1%32.4%3441,181
Asian/Pacific Islander201725.0%22.3%28.1%2961,182
Asian/Pacific Islander201826.6%23.6%29.8%2961,115
Black200019.0%15.2%23.5%85447
Black200118.1%14.3%22.6%76420
Black200216.4%12.7%20.9%66402
Black200318.6%14.4%23.6%67360
Black200414.6%10.8%19.2%51350
Black200517.9%13.9%22.7%69385
Black200616.0%12.4%20.4%67418
Black200718.8%14.9%23.4%81431
Black200821.1%16.8%26.1%83394
Black200920.0%15.9%25.0%79394
Black201017.0%13.1%21.5%67395
Black201127.2%22.7%32.4%128470
Black201224.6%19.8%30.2%92374
Black201323.7%19.5%28.5%111469
Black201424.6%20.2%29.6%109444
Black201522.4%18.1%27.3%95425
Black201620.4%16.4%25.1%90441
Black201715.0%11.7%18.9%72480
Black201820.1%16.1%24.8%86428
White200015.2%14.2%16.2%9366,157
White200115.6%14.6%16.6%9586,148
White200215.8%14.8%16.8%9556,063
White200316.1%15.1%17.1%9875,145
White200414.5%13.5%15.4%8946,184
White200514.8%13.9%15.8%9356,306
White200615.2%14.3%16.2%1,0116,637
White200714.8%13.9%15.8%9756,567
White200814.8%13.9%15.8%1,0086,797
White200915.1%14.1%16.1%9296,156
White201017.4%16.4%18.4%1,1086,373
White201118.8%17.8%19.9%1,2436,617
White201219.6%18.6%20.8%1,2416,316
White201318.0%17.0%19.1%1,1396,332
White201419.1%18.0%20.2%1,1846,199
White201517.4%16.4%18.5%1,0806,213
White201617.3%16.3%18.4%1,0706,185
White201716.8%15.7%17.9%9535,678
White201816.0%15.0%17.1%8665,411

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Starting in 2013, Alaska birth certificates allowed for one or more races to be identified. We use a prioritized race classification starting with any mention of Alaska Native, followed by any mention of Black, then by any mention of Asian or Pacific Islander, and ending with any mention of White. All other or unknown races are excluded. This method is preferred over the race alone or bridged race methods because the denominators more closely align with the preceding years. It also eliminates the chance of including the same person in 2 or more races.


Women who did not receive prenatal care beginning in first trimester of pregnancy, by public health regions, all Alaskans, 2014-2018 (5-year average)

::chart - missing::
confidence limits

The measure shown in the graph is women who reported receiving prenatal care beginning in the second or third trimester of pregnancy. Excludes live births with missing data on timing of first prenatal care.
Percentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 9
Anchorage19.1%18.5%19.7%4,07321,309
Gulf Coast23.3%22.0%24.7%1,1805,058
Interior19.8%18.9%20.7%1,7618,910
Mat-Su19.9%18.8%21.0%1,3846,961
Northern22.8%21.0%24.7%6122,684
Southeast16.8%15.5%18.1%6493,866
Southwest30.4%28.7%32.1%1,2714,185
Healthy Alaskans Goal19.0%
Statewide20.6%20.3%21.0%10,94553,011

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Region is determined by maternal residence at birth, not site of delivery.

Data Sources

  • [http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Health Analytics and Vital Records Section (HAVRS)], Division of Public Health, Alaska Department of Health and Social Services
  • U.S. Center for Disease Control and Prevention, on-line data - CDC WONDER


Women who did not receive prenatal care beginning in first trimester of pregnancy, by behavioral health regions, all Alaskans, 2014-2018 (5-year average)

::chart - missing::
confidence limits

The measure shown in the graph is women who reported receiving prenatal care beginning in the second or third trimester of pregnancy. Excludes live births with missing data on timing of first prenatal care.
Percentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 12
Anchorage Muncipality19.1%18.5%19.7%4,07321,309
Fairbanks North Star Borough18.3%17.3%19.2%1,4467,921
City and Borough of Juneau11.1%9.6%12.8%1981,782
Kenai Peninsula Borough25.8%24.1%27.6%8923,456
Matanuska-Susitna Borough19.9%18.8%21.0%1,3846,961
Northwest Region22.8%21.0%24.7%6122,684
Other Interior Region28.1%25.6%30.8%4491,598
Other SE - Northern20.0%17.3%23.1%189944
Other SE - Southern23.0%20.3%25.9%2621,140
Y-K Delta Region31.5%29.6%33.5%1,0313,270
Southwest Region20.6%18.7%22.8%3941,908
Healthy Alaskans Goal19.0%

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Region is determined by maternal residence at birth, not site of delivery.


Women who did not receive prenatal care beginning in first trimester of pregnancy, by tribal health regions, all Alaskans, 2014-2018 (5-year average)

::chart - missing::
confidence limits

The measure shown in the graph is women who reported receiving prenatal care beginning in the second or third trimester of pregnancy. Excludes live births with missing data on timing of first prenatal care.
Percentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 13
Aleutians and Pribilofs30.2%23.4%38.3%67222
Anchorage/Mat-Su19.3%18.8%19.8%5,45728,270
Arctic Slope27.5%23.6%31.9%178647
Bristol Bay26.3%22.7%30.3%192730
Copper R/Prince William Snd.22.2%18.6%26.2%137617
Interior19.8%18.9%20.8%1,7648,897
Kenai Peninsula25.8%24.1%27.6%8923,456
Kodiak Area15.5%13.2%18.2%154993
Northwest Arctic19.3%16.6%22.3%185960
Norton Sound21.6%18.8%24.6%2221,029
Southeast16.8%15.5%18.1%6493,866
Yukon-Kuskokwim31.4%29.5%33.4%1,0333,286
Healthy Alaskans Goal19.0%

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Region is determined by maternal residence at birth, not site of delivery.


Women who did not receive prenatal care beginning in first trimester of pregnancy, by boroughs and census areas, all Alaskans, 2009-2018 (10-year average)

::chart - missing::
confidence limits

The measure shown in the graph is women who reported receiving prenatal care beginning in the second or third trimester of pregnancy. Excludes live births with missing data on timing of first prenatal care.
Percentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 30
Aleutians East Borough19.2%13.0%27.5%30156
Aleutians West CA34.8%28.4%42.2%103296
Anchorage Municipality19.6%19.2%20.0%8,34942,566
Bethel CA27.7%26.1%29.3%1,1634,205
Bristol Bay Borough26.5%17.4%38.5%27102
Denali Borough25.8%19.5%33.5%56217
Dillingham CA26.9%23.8%30.3%2711,006
Fairbanks North Star Borough19.2%18.5%19.9%3,03115,799
Haines Borough22.6%16.5%30.3%45199
Hoonah-Angoon CA30.3%23.4%38.7%64211
Juneau City and Borough12.4%11.3%13.6%4643,736
Kenai Peninsula Borough23.0%21.8%24.1%1,5816,886
Ketchikan Gateway Borough15.2%13.4%17.2%2561,686
Kodiak Island Borough18.8%17.0%20.8%3932,088
Kusilvak CA37.8%35.4%40.4%8862,341
Lake and Peninsula Borough21.0%16.2%26.7%66315
Matanuska-Susitna Borough20.8%20.1%21.6%2,74713,182
Nome CA23.7%21.7%25.8%5202,195
North Slope Borough36.5%33.6%39.5%3021,650
Northwest Arctic Borough21.9%19.9%24.2%4101,869
Petersburg Borough20.4%15.9%25.7%70344
Prince of Wales-Hyder CA28.9%25.1%33.0%213738
Sitka City and Borough13.7%11.5%16.3%129940
Skagway Municipality22.4%14.1%34.0%2298
Southeast Fairbanks CA35.6%32.2%39.4%3791,063
Valdez-Cordova CA21.2%18.8%24.0%2611,228
Wrangell City and Borough21.4%15.8%28.4%48224
Yakutat City and Borough29.0%18.1%43.8%2276
Yukon-Koyukuk CA34.0%30.1%38.3%278817
Healthy Alaskans Goal19.0%

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Region is determined by maternal residence at birth, not site of delivery. Rates based upon less than 20 cases are unreliable.

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Health Analytics and Vital Records Section (HAVRS)], Division of Public Health, Alaska Department of Health and Social Services


Women who received adequate prenatal care (APNCU index), all Alaskans, Alaska Native people, and U.S., 2000-2018

::chart - missing::
confidence limits

The measure shown in the graph is women who were categorized as receiving Adequate or Adequate Plus care (APNCU index). Excludes live births with missing data on prenatal care. Limited data for U.S. is available. Estimates for 2007 are based on 22 states (representing 53 percent of all U.S. births) that had adopted the 2003 version of the U.S. State Certification of Live Births, excluding AL, AK, AZ, AR, CT, GA, HI, IL, LA, ME, MD, MA, MI, MN, MS, MO, MT, NV, NJ, NM, NC, OK, OR, RI, UT, VA, WV, WI, DC, and New York City. The most recent estimate (2016) is the first report on the adequacy of PNC based on 100% of births registered to residents of the 50 states and the District of Columbia (D.C.) from the 2003 birth certificate.
Alaska ComparisonsYearPercentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 57
All Alaskans200067.5%65.8%69.1%6,3769,452
All Alaskans200166.5%64.8%68.2%6,0959,169
All Alaskans200264.2%62.5%65.8%5,7779,003
All Alaskans200366.2%64.5%67.9%5,8568,847
All Alaskans200463.3%61.7%65.0%5,7649,100
All Alaskans200563.9%62.3%65.5%6,2399,761
All Alaskans200661.9%60.4%63.4%6,32910,224
All Alaskans200759.7%58.3%61.3%6,13910,276
All Alaskans200857.4%56.0%58.9%5,94510,357
All Alaskans200959.5%58.0%61.1%5,5689,351
All Alaskans201059.4%57.9%60.9%6,06810,214
All Alaskans201157.4%56.0%58.9%6,16910,742
All Alaskans201261.5%60.0%63.0%6,37410,363
All Alaskans201359.5%58.1%61.0%6,29110,568
All Alaskans201460.0%58.6%61.5%6,45210,749
All Alaskans201561.5%60.0%63.0%6,59710,728
All Alaskans201664.6%63.1%66.2%7,00810,842
All Alaskans201764.3%62.8%65.9%6,51710,129
All Alaskans201865.1%63.5%66.7%6,3129,693
Alaska Native people200050.9%48.1%53.9%1,2112,378
Alaska Native people200151.0%48.1%54.0%1,1932,340
Alaska Native people200246.5%43.7%49.4%1,0542,267
Alaska Native people200348.4%45.6%51.3%1,1282,332
Alaska Native people200442.0%39.5%44.6%1,0242,439
Alaska Native people200547.1%44.5%49.8%1,2452,642
Alaska Native people200645.2%42.7%47.9%1,1822,613
Alaska Native people200740.1%37.7%42.5%1,0782,690
Alaska Native people200840.3%38.0%42.7%1,1252,790
Alaska Native people200944.3%41.9%46.8%1,2532,829
Alaska Native people201046.5%44.0%49.1%1,2962,786
Alaska Native people201145.1%42.6%47.7%1,2372,743
Alaska Native people201251.6%49.0%54.4%1,3962,703
Alaska Native people201355.6%52.9%58.4%1,5492,786
Alaska Native people201454.5%51.8%57.3%1,5492,841
Alaska Native people201556.7%53.9%59.5%1,5822,791
Alaska Native people201660.1%57.4%63.0%1,7712,945
Alaska Native people201758.0%55.2%61.0%1,5582,686
Alaska Native people201860.4%57.5%63.5%1,5982,645
U.S.200770.5%
U.S.201675.6%
Healthy People Target200190.0%
Healthy People Target200290.0%
Healthy People Target200390.0%
Healthy People Target200490.0%
Healthy People Target200590.0%
Healthy People Target200690.0%
Healthy People Target200790.0%
Healthy People Target200890.0%
Healthy People Target200990.0%
Healthy People Target201090.0%
Healthy People Target201177.6%
Healthy People Target201277.6%
Healthy People Target201377.6%
Healthy People Target201477.6%
Healthy People Target201577.6%
Healthy People Target201677.6%
Healthy People Target201777.6%

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Adequacy of Prenatal Care Utilization (APNCU) index classifies the adequacy of initiation as follows: pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. To classify the adequacy of received services, the number of prenatal visits is compared to the expected number of visits for the period between when care began and the delivery date. The expected number of visits is based on the American College of Obstetricians and Gynecologists prenatal care standards for uncomplicated pregnancies and is adjusted for the gestational age when care began and for the gestational age at delivery. A ratio of observed to expected visits is calculated and grouped into four categories - Inadequate (received less than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), and Adequate Plus (110%). The final APNCU index measure combines these two dimensions into a single summary score.^5^

Data Sources

  • [http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Health Analytics and Vital Records Section (HAVRS)], Division of Public Health, Alaska Department of Health and Social Services
  • National Center for Health Statistics, Centers for Disease Control and Prevention


Women who received adequate prenatal care (APNCU index), by race, Alaska, 2000-2018

::chart - missing::
confidence limits

The measure shown in the graph is women who were categorized as receiving Adequate or Adequate Plus care (APNCU index). Excludes live births with missing data on prenatal care.
Race: Alaska Native, Asian/Pacific Is, Black, WhiteYearPercentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 76
Alaska Native people200050.9%48.1%53.9%1,2112,378
Alaska Native people200151.0%48.1%54.0%1,1932,340
Alaska Native people200246.5%43.7%49.4%1,0542,267
Alaska Native people200348.4%45.6%51.3%1,1282,332
Alaska Native people200442.0%39.5%44.6%1,0242,439
Alaska Native people200547.1%44.5%49.8%1,2452,642
Alaska Native people200645.2%42.7%47.9%1,1822,613
Alaska Native people200740.1%37.7%42.5%1,0782,690
Alaska Native people200840.3%38.0%42.7%1,1252,790
Alaska Native people200944.3%41.9%46.8%1,2532,829
Alaska Native people201046.5%44.0%49.1%1,2962,786
Alaska Native people201145.1%42.6%47.7%1,2372,743
Alaska Native people201251.6%49.0%54.4%1,3962,703
Alaska Native people201355.6%52.9%58.4%1,5492,786
Alaska Native people201454.5%51.8%57.3%1,5492,841
Alaska Native people201556.7%53.9%59.5%1,5822,791
Alaska Native people201660.1%57.4%63.0%1,7712,945
Alaska Native people201758.0%55.2%61.0%1,5582,686
Alaska Native people201860.4%57.5%63.5%1,5982,645
Asian/Pacific Islander200063.9%57.5%70.8%363568
Asian/Pacific Islander200161.6%55.3%68.5%344558
Asian/Pacific Islander200264.2%57.7%71.2%360561
Asian/Pacific Islander200365.7%59.1%72.8%360548
Asian/Pacific Islander200461.4%55.4%67.9%382622
Asian/Pacific Islander200563.3%57.4%69.5%427675
Asian/Pacific Islander200660.8%55.3%66.7%449738
Asian/Pacific Islander200759.5%54.1%65.4%438736
Asian/Pacific Islander200858.2%52.9%63.9%442759
Asian/Pacific Islander200961.5%55.8%67.6%427694
Asian/Pacific Islander201055.2%50.4%60.3%489886
Asian/Pacific Islander201151.8%47.3%56.6%489944
Asian/Pacific Islander201256.8%52.2%61.8%560985
Asian/Pacific Islander201351.8%47.5%56.4%5371,036
Asian/Pacific Islander201455.8%51.4%60.3%6211,114
Asian/Pacific Islander201554.8%50.6%59.2%6291,148
Asian/Pacific Islander201655.6%51.3%60.0%6401,152
Asian/Pacific Islander201759.2%54.9%63.8%6891,164
Asian/Pacific Islander201856.6%52.2%61.2%6241,103
Black200072.7%64.8%81.2%311428
Black200172.0%63.9%80.8%285396
Black200268.1%60.0%77.0%256376
Black200371.8%62.6%82.1%217302
Black200467.0%58.1%76.9%203303
Black200569.2%60.7%78.6%236341
Black200666.4%58.5%75.1%253381
Black200760.2%52.9%68.3%242402
Black200853.6%46.2%61.8%187349
Black200956.9%48.9%65.8%181318
Black201059.0%51.4%67.3%220373
Black201158.1%51.3%65.5%263453
Black201262.7%54.9%71.4%229365
Black201359.0%52.1%66.5%266451
Black201457.1%50.2%64.7%246431
Black201563.4%55.9%71.5%261412
Black201667.1%59.6%75.3%290432
Black201772.0%64.6%80.1%340472
Black201864.7%57.2%72.9%271419
White200074.3%72.1%76.5%4,4435,982
White200173.0%70.8%75.2%4,2175,779
White200271.0%68.9%73.3%4,0375,683
White200373.4%71.1%75.7%4,0845,566
White200472.7%70.4%74.9%4,0925,632
White200571.0%68.9%73.1%4,2565,996
White200668.4%66.3%70.4%4,3126,307
White200768.2%66.2%70.2%4,2666,259
White200864.9%62.9%66.9%4,1256,358
White200967.7%65.5%69.9%3,6695,421
White201066.0%64.0%68.1%4,0236,092
White201163.6%61.7%65.6%4,1316,495
White201266.6%64.5%68.6%4,1096,174
White201362.9%60.9%64.9%3,8396,102
White201463.9%61.9%65.9%3,8596,042
White201564.9%62.9%67.0%3,9156,032
White201668.3%66.2%70.4%4,1536,080
White201767.8%65.7%70.0%3,8175,628
White201869.5%67.3%71.8%3,7075,334

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Adequacy of Prenatal Care Utilization (APNCU) index classifies the adequacy of initiation as follows: pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. To classify the adequacy of received services, the number of prenatal visits is compared to the expected number of visits for the period between when care began and the delivery date. The expected number of visits is based on the American College of Obstetricians and Gynecologists prenatal care standards for uncomplicated pregnancies and is adjusted for the gestational age when care began and for the gestational age at delivery. A ratio of observed to expected visits is calculated and grouped into four categories - Inadequate (received less than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), and Adequate Plus (110%). The final APNCU index measure combines these two dimensions into a single summary score.^5^

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Health Analytics and Vital Records Section (HAVRS)], Division of Public Health, Alaska Department of Health and Social Services


Women who received adequate prenatal care (APNCU index), by public health regions, all Alaskans, 2014-2018 (5-year average)

::chart - missing::
confidence limits

The measure shown in the graph is women who were categorized as receiving Adequate or Adequate Plus care (APNCU index). Excludes live births with missing data on prenatal care.
Percentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 9
Anchorage66.8%66.2%67.4%14,03321,004
Gulf Coast57.5%55.4%59.7%2,8775,001
Interior60.7%59.1%62.4%5,2838,700
Mat-Su72.5%70.5%74.6%4,9026,762
Northern56.7%53.8%59.6%1,5092,663
Southeast67.1%64.5%69.7%2,5693,829
Southwest40.8%38.9%42.8%1,6924,142
Healthy People Target77.6%
Statewide63.1%62.7%63.5%32,88452,137

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Adequacy of Prenatal Care Utilization (APNCU) index classifies the adequacy of initiation as follows: pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. To classify the adequacy of received services, the number of prenatal visits is compared to the expected number of visits for the period between when care began and the delivery date. The expected number of visits is based on the American College of Obstetricians and Gynecologists prenatal care standards for uncomplicated pregnancies and is adjusted for the gestational age when care began and for the gestational age at delivery. A ratio of observed to expected visits is calculated and grouped into four categories - Inadequate (received less than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), and Adequate Plus (110%). The final APNCU index measure combines these two dimensions into a single summary score.^5^ Region is determined by maternal residence at birth, not site of delivery.


Women who received adequate prenatal care (APNCU index), by behavioral health regions, all Alaskans, 2014-2018 (5-year average)

::chart - missing::
confidence limits

The measure shown in the graph is women who were categorized as receiving Adequate or Adequate Plus care (APNCU index). Excludes live births with missing data on prenatal care.
Percentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 12
Anchorage Muncipality66.8%66.2%67.4%14,03321,004
Fairbanks North Star Borough63.4%61.6%65.1%4,8917,721
City and Borough of Juneau68.3%64.5%72.3%1,2021,760
Kenai Peninsula Borough56.4%53.9%59.0%1,9293,419
Matanuska-Susitna Borough72.5%70.5%74.6%4,9026,762
Northwest Region56.7%53.8%59.6%1,5092,663
Other Interior Region44.2%41.0%47.6%6971,578
Other SE - Northern63.2%58.2%68.5%588931
Other SE - Southern68.4%63.7%73.5%7791,138
Y-K Delta Region38.2%36.1%40.4%1,2363,237
Southwest Region58.2%54.8%61.8%1,0991,888
Healthy People Target77.6%

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Adequacy of Prenatal Care Utilization (APNCU) index classifies the adequacy of initiation as follows: pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. To classify the adequacy of received services, the number of prenatal visits is compared to the expected number of visits for the period between when care began and the delivery date. The expected number of visits is based on the American College of Obstetricians and Gynecologists prenatal care standards for uncomplicated pregnancies and is adjusted for the gestational age when care began and for the gestational age at delivery. A ratio of observed to expected visits is calculated and grouped into four categories - Inadequate (received less than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), and Adequate Plus (110%). The final APNCU index measure combines these two dimensions into a single summary score.^5^ Region is determined by maternal residence at birth, not site of delivery.


Women who received adequate prenatal care (APNCU index), by tribal health regions, all Alaskans, 2014-2018 (5-year average)

::chart - missing::
confidence limits

The measure shown in the graph is women who were categorized as receiving Adequate or Adequate Plus care (APNCU index). Excludes live births with missing data on prenatal care.
Percentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 13
Aleutians and Pribilofs52.5%43.4%63.0%116221
Anchorage/Mat-Su68.2%67.6%68.7%18,93527,766
Arctic Slope49.0%43.7%54.7%615643
Bristol Bay48.4%43.5%53.8%349721
Copper R/Prince William Snd.51.1%45.5%57.1%310607
Interior60.7%59.0%62.3%5,2718,687
Kenai Peninsula56.4%53.9%59.0%1,9293,419
Kodiak Area65.4%60.5%70.7%643983
Northwest Arctic53.1%48.6%58.0%507954
Norton Sound66.1%61.2%71.3%6731,018
Southeast67.1%64.5%69.7%2,5693,829
Yukon-Kuskokwim38.4%36.3%40.6%1,2483,253
Healthy People Target77.6%

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Adequacy of Prenatal Care Utilization (APNCU) index classifies the adequacy of initiation as follows: pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. To classify the adequacy of received services, the number of prenatal visits is compared to the expected number of visits for the period between when care began and the delivery date. The expected number of visits is based on the American College of Obstetricians and Gynecologists prenatal care standards for uncomplicated pregnancies and is adjusted for the gestational age when care began and for the gestational age at delivery. A ratio of observed to expected visits is calculated and grouped into four categories - Inadequate (received less than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), and Adequate Plus (110%). The final APNCU index measure combines these two dimensions into a single summary score.^5^ Region is determined by maternal residence at birth, not site of delivery.


Women who received adequate prenatal care (APNCU index), by boroughs and census areas, all Alaskans, 2009-2018 (10-year average)

::chart - missing::
confidence limits

The measure shown in the graph is women who were categorized as receiving Adequate or Adequate Plus care (APNCU index). Excludes live births with missing data on prenatal care.
Percentage of women delivering live birthsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 30
Aleutians East Borough74.4%61.4%89.2%116156
Aleutians West CA50.3%42.6%59.1%148294
Anchorage Municipality65.4%65.0%65.9%26,74540,871
Bethel CA38.6%36.8%40.6%1,6084,163
Bristol Bay Borough41.4%29.7%56.2%4199
Denali Borough49.3%40.4%59.6%107217
Dillingham CA37.4%33.7%41.4%373996
Fairbanks North Star Borough61.4%60.2%62.7%9,54715,541
Haines Borough52.8%43.1%64.2%102193
Hoonah-Angoon CA46.4%37.6%56.6%96207
Juneau City and Borough65.5%62.9%68.2%2,4193,692
Kenai Peninsula Borough59.0%57.2%60.9%4,0016,776
Ketchikan Gateway Borough65.3%61.4%69.2%1,0951,678
Kodiak Island Borough69.0%65.5%72.7%1,4252,065
Kusilvak CA31.0%28.8%33.4%7222,325
Lake and Peninsula Borough59.4%51.1%65.6%184310
Matanuska-Susitna Borough72.4%70.9%73.9%9,15012,637
Nome CA56.1%53.0%59.4%1,2192,172
North Slope Borough39.8%36.8%43.0%6551,645
Northwest Arctic Borough45.9%42.9%49.1%8541,861
Petersburg Borough54.8%47.1%63.4%182332
Prince of Wales-Hyder CA44.5%39.8%49.6%326733
Sitka City and Borough75.1%70.4%81.7%709934
Skagway Municipality50.5%37.1%67.2%4793
Southeast Fairbanks CA38.6%34.9%42.6%4051,049
Valdez-Cordova CA50.2%46.3%54.5%5941,182
Wrangell City and Borough52.0%43.0%62.5%115221
Yakutat City and Borough45.2%31.1%63.5%3373
Yukon-Koyukuk CA38.5%34.4%43.0%313813
Healthy People Target77.6%

Data Notes

Data for prenatal care indicators updated by Maternal and Child Health Health Epidemiology Unit (MCH-Epi), Section of Women's, Children's and Family Health in August 2019. [SAS Analysis in July 2019] Birth certificate data updated by HAVRS on May 22, 2019.   Adequacy of Prenatal Care Utilization (APNCU) index classifies the adequacy of initiation as follows: pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. To classify the adequacy of received services, the number of prenatal visits is compared to the expected number of visits for the period between when care began and the delivery date. The expected number of visits is based on the American College of Obstetricians and Gynecologists prenatal care standards for uncomplicated pregnancies and is adjusted for the gestational age when care began and for the gestational age at delivery. A ratio of observed to expected visits is calculated and grouped into four categories - Inadequate (received less than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), and Adequate Plus (110%). The final APNCU index measure combines these two dimensions into a single summary score.^5^ Region is determined by maternal residence at birth, not site of delivery.

References and Community Resources

'''References:''' 1. Calculations | PeriStats | March of Dimes. [http://www.marchofdimes.org/peristats/calculationsp.aspx?id=23]. Accessed August 6, 2019. 2. DeVoe, Baez A, Angier H, Krois L, et al. Insurance plus Access Does not Equal Health Care: Typology of Barriers to Health Care Access for Low-Income Families. Ann Fam Med. 2007;5(6):511-518. [http://www.medscape.com/viewarticle/567154] Accessed August 6, 2019. 3. Young MB, Perham-Hester KA, Kemberling MM. Alaska Maternal and Child Health Data Book 2011: Alaska Native Edition. Anchorage, AK: A collaboration of the Alaska Department of Health and Social Services, Division of Public Health, and the Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center. October 2011. [http://anthctoday.org/epicenter/publications/prams/pramsFullVersion.pdf] Accessed August 6, 2019. 4. Newby-Kew AJ, DeLozier DP, Prince CB, Perham-Hester KA, Young MB. Alaska Maternal and Child Health Data Book 2014: Life Course Edition. Anchorage, AK. Maternal and Child Health Epidemiology Unit, Section of Women's, Children's, and Family Health, Division of Public Health, Alaska Department of Health and Social Services, September 2014. [http://dhss.alaska.gov/dph/wcfh/Documents/mchepi/pubs/databook/MCHDataBook2014toweb.pdf]. Accessed August 6, 2019. 5. Hamilton BE, Martin JA, Osterman MJK, Rossen LM. Births: Provisional data for 2018. Vital Statistics Rapid Release; no 7. Hyattsville, MD: National Center for Health Statistics. May 2019. Available from [https://www.cdc.gov/nchs/data/vsrr/vsrr-007-508.pdf]. Accessed August 6, 2019. 6. Osterman MJK, Martin JA. Timing and adequacy of prenatal care in the United States, 2016. National Vital Statistics Reports, vol 67 no 3. Hyattsville, MD: National Center for Health Statistics. 2018 Available from [https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_03.pdf]. Accessed August 6, 2019. '''Resources:''' Alaska Department of Health and Social Services, Division of Public Health, Health Analytics and Vital Records Section. Alaska Vital Statistics 2017 Annual Report. [http://dhss.alaska.gov/dph/VitalStats/Documents/PDFs/VitalStatistics_Annualreport_2017.pdf]. Accessed August 6, 2019. [[br]] ---- '''Acknowledgement''' This Indicator Report is partially supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $100,000 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.

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 08/26/2019, Published on 08/27/2019
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 Tue, 22 October 2019 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, 27 Aug 2019 10:26:33 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics 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 Tue, 22 October 2019 13:08:16 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Tue, 27 Aug 2019 10:26:33 AKDT