Complete Indicator Profile - Physical Activity - Adults (18+) - Recommended Levels - 2008 Guidelines (HA2020 Leading Health Indicator: 6A)

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State of Alaska

Complete Indicator Profile of Physical Activity - Adults (18+) - Recommended Levels - 2008 Guidelines (HA2020 Leading Health Indicator: 6A)

Definition

Percentage of adults (18+) who do at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.

Numerator

Number of adults aged 18 years and older who report 150 minutes or more total per week of moderate or vigorous exercise where each minute of vigorous exercise contributes two minutes to the total.

Denominator

Number of adults aged 18 years and older responding to physical activity questions.

Why Is This Important?

Regular physical activity can improve the health and quality of life of Alaskans of all ages, regardless of the presence of a chronic disease or disability. Regular physical activity protects against heart disease, colon cancer, diabetes, depression, and anxiety. Regular physical activity maintains normal muscle strength, joint structure and function, and is essential for normal skeletal development and attainment of optimal peak bone mass during childhood and adolescence. Adults benefit from moderate physical activity, of at least 150 minutes each week.

Physical activity is recognized as an independent protective factor against cardiovascular disease. Physical activity has been shown to reduce the risk of some cancers, type 2 diabetes, stroke, and heart disease; and improve general physical and mental health.[1] Weight-bearing activity can improve bone density, reducing the risk of hip fractures in elderly persons. Regular activity helps to relieve pain from osteoarthritis.[2] Regular physical activity is also known to improve affective disorders such as depression and anxiety, and increase quality of life and independent living among the elderly.[3]

References:
1. Centers for Disease Control and Prevention. Physical activity and health: a report of the surgeon general. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Promotion; 1996.
2. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393-403.
3. Kesaniemi, Y., et al. (1994). Dose-response issues concerning physical activity and health: an evidence-based symposium. Medicine and Science in Sports and Exercise, 33(6 suppl), S351-S358

Healthy People Objective PA-2.1:

Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for at least 150 minutes/week, or 75 minutes/week of vigorous intensity, or an equivalent combination
U.S. Target: 47.9 percent
State Target: Healthy Alaskans 2020 Target: 61%

How Do We Compare With U.S.?

When compared to the nation, Alaskans are equally physically active.

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaskan 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. Below are the strategies identified for enhancing adolescent support systems.

Strategy 1:
Implement a comprehensive social marketing campaign promoting physical activity. Choose campaign topics strategically.

Evidence Base:
Citing the Community Guide and other reviews, the CDC recommends community-wide campaigns as effective in increasing physical activity.

Sources:
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.
the Community Guide: http://www.thecommunityguide.org/pa/index/html
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:
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:
CDC School Health Guidelines:
http://www.cdc.gov/healthyyouth/npao/strategies.htm
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 Local School Wellness Policy Implementation: http://www.gpo.gov/fdsys/pkg/PLAW-111publ296/pdf/PLAW-111publ296.pdf



Related Indicators

Relevant Population Characteristics

There are age, gender, and socio-economic related risk factors associated with physical inactivity.

Related Relevant Population Characteristics Indicator Profiles:


Health Care System Factors

Health care system factors relate primarily to access to care and a reported low rate of health care provider counseling for physical activity recommendations.

Related Health Care System Factors Indicator Profiles:


Risk Factors

The percentage of persons who reported no physical activity during leisure time was higher among women, older adults, people who were overweight or obese, and those with less formal education and less income.

Related Risk Factors Indicator Profiles:


Health Status Outcomes

Small changes in levels of physical activity such as walking or gardening can lead to big improvements in personal health. In fact, the greatest benefits occur among those who have never exercised regularly. Even moderate amounts of exercise can substantially reduce an individual's chance of dying from heart disease, cancer, or other causes.

Related Health Status Outcomes Indicator Profiles:




Graphical Data Views

Percentage of adults (18+) who reported getting the recommended amount of physical activity, all Alaskans, Alaska Natives, and U.S., 2011-2020

::chart - missing::

Alaska Comparisons Year Percentage of Adults Lower Limit Upper Limit
Record Count: 17
All Alaskans 2011 57.5% 55.0% 59.8%
All Alaskans 2012 **
All Alaskans 2013 55.0% 52.7% 57.4%
Alaska Natives 2011 52.0% 46.2% 57.7%
Alaska Natives 2012 **
Alaska Natives 2013 46.8% 40.6% 53.1%
U.S. 2011 51.6%
U.S. 2012 **
U.S. 2013 50.5%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.

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+) who reported getting the recommended amount of physical activity, by sex, all Alaskans, 2011-2020

::chart - missing::

HA: Males vs. Females Year Percentage of Adults Lower Limit Upper Limit
Record Count: 6
Males 2011 58.2% 54.7% 61.6%
Males 2012 **
Males 2013 54.3% 51.0% 57.6%
Females 2011 56.7% 53.3% 60.0%
Females 2012 **
Females 2013 55.8% 52.5% 59.1%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.



Percentage of adults (18+) who reported getting the recommended amount of physical activity, by age group, all Alaskans, 2011-2020

::chart - missing::

HA: Age Group: 18-24,25-34,35-44,45-64,65+ Year Percentage of Adults Lower Limit Upper Limit
Record Count: 23
18-24 2011 61.6% 53.0% 69.5%
18-24 2012 **
18-24 2013 59.7% 51.9% 67.1%
25-34 2011 58.3% 52.2% 64.1%
25-34 2012 **
25-34 2013 62.1% 56.5% 67.5%
35-44 2011 55.7% 50.1% 61.2%
35-44 2012 **
35-44 2013 46.6% 41.0% 52.2%
45-64 2011 56.4% 52.9% 59.8%
45-64 2012 **
45-64 2013 54.5% 51.0% 57.9%
65+ 2011 58.5% 52.9% 64.0%
65+ 2012 **
65+ 2013 51.8% 46.5% 57.1%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.



Percentage of adults (18+) who reported getting the recommended amount of physical activity, by ethnicity, all Alaskans, 2011-2020

::chart - missing::

HA: Ethnicity - Hispanic/Latino Year Percentage of Adults Lower Limit Upper Limit
Record Count: 14
Hispanic/Latino 2011 46.9% 33.4% 60.9%
Hispanic/Latino 2012 **
Hispanic/Latino 2013 56.6% 44.5% 68.0%
Not Hispanic/Latino 2011 58.0% 55.5% 60.4%
Not Hispanic/Latino 2012 **
Not Hispanic/Latino 2013 54.9% 52.5% 57.3%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.

Data Sources

BRFSS 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+) who reported getting the recommended amount of physical activity, by marital status, all Alaskans, 2011-2020

::chart - missing::

HA: Marital Status Year Percentage of Adults Lower Limit Upper Limit
Record Count: 23
Married 2011 57.3% 54.2% 60.6%
Married 2012 **
Married 2013 57.4% 54.5% 60.3%
Widowed 2011 51.6% 40.9% 62.1%
Widowed 2012 **
Widowed 2013 47.0% 37.8% 56.3%
Divorced/Separated 2011 53.1% 47.3% 58.8%
Divorced/Separated 2012 **
Divorced/Separated 2013 44.1% 38.3% 50.0%
Never Married 2011 57.6% 51.4% 63.7%
Never Married 2012 **
Never Married 2013 58.3% 52.5% 63.9%
Living with a Partner 2011 69.1% 58.9% 77.7%
Living with a Partner 2012 **
Living with a Partner 2013 49.8% 39.7% 59.9%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.



Percentage of adults (18+) who reported getting the recommended amount of physical activity, by education, all Alaskans, 2011-2020

::chart - missing::

HA: Edu Level: < HS, HS, Some Coll, Coll Grad Year Percentage of Adults Lower Limit Upper Limit
Record Count: 20
< HS 2011 52.2% 43.0% 61.3%
< HS 2012 **
< HS 2013 39.5% 29.4% 50.6%
HS 2011 47.5% 42.9% 52.1%
HS 2012 **
HS 2013 49.8% 45.2% 54.3%
Some Coll 2011 58.6% 54.1% 63.0%
Some Coll 2012 **
Some Coll 2013 51.8% 47.7% 55.9%
Coll Grad 2011 65.8% 61.8% 69.6%
Coll Grad 2012 **
Coll Grad 2013 67.0% 63.5% 70.3%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.

Data Sources

BRFSS 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+) who reported getting the recommended amount of physical activity, by employment status, all Alaskans, 2011-2020

::chart - missing::

HA: Employment Year Percentage of Adults Lower Limit Upper Limit
Record Count: 20
Employed 2011 58.0% 54.9% 61.0%
Employed 2012 **
Employed 2013 54.9% 52.0% 57.7%
Unemployed 2011 55.9% 47.5% 63.9%
Unemployed 2012 **
Unemployed 2013 53.1% 44.6% 61.5%
Not In Work Force 2011 60.3% 55.2% 65.1%
Not In Work Force 2012 **
Not In Work Force 2013 60.7% 55.8% 65.3%
Unable to Work 2011 44.9% 34.0% 56.2%
Unable to Work 2012 **
Unable to Work 2013 32.5% 22.9% 43.8%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.



Percentage of adults (18+) who reported getting the recommended amount of physical activity, by income, all Alaskans, 2011-2020

::chart - missing::

HA: Income: <$15k, $15k-$25k, $25k-$50k, $50-$75k, $75k+ Year Percentage of Adults Lower Limit Upper Limit
Record Count: 23
<$15,000 2011 54.0% 44.5% 63.1%
<$15,000 2012 **
<$15,000 2013 45.3% 35.9% 55.1%
$15,000 - $24,999 2011 52.2% 44.6% 59.6%
$15,000 - $24,999 2012 **
$15,000 - $24,999 2013 50.3% 42.8% 57.8%
$25,000 - $49,999 2011 55.7% 50.1% 61.2%
$25,000 - $49,999 2012 **
$25,000 - $49,999 2013 54.2% 48.9% 59.4%
$50,000 - $74,999 2011 59.3% 53.5% 54.9%
$50,000 - $74,999 2012 **
$50,000 - $74,999 2013 53.8% 48.3% 59.2%
$75,000+ 2011 62.7% 58.7% 66.5%
$75,000+ 2012 **
$75,000+ 2013 59.8% 56.1% 63.4%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.

Data Sources

BRFSS 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+) who reported getting the recommended amount of physical activity, by poverty threshold, all Alaskans, 2011-2020

::chart - missing::

HA: Poverty Threshold Year Percentage of Adults Lower Limit Upper Limit
Record Count: 17
Poor 2011 58.4% 47.9% 68.3%
Poor 2012 **
Poor 2013 44.5% 34.8% 54.5%
Near Poor 2011 45.9% 38.8% 53.2%
Near Poor 2012 **
Near Poor 2013 50.4% 44.1% 56.6%
Middle/High 2011 59.8% 56.7% 62.7%
Middle/High 2012 **
Middle/High 2013 57.7% 55.0% 60.3%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.   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).

Poverty thresholds computed using the BRFSS assume that householders are less than 65 years of age as the household composition cannot be determined with accuracy. 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 high 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]



Percentage of adults (18+) who reported getting the recommended amount of physical activity, by metropolitan/micropolitan statistical areas, all Alaskans, 2011-2020

::chart - missing::

HA: Metro/Micropolitan Area Year Percentage of Adults Lower Limit Upper Limit
Record Count: 29
Anchorage 2011 57.4% 52.7% 62.0%
Anchorage 2012 **
Anchorage 2013 54.2% 49.8% 58.6%
Fairbanks North Star MSA 2011 55.2% 49.7% 60.6%
Fairbanks North Star MSA 2012 **
Fairbanks North Star MSA 2013 53.8% 48.9% 58.7%
Jeneau MicroSA 2011 61.9% 52.9% 70.1%
Jeneau MicroSA 2012 **
Jeneau MicroSA 2013 66.7% 59.3% 73.3%
Ketchikan Gateway MicroSA 2011 54.8% 41.0% 67.9%
Ketchikan Gateway MicroSA 2012 **
Ketchikan Gateway MicroSA 2013 59.8% 48.0% 70.5%
Kodiak Island MicroSA 2011 61.9% 49.0% 73.3%
Kodiak Island MicroSA 2012 **
Kodiak Island MicroSA 2013 55.0% 41.7% 67.7%
Matanuska-Susitna 2011 55.9% 50.4% 61.2%
Matanuska-Susitna 2012 **
Matanuska-Susitna 2013 55.6% 48.7% 62.3%
Rural (non-Metro/MicroSA) 2011 58.9% 55.2% 62.5%
Rural (non-Metro/MicroSA) 2012 **
Rural (non-Metro/MicroSA) 2013 54.4% 50.9% 57.9%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.



Percentage of adults (18+) who reported getting the recommended amount of physical activity, by Alaska Public Health Regions, all Alaskans, 2011-2020

::chart - missing::

HA: Geog PHR Year Percentage of Adults Lower Limit Upper Limit
Record Count: 26
Anchorage-Mat-Su 2011 57.0% 53.2% 60.8%
Anchorage-Mat-Su 2012 **
Anchorage-Mat-Su 2013 54.5% 50.7% 58.2%
Gulf Coast 2011 59.6% 54.2% 64.7%
Gulf Coast 2012 **
Gulf Coast 2013 52.5% 47.7% 57.3%
Interior 2011 55.8% 50.8% 60.6%
Interior 2012 **
Interior 2013 55.1% 50.5% 59.5%
Northern 2011 57.9% 47.2% 68.0%
Northern 2012 **
Northern 2013 49.9% 39.4% 60.5%
Southeast 2011 60.7% 55.1% 66.1%
Southeast 2012 **
Southeast 2013 62.5% 57.8% 67.1%
Southwest 2011 55.2% 46.3% 63.8%
Southwest 2012 **
Southwest 2013 53.4% 44.3% 62.3%
Healthy Alaskans Goal 2013 61.0%
Healthy Alaskans Goal 2014 61.0%
Healthy Alaskans Goal 2015 61.0%
Healthy Alaskans Goal 2016 61.0%
Healthy Alaskans Goal 2017 61.0%
Healthy Alaskans Goal 2018 61.0%
Healthy Alaskans Goal 2019 61.0%
Healthy Alaskans Goal 2020 61.0%

Data Notes

Healthy Alaskans 2020 Target: 61%

** Data Not Available

Alaska data were obtained from the Standard AK BRFSS from 2011 onward.

Data Sources

BRFSS 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

CDC's Division of Nutrition and Physical Activity: www.cdc.gov/nccdphp/dnpa

The National Heart, Lung, and Blood Institute has extensive resources on physical activity for patients, health care providers, and general consumers: http://www.nhlbi.nih.gov

The University of South Carolina's Prevention Research Centers provide resources and information about physical activity to researchers, public health practitioners, and others who are interested in promoting physical activity in their communities: http://prevention.sph.sc.edu/index.htm

More information on the Behavioral Risk Factor Surveillance System may be found on the website of the Centers for Disease Control and Prevention - http://www.cdc.gov/brfss/

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 03/24/2015, Published on 03/24/2015
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 Mon, 04 May 2015 2:00:10 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, 24 Mar 2015 12:37:28 AKDT