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State of Alaska

Complete Health Indicator Report of Adverse Childhood Experiences: Mental Illness in Household

Definition

Percentage of adults 18 years of age and older who responded "Yes" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the question: "Did you live with anyone who was depressed, mentally ill, or suicidal?"

Numerator

Weighted number of adults (18+) who responded "Yes" on the BRFSS to the question: "Did you live with anyone who was depressed, mentally ill, or suicidal?"

Denominator

Weighted number of adults (18+) who responded to the household mental illness question on the BRFSS, excluding those with missing or "Refused" responses. Those who responded "Don't know/Not sure" are defined as a negative response.

Data Interpretation Issues

The preamble to each of the Adverse Childhood Experiences (ACEs) question was: "I'd like to ask you some questions about events that happened during your childhood. This information will allow us to better understand problems that may occur early in life, and may help others in the future. This is a sensitive topic and some people may feel uncomfortable with these questions. At the end of this section, I will give you a phone number for an organization that can provide information and referral for these issues. Please keep in mind that you can ask me to skip any question you do not want to answer. All questions refer to the time period before you were 18 years of age. Now, looking back before you were 18 years of age ---" While the individual adverse childhood experience (ACE) an Alaska adult may have experienced is important, the strength of the research lies in the often multiple ACEs an individual has during childhood: "The ACE score, a total sum of the different categories of ACEs reported by participants, is used to assess cumulative childhood stress. Study findings repeatedly reveal a graded dose-response relationship between ACEs and negative health and well-being outcomes across the life course...Dose response describes the changes in an outcome (e.g., alcoholism) associated with differing levels of exposure (or doses) to a stressor (e.g., ACEs). A graded dose-response means that as the dose of the stressor increases the intensity of the outcome also increases."^1^ The ACEs question on mental illness in the household was asked in 2013 through 2015.[[br]] [[br]] ---- {{class .SmallerFont 1. U.S. Centers for Disease Control and Prevention (CDC). Adverse Childhood Experiences (ACE) Study. [http://www.cdc.gov/violenceprevention/acestudy/index.html]. Updated April 1, 2016. Accessed April 26, 2016.}}

Why Is This Important?

Mental health problems are common in the United States - about one in four adults suffer from a diagnosable mental disorder in a given year.^2^ Mental illness can cause disturbances and inability to cope with life's ordinary demands. Consequently, it can have a significant impact on family stability. Family members often become preoccupied with managing the illness, and much of the family's attention is directed to that person. Children may take on an inappropriate level of responsibility in caring for themselves and managing the household. Parents with mental health problems may struggle to manage their parenting role. When parents are depressed, for example, they may become less emotionally involved and invested in their children's daily lives. Children whose parents have a mental illness are at risk of developing social, emotional, and behavioral problems.^3^ As a child experiences living with someone who is depressed, mentally ill, or suicidal, the impacts of overwhelming stress on the brain continue into adulthood and can have generational impacts. As Alaska children are exposed to household mental illness, they may find negative ways to cope with their damaged stress responses. When adults start families of their own, these behaviors can become ACEs for another generation.^4^ The Adverse Childhood Experiences (ACE) Study, a collaborative between the Centers for Disease Control and Prevention and Kaiser Permanente's Health Appraisal Clinic in San Diego, assessed associations between childhood maltreatment and later-life health and well-being.^1^ It is critical to understand how some of the worst health and social problems can arise as a consequence of adverse childhood experiences. Sixteen of the Healthy Alaskans 2020 measures have been shown through peer-reviewed journal articles to be negatively impacted by adverse childhood experiences. Alaska takes on the burden of approximately $82 million in costs (e.g., health care costs, welfare costs, special education costs) each year due to nonfatal child maltreatment. Realizing these connections is likely to improve efforts towards prevention and recovery.^5^[[br]] [[br]] ---- {{class .SmallerFont 1. U.S. Centers for Disease Control and Prevention (CDC). Adverse Childhood Experiences (ACE) Study. [http://www.cdc.gov/violenceprevention/acestudy/index.html]. Updated April 1, 2016. Accessed April 26, 2016. 2. Duckworth, K. Mental illness facts and numbers. National Alliance on Mental Illness. [http://www2.nami.org/factsheets/mentalillness_factsheet.pdf]. Published March 2013. Accessed April 26, 2016. 3. Social Work Today. Reaching out to children of parents with mental illness. [http://www.socialworktoday.com/archive/septoct2007p26.shtml]. Accessed April 26, 2016. 4. Alaska Department of Health and Social Services. Alaska Mental Health Board and the Advisory Board on Alcoholism and Drug Abuse. Investing in prevention: working together in early childhood for healthy Alaskan children, families, and communities 2015. [http://dhss.alaska.gov/abada/ace-ak/Documents/State_Interagency_Prevention_2015.pdf]. Accessed April 26, 2016. 5. Sidmore P. Alaska Department of Health and Social Services. Alaska Mental Health Board and the Advisory Board on Alcoholism and Drug Abuse. Economic costs of adverse childhood experiences in Alaska. [http://dhss.alaska.gov/abada/aceak/ Documents/ACEsEconomicCosts-AK.pdf]. Accessed April 26, 2016. }}

How Are We Doing?

In 2013-2015 combined, 21.4% of Alaska adults reported having experienced living with a household member who was depressed, mentally ill, or suicidal. There were significant differences in the reporting of experiencing mental illness in the household between males (17.7%) and females (25.4%). The percentage of Alaska adults reporting exposure to mental illness in the household while growing up was lower in the older age groupings. Asians (6.8%) and Native Hawaiian and other Pacific Islanders (8.3%) were significantly less likely to report exposure than were Alaskans of other races. Individuals who were married (17.7%) or widowed (10.0%) reported less exposure than those who were divorced/separated (22.1%), never married (27.9%), or were living with a partner (35.4%). Those unable to work reported exposure at 34.2%, significantly higher than those who were employed (21.0%) or not in the work force (18.9%). No significant differences were seen based upon income or poverty levels. Alaska Native adults living in road-connected areas of the state reported equal or higher percentages of exposure to household mental illness while growing up as those residing in rural settings. Rates of mental illness in household members during childhood from the BRFSS are initially presented for all Alaskans and Alaska Native people for the combined 3-year period from 2013-2015. Subsequent analyses were conducted for demographic subpopulations (i.e., sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status). Crosstabulations were also conducted for 3-year averages by body mass index, current smoking, sexual orientation, and disability. Significant differences were evident in contrasts by current smoking, sexual orientation, and disability. Rates of mental illness in household members during childhood by regions of Alaska are presented for all Alaskans and Alaska Native people for the 3-year average of surveys conducted between 2013-2015: 1) 7 Alaska Public Health Regions, 2) 5 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) 29 boroughs and census areas, and 5) 12 tribal health organization regions.

How Do We Compare With the U.S.?

There are no national statistics on ACEs available. However in 2009, the CDC released a study comparing ACEs data from five states (Arkansas, Louisiana, Tennessee, New Mexico, Washington) that used the BRFSS ACEs module. When compared to the five states, Alaska reported the second highest rate of adults who had experienced living with someone with a mental illness.^1^ Compared to data from adults from the 10 states (i.e., Hawaii, Maine, Nebraska, Nevada, Ohio, Pennsylvania, Utah, Vermont, Washington, and Wisconsin) that implemented the ACEs module in 2010, the rate of Alaskan adults reporting experiencing household mental illness was lower.^6^[[br]] [[br]] ---- {{class .SmallerFont 1. U.S. Centers for Disease Control and Prevention (CDC). Adverse Childhood Experiences (ACE) Study. [http://www.cdc.gov/violenceprevention/acestudy/index.html]. Updated April 1, 2016. Accessed April 26, 2016. 6. U.S. Centers for Disease Control and Prevention (CDC). Adverse childhood experiences reported by adults - five states, 2009. MMWR 2010;59(49):1609-13. }}

What Is Being Done?

The [http://hss.state.ak.us/ha2020/ Healthy Alaskans 2020] initiative lists "Reduce the number of Alaskans experiencing poor mental health" and "Increase the proportion of Alaska youth with family and/or social support" as leading health priorities for Alaska. The initiative compiles evidence-based health improvement strategies, actions and key partners to help support achievement of improving these priorities and reaching target health goals.^7^ Alaska also has many groups working on preventing childhood trauma and easing the effects of damage already done. Here are a few examples (as of early 2015):^8^ The Division of Behavioral Health has promoted trauma-informed care for several years. Efforts include development of "Trauma 101" and "Trauma 201" curriculum for behavioral health providers, used around the state. [http://tundrapeace.org/programs/taav/ Teens Acting Against Violence (TAAV)] is a violence-prevention and youth empowerment program at the [http://tundrapeace.org/ Tundra Women's Coalition] for teenagers living in Bethel. Participation is voluntary and open for any interested teens age 12-18.^9^[[br]] [[br]] ---- {{class .SmallerFont 7. Alaska Department of Health and Social Services. Healthy Alaskans 2020. [http://hss.state.ak.us/ha2020/]. Accessed April 26, 2016. 8. Alaska Department of Health and Social Services. Alaska Mental Health Board and the Advisory Board on Alcoholism and Drug Abuse. Adverse childhood experiences - overcoming ACEs in Alaska. [http://dhss.alaska.gov/abada/ace-ak/Documents/ACEsReportAlaska.pdf]. Published January 2015. Accessed April 26, 2016. 9. Teens Acting Against Violence. Tundra Women's Coalition - Crisis Line - 1-800-478-7799 or 907-543-3456 website. [http://tundrapeace.org/programs/taav/]. Accessed April 26, 2016. }}

Evidence-based Practices

The [http://hss.state.ak.us/ha2020/ Healthy Alaskans 2020] initiative developed strategies by content experts to increase youth with family and/or social support. Their strategies were based on evidence-based practices and include: 1. A positive school climate promotes childhood and youth development and fosters connectedness. School connectedness is the belief by students that adults and peers in the school care about their learning as well as about them as individuals. Relationships are essential to adolescent health. Connections with parents, peers, and other adults/mentors support and influence youth development. 2. Research shows that healthy youth development strategies that provide all youth with the supports needed to become successful and competent adults are promising approaches for preventing or reducing a wide range of adolescent health-risk behaviors. Positive Youth Development (PYD) programs promote mental and emotional wellbeing by providing the supports and opportunities youth need to successfully transition to adulthood. PYD programs build on young persons' strengths and talents to help them gain the knowledge and skills they need to become healthy and productive adults. PYD programs are most effective when implemented by entire communities with meaningful youth participation.^7^ Recovering from trauma is a challenging process. Building resiliency and having a supportive adult in your life can help with recovery. Positive experiences - such as exposure to environments rich in a range of developmentally appropriate opportunities for social play and exploration - can compensate for and even reverse the negative consequences of stress Efforts during childhood are essential because over time, some stress-induced detriments are increasingly resistant to reversal. Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment approach shown to help children, adolescents, and their caregivers overcome trauma-related difficulties. It is designed to reduce negative emotional and behavioral responses following traumatic events. The treatment - based on learning and cognitive theories - addresses distorted beliefs and attributions related to the abuse and provides a supportive environment in which children are encouraged to talk about their traumatic experience. TF-CBT also helps parents who were not abusive to cope effectively with their own emotional distress and develop skills that support their children.^10^ ACEs are best addressed through a coordinated effort to implement prevention programs across multiple settings and populations. Research indicates the majority of health and social challenges are interconnected and often share the same root causes. The following steps need to be taken to address these root causes: 1. Support quality early childhood programs. 2. Ensure access to health care including behavioral health care. 3. Strengthen capacity for social emotional learning throughout Alaska's schools. 4. Maintain and expand prevention efforts that have proven to be effective.^4^ The [http://www.cssp.org/ Center for the Study of Social Policy] spent two years researching and identifying five protective factors that prevent child abuse and neglect. These are: parental resilience, social connections, concrete support in times of need, knowledge of parenting and child development, and social and emotional competence of children. Research studies support the common-sense notion that when these Protective Factors are well established in a family, the likelihood of child abuse and neglect diminishes. Research shows that these Protective Factors are also "promotive" factors that build family strengths and a family environment that promotes optimal child and youth development.^11^[[br]] [[br]] ---- {{class .SmallerFont See the "Resources and References" page for references. }}


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 adults (18+) who experienced household mental illness, crude rate, by all Alaskans and Alaska Natives, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
All Alaskans21.4%20.2%22.7%2,15211,242
Alaska Native people22.6%19.8%25.7%3831,952

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by sex, all Alaskans, 2013-2015 (3-year average)

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confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Males17.7%16.1%19.4%7725,101
Females25.4%23.6%27.3%1,3806,141

Data Notes

The sex of the respondent is only asked if necessary.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by sex, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 5
18-2432.8%28.0%38.0%195677
25-3428.1%25.0%31.6%3901,414
35-4423.7%20.6%27.1%3931,647
45-6417.5%16.0%19.0%9054,915
65+9.6%8.1%11.4%2632,498

Data Notes

Respondents are asked, "What is your age?, which is coded in years. Responses of Refused are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by race/ethnicity, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 7
Alaska Native (any mention)22.6%19.8%25.7%3831,952
Asian (non-Hispanic)6.8%3.1%14.2%15203
Black (non-Hispanic)23.5%15.4%34.1%26147
Native Hawaiian/Other Pacific Islander (non-Hispanic)8.3%2.6%23.6%457
White (non-Hispanic)22.4%21.0%23.9%1,6188,333
Multiracial/Other (non-Hisp.)30.0%16.8%47.7%1768
Hispanic (alone or multi)21.9%15.8%29.5%61281

Data Notes

Race/ethnicity is determined by responses to three questions: [[br]] 1) "Are you Hispanic, Latino/a, or Spanish origin?" "If yes, are you...?" One or more categories may be selected from categories of (1) "Mexican, Mexican American, Chicano/a"; (2) "Puerto Rican"; (3) "Cuban"; (4) "Another Hispanic, Latino/a, or Spanish origin".[[br]] 2) "Which one or more of the following would you say is your race?" Response categories consist of "White", "Black or African American", "American Indian or Alaska Native", "Asian" (with subcategories of Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or Other Asian), "Pacific Islander" (with subcategories of Native Hawaiian, Guamanian or Chamorro, Samoan, or Other Pacific Islander), Other, or No additional choices. [[br]] 3) If more than one response to race, then "Which one of these groups would you say best represents your race?" with choices from the list enumerated above. Responses of Don't Know/Not Sure or Refused are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by ethnicity, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Hispanic/Latino23.7%17.7%31.0%75324
Non-Hispanic/Latino21.4%20.1%22.7%2,05310,787

Data Notes

Ethnicity is defined independent of race. It is based upon responses to the question, "Are you Hispanic, Latino/a, or Spanish origin?" Responses of "Don't Know/Not Sure" or "Refused" are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by marital status, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 5
Married17.7%16.4%19.1%1,0806,172
Widowed10.0%7.6%13.1%108905
Divorced/Separated22.1%19.2%25.3%4011,865
Never Married27.9%24.6%31.4%4071,758
Living with a Partner35.4%29.1%42.3%146463

Data Notes

Marital status is determined by the question, "Are you ...?" with responses of "Married", 'Divorced", "Widowed", "Separated", "Never married," or "A member of an unmarried couple". Responses of "Refused" are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by education, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 4
Less than High School23.0%17.7%29.4%91540
High School Graduate or GED16.0%14.1%18.2%3942,630
Some College or Tech. School20.5%18.4%22.6%6173,096
College Graduate21.4%19.6%23.3%8504,235

Data Notes

Education is based upon education completed by or after 25 years of age. Individuals less than 25 years of age are excluded. Education is assessed by responses to the question: "What is the highest grade or year of school you completed?" Responses are "Never attended school or only attended kindergarten", "Grades 1 through 8 (Elementary)", "Grades 9 through 11 (Some high school)", "Grade 12 (High School Graduate)", "College 1 year to 3 years (Some college or technical school)", "College 4 years or more (College graduate)", or "Refused". Refusals are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by employment status, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 4
Employed21.0%19.5%22.6%1,3286,655
Unemployed27.0%22.2%32.4%169715
Not in Work Force18.9%16.5%21.6%4753,218
Unable to Work34.2%27.7%41.4%167547

Data Notes

Employment status is assessed by the question: "Are you currently ...?" with responses of "Employed for wages", "Self-employed", "Out of work for 1 year or more", "Out of work for less than 1 year", "A Homemaker", "A Student", "Retired", "Unable to work" or "Refused". Refusals are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by income, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 5
<$15,00025.0%20.2%30.4%196879
$15,000-$24,99923.8%20.0%28.0%2541,227
$25,000-$49,00023.4%20.4%26.7%4032,150
$50,000-$74,00022.1%19.4%25.0%3571,767
$75,000+19.8%18.0%21.8%7974,236

Data Notes

Income is measure by the question: "Is your annual household income from all sources ---" with categories of "Less than $10,000", "Less than $15,000", "less than $20,000", "less than $25,000", "less than $35,000", "less than $50,000", "less than $75,000", "$75,000 or more", and "Don't know / Not sure" or "Refused". Responses of "Don't know / Not sure" or "Refused" are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by poverty threshold, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Poverty thresholds are intended for use as a statistical yardstick, not as a complete description of what people and families need to live. Poverty thresholds are the dollar amounts assigned by the U.S. Census Bureau to determine poverty status. Poverty thresholds are assigned based upon the size of the family and the ages of the members (i.e., adults versus children). The same thresholds are used throughout the United States. Poverty thresholds were originally derived in the 1963-1964 using U.S. Department of Agriculture food budgets designed for families under economic stress and data about what proportion of their income families spent on food. The thresholds are updated annually for inflation using the Consumer Price Index for All Urban Consumers (CPI-U). How the Census Bureau Measures Poverty - U.S. Census Bureau [https://www.census.gov/hhes/www/poverty/about/overview/measure.html]
Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 3
Poor23.9%18.7%30.1%154754
Near Poor22.8%19.6%26.4%2961,382
Middle/High20.3%18.9%21.7%1,3547,210

Data Notes

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

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by body mass index, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Weight CategoryPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 3
Neither Overweight nor Obese22.5%20.3%24.9%6833,551
Overweight19.9%17.9%22.0%7143,974
Obese21.8%19.7%24.1%6703,269

Data Notes

Body Mass Index (BMI) is computed based upon responses to the questions, "About how much do you weight without shoes?" and "About how tall are you without shoes?" Responses of "Don't know / Not sure" or "Refused" to either questions are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by current smoking, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Not current smoker19.8%18.4%21.1%1,6469,137
Current smoker27.8%24.8%31.1%4932,042

Data Notes

Current smoking is assessed using two questions: "Have you smoked at least 100 cigarettes in your entire life?" and, if "Yes", "Do you now smoke cigarettes every day, some days, or not at all?" Current smokers are defined as those who have smoked at least 100 cigarettes and who now smoke every day or some days. Non-current smokers are those who have either never smoke 100 cigarettes or whom now smoke cigarettes not at all. Responses of "Don't know / Not sure" or "Refused" to either question are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by sexual orientation, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Heterosexual20.9%19.7%22.2%1,97010,550
Gay, Lesbian, or Bisexual39.8%32.5%47.5%120314

Data Notes

Sexual orientation is assessed by the question: "Now I'm going to ask you a question about sexual orientation. Do you think of yourself as A. Gay or lesbian, B. Straight, that is, not lesbian or gay, C. Bisexual, or D. something else?" Responses of "Straight, that is not lesbian or gay" are contrasted with the combined responses to "Gay or lesbian" and "Bisexual". Responses of "Something else", "Don't Know / Not sure", or "Refused" are excluded.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by disability, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Disability Present32.7%29.3%36.3%5712,013
Disability Absent19.0%17.7%20.4%1,5509,089

Data Notes

Disability is assessed using responses from 5 questions: 1) "Are you blind or do you have serious difficulty seeing, even when wearing glasses?"; 2) Because of physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?"; 3) "Do you have a serious difficulty walking or climbing stairs?"; 4) "Do you have difficulty dressing or bathing?"; and 5) "Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping?" A "Yes" response to one or more of the questions when all questions have valid answers is used to classify the respondent as having a disability. Responses of "No" to all 5 questions denotes the absence of a disability. Responses of "Don't know / Not sure" or "Refused" to one or more questions result in the survey being excluded from analysis on disability status.

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by Alaska Public Health Regions, all Alaskans and Alaska Natives, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 14
All AlaskansAnchorage23.5%21.0%26.1%4722,221
All AlaskansGulf Coast19.2%16.8%21.9%3201,711
All AlaskansInterior21.8%19.4%24.4%4282,362
All AlaskansMat-Su19.5%16.9%22.5%3181,652
All AlaskansNorthern16.7%12.9%21.3%96480
All AlaskansSoutheast21.4%18.9%24.1%3451,710
All AlaskansSouthwest16.0%12.8%19.9%1731,106
Alaska Native peopleAnchorage26.3%19.4%34.5%59220
Alaska Native peopleGulf Coast24.4%16.8%34.2%38168
Alaska Native peopleInterior24.1%18.1%31.4%64307
Alaska Native peopleMat-Su26.7%16.5%40.1%37140
Alaska Native peopleNorthern16.7%11.9%22.8%51276
Alaska Native peopleSoutheast24.6%18.3%32.2%52244
Alaska Native peopleSouthwest15.8%11.8%20.8%82597

Data Notes

Geographic descriptions of the public health regions can be found at: [http://dhss.alaska.gov/dph/InfoCenter/Pages/ia/brfss/geo_phr.aspx].

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by metropolitan/micropolitan statistical areas, all Alaskans and Alaska Natives, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 10
All AlaskansAnchorage MSA22.5%20.5%24.6%7903,873
All AlaskansFairbanks North Star MSA22.6%19.9%25.6%3251,729
All AlaskansJuneau MicroSA23.6%19.7%28.0%165734
All AlaskansKetchikan Gateway MicroSA20.9%15.5%27.4%57309
All AlaskansRural (non-Metro/MicroSA)18.2%16.7%19.8%8154,597
Alaska Native peopleAnchorage MSA26.4%20.5%33.3%96360
Alaska Native peopleFairbanks North Star MSA32.2%23.3%42.6%42147
Alaska Native peopleJuneau MicroSA30.2%19.1%44.3%1975
Alaska Native peopleKetchikan Gateway MicroSA**45
Alaska Native peopleRural (non-Metro/MicroSA)17.1%14.5%20.1%2161,325

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator. Geographic descriptions of the metropolitan and micropolitan statistical areas can be found at: [http://dhss.alaska.gov/dph/InfoCenter/Pages/ia/brfss/geo_mmsa.aspx].

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by behavioral health areas, all Alaskans and Alaska Natives, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 20
All AlaskansAnchorage Muncipality23.5%21.0%26.1%4722,221
All AlaskansFairbanks North Star Borough22.6%19.8%25.5%3261,736
All AlaskansCity and Borough of Juneau23.6%19.7%28.0%165734
All AlaskansKenai Peninsula Borough20.2%17.4%23.4%2361,215
All AlaskansMatanuska-Susitna Borough19.5%16.9%22.5%3181,652
All AlaskansNorthwest Region16.7%12.9%21.3%96480
All AlaskansOther Interior Region18.3%14.8%22.3%148876
All AlaskansOther Southeast Region19.5%16.5%22.9%180976
All AlaskansY-K Delta Region16.4%11.9%22.2%75502
All AlaskansSouthwest Region15.7%12.0%20.3%136850
Alaska Native peopleAnchorage Muncipality26.3%19.4%34.5%59220
Alaska Native peopleFairbanks North Star Borough31.9%23.1%42.2%42148
Alaska Native peopleCity and Borough of Juneau30.2%19.1%44.3%1975
Alaska Native peopleKenai Peninsula Borough28.3%19.1%39.8%28101
Alaska Native peopleMatanuska-Susitna Borough26.7%16.5%40.1%37140
Alaska Native peopleNorthwest Region16.7%11.9%22.8%51276
Alaska Native peopleOther Interior Region12.0%7.3%19.2%25189
Alaska Native peopleOther Southeast Region22.0%14.9%31.3%33169
Alaska Native peopleY-K Delta Region16.7%11.6%23.3%48324
Alaska Native peopleSouthwest Region16.7%10.4%25.8%41310

Data Notes

Geographic descriptions of the behavioral health systems assessment reporting regions can be found at: [http://dhss.alaska.gov/dph/InfoCenter/Pages/ia/brfss/geo_bhs.aspx].

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by boroughs and census areas, all Alaskans and Alaska Natives, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 58
All AlaskansAleutians East Borough11.0%5.1%22.0%1393
All AlaskansAleutians West CA14.4%7.7%25.3%35148
All AlaskansAnchorage Municipality23.5%21.0%26.1%4722,221
All AlaskansBethel CA17.3%11.8%24.7%54373
All AlaskansBristol Bay Borough14.0%6.1%29.0%883
All AlaskansDenali Borough19.2%10.1%33.6%1699
All AlaskansDillingham CA22.5%13.9%34.4%32189
All AlaskansFairbanks North Star Borough22.6%19.8%25.5%3261,736
All AlaskansHaines Borough20.5%11.1%34.9%1590
All AlaskansHoonah-Angoon CA16.9%8.6%30.5%1057
All AlaskansJuneau City and Borough23.6%19.7%28.0%165734
All AlaskansKenai Peninsula Borough20.2%17.4%23.4%2361,215
All AlaskansKetchikan Gateway Borough20.9%15.5%27.4%57309
All AlaskansKodiak Island Borough15.7%9.9%24.1%38246
All AlaskansKusilvak CA14.6%8.1%24.7%21129
All AlaskansLake and Peninsula Borough11.4%3.8%29.9%1091
All AlaskansMatanuska-Susitna Borough19.5%16.9%22.5%3181,652
All AlaskansNome CA20.5%14.1%28.8%43215
All AlaskansNorth Slope Borough12.6%7.8%19.8%28122
All AlaskansNorthwest Arctic Borough15.7%9.5%25.0%25143
All AlaskansPetersburg Borough11.1%5.9%19.9%1297
All AlaskansPrince of Wales-Hyder CA23.0%15.2%33.2%29128
All AlaskansSitka City and Borough21.2%15.1%29.0%46205
All AlaskansSkagway Municipality**21
All AlaskansSoutheast Fairbanks CA18.7%12.8%26.5%48292
All AlaskansValdez-Cordova CA18.1%12.4%25.7%46250
All AlaskansWrangell City and Borough**47
All AlaskansYakutat City and Borough**22
All AlaskansYukon-Koyukuk CA17.3%11.6%25.0%38235
Alaska Native peopleAleutians East Borough**47
Alaska Native peopleAleutians West CA**45
Alaska Native peopleAnchorage Municipality26.3%19.4%34.5%59220
Alaska Native peopleBethel CA16.5%10.4%25.3%29213
Alaska Native peopleBristol Bay Borough**35
Alaska Native peopleDenali Borough**3
Alaska Native peopleDillingham CA24.6%13.0%41.6%1597
Alaska Native peopleFairbanks North Star Borough31.9%23.1%42.2%42148
Alaska Native peopleHaines Borough**12
Alaska Native peopleHoonah-Angoon CA**15
Alaska Native peopleJuneau City and Borough30.2%19.1%44.3%1975
Alaska Native peopleKenai Peninsula Borough28.3%19.1%39.8%28101
Alaska Native peopleKetchikan Gateway Borough**45
Alaska Native peopleKodiak Island Borough**37
Alaska Native peopleKusilvak CA16.9%9.4%28.5%19111
Alaska Native peopleLake and Peninsula Borough**49
Alaska Native peopleMatanuska-Susitna Borough26.7%16.5%40.1%37140
Alaska Native peopleNome CA20.0%12.3%30.9%25120
Alaska Native peopleNorth Slope Borough11.7%5.5%23.0%1061
Alaska Native peopleNorthwest Arctic Borough16.1%8.8%27.5%1695
Alaska Native peoplePetersburg Borough**9
Alaska Native peoplePrince of Wales-Hyder CA**39
Alaska Native peopleSitka City and Borough**29
Alaska Native peopleSkagway Municipality**1
Alaska Native peopleSoutheast Fairbanks CA**35
Alaska Native peopleValdez-Cordova CA**30
Alaska Native peopleWrangell City and Borough**9
Alaska Native peopleYakutat City and Borough**10
Alaska Native peopleYukon-Koyukuk CA13.3%7.0%23.8%17121

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator. Geographic descriptions of boroughs and census areas can be found at: [http://dhss.alaska.gov/dph/InfoCenter/Pages/ia/brfss/geo_bca.aspx].

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion


Percentage of adults (18+) who experienced household mental illness, crude rate, by tribal health regions, all Alaskans and Alaska Natives, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 24
All AlaskansAleutians and Pribilofs13.2%8.1%20.8%48241
All AlaskansAnchorage/Mat-Su22.5%20.5%24.6%7903,873
All AlaskansArctic Slope12.2%7.3%19.6%25111
All AlaskansBristol Bay17.3%11.5%25.3%50369
All AlaskansCopper R/Prince William Snd.18.3%12.6%25.7%48260
All AlaskansInterior21.7%19.3%24.3%4242,346
All AlaskansKenai Peninsula20.2%17.4%23.4%2361,215
All AlaskansKodiak Area15.7%9.9%24.1%38246
All AlaskansNorthwest Arctic15.8%9.7%24.8%27152
All AlaskansNorton Sound20.5%14.1%28.8%43215
All AlaskansSoutheast21.4%18.9%24.1%3451,710
All AlaskansYukon-Kuskokwim17.5%12.8%23.3%78504
Alaska Native peopleAleutians and Pribilofs9.2%4.4%18.1%1492
Alaska Native peopleAnchorage/Mat-Su26.4%20.5%33.3%96360
Alaska Native peopleArctic Slope12.1%5.6%24.2%953
Alaska Native peopleBristol Bay16.6%9.1%28.5%20185
Alaska Native peopleCopper R/Prince William Snd.**32
Alaska Native peopleInterior24.2%18.0%31.5%62300
Alaska Native peopleKenai Peninsula28.3%19.1%39.8%28101
Alaska Native peopleKodiak Area**37
Alaska Native peopleNorthwest Arctic15.8%8.8%26.8%17102
Alaska Native peopleNorton Sound20.0%12.3%30.9%25120
Alaska Native peopleSoutheast24.6%18.3%32.2%52244
Alaska Native peopleYukon-Kuskokwim17.1%12.1%23.8%50326

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator. Geographic descriptions of the tribal health organization regions can be found at: [http://dhss.alaska.gov/dph/InfoCenter/Pages/ia/brfss/geo_thr.aspx].

Data Source

Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion

References and Community Resources

'''References:''' 1. U.S. Centers for Disease Control and Prevention (CDC). Adverse Childhood Experiences (ACE) Study. [http://www.cdc.gov/violenceprevention/acestudy/index.html]. Updated April 1, 2016. Accessed April 26, 2016. 2. Duckworth, K. Mental illness facts and numbers. National Alliance on Mental Illness. [http://www2.nami.org/factsheets/mentalillness_factsheet.pdf]. Published March 2013. Accessed April 26, 2016. 3. Social Work Today. Reaching out to children of parents with mental illness. [http://www.socialworktoday.com/archive/septoct2007p26.shtml]. Accessed April 26, 2016. 4. Alaska Department of Health and Social Services. Alaska Mental Health Board and the Advisory Board on Alcoholism and Drug Abuse. Investing in prevention: working together in early childhood for healthy Alaskan children, families, and communities 2015. [http://dhss.alaska.gov/abada/ace-ak/Documents/State_Interagency_Prevention_2015.pdf]. Accessed April 26, 2016. 5. Sidmore P. Alaska Department of Health and Social Services. Alaska Mental Health Board and the Advisory Board on Alcoholism and Drug Abuse. Economic costs of adverse childhood experiences in Alaska. [http://dhss.alaska.gov/abada/aceak/ Documents/ACEsEconomicCosts-AK.pdf]. Accessed April 26, 2016. 6. U.S. Centers for Disease Control and Prevention (CDC). Adverse childhood experiences reported by adults - five states, 2009. MMWR 2010;59(49):1609-13. 7. Alaska Department of Health and Social Services. Healthy Alaskans 2020. [http://hss.state.ak.us/ha2020/]. Accessed April 26, 2016. 8. Alaska Department of Health and Social Services. Alaska Mental Health Board and the Advisory Board on Alcoholism and Drug Abuse. Adverse childhood experiences - overcoming ACEs in Alaska. [http://dhss.alaska.gov/abada/ace-ak/Documents/ACEsReportAlaska.pdf]. Published January 2015. Accessed April 26, 2016. 9. Teens Acting Against Violence. Tundra Women's Coalition - Crisis Line - 1-800-478-7799 or 907-543-3456 website. [http://tundrapeace.org/programs/taav/]. Accessed April 26, 2016. 10. Child Welfare Information Gateway. Trauma-focused cognitive behavioral therapy for children affected by sexual abuse or trauma. [https://www.childwelfare.gov/pubPDFs/trauma.pdf]. Accessed April 26, 2016. 11. Alaska Department of Health and Social Services. Office of Children's Services. Strengthening families. [http://dhss.alaska.gov/ocs/Pages/families/default.aspx]. Accessed April 26, 2016.

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 12/14/2016, Published on 12/14/2016
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 Sun, 18 August 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: Wed, 14 Dec 2016 15:35:54 AKST
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 Sun, 18 August 2019 23:52:12 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: Wed, 14 Dec 2016 15:35:54 AKST