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State of Alaska

Complete Health Indicator Report of Adverse Childhood Experiences: Emotional Neglect

Definition

Percentage of adults 18 years of age and older who responded "Once" or "More than once" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the question: "How often did you feel that your parents or adults in your home did not love you or appreciate you?"

Numerator

Weighted number of adults (18+) who responded "Once" or "More than once" on the BRFSS to the question: "How often did you feel that your parents or adults in your home did not love you or appreciate you?"

Denominator

Weighted number of adults (18+) who responded to the emotional neglect 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 for that ACE category.

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 emotional neglect was asked in 2014 and 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?

The impacts of overwhelming stress on the brain continue into adulthood and can have generational impacts. As Alaska children exposed to emotional neglect grow up, they may find negative ways to cope with their damaged stress responses. A study found that neglect can have severe, deleterious short- and long-term effects on children's cognitive, socio-emotional, and behavioral development. Relative to physically abused children, neglected children have more severe cognitive and academic deficits, social withdrawal and limited peer interactions, and internalizing problems.^2^ A study found that children's perceptions of emotional neglect and control are associated with over twice the odds of psychiatric disorder at age 15.^3^ Adverse Childhood Experiences (ACEs) are potent risk factors for involvement in domestic violence, alcohol dependence, and suicide attempts. If individuals abused as children start families of their own, they can perpetuate 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 [http://hss.state.ak.us/ha2020/ Healthy Alaskans 2020] leading health indicators 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. Recognizing the connections between ACEs and health outcomes and their associated costs 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. Hildyard K, Wolfe DA. Child neglect: developmental issues and outcomes. Child Abuse & Neglect 2002;26:679-95. 3. Young R, Lennie S, Minnis H. Children's perceptions of parental emotional neglect and control and psychopathology. Journal of Child Psychology and Psychiatry 2011;52(8):889-97. 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/ace-ak/Documents/ACEsEconomicCosts-AK.pdf]. Accessed April 26, 2016. }}

How Are We Doing?

In 2014-2015 combined, 15.8% of Alaska adults reported having experienced childhood emotional neglect. Female adults reported a significantly higher prevalence of 20.1% of experiencing childhood emotional neglect, while 11.7% of male adults reported similar exposure. Those adults who were divorced or separated reported significantly higher prevalence of childhood emotional neglect at 22.9% than adults who were married with exposures of 13.9%. Employment status was also associated with prevalence of emotional neglect: 14.2% of employed adults had been emotionally neglected but 31.4% of those unable to work reported exposure. The prevalence of emotional neglect was significantly lower in the Southwest region than in the Anchorage-Matanuska-Susitna region for both all Alaska adults (9.5% versus 16.3%) and Alaska Native adults (8.6% versus 21.3%). Rates of emotional neglect during childhood from the BRFSS are initially presented for all Alaskans and Alaska Native people for the combined 2-year period from 2014-2015. 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 2-year averages by body mass index, current smoking, sexual orientation, and disability. Significant differences were evident in these contrasts. Rates of childhood emotional neglect by regions of Alaska are presented for all Alaskans and Alaska Native people for the 2-year average of surveys conducted between 2014-2015: 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 emotional neglect available.

What Is Being Done?

The [http://hss.state.ak.us/ha2020/ Healthy Alaskans 2020] initiative developed strategies by content experts to reduce child maltreatment. Public health partners around the state are aligning work around these approaches adapted by Alaska's unique needs. Alaska strategies include: 1. Promote screening and monitoring for child abuse in primary care offices and public health clinics. 2. Use the [http://dhss.alaska.gov/ocs/Pages/families/default.aspx Strengthening Families Protective Factors] framework in family programs. 3. Expand home visiting programs. 4. Expand and strengthen quality early childhood programs. 5. Train providers on brain development, adverse childhood experiences (ACEs), and resiliency.^6^ Alaska 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):^7^ 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.^8^[[br]] [[br]] ---- {{class .SmallerFont 6. Alaska Department of Health and Social Services. Healthy Alaskans 2020. [http://hss.state.ak.us/ha2020/]. Accessed April 26, 2016. 7. 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. 8. 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

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.^9^ 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 been 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 pactors are also "promotive" factors that build family strengths and a family environment that promotes optimal child and youth development.^10^[[br]] [[br]] ---- {{class .SmallerFont 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. 9. 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. 10. 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. }}


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 emotional neglect, crude rate, by all Alaskans and Alaska Natives, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
All Alaskans15.8%14.5%17.2%1,1657,144
Alaska Native people16.5%13.8%19.7%2171,233

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 emotional neglect, crude rate, by sex, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Males11.7%10.2%13.4%3783,216
Females20.1%18.0%22.3%7873,928

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 emotional neglect, crude rate, by age, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 5
18-2414.9%10.7%20.4%57390
25-3415.8%12.5%19.7%136866
35-4416.5%13.5%19.9%1751,000
45-6417.0%15.2%19.1%5703,144
65+12.7%10.6%15.2%2221,682

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 emotional neglect, crude rate, by race/ethnicity, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 7
Alaska Native (any mention)16.5%13.8%19.7%2171,233
Asian (non-Hispanic)14.3%7.4%25.9%14128
Black (non-Hispanic)17.4%9.5%29.6%1589
Native Hawaiian/Other Pacific Islander (non-Hispanic)**30
White (non-Hispanic)15.8%14.3%17.3%8525,309
Multiracial/Other (non-Hisp.)**48
Hispanic (alone or multi)19.9%12.4%30.2%36175

Data Notes

** = Data not available. 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

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 emotional neglect, crude rate, by ethnicity, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Hispanic/Latino20.8%13.8%30.2%48205
Non-Hispanic/Latino15.5%14.2%16.9%1,0996,850

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 emotional neglect, crude rate, by marital status, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 5
Married13.9%12.4%15.5%5673,973
Widowed15.6%12.1%19.8%87583
Divorced/Separated22.9%19.5%26.6%2851,174
Never Married14.5%11.7%17.9%1691,081
Living with a Partner22.4%15.0%32.0%50282

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 emotional neglect, crude rate, by education, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 4
Less than High School18.2%12.8%25.2%68352
High School Graduate or GED15.7%13.1%18.8%2411,628
Some College or Tech. School16.0%14.0%18.5%3481,974
College Graduate15.0%13.2%17.1%4492,774

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 emotional neglect, crude rate, by employment status, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 4
Employed14.2%12.7%15.8%6654,194
Unemployed20.8%15.7%27.1%90423
Not in Work Force16.0%13.2%19.2%2962,116
Unable to Work31.4%24.8%39.0%107349

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 emotional neglect, crude rate, by income, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 5
<$15,00022.8%17.7%28.8%117538
$15,000-$24,99919.5%15.3%24.5%148762
$25,000-$49,00015.3%12.7%18.1%2251,345
$50,000-$74,00014.7%11.9%17.9%1721,078
$75,000+14.6%12.6%16.8%4252,761

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 emotional neglect, crude rate, by poverty threshold, all Alaskans, 2014-2015 (2-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
Poor18.0%12.9%24.4%79465
Near Poor18.6%15.0%22.8%151770
Middle/High14.8%13.4%16.4%6934,358

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 emotional neglect, crude rate, by body mass index, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Weight CategoryPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 3
Neither Overweight nor Obese13.0%11.0%15.3%3182,254
Overweight16.1%13.8%18.6%3952,489
Obese18.0%15.7%20.6%3932,093

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 emotional neglect, crude rate, by current smoking, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Not current smoker14.7%13.3%16.1%9045,869
Current smoker20.5%17.2%24.3%2541,235

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 emotional neglect, crude rate, by sexual orientation, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Heterosexual15.5%14.2%16.9%1,0836,704
Gay, Lesbian, or Bisexual25.9%18.2%35.4%48205

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 emotional neglect, crude rate, by disability, all Alaskans, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
Disability Present28.4%24.6%32.5%3671,280
Disability Absent13.2%11.9%14.7%7825,781

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 emotional neglect, crude rate, by Alaska Public Health Regions, all Alaskans and Alaska Natives, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 14
All AlaskansAnchorage16.3%13.8%19.2%2491,434
All AlaskansGulf Coast14.9%12.4%17.8%1661,065
All AlaskansInterior16.0%13.4%18.9%2281,496
All AlaskansMat-Su17.1%14.4%20.2%1971,090
All AlaskansNorthern13.4%8.9%19.8%48296
All AlaskansSoutheast16.0%13.4%19.0%1901,053
All AlaskansSouthwest9.5%7.0%12.7%87710
Alaska Native peopleAnchorage21.3%13.6%31.8%31128
Alaska Native peopleGulf Coast13.5%7.6%22.8%16103
Alaska Native peopleInterior17.2%11.7%24.5%39201
Alaska Native peopleMat-Su18.6%11.5%28.6%2499
Alaska Native peopleNorthern16.4%10.2%25.2%30165
Alaska Native peopleSoutheast20.5%13.8%29.3%36150
Alaska Native peopleSouthwest8.6%5.7%12.7%41387

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 emotional neglect, crude rate, by metropolitan/micropolitan statistical areas, all Alaskans and Alaska Natives, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 10
All AlaskansAnchorage MSA16.5%14.5%18.8%4462,524
All AlaskansFairbanks North Star MSA16.7%13.8%20.1%1731,084
All AlaskansJuneau MicroSA15.6%11.8%20.4%86454
All AlaskansKetchikan Gateway MicroSA20.7%14.2%29.1%39195
All AlaskansRural (non-Metro/MicroSA)13.4%11.8%15.1%4212,887
Alaska Native peopleAnchorage MSA20.7%14.3%28.9%55227
Alaska Native peopleFairbanks North Star MSA23.2%14.7%34.6%2598
Alaska Native peopleJuneau MicroSA**49
Alaska Native peopleKetchikan Gateway MicroSA**24
Alaska Native peopleRural (non-Metro/MicroSA)12.6%9.9%16.0%117835

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 emotional neglect, crude rate, by behavioral health areas, all Alaskans and Alaska Natives, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 20
All AlaskansAnchorage Muncipality16.3%13.8%19.2%2491,434
All AlaskansFairbanks North Star Borough16.6%13.7%20.0%1731,088
All AlaskansCity and Borough of Juneau15.6%11.8%20.4%86454
All AlaskansKenai Peninsula Borough15.0%12.1%18.6%120753
All AlaskansMatanuska-Susitna Borough17.1%14.4%20.2%1971,090
All AlaskansNorthwest Region13.4%8.9%19.8%48296
All AlaskansOther Interior Region14.4%11.0%18.8%81566
All AlaskansOther Southeast Region16.4%13.1%20.4%104599
All AlaskansY-K Delta Region9.8%6.3%15.0%36321
All AlaskansSouthwest Region10.5%7.4%14.7%71543
Alaska Native peopleAnchorage Muncipality21.3%13.6%31.8%31128
Alaska Native peopleFairbanks North Star Borough22.8%14.5%34.0%2599
Alaska Native peopleCity and Borough of Juneau**49
Alaska Native peopleKenai Peninsula Borough16.1%8.6%28.1%1161
Alaska Native peopleMatanuska-Susitna Borough18.6%11.5%28.6%2499
Alaska Native peopleNorthwest Region16.4%10.2%25.2%30165
Alaska Native peopleOther Interior Region9.4%5.0%17.1%15120
Alaska Native peopleOther Southeast Region22.9%14.0%35.1%22101
Alaska Native peopleY-K Delta Region9.7%5.7%16.2%20203
Alaska Native peopleSouthwest Region7.6%4.2%13.5%25208

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator. 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 emotional neglect, crude rate, by boroughs and census areas, all Alaskans and Alaska Natives, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 58
All AlaskansAleutians East Borough5.7%1.3%22.3%463
All AlaskansAleutians West CA14.0%6.8%26.7%1582
All AlaskansAnchorage Municipality16.3%13.8%19.2%2491,434
All AlaskansBethel CA10.5%6.2%17.3%28242
All AlaskansBristol Bay Borough6.6%2.7%15.4%660
All AlaskansDenali Borough15.5%5.5%36.6%869
All AlaskansDillingham CA8.9%4.5%16.9%17120
All AlaskansFairbanks North Star Borough16.6%13.7%20.0%1731,088
All AlaskansHaines Borough19.6%8.6%38.7%957
All AlaskansHoonah-Angoon CA**40
All AlaskansJuneau City and Borough15.6%11.8%20.4%86454
All AlaskansKenai Peninsula Borough15.0%12.1%18.6%120753
All AlaskansKetchikan Gateway Borough20.7%14.2%29.1%39195
All AlaskansKodiak Island Borough12.1%7.0%20.0%20154
All AlaskansKusilvak CA8.4%3.7%18.2%879
All AlaskansLake and Peninsula Borough6.3%2.3%15.9%964
All AlaskansMatanuska-Susitna Borough17.1%14.4%20.2%1971,090
All AlaskansNome CA21.1%11.6%35.4%21126
All AlaskansNorth Slope Borough6.3%3.0%12.9%1077
All AlaskansNorthwest Arctic Borough11.7%6.2%21.1%1793
All AlaskansPetersburg Borough10.7%4.5%23.5%559
All AlaskansPrince of Wales-Hyder CA14.0%7.7%24.2%1574
All AlaskansSitka City and Borough14.3%8.8%22.4%23119
All AlaskansSkagway Municipality**12
All AlaskansSoutheast Fairbanks CA13.6%8.9%20.3%28189
All AlaskansValdez-Cordova CA17.6%11.3%26.2%26158
All AlaskansWrangell City and Borough**30
All AlaskansYakutat City and Borough**13
All AlaskansYukon-Koyukuk CA10.1%5.6%17.7%19150
Alaska Native peopleAleutians East Borough**35
Alaska Native peopleAleutians West CA**25
Alaska Native peopleAnchorage Municipality21.3%13.6%31.8%31128
Alaska Native peopleBethel CA10.8%5.5%19.8%14134
Alaska Native peopleBristol Bay Borough**29
Alaska Native peopleDenali Borough**3
Alaska Native peopleDillingham CA8.5%3.5%19.2%1160
Alaska Native peopleFairbanks North Star Borough22.8%14.5%34.0%2599
Alaska Native peopleHaines Borough**7
Alaska Native peopleHoonah-Angoon CA**12
Alaska Native peopleJuneau City and Borough**49
Alaska Native peopleKenai Peninsula Borough16.1%8.6%28.1%1161
Alaska Native peopleKetchikan Gateway Borough**24
Alaska Native peopleKodiak Island Borough**24
Alaska Native peopleKusilvak CA8.2%3.2%19.1%669
Alaska Native peopleLake and Peninsula Borough**35
Alaska Native peopleMatanuska-Susitna Borough18.6%11.5%28.6%2499
Alaska Native peopleNome CA28.3%15.1%46.7%1765
Alaska Native peopleNorth Slope Borough**37
Alaska Native peopleNorthwest Arctic Borough10.7%4.9%21.8%863
Alaska Native peoplePetersburg Borough**6
Alaska Native peoplePrince of Wales-Hyder CA**21
Alaska Native peopleSitka City and Borough**18
Alaska Native peopleSkagway Municipality**0
Alaska Native peopleSoutheast Fairbanks CA**21
Alaska Native peopleValdez-Cordova CA**18
Alaska Native peopleWrangell City and Borough**8
Alaska Native peopleYakutat City and Borough**5
Alaska Native peopleYukon-Koyukuk CA10.2%4.6%21.1%1078

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 emotional neglect, crude rate, by tribal health regions, all Alaskans and Alaska Natives, 2014-2015 (2-year average)

::chart - missing::
confidence limits

Alaska ComparisonsPercentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 24
All AlaskansAleutians and Pribilofs10.8%5.7%19.5%19145
All AlaskansAnchorage/Mat-Su16.5%14.5%18.8%4462,524
All AlaskansArctic Slope6.6%3.1%13.5%1071
All AlaskansBristol Bay7.7%4.7%12.4%32245
All AlaskansCopper R/Prince William Snd.17.3%11.2%25.8%28165
All AlaskansInterior16.0%13.4%18.9%2261,486
All AlaskansKenai Peninsula15.0%12.1%18.6%120753
All AlaskansKodiak Area12.1%7.0%20.0%20154
All AlaskansNorthwest Arctic11.3%6.0%20.3%1798
All AlaskansNorton Sound21.1%11.6%35.4%21126
All AlaskansSoutheast16.0%13.4%19.0%1901,053
All AlaskansYukon-Kuskokwim9.8%6.3%14.9%36324
Alaska Native peopleAleutians and Pribilofs5.0%1.8%13.5%560
Alaska Native peopleAnchorage/Mat-Su20.7%14.3%28.9%55227
Alaska Native peopleArctic Slope**34
Alaska Native peopleBristol Bay7.4%3.8%14.0%16125
Alaska Native peopleCopper R/Prince William Snd.**20
Alaska Native peopleInterior17.6%12.0%25.1%39196
Alaska Native peopleKenai Peninsula16.1%8.6%28.1%1161
Alaska Native peopleKodiak Area**24
Alaska Native peopleNorthwest Arctic10.3%4.7%21.1%866
Alaska Native peopleNorton Sound28.3%15.1%46.7%1765
Alaska Native peopleSoutheast20.5%13.8%29.3%36150
Alaska Native peopleYukon-Kuskokwim9.7%5.7%16.0%20205

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. Hildyard K, Wolfe DA. Child neglect: developmental issues and outcomes. Child Abuse & Neglect 2002;26:679-95. 3. Young R, Lennie S, Minnis H. Children's perceptions of parental emotional neglect and control and psychopathology. Journal of Child Psychology and Psychiatry 2011;52(8):889-97. 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/ace-ak/Documents/ACEsEconomicCosts-AK.pdf]. Accessed April 26, 2016. 6. Alaska Department of Health and Social Services. Healthy Alaskans 2020. [http://hss.state.ak.us/ha2020/]. Accessed April 26, 2016. 7. 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. 8. 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. 9. 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. 10. 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 Thu, 19 September 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 15:28:26 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 Thu, 19 September 2019 13:10:58 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 15:28:26 AKST