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State of Alaska

Complete Health Indicator Report of Adverse Childhood Experiences: Incarcerated Household Member

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 served time or was sentenced to serve time in a prison, jail, or other correctional facility?"

Numerator

Weighted number of adults (18+) who responded "Yes" on the BRFSS to the question: "Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility?"

Denominator

Weighted number of adults (18+) who responded to the incarcerated household member question, 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 an incarcerated household member 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?

More than 2.7 million children in the U.S. have an incarcerated parent, and approximately 10 million children have experienced parental incarceration at some point in their lives.^2^ Living with someone who served time or was sentenced to serve time in a prison, jail, or other correctional facility can have an impact on a child's mental health, social behavior, and educational prospects. The emotional trauma that may occur and the practical difficulties of a disrupted family life can be compounded by the social stigma that children may face as a result of having a parent in prison or jail. Children who have an incarcerated parent may experience financial hardships that result from the loss of that parent's income. Incarcerated household members are unable to work on adult-child relationship skills that may be necessary for reunification, and separation interferes with the ability of the household member and child to form or maintain a strong attachment. Children may have experienced trauma related to the person's arrest or experiences leading up to it.^3^ Separation due to a parent's incarceration can be as painful as other forms of parental loss and can be even more complicated because of the stigma, ambiguity, and lack of social support and compassion that accompanies it. The impacts of overwhelming stress on a child's brain continue into adulthood and can have generational impacts. As Alaska children experience a household member being incarcerated, they may find negative ways to cope with their damaged stress responses. As adults who start families of their own, these behaviors can become Adverse Childhood Experiences (ACEs) for another generation.^4^ In fact, children of incarcerated parents are more likely to drop out of school, engage in delinquency, and subsequently be incarcerated themselves.^5^ 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] 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.^6^[[br]] [[br]] ---- {{class .SmallerFont See "Resources and References" section for references. }}

How Are We Doing?

In 2013-2015 combined, 11.3% of Alaska adults reported having experienced living with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility. Alaska Native adults reported significantly higher prevalence of 21.4%. Married adults reported significantly lower prevalence at 7.7% compared to divorced/separated adults (13.7%), never married adults (17.2%), and adults living with a partner (19.5%). Those adults who were college graduates reported a prevalence of 5.5%, significantly lower than those who had less than a high school education at 23.1%. There was also a significant difference among adults with different incomes - those making less than $15,000 reported a prevalence of 19.4%, while those making more than $75,000 reported 7.3% having experienced an incarcerated household member. Overall, there were few differences in rates among geographic areas, but the prevalence in Northern Alaska was the highest at 20.4%. Rates of an incarceration of a household member 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 by demographic subpopulations (i.e., sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status). Crosstabulations were also conducted for three-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 incarceration of a household member 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 (i.e., Arkansas, Louisiana, Tennessee, New Mexico, and Washington) that used the BRFSS ACEs module. When compared to the five states, Alaska reported the highest rate of adults reporting that they had lived with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility.^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, Alaska had higher rates of adults reporting they have lived with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility.^7^[[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. 7. U.S. Centers for Disease Control and Prevention (CDC). Adverse childhood experiences reported by adults - five states, 2009. MMWR 2010;59(49):1609-13. [https://www.cdc.gov/mmwr/pdf/wk/mm5949.pdf] Accessed October 31, 2017. }}

What Is Being Done?

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):^4^ 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. Public health partners around the state are aligning work around these approaches adapted by Alaska's unique needs. Alaska strategies include: promoting connectedness and healthy youth-adult relationships in schools, and providing services to support all young people in developing a sense of competence, usefulness, belonging, and empowerment.^8^ The [http://www.bbbsak.org/site/c.8oJELSPuFeJYG/b.8767999/k.F189/Home_Page.htm Big Brothers Big Sisters] program matches adult volunteers with children of prisoners. The goal is to support healthy development through positive adult contact, reducing risk factors for negative behavior, and enhancing protective factors for positive behavior. The increased level of support allows youths to view themselves more positively and to engage in more constructive behavior.^8^ Statewide, teachers and public health nurses provide teens with information on healthy relationships and life skills. They have partnered with the Alaska departments of Health and Social Services and Education and Early Development, the [http://www.dps.alaska.gov/cdvsa/ Council on Domestic Violence and Sexual Assault], and the [http://www.andvsa.org/ Alaska Network on Domestic Violence and Sexual Assault] on an evidenced-based curriculum for the 7th-9th grade called [https://education.alaska.gov/tls/schoolhealth/fourth.html "the Fourth R for Healthy Relationships."] The Division of Public Health partnered with the Alaska Native Tribal Health Consortium and the [http://dhss.alaska.gov/dph/chronic/pages/injuryprevention/akfvpp/default.aspx Alaska Family Violence Prevention Project] to develop a teen safety card, a gender-neutral resource developed for Alaska teens with guidance from Alaska teens. The card provides information about healthy and unhealthy relationship characteristics, what consent looks and sounds like, and where to get help, if needed. Another safety card was designed specifically for women.^9^ 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.^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. 8. Alaska Department of Health and Social Services. Healthy Alaskans 2020. [http://hss.state.ak.us/ha2020/]. Accessed April 26, 2016. 9. Alaska Native Tribal Health Consortium. Getting together - teen relationship safety card. [http://www.anthctoday.org/epicenter/healthyfamilies/teenCard_111014.pdf]. Accessed April 26, 2016. 10. 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 supports. Their strategies were based on evidence based practices including: School climate is the quality and character of the experiences of students, parents, educators, and school personnel. School climate reflects the values and community norms of the school community. 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" (CDC, 2009). Relationships are essential to adolescent health. Connections with parents, peers, and other adults/mentors support and influence youth development. 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.^8^ 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.^11^ 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.^5^ The 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.^12^


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 an incarceration of a household member, crude rate, by all Alaskans and Alaska Natives, 2013-2015 (3-year average)

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confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 2
All Alaskans11.3%10.3%12.3%98211,268
Alaska Native people21.4%18.7%24.3%3641,958

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 an incarceration of a household member, 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
Males10.8%9.6%12.2%4495,108
Females11.3%10.3%12.3%98211,268

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 an incarceration of a household member, crude rate, by age, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of AdultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 5
18-2419.2%15.6%23.4%145679
25-3418.0%15.2%21.1%2421,414
35-4412.3%10.2%14.9%1951,654
45-647.4%6.3%8.7%3274,928
65+3.1%2.3%4.2%702,500

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 an incarceration of a household member, 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)21.4%18.7%24.3%3641,958
Asian (non-Hispanic)4.2%1.8%9.5%7208
Black (non-Hispanic)13.7%8.2%21.9%17147
Native Hawaiian/Other Pacific Islander (non-Hispanic)18.7%8.3%36.8%857
White (non-Hispanic)8.4%7.5%9.4%5238,345
Multiracial/Other (non-Hisp.)27.3%14.7%45.1%1269
Hispanic (alone or multi)21.5%14.6%30.5%38282

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 an incarceration of a household member, 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/Latino23.0%16.5%31.2%54325
Non-Hispanic/Latino10.5%9.6%11.4%91110,811

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 an incarceration of a household member, 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
Married7.7%6.7%8.8%4206,179
Widowed5.0%3.4%7.4%46906
Divorced/Separated13.7%11.1%16.8%1691,875
Never Married17.2%14.6%20.0%2581,762
Living with a Partner19.5%14.9%25.1%86465

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 an incarceration of a household member, 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 School23.1%18.1%29.0%108539
High School Graduate or GED11.6%9.8%13.7%2772,639
Some College or Tech. School9.4%8.0%11.1%2623,103
College Graduate5.5%4.4%6.8%1854,245

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 an incarceration of a household member, crude rate, by employment, all Alaskans, 2013-2015 (3-year average)

::chart - missing::
confidence limits

Percentage of adultsLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 4
Employed11.2%10.0%12.5%5886,673
Unemployed19.5%15.4%24.5%127717
Not in Work Force7.6%6.0%9.6%1783,219
Unable to Work19.6%14.4%26.1%82550

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 an incarceration of a household member, 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
<$15,00019.4%15.0%24.8%131878
$15,000-$24,99918.8%15.5%22.7%1781,229
$25,000-$49,00013.6%11.4%16.0%2162,152
$50,000-$74,0008.1%6.4%10.2%1201,773
$75,000+7.3%6.0%8.8%2584,246

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 an incarceration of a household member, crude rate, by poverty status, 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
Poor20.3%15.9%25.6%143755
Near Poor18.6%15.4%22.3%1891,384
Middle/High8.6%7.6%9.7%4927,226

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 an incarceration of a household member, 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 Obese10.3%8.7%12.2%2743,561
Overweight10.8%9.3%12.5%3243,985
Obese13.1%11.3%15.2%3493,268

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 an incarceration of a household member, 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 smoker9.0%8.1%10.1%6429,158
Current smoker20.1%17.4%23.0%3352,047

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 an incarceration of a household member, 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
Heterosexual11.0%10.0%12.1%90510,574
Gay, Lesbian, or Bisexual20.4%15.0%27.1%52314

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 an incarceration of a household member, 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 Present15.8%13.1%18.8%2462,016
Disability Absent10.3%9.3%11.4%7229,111

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 an incarceration of a household member, 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 AlaskansAnchorage10.6%8.8%12.7%1832,227
All AlaskansGulf Coast8.2%6.5%10.3%1161,717
All AlaskansInterior11.8%9.9%14.0%1802,364
All AlaskansMat-Su12.3%9.9%15.1%1411,655
All AlaskansNorthern20.4%15.7%26.1%82482
All AlaskansSoutheast10.4%8.5%12.6%1361,708
All AlaskansSouthwest15.7%12.6%19.4%1441,115
Alaska Native peopleAnchorage16.1%11.0%22.9%39220
Alaska Native peopleGulf Coast16.9%10.9%25.1%23168
Alaska Native peopleInterior20.4%14.7%27.6%44309
Alaska Native peopleMat-Su21.8%12.1%36.1%23142
Alaska Native peopleNorthern27.6%20.8%35.6%67276
Alaska Native peopleSoutheast25.3%18.9%32.9%51241
Alaska Native peopleSouthwest23.6%18.9%29.0%117602

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 an incarceration of a household member, 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 MSA11.0%9.5%12.7%3243,882
All AlaskansFairbanks North Star MSA12.0%9.8%14.6%1291,729
All AlaskansJuneau MicroSA9.2%6.7%12.6%53737
All AlaskansKetchikan Gateway MicroSA16.2%11.0%23.1%35308
All AlaskansRural (non-Metro/MicroSA)11.4%10.1%12.8%4414,612
Alaska Native peopleAnchorage MSA18.0%13.0%24.4%62362
Alaska Native peopleFairbanks North Star MSA25.1%16.8%35.8%25147
Alaska Native peopleJuneau MicroSA34.0%22.1%48.2%2074
Alaska Native peopleKetchikan Gateway MicroSA**44
Alaska Native peopleRural (non-Metro/MicroSA)22.1%19.1%25.5%2481,331

Data Notes

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 an incarceration of a household member, 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 Muncipality10.6%8.8%12.7%1832,227
All AlaskansFairbanks North Star Borough12.1%10.0%14.7%1321,736
All AlaskansCity and Borough of Juneau9.2%6.7%12.6%53737
All AlaskansKenai Peninsula Borough8.2%6.4%10.5%841,220
All AlaskansMatanuska-Susitna Borough12.3%9.9%15.1%1411,655
All AlaskansNorthwest Region20.4%15.7%26.1%82482
All AlaskansOther Interior Region10.2%7.6%13.6%69879
All AlaskansY-K Delta Region17.6%13.2%23.0%79504
All AlaskansSouthwest Region10.5%7.4%14.7%76857
All AlaskansOther Southeast Region11.3%8.8%14.5%83971
Alaska Native peopleAnchorage Muncipality16.1%11.0%22.9%39220
Alaska Native peopleFairbanks North Star Borough25.9%17.6%36.5%26148
Alaska Native peopleCity and Borough of Juneau34.0%22.1%48.2%2074
Alaska Native peopleKenai Peninsula Borough19.9%12.1%31.0%16101
Alaska Native peopleMatanuska-Susitna Borough21.8%12.1%36.1%23142
Alaska Native peopleNorthwest Region27.6%20.8%35.6%67276
Alaska Native peopleOther Interior Region13.9%8.7%21.4%23191
Alaska Native peopleY-K Delta Region24.2%18.3%31.3%72326
Alaska Native peopleSouthwest Region19.0%13.1%26.7%47313
Alaska Native peopleOther Southeast Region21.3%14.4%30.4%31167

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 an incarceration of a household member, 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 Borough10.1%4.2%22.2%894
All AlaskansAleutians West CA12.2%5.4%25.2%12151
All AlaskansAnchorage Municipality10.6%8.8%12.7%1832,227
All AlaskansBethel CA12.9%8.5%19.1%43375
All AlaskansBristol Bay Borough6.0%2.7%12.9%785
All AlaskansDenali Borough1.7%0.3%8.1%299
All AlaskansDillingham CA19.4%11.9%30.1%27189
All AlaskansFairbanks North Star Borough12.1%10.0%14.7%1321,736
All AlaskansHaines Borough9.1%3.2%23.4%590
All AlaskansHoonah-Angoon CA7.0%2.3%18.9%457
All AlaskansJuneau City and Borough9.2%6.7%12.6%53737
All AlaskansKenai Peninsula Borough8.2%6.4%10.5%841,220
All AlaskansKetchikan Gateway Borough16.2%11.0%23.1%35308
All AlaskansKodiak Island Borough6.5%2.6%15.6%11246
All AlaskansKusilvak CA28.0%18.7%39.7%36129
All AlaskansLake and Peninsula Borough16.5%6.6%35.5%1192
All AlaskansMatanuska-Susitna Borough12.3%9.9%15.1%1411,655
All AlaskansNome CA17.7%11.6%26.0%31216
All AlaskansNorth Slope Borough13.7%8.1%22.3%20123
All AlaskansNorthwest Arctic Borough31.1%21.0%43.5%31143
All AlaskansPetersburg Borough6.2%2.2%16.1%496
All AlaskansPrince of Wales-Hyder CA14.7%8.4%24.5%16128
All AlaskansSitka City and Borough6.7%3.4%12.8%13204
All AlaskansSkagway Municipality**20
All AlaskansSoutheast Fairbanks CA8.1%4.0%15.6%18292
All AlaskansValdez-Cordova CA10.1%6.1%16.5%21251
All AlaskansWrangell City and Borough**46
All AlaskansYakutat City and Borough**22
All AlaskansYukon-Koyukuk CA17.3%11.3%25.5%28237
Alaska Native peopleAleutians East Borough**48
Alaska Native peopleAleutians West CA**46
Alaska Native peopleAnchorage Municipality16.1%11.0%22.9%39220
Alaska Native peopleBethel CA18.6%12.0%27.6%37215
Alaska Native peopleBristol Bay Borough**35
Alaska Native peopleDenali Borough**3
Alaska Native peopleDillingham CA29.7%18.0%44.8%2397
Alaska Native peopleFairbanks North Star Borough25.9%17.6%36.5%26148
Alaska Native peopleHaines Borough**12
Alaska Native peopleHoonah-Angoon CA**15
Alaska Native peopleJuneau City and Borough34.0%22.1%48.2%2074
Alaska Native peopleKenai Peninsula Borough19.9%12.1%31.0%16101
Alaska Native peopleKetchikan Gateway Borough**44
Alaska Native peopleKodiak Island Borough**37
Alaska Native peopleKusilvak CA34.1%23.6%46.5%35111
Alaska Native peopleLake and Peninsula Borough24.8%12.5%43.3%950
Alaska Native peopleMatanuska-Susitna Borough21.8%12.1%36.1%23142
Alaska Native peopleNome CA25.0%15.8%37.2%27120
Alaska Native peopleNorth Slope Borough15.8%7.7%29.6%1261
Alaska Native peopleNorthwest Arctic Borough37.0%24.8%51.3%2895
Alaska Native peoplePetersburg Borough**9
Alaska Native peoplePrince of Wales-Hyder CA**39
Alaska Native peopleSitka City and Borough**28
Alaska Native peopleSkagway Municipality**1
Alaska Native peopleSoutheast Fairbanks CA**36
Alaska Native peopleValdez-Cordova CA**30
Alaska Native peopleWrangell City and Borough**9
Alaska Native peopleYakutat City and Borough**10
Alaska Native peopleYukon-Koyukuk CA13.2%7.1%23.0%15122

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 an incarceration of a household member, crude rate, by tribal health organization 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 Pribilofs11.5%6.2%20.2%20245
All AlaskansAnchorage/Mat-Su11.0%9.5%12.7%3243,882
All AlaskansArctic Slope13.8%8.0%22.6%19112
All AlaskansBristol Bay15.5%10.3%22.6%45372
All AlaskansCopper R/Prince William Snd.9.9%5.9%16.0%21261
All AlaskansInterior11.8%9.9%14.0%1782,348
All AlaskansKenai Peninsula8.2%6.4%10.5%841,220
All AlaskansKodiak Area6.5%2.6%15.6%11246
All AlaskansNorthwest Arctic30.5%20.6%42.5%32152
All AlaskansNorton Sound17.7%11.6%26.0%31216
All AlaskansSoutheast10.4%8.5%12.6%1361,708
All AlaskansYukon-Kuskokwim18.1%13.7%23.5%81506
Alaska Native peopleAleutians and Pribilofs19.0%8.3%38.0%1194
Alaska Native peopleAnchorage/Mat-Su18.0%13.0%24.4%62362
Alaska Native peopleArctic Slope16.9%8.2%31.7%1253
Alaska Native peopleBristol Bay23.9%15.9%34.4%34186
Alaska Native peopleCopper R/Prince William Snd.**32
Alaska Native peopleInterior20.3%14.5%27.6%42302
Alaska Native peopleKenai Peninsula19.9%12.1%31.0%16101
Alaska Native peopleKodiak Area**37
Alaska Native peopleNorthwest Arctic35.7%23.8%49.6%28102
Alaska Native peopleNorton Sound25.0%15.8%37.2%27120
Alaska Native peopleSoutheast25.3%18.9%32.9%51241
Alaska Native peopleYukon-Kuskokwim24.7%18.8%31.8%74328

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. The Pew Charitable Trusts: Pew Center on the States. Collateral costs: incarceration's effect on economic mobility. [http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2010/collateralcosts1pdf.pdf]. Published 2010. Accessed April 26, 2016. 3. Youth.gov. Children of Incarcerated Parents. [http://youth.gov/youth-topics/children-of-incarcerated-parents]. 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. Dallaire DH. Incarcerated mothers and fathers: a comparison of risks for children and families. Family Relations 2007;56(5):440-53. 6. 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. 7. U.S. Centers for Disease Control and Prevention (CDC). Adverse childhood experiences reported by adults - five states, 2009. MMWR 2010;59(49):1609-13. [https://www.cdc.gov/mmwr/pdf/wk/mm5949.pdf] Accessed October 31, 2017. 8. Alaska Department of Health and Social Services. Healthy Alaskans 2020. [http://hss.state.ak.us/ha2020/]. Accessed April 26, 2016. 9. Alaska Native Tribal Health Consortium. Getting together - teen relationship safety card. [http://www.anthctoday.org/epicenter/healthyfamilies/teenCard_111014.pdf]. Accessed April 26, 2016. 10. 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. 11. 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. 12. 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 10/31/2017, Published on 10/31/2017
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, 18 February 2019 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Tue, 31 Oct 2017 10:19:59 AKDT
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 18 February 2019 0:04:55 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Tue, 31 Oct 2017 10:19:59 AKDT