DefinitionPercentage of adults 18 years of age and older who responded "fair" or "poor" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the question: "Would you say that in general your health is excellent, very good, good, fair, or poor?"
NumeratorWeighted number of adults (18+) who responded "fair" or "poor" on the BRFSS to the question: "Would you say that in general your health is excellent, very good, good, fair, or poor?"
DenominatorWeighted number of adults (18+) with complete and valid responses on the BRFSS to the general health question, excluding those with missing, "Don't know/Not Sure" or "Refused" responses.
Data Interpretation IssuesData from the survey should be considered representative of all Alaska adults in households with telephones. Data were collected using a random sample of all possible telephone numbers. Prior to analysis, data were weighted to represent the population distribution of adults by sex, age group, and area of residence. As with all surveys, some error results from nonresponse (e.g., refusal to participate in the survey or to answer specific questions) and measurement (e.g., social desirability or recall bias). Error was minimized by use of strict calling protocols (up to 15 calls were made to reach each household), good questionnaire design, standardization of interviewer behavior, interviewer training, and frequent, on-site interviewer monitoring and supervision.
The general health question has been asked since 1993 on the standard survey and on the supplemental survey since its inception in 2004. Combined results of the two surveys are reports for 2004 and later.
Post-stratification weights were used for Alaska prior to 2006; raking weights were used from 2007 onward. For more on this methodological change see: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/method.aspx].
Why Is This Important?Self-assessed health status is a measure of how an individual perceives his or her health -- rating it as excellent, very good, good, fair, or poor. Self-assessed health status has been validated as a useful indicator of health for a variety of populations and allows for broad comparisons across different conditions and populations.^1^
Self-rated health (SRH) has been collected for many years on National Center for Health Statistics surveys and since 1993 on the state-based BRFSS. SRH is an independent predictor of important health outcomes including mortality, morbidity, and functional status. It is considered to be a reliable indicator of a person's perceived health and is a good global assessment of a person's well being.^1^[[br]]
1. Idler E, Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies. J Health Soc Behav 1997;38(1):21-37.
How Are We Doing?In 2017, 16.9% of Alaska adults aged 18 and older reported fair or poor general health status. This means that 83.1% of Alaska adults reported good, very good, or excellent general health status. This rate is higher than the Healthy People 2020 objective of 79.8% reporting good or better physical health. Despite this success of surpassing the Healthy People 2020 objective, it is important to note the trend of increasing prevalence of fair or poor general health status over time (8% in 1993 versus 17% in 2017).
Self-reported health prevalence rates from the BRFSS are initially presented for all Alaskans, Alaska Native people, and the median from states, District of Columbia, and territories for all available years. Demographic subpopulation analyses indicated Alaska Native people reported higher rates of fair or poor general health (24.8%) when compared to all Alaskans. The prevalence of fair or poor health increases with increasing age and decreasing levels of education and income. Those who were widowed or divorced reported higher rates of fair or poor general health (28.8% and 26.6% respectively) when compared to those who were married (13.9%) or never married (16.1%). Alaskans who were unable to work reported substantially higher rates of fair or poor general health (53.6%) than those who were employed (11.3%), unemployed (30.5%), or not in the workforce (19.2%). Finally, increasing levels of income and education were associated with decreasing prevalence of fair or poor health.
Crosstabulations were also conducted for three-year averages by body mass index, current smoking, sexual orientation, disability, and Adverse Childhood Experiences (ACEs). Significant differences were evident in all contrasts. Of note, Alaskans with 4 or more ACEs were twice as likely to report fair or poor health when compared to those with 0 ACEs.
General health prevalence by regions of Alaska are presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 6 Alaska Public Health Regions, 2) three-year averages by the 7 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) single-year for the 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) three-year averages for 29 boroughs and census areas, and 5) five-year averages for the 12 tribal health organization regions. These time intervals match those for the InstantAtlas health profiles for each of the geographic regionalizes of Alaska for those desiring longer time series.
How Do We Compare With the U.S.?Between the years 1993-2016, the proportion of adults who reported fair or poor health was significantly lower in Alaska than for the U.S. as a whole. The prevalence in 2016, the most recent year for which national data are available, was 15% in Alaska compared to 17% in the U.S.
What Is Being Done?The Alaska Department of Health and Social Services, through many programs, works to prevent avoidable illness, injury, disability, and premature death; assure access to affordable, quality health care; and to promote healthy lifestyles.