Friday, November 9, 2012

Public Health Trends Alaska

 Name: Gentry Ensign
I talked to Karen Martinek who is a Epidemiological Nurse and Kathy Allely, MPH, who is the Section Chief of the Chronic Disease Prevention and Health Promotion Division of the Department of Public Health, State of Alaska.  They helped me identify the following public health trends in Alaska.

1.       Alaska has the highest rate of Tuberculosis in the United States
                The first trend they mentioned was that Alaska is consistently the state in America with the highest rate of Tuberculosis. According to data collected in 2011, Alaska had 9.3 cases of tuberculosis per 100,000 residents, which is about 5.9 cases per 100,000 more than the national average.  Much of this difference is attributed to the Native Alaska population. Many of the members of Native Alaskan tribes live in very secluded areas of the state in which access to medical care is scarce. They live in close knit communities and since tuberculosis is a communicable disease when one member contracts the disease it spreads quickly. Coupled with relative inaccessibility to health care, this increases the incidence of tuberculosis in Alaska
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2.       The STD rate in Alaska is increasing
                Every year since 2000, Alaska is one of the top two states in America for cases of Chlamydia and currently leads the nation. Alaska is also second in the nation for cases of Gonorrhea in 2011. The vast majority of the cases are found in people under the age of 30 who typically have more sexual partners. With this increase in STD’s, especially Chlamydia (which when left untreated, is a major cause of infertility in women), there has been a decrease in fertility throughout the state.  The major reasons Ms. Martinek believed that sexually transmitted disease was on the rise was twofold. Firstly, during the prolonged winter season, people will seek out companionship and, in some cases, since symptoms can be mild, the infected individual is unaware they are affected.  The other reason for the increase is the inaccessibility of many native Alaskan tribes to health care or their reliance on ancient traditional medicine.

3.       Alaska is seeing an decrease in childhood immunization rates
                The National Immunization Survey in 2009 ranked Alaska 49th among all the states for their childhood vaccination coverage rate. Currently the coverage rate in Alaska is around 56.6 percent which is incredibly low considering the national coverage rate is 70.5 percent.  Ms. Martinek listed a number of reasons, such as cultural differences, poverty, and the lack of understanding many people have of the importance of childhood vaccination, which have lead to Alaska being named by the Associated Press the state with the highest ‘opt out’ vaccination rate for kindergartners (did the Associated press cite a more authorative source?). In order to combat this problem the Department of Public Health has focused on a variety of approaches, including strengthening partnerships with healthcare providers, surveying parents to determine perceived barriers to immunization, increasing educational opportunities for providers and patients, using a computer system for development and publication of immunization coverage rates, and finally working with healthcare providers to get the information out. 

4.       Alaska has seen a sustained increase in obesity.
                Around 60 percent of Alaskan adults and 26% of high school aged children in Alaska can be deemed obese or overweight. This number has been consistently increasing annually for the past thirty years. Much of the problem is influenced by the environment in Alaska, namely that when it gets cold and dark in the winter people become more physically inactive. Other contributors to the increase in obesity are an increase in the amount of alcohol consumed, a decrease in physical education classes in the schools, and the difficulty Alaskans have in finding fresh fruits and vegetables at reasonable prices. To combat this problem, the state legislature has allotted 923,000 dollars to help develop the Obesity Prevention and Control Program which, over the course of 10 years, hopes to significantly decrease the obesity rate through education, training, and physical activity programs in the schools and parks throughout Alaska.

5.       The number of suicides per year in Alaska has been consistently high.
                The state of Alaska has a suicide rate that is double the national rate according to the 2010 report and this relationship hasn’t changed since then. Millions of dollars have been put into program funding and community efforts and programs but despite all these efforts Alaskans are still resorting to suicide. The populations which account for the most deaths are the native Alaskan peoples and the elderly. One of the weaknesses in the programs in Alaska is that there simply aren’t enough support groups for survivors and their loved ones to cover the state. Only six communities in Alaska have support groups but around 180 communities are affected by suicides every year. The state is too big and the population is to spread out for an effective suicide support group to be everywhere it needs to be. 

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