Challenges and barriers to preventive behaviors in Alaskan older adults: Evidence from a national survey

From 1970 to 2010, the Alaskan population increased from 302,583 to 698,473. During that time, the growth rate of Alaskan seniors (65+) was four times higher than their national counterparts'. Aging in Alaska requires confronting unique environmental, sociodemographic, and infrastructural challenges, including an extreme climate, geographic isolation, and less developed health care infrastructure compared to the continental US. The objectives of this analysis are to compare the health needs of Alaskan seniors to those in the continental US. We abstracted 180,685 records of individuals age 60+ from the 2009 Behavioral Risk Factor Surveillance System (BRFSS), of which 621 were Alaska residents. To compare Alaskans to non-Alaskans, we used generalized linear models which allowed us to adjust for demographic differences and survey weighting procedures. We examined three primary outcomes—general health status, health care coverage status, and length of time since last routine checkup. After adjusting for age, sex, BMI, and socioeconomic status, Alaskan seniors were 16.1% (95% CI: 12.7, 19.5%) less likely to have any health care coverage, 39.6% (38.7, 40.6%) less likely to have had a routine checkup in the past year, and 6.2% (4.3, 8.1%) less likely to report excellent health status than comparable seniors in the continental US. Given the growth rate of Alaskan seniors and inherent health care challenges this vulnerable population faces, future research should examine the specific pathways through which these disparities occur and inform policies to ensure that all US seniors, regardless of geographic location, have access to high quality health services.