Health and Wellness

Sitka’s Increase in Medicaid Eligibles Parallels State

How are we doing?

There has been a steady rise in the number of Alaskans and Sitkans who are eligible for medical assistance. The increased numbers are due in part to the newly expanded medical insurance program called Denali Kid Care. Some families may not qualify for Medicaid under the federal poverty guidelines of the traditional Medicaid system but are nonetheless lower income families and may not have adequate insurance or are unable to pay for insurance.

Why is this important?

This indicator relates to the number of people in the community who require help to meet a basic need. Access to health insurance is an important part of ensuring young Sitkans receive the necessary medical care to grow up healthy.

Heart Disease and Cancer Leading Causes of Death

How are we doing?

Heart disease and cancer are the leading causes of death in the United States, and the same holds true for Alaska and Sitka. 46% of deaths in Sitka from 1990 to 1998 were due to heart disease and cancer. In the rest of the United States, cerebrovascular disease is the third leading cause of death, whereas in Sitka and Alaska we see unintentional injuries take that place. Drowning remains at the top of Sitka’s list of injury-related deaths.

Why is this important?

The reasons for illness are often related to the way we live our lives - our physical activity levels, our eating habits and our emotional health. These are greatly influenced by our environment , the availability of safe recreation opportunities, a healthy diet, and a strong network of friends and social services.

Sitka’s Injury Hospitalization Rates Higher Than State

How are we doing?

Sitka’s non-fatal injury hospitalization rates are consistently higher than the state’s. Sitka’s fall rate is about twice the state’s rate, as are rates for suicide attempts, assault, and boating/water injury hospitalizations. Falls continue to lead the list of non-fatal injuries requiring hospitalization with 281 reported hospitalizations from 1991 to 1998.

Why is this important?

Injury hospitalizations cost Sitka in terms of health care services, emergency services and time off work and away from school. Injuries affect young people in the community, with 10 to 49 year olds being most at risk. The injuries surveyed are preventable with specific intervention and education services.

Ages 20-35 Prime Childbearing Years

How are we doing?

Sitka has seen a general decline in the under 20 female population giving birth. Alaska has seen a greater decline in teen births than any other state. The most common ages for bearing children are between 20-39.

Why is this important?

While there appears to be no clear-cut ideal age for childbirth, there is evidence that risks for complications are lowest when both parents are between the ages of 20 to 35 years of age. In women over 40, diabetes and high blood pressure are associated with risks to a successful birth, especially when the mother is also overweight. Chromosomal abnormalities are also a concern for both males and females over the age of 40.

Adequate Prenatal Care for Alaskan Natives Strong in Sitka

How are we doing?

The percentage of Alaskan Natives receiving adequate prenatal care is higher in Sitka than in the rest of the state. On average, non-Native women in Sitka obtain slightly less prenatal care than their counterparts in the rest of the state. In Sitka, a higher percentage of Alaskan Natives receive adequate prenatal care than is true for non-Natives. The opposite is true statewide where a higher percentage of non-Natives receive adequate prenatal care than is true for Alaskan natives.

Why is this important?

Obtaining early and comprehensive prenatal care is the best thing a woman can do for her health and the health of her baby. Prenatal care provides more than physical health assessment, it also looks at the nurturing environment, parent readiness, and the emotional environment. Prenatal care helps reduce infant mortality, birth defects, poor nutrition, alcohol and other drug use, and low birth weight.

Harm to Children Continues to be of Concern

How are we doing?

There has been a decrease in reports of harm to children in Sitka over the past two years from a peak in 1998, with rates dropping from 27 per 1,000 to 22 per 1,000. Reports of harm to children statewide have remained steady at 26 per 1,000. At 57%, neglect remains the most common type of child harm reported, followed by physical abuse at 23%, sexual abuse at 11%, and mental injury at 9%.

Why is this important?

One-third of child abuse victims become abusive parents themselves. There is a strong correlation between domestic violence and child abuse, with both forms of violence frequently occurring in the same household. Ninety percent of juvenile delinquents and adult prisoners report having been abused as children. Changing this situation for children requires partnerships between community members, schools, law enforcement, state and health agencies to break this repetitive cycle.

Local Forest Service Cabin Registrations Climb

How are we doing?

In the last ten years the number of registered users visiting USDA Forest Service cabins in the Sitka Ranger District has increased tenfold. The Forest Service reports that Alaskan residents visited area cabins 3,000 times in 2000, up from 314 times in 1990. Non-residents registered for 407 visits in 2000, up from 72 visits in 1990. Robust interest by registered users reflects a steady expansion of available cabins from 14 in 1990 to 23 in 1994 and 24 in 1998. The significant increase in registered use after 1998 suggests overwhelming approval of a new internet registration process with an option for credit card payment.

Why is this important?

USDA Forest Service cabins are a regional asset and a source of community pride. Although not all visits to area cabins are registered, official activity illustrates the value and benefit of this federal program to hunters, hikers, boaters, campers and those who feel a cabin is a destination in itself.

Sitka National Historical Park Popular Site for Sitkans

How are we doing?

The off-season trail activity at the Sitka National Historical Park grew to more than 50,000 visits in 2000. After a historical high in 1996, the park logged increases of 5,000 visits per year during the months September through May. Steady increases in trail use at the park for 3 years suggest that outdoor walking opportunities near town appeal to locals. The decline of trail use in 1997 may be explained by actual and perceived criminal activity in and near the park which diminished its popularity for a short time.

Why is this important?

The Sitka National Historical Park offers a distinctive blend of history, culture and atmosphere which dates back almost a century. The popularity of this site and its many features is a commentary on its mission and the manner in which it serves both visitors and locals with an enduring experience in and out of doors.

More Assisted Living But Fewer Nursing Facilities for Sitka Seniors

How are we doing?

Changes at the Sitka Pioneer Home have resulted in less skilled nursing care and more assisted living accommodations for seniors. With the increase in Sitka’s elderly population, more adequate senior living facilities are needed. Expansion plans underway at Sitka Community Hospital will help to meet this need. Some seniors are presently forced to leave Sitka to find adequate living facilities.

Why is this important?

A community made up of mixed generations is a stronger one. Options for elderly people to live comfortably in Sitka contribute to that strength. Elders offer a sense of history and community memory that can be vital to the shaping of Sitka’s future.

Sitkans Seek More Health Care Assistance

How are we doing?

In 1997 and 1998, the total number of persons receiving various types of public assistance climbed to the level immediately following the APC mill closure. The components of this change are complex and sometimes related to changes in these government programs.

One important change was that, in 1997, AFDC/ATAP and Medicaid were separated, so that a family could get Medicaid without applying for AFDC/ATAP. This increased the number of people applying for Medicaid. The rising number of uninsured Americans and the rising cost of health care probably also contribute to the growing demand for Medicaid.

The number of AFDC/ATAP and AF/AT - FS cases has dropped. This is partly because of policy changes such as work requirements and the limited time a family can receive assistance.

The two programs not affected by significant policy changes are Food Stamps and Adult Public Assistance. The number of families served by these programs has increased slightly over the last two years.

Why is this important?

Even when the economy as a whole is performing relatively well, there are those who do not share in the benefits. The total number of people receiving some form of public assistance is a measure of the extent to which Sitkans require help to meet basic needs.

Heart Disease and Cancer Leading Causes of Death

How are we doing?

Heart disease, cancer and stroke are the three leading causes of death in the United States, accounting for 40% of all deaths. In Alaska, injuries related to our occupations and environment are a leading cause, and in Sitka, these injuries rank in third place. Drowning is highest on Sitka’s list of injury-related deaths.

Why is this important?

The reasons for our illnesses are often related to the way we live our lives—our physical activity levels, our eating habits, and our emotional health. These are greatly influenced by our environment—the availability of safe recreational opportunities, heart-healthy foods, and a strong network of friends and social services.

Falls Lead List of Injuries Requiring Hospitalization

How are we doing?

Injuries were the cause of 540 hospitalizations from 1990-1996. This amounted to 251 hospital days per year. Alcohol was a contributing factor in 32% of these hospitalizations. Falls were three times as common as any other injury requiring hospitalization. 64% of all these hospitalizations involved men. Most of the suicide attempts involved ingestion of pharmaceuticals. 62% of the suicide attempts were by females.

Why is this important?

Injury hospitalizations cost Sitka in terms of health care services, emergency services, and time off work and away from school. Injuries affect young people in our community with 10-49 year olds being most at risk. Unintentional injuries such as falls and vehicle or boating accidents can be prevented through home safety checks and use of seat belts and personal flotation devices.

Teenage Pregnancies in Sitka Lower Than State

How are we doing?

The teen birth rate in Sitka is lower than other communities in Southeast Alaska such as Ketchikan and Juneau, and lower than Alaska as a whole.

Why is this important?

Children of adolescent parents are more likely to suffer health problems, lag behind academically and socially in school, and experience behavior problems. They are also more likely to become teen parents themselves. Most adolescents are not emotionally or financially prepared for the rigorous demands of parenthood. Their own developmental growth is often stalled as they struggle to meet the needs of their child and family. Adolescent parents risk losing educational, career, social, and financial opportunities for themselves and their children. Their frequent dependence on social service programs such as Medicaid and welfare increase the cost of those services across our society.

Reports of Harm to Children Higher Than Nation

How are we doing?

Sitka’s rate of reported harm to children is 50% higher than what it is for the nation, and close to rates statewide. Child neglect accounts for 46% of these reports, physical abuse 30%, sexual abuse 17%, and mental injury 7%. Reports of all these kinds of child harm have increased in Alaska in the last decade. This increase may be the result of increased public education regarding child abuse as well as the willingness of more individuals to report suspected cases to authorities.

Why is this important?

One third of child abuse victims become abusive parents themselves. There is a strong correlation between domestic violence and child abuse, with both these forms of violence frequently occurring in the same household. 90% of juvenile delinquents and adult prisoners report having been abused as children. Changing this situation for children and families in Sitka requires new partnerships between community members, schools, and law enforcement, state and health care agencies to break this repetitive cycle.

Prenatal Health Care Strong

How are we doing?

Prenatal health care is strong among both Alaska Natives and Caucasians in Sitka. Among Alaska Natives, the trend appears variable perhaps because of the small number of births. Despite the slight overall decline over the last seven years, the percentage of moms who received adequate health care is 74%, 21% above that of other Alaska Natives in Alaska.

While the rate of adequate prenatal care has decreased among Alaska Natives, it has increased among non-Natives. Throughout the period for which data was available, non-Natives in Sitka have had lower rates of adequate prenatal care than both other Sitkans and non-Natives in the rest of Alaska. In 1997, about 75% of both Alaska Natives and non-Natives received adequate prenatal care, a rate higher than their counterparts in the rest of Alaska.

Why is this important?

Obtaining early and comprehensive prenatal care is the single best thing a woman can do for her health and the health of her baby. Prenatal care provides more than physical health assessment. It also looks at the nurturing environment, parent readiness, and the emotional environment. An infant’s capacity to learn is directly linked to brain development in utero.

Reducing infant mortality, birth defects secondary to smoking, poor nutrition, alcohol and other drugs, and low-birth weight helps promote an optimal start for our infants. Low-birth weight infants (2500 grams or less) are significantly more likely than normal weight infants to have neurodevelopmental delays and disabilities. The effects of alcohol leading to FAS, the leading cause of mental retardation and the only cause that is 100% preventable, are well documented in Alaska.