A broad look into the health of counties nationwide placed the Kenai Peninsula into the top fifth of boroughs in Alaska.
The County Health Rankings and Roadmaps project, an annual report from the nonprofit Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, placed the Kenai Peninsula Borough fifth out of 25 boroughs in Alaska based on measures like premature death, health quality and low birthweight. The peninsula came in behind Juneau, Kodiak, Valdez-Cordova and Southeast Fairbanks, with a slightly higher rate of people reporting poor or fair health but slightly fewer years of life lost due to premature death, according to the ranking.
The researchers also ranked a number of health behaviors, medical care access and social and environmental factors, with the peninsula coming in overall 10th place. Though the borough did better than Alaska at large in categories like diabetes monitoring, teen birth rates, sexually transmitted infections and high school graduation, there are also more injury related deaths, more unemployment, more uninsured people and more physical inactivity here than in Alaska in general, according to the report.
But the rankings are just a starting place — the hope is that communities and local and state governments will look at individual numbers closer to help find solutions, said Jerry Spegman, a community coach with the County Health Rankings and Roadmaps project.
“There are a lot of different factors that come together, and the rankings are designed as a mosaic that contribute to the health of the community, and any one particular data set of measurement may not resonate with a community,” he said. “…There’s always something in every county’s rankings that are interesting.”
For instance, the Kenai Peninsula has two seemingly conflicting pieces of data — a higher number of people who drink excessively than the Alaska average, but alcohol-related driving deaths are significantly below the Alaska average in the report. That could tell a number of stories, but the community might have more information as to why that might be the case, he said.
Gathering data that applies across Alaska can be an issue, too — what applies in Anchorage may not apply in Anchor Point or Unalakleet, in part because of the resources available and difference in environments. The project began in Wisconsin and moved nationally, measuring by counties, which are typically smaller and more densely populated than most areas of Alaska, Spegman said.
“The model may work better in some states … it may not work as well in other places,” he said. “But it still is a method of gathering data and presenting it back to folks so they can see relative to other areas how they’re doing in these particular measures.”
Looking at specific measures can help a community identify a problem area, Spegman said. Though the high-level data may not specifically indicate each community’s issues, the premature death standard tends to be fairly sensitive if something is happening because it is measured in years of life lost — if a lot of young people are dying, the number increases more. The counties hardest hit by the opioid crisis, which has impacted young adults most nationally, saw a jump in the premature death number, Spegman said.
The report also includes some health statistics that did not calculate into total rank, such as food insecurity, insufficient sleep, drug overdose deaths and health care costs. The Kenai Peninsula has a higher rate of drug overdose deaths than both Alaska and the nation in general, with between 24–25.9 per 100,000 people versus 16.8 in Alaska and 10 nationally. That’s the same rate as the Matanuska-Susitna Valley and the Yukon-Koyukuk Census Area, the three highest regions in the state, according to the report.
More adults are uninsured and health care costs are also significantly higher on the peninsula than in Alaska at large, according to the report. The cost numbers included come from Medicare reimbursements, some of the only public data widely available on health care costs, and put the Kenai Peninsula at about $7,830 per enrolled, compared to a low of $3,896 in Yakutat and $10,206 in Sitka. Among adults not eligible for Medicare — younger than 65 — about 21 percent were uninsured, slightly higher than the Alaska average of 19 percent.
Sometimes, looking at specific measures helps communities identify goals, and the County Health Rankings and Roadmaps organizers want to help communities do that, Spegman said. He gave the example of a community in New York that noted higher drunk driving fatalities and connected it possibly to the fact that it was one of two counties where the bars stayed open until 4 a.m., possibly contributing to drunk driving. The community members can then decide whether to change that, he said.
“We work with a variety of organizations at a state and national level that try to see these numbers as a call to action … the hard work comes when a community says we want to do something about it,” he said. “We want to be part of that process but it takes all hands, basically. And because we have this wide mix of measures … you need a wide mix of individuals involved.”
The state of Alaska has its own population health initiative going, called Healthy Alaskans 2020, that tracks a set of individual health measures in an effort to improve outcomes for people across Alaska. The goals include reducing smoking, adult obesity and suicide among a variety of others. So far, with two years left before the original target date, the state has met four of the 32 goals and estimates that it is on track to meet another 15.
The Kenai Peninsula specifically has met seven of the target goals, including reducing teen dating violence, reducing the alcohol induced mortality rate and increasing the percentage of adults exercising more than 150 minutes per week, according to a September 2017 update.
Reach Elizabeth Earl at eearl@peninsulaclarion.com.
