Disparities in social determinants of health outcomes and behaviours between older adults in Alaska and the contiguous US: evidence from a national survey

Fruit and vegetable intake, physical activity, and functional fitness among older adults in urban Alaska

Older adults often face barriers to obtaining recommended diet, physical activity, and fitness levels. Understanding these patterns can inform effective interventions targeting health beliefs and behavior. This cross-sectional study included a multicultural sample of 58 older adults (aged 55+ years, M=71.98) living in independent senior housing in urban Southcentral Alaska. Participants completed a questionnaire and the Senior Fitness Test that assessed self-reported fruit and vegetable intake, physical activity, self-efficacy, and functional fitness. T-tests and bivariate correlation analyses were used to test six hypotheses. Results indicated that participants had low physical activity but had a mean fruit and vegetable intake that was statistically significantly higher than the hypothesized "low" score. Only 4.26% of participants met functional fitness standards for balance/agility, and 8.51% met standards for lower-body strength. However, 51.1% met standards for upper-body strength and 46.8% met standards for endurance The results also indicated that nutrition self-efficacy and exercise self-efficacy were positively related to fruit and vegetable intake and physical activity levels, respectively. Interestingly, income was not related to nutrition or activity patterns. These data complicate the picture on dietary and physical activity patterns for older adults in Alaska and offer recommendations for future health promotion activities.

Seasonal variation in added sugar or sugar sweetened beverage intake in Alaska native communities: an exploratory study

Excess added sugar intake contributes to tooth decay risk in Alaska Native communities. The goal of this exploratory study was to determine if there is seasonal variation in total added sugar intake or in the leading sources of added sugars in a Yup'ik population. Data were collected in spring and winter from 2008-2010 using self-reported intake data measured by 24-hour recall and by hair biomarker (carbon and nitrogen stable isotope). Seventy Yup'ik participants ages 14-70 years were recruited from two communities and data were collected twice from a subset of 38 participants. Self-reported added sugar intake (g/day), biomarker-predicted added sugar intake (g/day), and leading sources of added sugar were calculated. Seasonal variation was evaluated using a paired sample t-test. Total added sugar intake was 93.6 g/day and did not significantly differ by season. Sodas and other sugar-sweetened beverages (e.g. Tang, Kool-Aid) were the leading sources and added sugar from these sources did not significantly differ by season (p=.54 and p=.89, respectively). No seasonal variation in added sugar intake was detected by either self-report or biomarker. Dietary interventions that reduce intake of added sugars have the potential to reduce tooth decay in Yup'ik communities.

Strategic Radiology Outreach Planning for Underserved Populations Using Geographic Information Systems

PURPOSE

Geographic information systems (GIS) are widely used in public health research but rarely used in radiology research. GIS can be an impactful tool in radiology global health to locate medically underserved populations and poor transportation infrastructure, characterize medical needs, and design outreach programs. Using the example of aircraft-based outreach in Alaska, we demonstrate the utility of GIS in radiological program planning for global health.

METHODS

Multicriteria GIS evaluations were performed to create a health severity index, using life expectancy and percentage uninsured data, and an accessibility severity index, using distance from roads and health centers or hospitals. These indices were combined with population density to create a final health access severity index (HASI). A map presenting suitable hybrid airship operating areas was produced using land cover data. Alaskan health care facilities were georeferenced to create a coordinate data set. Infrastructure was obtained from OpenStreetMap. Health data were accessed from the 2017 American Community Survey and CDC US Small-area Life Expectancy Estimates Project.

RESULTS

GIS analyzed 738,050 Alaskans. The health severity index identified decreased health outcomes (high or very high severity) in 285,446 (39%) Alaskans, and the accessibility severity index determined decreased access to care in 218,201 (30%). Combined, the HASI established 165,108 (22%) Alaskans as underserved with high or very high overall severity. Thirty-nine percent of Alaska land area is suitable for hybrid airship operations, including 27% of HASI high and very high severity areas.

CONCLUSIONS

GIS identified underserved populations for mobile radiology outreach in Alaska and may be useful for global health outreach planning and resource allocation.

Self-rated health and socio-economic status among older adults in Northern Iceland

Little is known about self-rated health (SRH) of older people living in more remote and Arctic areas. Iceland is a high-income country with one of the lowest rates of income inequality in the world, which may influence SRH. The research aim was to study factors affecting SRH, in such a population living in Northern Iceland. Stratified random sample according to the place of residency, age and gender was used and data collected via face-to-face interviews. Inclusion criteria included community-dwelling adults ≥65 years of age. Response rate was 57.9% (N = 175), average age 74.2 (sd 6.3) years, range 65–92 years and 57% were men. The average number of diagnosed diseases was 1.5 (sd 1.3) and prescribed medications 3.0 (sd 1.7). SRH ranged from 5 (excellent) to 1 (bad), with an average of 3.26 (sd 1.0) and no difference between the place of residency. Lower SRH was independently explained by depressed mood (OR = 0.88, 95% CI = 0.80–0.96), higher body mass index (OR = 0.93, 95% CI = 0.87–0.99), number of prescribed medications (OR = 0.88, 95% CI = 0.78–1.00) and perception of inadequate income (OR = 0.45, 95% CI = 0.21–0.98). The results highlight the importance of physical and mental health promotion for general health and for ageing in place and significance of economic factors as predictors of SRH.