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Infectious Disease
COVID-19: DHSS Insights

Two out of three Alaska adults have underlying health conditions that increase their chances of serious illness from COVID-19

Obesity, smoking, diabetes, heart disease, COPD and chronic kidney disease raise risks

NOVEMBER 17, 2020 — When someone becomes seriously ill from COVID-19 and gets hospitalized or dies, there’s a tendency to wonder if that person had other ongoing health problems that made the outcome more likely.

Then there’s the tendency to think those types of health problems affect only other people, not you or your family.  

But a new analysis in Alaska shows they affect most of us: Two out of three Alaska adults have an underlying health condition that can make COVID-19 more serious. The U.S. Centers for Disease Control and Prevention (CDC) states strong evidence links serious COVID-19 illness with current or former smoking, obesity, diabetes, chronic obstructive pulmonary disease (COPD), heart disease or heart attacks, and chronic kidney disease. A serious COVID-19 illness means being hospitalized, admitted to the intensive care unit, or put on a ventilator, even dying. 

These underlying health conditions are often called chronic diseases because they can continue for years, even a lifetime. Many of these health concerns can be managed with changes to nutrition and physical activity, and sometimes medication. Some, like smoking, can be stopped with support. Most can be prevented. The two most common ongoing health problems are obesity and smoking. Almost 1 out of 2 Alaska adults (47%) have obesity or currently smoke. 

“What we’re experiencing right now is the intersection between infectious diseases like the COVID-19 virus and chronic diseases and behaviors like obesity, diabetes and smoking,” said Karol Fink, manager of Alaska’s Chronic Disease Prevention and Health Promotion section. “Living with an ongoing disease can make it harder for your body to fight viruses like COVID-19.” 

“Learning about this connection between infectious and ongoing diseases has reinforced the value of being active every day, choosing healthy foods and drinks, never smoking or quitting if you do, getting enough sleep, managing stress and taking care of ourselves in all kinds of ways,” Fink said. 

The Section of Chronic Disease Prevention and Health Promotion and other sections within the Alaska Department of Health and Social Services use many strategies shown to prevent and manage these ongoing diseases. This includes working with partners to make it easier for Alaskans to choose active ways like walking or biking to get to schools, stores and workplaces. Programs promote screenings to detect and treat problems like diabetes, high blood pressure and cancer as early as possible. The Section runs public education campaigns focused on helping Alaska children grow up at a healthy weight and preventing and reducing smoking and vaping

“This pandemic has really reinforced how important it is for all of us to make these daily decisions that help us stay healthy for a lifetime,” Fink said.

Many Alaskans live with underlying health concerns


Epidemiologists within the Section of Chronic Disease Prevention and Health Promotion analyzed reports from about 8,500 randomly-selected Alaska adults who participated in the annual Behavioral Risk Factor Surveillance System (BRFSS) telephone survey between 2016 and 2018. 

About 67% of Alaska adults — two out of three — have at least one of the following ongoing health concerns that have been shown to increase chances for serious illness from COVID-19:

  • 46% of Alaska adults are current or former smokers
  • 32% have obesity
  • 8% have type 1 or type 2 diabetes
  • 6% have chronic obstructive pulmonary disease (COPD)
  • 5% have heart disease or have had a heart attack
  • 2% have chronic kidney disease

Older age and other health concerns can lead to COVID-19 complications

The CDC lists other factors that increase chances for serious illness from COVID-19 infection. Age is one of them. Even in the absence of any other risk factors, older age increases someone’s chances of serious health problems related to COVID-19. In Alaska, about 15% of adults are ages 65 years or older. If you consider older age and underlying health conditions, 71% of Alaska adults are at increased risk for serious illness from COVID-19. 

This estimate is likely an undercount, given that strong evidence links other known health concerns with severe COVID-19 illness. Those health concerns include currently having cancer and sickle cell disease, as well as having had an organ transplant. The BRFSS survey does not measure the number of Alaska adults with those conditions.  

There is some evidence that other conditions also may increase chances of serious COVID-19 illness. Two of those problems include high blood pressure and asthma. Those conditions affect a significant number of Alaska adults. Almost 1 out of 3 Alaska adults (31%) has ever had high blood pressure, according to recent BRFSS data. About 9% of Alaska adults have current asthma.

Daily and yearly actions can improve overall health

Better health for a lifetime comes with decisions we make every day — like what to eat, how to move and getting enough sleep — and actions we take year after year. Those include regularly checking our blood pressure and blood sugar levels, as well as getting screenings to detect cancer early. All of these actions can improve overall health: