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Some groups of Alaska adults face much higher chances of serious COVID-19 illness than others

Race, education, income, age, sexual orientation, and sex are linked to differing health outcomes

JANUARY 25, 2021 — The COVID-19 pandemic has provided yet another example of the health inequities among Alaskans: Some groups of Alaska adults face significantly higher chances than other groups of living with ongoing health conditions that can increase the seriousness of COVID-19, should they become infected. Race, education, income, age, sexual orientation, and sex are all linked to differing levels of risk for COVID-19 complications.

In November, Alaska’s Section of Chronic Disease Prevention and Health Promotion reported the first stage of its data analysis that showed 2 out of 3 Alaska adults have at least one underlying health condition that increases their chances of serious COVID-19 illness. Serious illness means being hospitalized, admitted to the intensive care unit (ICU), put on a ventilator, or dying. Those conditions include obesity, current or past smoking, diabetes, heart disease or heart attacks, chronic kidney disease and lung disease such as chronic obstructive pulmonary disease (COPD). Alaska’s new vaccine allocation plan considers these underlying health conditions when prioritizing distribution of shots, providing some of the first-available vaccines in the state to older Alaskans and people with multiple conditions.

Some groups of Alaska adults are more likely to have ongoing health conditions

The Section’s epidemiologists have continued their analysis of reports from nearly 9,000 randomly-selected Alaska adults who participated in the annual Behavioral Risk Factor Surveillance System (BRFSS) telephone survey between 2016 and 2018. They explored further differences among groups of Alaska adults.

Alaska adults who are more likely to have underlying health conditions — and in turn higher risks for serious COVID-19 illness — include these groups:

  • Alaska Native or American Indian adults
  • Adults who have less than a college education
  • Adults with lower incomes
  • Older adults
  • Adults who identify as gay, lesbian, bisexual, or another sexuality
  • Adult men

“We continue to see inequities for Alaskans across many health conditions, and we need to keep working to address those starting from an early age all the way throughout their life span,” said Karol Fink, registered dietitian and manager of Alaska’s Section of Chronic Disease Prevention and Health Promotion. “Our analysis shows that factors like race, poverty, and lower levels of education are linked to poor health outcomes. But it’s important to understand that these factors are connected to health because they can impact the ability to find and afford nutritious foods, to live in safe communities that make it easier to walk or bike to stores and workplaces, to find and pay for quality medical care, and even to get to and from hospitals and clinics that provide that care.”

“It’s these areas of access and affordability that we need to improve so all Alaskans have better health overall,” Fink said. “Many programs within our section and the health department focus on improving where we live, learn, work and play. Those improvements give everyone better chances of staying healthy for a lifetime.”

Taking a closer look at differences in health outcomes across groups of Alaska adults


When looking at Alaska adults, 68% (or about 2 out of 3) have at least one underlying health condition that increases their risk of severe complications should they contract COVID-19. About 66% of white Alaska adults have at least one underlying condition. That percentage is significantly higher for Alaska Native and American Indian adults, with 81% having at least one underlying condition. The percentage is significantly lower for Asian adults, with 48% having at least one condition.

Increased likelihood of living with ongoing health conditions is also linked with lower levels of education, higher levels of poverty, homosexuality or bisexuality, older age, and male sex. When focusing only on college graduates, 54% of Alaska adults have one or more of these conditions. That percentage significantly rises to 80% for adults who earned their high school diploma or GED but then did not continue to college. It rises even higher to 86% for adults who didn’t finish high school.

Alaskans who earn lower annual incomes face increased chances for developing ongoing health problems. Almost 65% of Alaskans living above 185% of the federal poverty guidelines (the cutoff for qualifying for many federal assistance programs) have at least one ongoing health problem. That jumps significantly to 77% for Alaskans living at or below 185% of the federal poverty guidelines.

As Alaskans get older, their chances for developing ongoing health problems increase. Among 18- to 29-year-old Alaskans, 52% report having at least one ongoing health condition. Nearly 80% of Alaskans ages 70 or older have at least one condition.

Alaska adults who are gay, lesbian, bisexual, or another sexuality are also more likely to have at least one ongoing health condition. About 68% of heterosexual adults have at least one condition. That jumps significantly to 76% for Alaska adults who are gay, lesbian, bisexual, or another sexuality.

Adult men in Alaska are significantly more likely than women to have one or more of these underlying health conditions. About 70% of men have at least one condition, compared to 65% of women.

Alaskans can manage and prevent these ongoing conditions for better health

Alaskans of all ages can make daily and yearly decisions to manage and prevent chronic diseases, helping them feel better year-round:

Everyone can take steps to prevent getting COVID-19, whether or not they have ongoing health conditions. Keep six or more feet of space between you and other people, wear a mask around others, get vaccinated, and wash or sanitize your hands and frequently touched surfaces.

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