Data to Action Success Story: Alaska

Alaska: PRAMS Data Informs Maternal and Child Health Activities in the North Slope Borough

Problem Overview

In 2006, the Alaska Bureau of Land Management began an environmental assessment to evaluate the potential land- and health-related effects of a proposed plan to lease oil and gas rights in northern Alaska. To provide a more robust analysis of the potential health issues associated with the leasing of oil and gas rights, the North Slope Borough (NSB) Health Department undertook a health impact assessment, with plans to include the findings in the final environmental impact statement. After the health impact assessment was completed, the NSB Health Department obtained a National Petroleum Reserve-Alaska Impact Grant to build a local program to monitor health issues. As a result, the NSB Baseline Community Health Analysis, a report on health issues in the North Slope rural villages, was developed and released in 2012 to inform future health impact assessments and guide public health and community planning efforts.  

The report, using the most recent data available at the time from Alaska PRAMS, along with vital registries and other sources, identified disparities in many maternal and child health indicators between the North Slope region and the rest of the state. Alaska PRAMS data from 2004–2008 showed that, compared with the entire state, the northern region of Alaska had lower breastfeeding initiation rates (79% vs. 91%, respectively) and lower rates of continuation of breastfeeding at 4 weeks postpartum (64% vs. 80%, respectively). In addition, the 2004–2008 reported prevalence of cigarette smoking during the last 3 months of pregnancy was more than twice as high among women from NSB compared with Alaska women statewide (37% vs. 17%, respectively). Furthermore, compared with Alaska women statewide, women from NSB reported a higher prevalence of physical abuse by a husband or partner 12 months before (10.5% vs. 4.4%) or sometime during (8.9% vs. 3.3%) pregnancy.

Program Activity Description

Based on analyses of Alaska PRAMS data and other health data, the North Slope Borough Baseline Community Health Analysis recommended prioritizing children and young families in community planning efforts. The NSB Health Department visited all of the 8 rural villages to conduct a series of “community cafés,” or community health and leadership forums, in 2012 and 2013 to bring this information to the villages and to get community input that would inform a series of strategic planning meetings designed to translate information into community-driven action.

Program Activity Outcomes

In 2012, in response to the results of the baseline analysis and the report recommendations, the NSB Health Department began putting into action a number of activities designed to improve maternal and child health in North Slope communities. The department collaborated with the Indian Health Service hospital to streamline the prenatal care referral process, making it easier for women to schedule prenatal appointments at local health clinics serving clients with high social or medical risk factors. To help improve rates of breastfeeding initiation and duration among new mothers, the region’s only hospital has conducted breastfeeding workshops and provides breastfeeding peer counseling training to their staff. Additionally, department staff have provided education on ways to prevent child obesity at health fairs in each NSB village, and a slope-wide obesity prevention coalition has been developed to address nutrition and physical activity issues among North Slope residents. The NSB also received grant funding to develop policies and prevention activities related to tobacco use. The department uses PRAMS data to aid in strategic planning to develop goals, objectives, and activities for the year. 

The NSB Health Department plans to continue using PRAMS data to monitor trends in prenatal care initiation, breastfeeding rates, prepregnancy overweight and obesity, physical abuse, and rates of alcohol and cigarette use among NSB women as well as other maternal child health indicators not mentioned above.