Analyzing state-based Silver Alert programs: the case of North Carolina.

ABSTRACT

BACKGROUND: Recent discussions about securing the autonomy and safety of older people in a cost-effective way have culminated in the establishment of "Silver Alert" media-alert policies in more than half of US states over the past 5 years. Although these policies have been established with exceptional legislative speed, research has not yet examined how these policies have been implemented across geographic areas. METHODS: Data from the 587 Silver Alerts activated in North Carolina in 2008, 2009, and 2010 were analyzed. Zero-inflated negative binomial regression and exploratory spatial analyses were employed. RESULTS: Despite a policy focus on older adults and individuals with cognitive impairment, activation of Silver Alerts in a county was not related to the proportion of the population 65 years of age or older or to the prevalence of poor mental health in the county. Rather, a 1-unit increase in the proportion of the population comprised of African Americans increased the rate of Silver Alert activation by a factor of 1.019 (P < 0.01). Additionally, spatial analyses suggested that the number of Silver Alerts in a county was related to its proximity to North Carolina's state capital, Raleigh. LIMITATIONS: These results should be interpreted with caution because an exploratory analytic approach was employed in both regression and spatial analyses. CONCLUSION: The current mission and implementation of the Silver Alert program should be reviewed, given that significant effects were observed for the proportion of African Americans in a county and the county's distance from the state capital, but not for the proportion of older adults in the county or for the prevalence of impaired mental status.