Analyzing State-Based Silver Alert Programs: The Case of North Carolina

Abstract

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. 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. 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. These results should be interpreted with caution because an exploratory analytic approach was employed in both regression and spatial analyses. 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.