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Santa Clara County Public Health Department Releases Health Profile Report

County Residents are Healthy Overall; Closer Look Reveals Disparities

Santa Clara County, California – The Santa Clara County Public Health Department and the Community Benefits Coalition released the Santa Clara County Health Profile Report today, which examines the health of county residents. While the report indicates that Santa Clara County is a healthy county on the surface, it also reveals some disparities that show certain populations are more at risk for poor health and disease than overall results would indicate.

“While there is certainly good news to be found in this report, there are two areas that are particularly troubling,” said Santa Clara County Board of Supervisors President Ken Yeager. “The increase in obesity rates for both children and adults and the continued decrease in health insurance coverage for our residents should raise alarm bells and serve as a call to action.”

In addition, some health factors that increase the risk for chronic diseases like heart disease, cancer, stroke, and diabetes are on the rise. These chronic diseases are a major cause of death and disability in Santa Clara County, with heart disease and cancer accounting for more than half of all deaths, according to the report.

“Santa Clara County is doing well in a number of areas, but there are segments of our population that are facing higher rates of disease,” said Dr. Marty Fenstersheib, health officer for Santa Clara County. “This report will help us better understand some of those disparities so we can work with our community partners to reduce them.”

The good news: fewer county residents are smoking, teen birth rates are declining, more children are getting immunized, and more adults are practicing safe sex.

  • The percentage of high school students who smoke decreased from 11% in 2001-02 to 9% in 2007-08.
  • The percentage of adults who are current smokers dropped from 15% to 10% over the past decade.
  • The teen birth rate decreased from 37 per 1,000 for those ages 15-19 in 1999 to 24 per 1,000 in 2008.
  • The immunization rate among kindergartners increased from 72% in 1999 to 77% in 2006.
  • Condom use during the previous sexual intercourse among sexually active adults increased from 32% in 2000 to 38% in 2009.

However, access to health care has declined in the past decade, risk factors that lead to chronic disease are on the rise, obesity among teens remains high, the adult diabetes rate is up, and air quality has worsened in the past decade.

  • The percentage of uninsured adults in Santa Clara County increased from 8% in 2000 to 18% in 2009.
  • The percentage of adults who could not see a doctor due to the cost or lack of insurance more than doubled from 5% in 2000 to 13% in 2009.
  • The percentage of adults without dental insurance increased from 27% in 2000 to 34% in 2009.
  • The percentage of adults in Santa Clara County who are overweight or obese increased from 52% in 2000 to 56% in 2009.
  • The percentage of adults with high blood pressure increased from 20% in 1997 to 26% in 2009.
  • The prevalence of overweight and obesity among middle and high school students in the county remains at 25%.
  • The percentage of adults who were told by a health professional that they have diabetes increased from 5% in 2000 to 8% in 2009.
  • The number of air quality days rated as good decreased in the county from 305 days in 1998 to 192 in 2008.

"Santa Clara County has continuously improved the health of our residents through both programs and policy. Our efforts to reach into all communities must continue in order to be successful in reducing chronic disease and those factors that contribute to it," said Liz Kniss, County Supervisor and Chair of the Board's Health and Hospital Committee. "As we implement federal health care reform I anticipate more of our residents will have health care coverage, however, the County is always here to serve those without resources, that is our Mission."

The report also shows some disparities in health outcomes. For example:

More Hispanics and African Americans are uninsured compared to overall county rates. While about 2 in 10 adults under age 65 did not have health insurance in 2009, more than 4 in 10 Hispanics and 3 in 10 African Americans were uninsured. In addition, while one-third of all adults did not have dental insurance, about half of Hispanics lacked insurance.

Overweight and obesity rates are higher among adults with low incomes. Sixty-eight percent (68%) of adults with annual household incomes less than $20,000 are overweight or obese compared to 49% of those with annual household incomes of $70,000 or higher.

Hispanic adults have the highest rate of overweight and obesity. Sixty-eight percent (68%) of Hispanic adults were overweight or obese compared to 55% of county residents overall in 2009. Thirty-seven percent (37%) of African-American and 36% of Hispanic middle and high school students were overweight or obese in 2007-08 compared to 25% of students overall.

A higher proportion of Hispanic adults have been diagnosed with diabetes. In 2009, 11% of Hispanics were diagnosed with diabetes compared to 7% of Whites and 5% of Asians. The overall county rate was 8%.

Smoking rates are still high among some adults and teens. Smoking prevalence is higher among adults with low incomes. Nineteen percent (19%) of adults with annual household incomes less than $20,000 are current smokers compared to 9% of adults with annual household incomes of $75,000 or higher. For teens, smoking rates are higher among Hispanics and African Americans (12% of middle and high school students) and Cambodian/Laotians (17% of high school students).

The teen birth rate is highest among Hispanic females: 35 per 1,000 for those ages 15-17 and 102 per 1,000 for those ages 18-19. In comparison, the overall county rates were 14 and 41 per 1,000 for those age groups, respectively.

Tuberculosis (TB) rates are higher among Asian/Pacific Islanders and Hispanics. Four in 5 TB cases in Santa Clara County were among Asian/Pacific Islanders (78%) in 2008. Hispanics accounted for 14% of the TB cases in the county.

Certain racial/ethnic groups experience a disproportionate share of AIDS infection. In 2008, African Americans represented less than 3% of the total county population, but accounted for 13% of the living AIDS cases. Similarly, 26% of the county population was Hispanic in origin in 2008, but Hispanics accounted for 34% of the living AIDS cases. The AIDS incidence rate for African Americans (26 per 100,000 people) and Hispanics (8) was higher than the county rate (6).

Suicide rates are higher among Whites at 9 per 100,000 people compared to 6 for Asians and 6 for Hispanics.

The report looks at health data in 10 key areas: social determinants of health; mortality rates; healthcare access; maternal, infant and child health; oral health; lifestyle and behavioral risk factors; chronic diseases; communicable diseases; injury and violence; and healthy environments. Each area includes a number of health indicators, which are examined by gender, age, race/ethnicity, income and education where possible.

The Santa Clara County Public Health Department is already working on a number of issues highlighted in the report. For example, Steps to a Healthier Santa Clara County is a federally funded program aimed at preventing chronic diseases. It is particularly focused on obesity, diabetes and asthma. The program is designed to reduce health disparities by reaching out to populations disproportionately affected by chronic disease.

The Public Health Department was recently awarded a $7 million federal grant for tobacco prevention. Funded by the Centers for Disease Control and Prevention through the American Recovery and Reinvestment Act, the grant will fund efforts to reduce exposure to secondhand smoke, promote smoke-free colleges and campuses, develop multilingual and multicultural social marketing and media campaigns to counter pro-tobacco influences, promote smoke-free workplaces, and promote public policies such as limiting tobacco advertising and requiring retailers to have a license to sell tobacco.

Part of the Champions for Change Network for a Healthy California, the Public Health Department is working with its community partners to promote healthy eating and physical activity through public education campaigns and local activities. For example, the current Soda-Free Summer campaign is designed to raise awareness about the health impacts of sugared drinks like soda.

In addition, the County of Santa Clara has taken the lead on policy issues designed to reduce obesity and related chronic diseases, including requiring restaurants to include nutritional information on menus and banning toys with unhealthy children’s meals.

To view the complete Santa Clara County Health Profile Report, visit www.sccphd.org.

Media Contact: Laurel Anderson, Office of Public Affairs (408) 299-5168; Joy Alexiou, Santa Clara Valley Health and Hospital System (408) 885-4164
Posted: July 20, 2010