Community Assessment - Health & Quality of Life in San Mateo
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key findings

In the past several years, considerable strides have been made in elevating childhood immunization levels in San Mateo County. However, while three out of four toddlers are up to date for immunizations, the Year 2000 objective is to achieve 90% coverage or higher. Another concern for the county is the high levels of obesity in young children.

For adolescents in the county, adolescent pregnancy is among the most pressing issues. Reducing adolescent pregnancies is important because, not only are adolescents at greater risk for poor birth outcomes, but adolescent pregnancy is a leading contributor to the cycle of poverty in young families. Other key concerns for the county’s youth relate to various risk behaviors, such as smoking, injury-producing behavior and sexual behavior.

Qualitative research (focus group) findings corresponding to this section can be found beginning on the Child & Adolescent Issues page.

childhood immunization

• Childhood immunization has improved considerably in San Mateo County in recent years. In 1997, there was 76.6% coverage for the basic immunization series in a retrospective look at 2-year-olds as they entered kindergarten; this compares to only 68.7% just two years earlier. The San Mateo County immunization rate (76.6%) is lower than the Year 2000 objective which is 90% or higher. ⁴⁸⁷

• The immunization rate is highest in Coastside (79.3%), and lowest in South County (71.3%). ⁴⁸⁸

• By school district, both Belmont and San Bruno satisfied the Year 2000 objective in 1997. The lowest levels of immunization coverage were found in the Jefferson, Laguna Salada, Millbrae, and Ravenswood districts. ⁴⁸⁹

pediatric obesity

Excess weight in children is often exacerbated by poor nutrition and low activity levels, though there is a strong genetic contribution to obesity. The proportion of children classified as overweight is on the rise nationally, and this trend can be seen among the low-income children receiving health screening exams through the San Mateo County Child Health and Disability Program (CHDP). [CHDP clients are children living in households with incomes below 200% of the federal poverty threshold]. ⁴⁹⁰

• For Whites and African-Americans, overweight prevalence among 1-year-olds drops at 2-4 years of age, but climbs back up to 17.2% and 13.2% respectively at 5-9 years of age, when children are in school. Among children of Hispanic ethnicity, there is no drop in the rate of overweight at 2-4 years of age, and the rate increases dramatically to 19.5% at ages 5-9. ⁴⁹¹

• Nearly one-quarter (24.4%) of all San Mateo County children aged 10-12 years receiving CHDP health exams were overweight in 1996. This rate is higher than that for both the state (20.3%), and the U.S. (20.4%).⁴⁹²

pediatric anemia

• The rate of anemia is 15.6% among 1- to 2-year-olds served by the CHDP program in San Mateo County, well above the Year 2000 objective of 5%. ⁴⁹³

• The rate of anemia is 13.4% among 3- to 4-year-olds served by the CHDP program in San Mateo County, also above the Year 2000 objective of 10%.⁴⁹⁴

Community perceptions regarding the ease of access of child health services can be found on the Health Insurance Coverage page.

adolescent pregnancy

consequences of adolescent pregnancy

Teenage parents and their children face a lifetime of disadvantages. The consequences of adolescent childbearing have been widely reported:

• Adolescent mothers have a higher than average chance of suffering pregnancy complications, including toxemia, anemia, bleeding, cervical trauma, and premature delivery. ⁴⁹⁵
• Teenage girls who give birth are less likely to ever complete a high school education than their non-parenting peers. ⁴⁹⁶
• Teenage mothers earn about half the lifetime income of women who first give birth in their 20’s. ⁴⁹⁷
• Teenage fathers, in general, have lower incomes, less education, and more children than men who postpone having children until their 20s. ⁴⁹⁸.

status of adolescent births in san mateo county

• Between 1994 and 1996, there were 39.8 births for every 1,000 girls aged 15 to 19 in San Mateo County. This rate compares favorably to those recorded statewide (66.6) and in neighboring Santa Clara County (50.5) during this period. ⁴⁹⁹

• In addition, in 1996, a total of 2.8% of all births in San Mateo County were to girls aged 17 or younger. Proportions of births to adolescents are exceptionally high among African-Americans (9%) and Hispanics (5.7%) in San Mateo County. Note that the Hispanic proportion has remained fairly steady for the past couple of years, while the African-American proportion has increased for three consecutive years. ⁵⁰⁰

• By geography, proportions of adolescent births greater than 5% were recorded in 1996 in ZIP Codes 94063 and 94303 in South County.⁵⁰¹

prenatal care & birth outcomes

• In 1996, 36.6% of adolescent pregnancies received late (after the first trimester) or no prenatal care; this proportion, however, has decreased from a high of 56% recorded in 1990. ⁵⁰²

• Only 60% of adolescent pregnancies in San Mateo County received "adequate" prenatal care in 1996 (as determined by the Kessner index). While the adequacy of prenatal care received among adolescents in San Mateo County improved significantly in the first half of this decade, the 1996 proportion is a drop from the 66% recorded in 1995, and adequacy of prenatal care among adolescents remains significantly below the county average for all pregnancies (84.6%). ⁵⁰³

• In 1996, 8.2% of adolescent births in San Mateo County were low birthweight; this percentage was 11.9% in 1995. These percentages are well above those recorded for all San Mateo County births. ⁵⁰⁴

• Nearly three out of four adolescent child deliveries (73%) were covered by Medi-Cal. This percentage increased dramatically between 1989 (50%) and 1992 (72.3%), and has been rather steady since 1992. As with the increase in the proportion of Medi-Cal births noted earlier, the change can primarily be attributed to expansions in Medi-Cal eligibility, i.e., coverage of prenatal and delivery services for undocumented immigrants and creation of Medi-Cal eligibility categories for pregnancy. ⁵⁰⁵

Adolescent sexual activity is addressed in the Youth Risk Behaviors section.

youth risk behaviors

youth tobacco use

• In a 1997 survey, 40% of male high school seniors and 41% of female high school seniors reported smoking cigarettes in the preceding 12 months. These proportions were highest (greater than 40%) among White, Multi-Ethnic and Hispanic students; proportions in these groups were higher among females than among males. ⁵⁰⁶

• Use of cigars was highest among White and Multi-Ethnic high school seniors (38% and 39%, respectively), while use of chewing tobacco was highest among White and African-American seniors (14% and 12%, respectively).⁵⁰⁷

adolescent sexual activity

• Among responding households with children between the ages of 10 and 17, 5.3% of parents are aware that their child is sexually active. This percentage increases to 10% among parents of 16- and 17-year-olds. ⁵⁰⁸ This perception is significantly different than the 36% of 9th through 11th graders reporting sexual activity. ⁵⁰⁹

For information regarding weapons carrying among adolescents, refer to the Firearms page.

For information regarding drug use among adolescents, refer to the Drug Use Amongst Adolescents page.

509  1998 San Mateo County Youth Risk Behavior Survey. San Mateo County Department of Public Health.

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