Community Assessment - Health & Quality of Life in San Mateo
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Appendix A: Qualitative Findings

 

Family Issues

san mateo county as a place to raise a family

number one problem facing families

Among community panel members, concerns for families in San Mateo County include lack of time to spend with children, the need for family counseling, and the need for parenting support.

"Parents working and the things we were talking about before and just the impact on how much time you are going to spend with your child and then whether or not the community is prepared to help you with the after-hours school. I think parents have a much harder challenge than they had. It’s all the demands on them to make a living and not be home and child care problems…"
— Community Leader

"I see kids, families, who really need a lot of services and economically they may be okay, both parents are working and they have medical insurance, but as far as connecting them to those resources like family counseling, it’s so limited. You get 10 visits or 20 visits. You really need so much more."
— Social Services Representative

"I’ve been thinking about all the research that’s been done about brain development and what happens to a child up to the age of 3 and how crucial it is to have good parenting and responsiveness and stimulation. I know there are projects for parents and lots of parents are in the know, but it seems to me more could be done. As I think of our families in child care, who are mostly single moms, they really have a struggle working and trying to raise their children. It seems like it’s more in the mental health area that so much more could be done with new moms and telling them how important what they do is."
— Social Services Representative

 

education

educational opportunity

Because schools play such an important role in children’s lives, these community panel participants believe schools should stretch beyond academics and offer things such as health education and mental health services.

"School is a large part of these kids’ lives, especially those who don’t have the balance of home. Our children are not there just for academics. They need a more holistic [approach] —whether it’s health care or mental health or connecting them to other members of the community."
— Social Services Representative

"In regard to mental health, I think the schools are just totally unaware of it. I know I had to prepare a list of family intervention services for the schools because they didn’t know. They didn’t know where to refer their parents."
— Social Services Representative

On the other hand, although panel participants recognize there are many dedicated teachers, they believed most do not have the time to do everything that is being asked of them.

"I don’t think every teacher can do that, they don’t have the time. There are more and more ideas coming through Healthy Start and things like that about what schools could provide, and I think there’s quite a bit of mismatch."
— Social Services Representative

"We’ve asked these teachers who are on overload anyway, to play all these roles. They’re not equipped, don’t get support. The financial resources aren’t there."
— Social Services Representative

"In the lower grades, I think our schools are really in overdrive trying to adapt… really courageous and wonderful… I can’t say enough good about the schools. I see people who are really dedicated and put everything they’ve got into it."
— Community Leader

Furthermore, this individual believes the family should take more responsibility and the school system receives unfair criticism.

"Given the challenges that public education faces in the county, I think it receives unfair criticism. We too often turn to the school system – whose primary function is to educate students – to ask the system to solve the problems of society. And we let the problems of society come to the school and expect the teachers and the administration to deal with them. I think we need to take more responsibility. I feel ultimately the success of education depends on the student and his or her parents or the adults in his or her life working with a competent teacher."
— Community Leader

Community panel participants also feel education must be culturally sensitive to those who do not speak English or come from different cultural backgrounds, particularly with recent legislation in the state.

"I have a very specific concern, and it is the education of children who don’t speak English. In a school district where we have 70 percent of our students arriving at school not speaking English, I think that contributes to youth feeling disenfranchised and not having access to the good things that they see around them. I think our schools are going to be mightily challenged to come up with programs and approaches that will allow children to become academically proficient in our public schools. I really worry about children and how they’re going to be affected and I worry about the greater message that is sent to a significant amount of our population that they’re not very welcome here. They have to adjust quickly and adjust to one way of doing things rather than having some tolerance for the differences that are among us."
— Community Leader

 

school safety

Many panel members are concerned with violence in schools and the lack of feeling of safety among students when they are in school.

"They are increasingly younger and younger who are preying on each other. We need intervention programs built into the school, built into the community so that we’re not reacting, we can take some more proactive [measures]. One-third of kids on the coast side say they’re frightened at school.
Not going there, but in the school."
— Social Services Representative

"That raises the whole issue of violence in schools. I think it’s a nationwide statistic that somewhere between 8 and 10 percent of students come to school armed. That’s what the suicide rate is as well. We’re reading all over the country now, kids shooting each other. And the violence that’s in our media and our movies and our video games. And also the violence of our society. I’m not hearing anybody talk about that. This is America. As wonderful
a country as it is, it is a violent society."
— Physician

Some participants emphasized that the school system or county should be doing more prevention and follow-up for students at risk or who have shown violent or inappropriate behavior.

"There are a lot of capable students in this county… and I think the school districts are under a lot of pressure to provide for those capable students. I’m not sure what’s going to happen with the less capable, the ones that are at risk, because the school districts are also very concerned about violence on campus, student behavior on campus. The current trend seems to be that administratively, a lot of districts are adopting zero tolerance policies for a whole host of things. And when they adopt a zero tolerance policy, kids are out on the first offense. And the response to the kids that get expelled or suspended is not that good. They may get home instruction or the county office of education has to provide community schools and court schools, but that’s still limited at best. So I think there’s an issue in education that still needs to be addressed for the kids who are at risk in this county because without a decent degree of literacy, if we can’t deal with those things, we’re really not doing any young person a favor as they grow up."
— Community Leader

"So what do you do with these kids? You expel them and then there’s no input. It seems to me that the school system needs to take care of all these children. Maybe not leave them in the routine flow, but we dump them out on the streets."
— Physician

One participant also said although these problems are less frequent, they must not forget to consider the safety of children from adults in the system who prey on minors.

"I would not exclude the vigilance toward monitoring the adults. Some kids are not going to come out and say they are being sexually harassed by a teacher or a counselor or something. Those things occur, even just abuses in the classroom."
— Social Services Representative

 

college preparedness & attendance

These two community leaders pointed to an increasing number of kids graduating from high school who are academically ill-prepared for college.

"I think from our perspective our mission is to try to reach out to the students who are maybe less prepared for college life. What we find is there’s an incredible amount of what we call grade inflation. And you can’t even look at a kid’s grades because an A in this school is an F in that school – you get an A because you showed up everyday that week and you didn’t harm anybody. So, it’s very hard to figure out who’s ready and who’s not."
— Community Leader

"If they’re not prepared, we let them know. So there’s a tremendous drop out rate. I don’t know if there’s some kind of a net where they try to scoop those people back up or not. In the fall, I’ll start with a class of 35 people and 15 will be gone within 6 weeks. It’s because they can’t read or they can’t write and you just can’t make it through college if you can’t do those things."
— Community Leader

Furthermore, knowing the cost of living in San Mateo County, this physician felt it must be difficult for kids who are not among the elite to believe they can make a living in the area.

"I can’t imagine what it’s like to be youth growing up in this area, especially if you are not among the elite who knows they’re going to Harvard, thinking about staying in this area and trying to make a living. When we were growing up, our choices were very broad, but if you’re not getting a high-level education at this time in this area, you don’t have a hell of a lot of look forward to."
— Physician

 

 

adult education

adult educational opportunities

This business representative believes the academic institutions present for continuing adult education are an advantage to San Mateo County.

"The academic presence is here. I know when the College District advertises for college presidents and other administrators, one of the things they say is ‘midway between San Jose and San Francisco.’ Then they list all the colleges and universities that are available for further
study. So that’s another advantage."
— Business Leader

 

 

child care

evaluation of services

All community panels stressed the need for convenient, affordable, extended-hour, quality child care in San Mateo County.

"Child care almost doesn’t exist for up through toddlers. It’s just really awful, there’s so few licensed child care services for infants and toddlers. Once you get to preschool, it starts getting somewhat better, but again the cost for quality child care and then what the reimbursement is for child care workers is still horrible."
— Social Services Representative

"Child care is a significant issue in San Mateo County based on my employees and other people who I’ve spoken to. They’re on waiting lists for child care and it becomes a real difficult situation, particularly when you have to have dual incomes in order to maintain a lifestyle. No sooner is the child born than you are trying to find quality child care. It becomes a real nightmare for the parents in our business which is operational 24 hours a day –we have employees that get off at 7:00 at night, and the care provider says 5:30 or 5:15 and 6:00 we lock the door. The one particular individual that I’m talking about now, she must be on about 8 or 9 waiting lists and they’re double-digit lists."
— Business Leader

"There’s a tremendous resistance of neighborhood people to having child care in homes because of the idea of residences being used as something other than residences. It’s unfortunate because I think one of the problems with child care – in addition to the lack of it being affordable and the quality – is the location of the child care, particularly if you’re working odd-ball hours. If that’s another drive far away for you to drop off your child and pick up your child, it creates all kinds of tensions and problems with the family going to work and trying to be on time for their own job. When you have child care in places of employment or if you have it for older children after school, those are the best. Or in the community where people live, those are the best locations for child care from the user’s point of view because it’s got to be quick and easy to get your child there."
— Business Leader

One area employer acknowledged some child care programs in the county, but indicated these do not meet the demand.

"There’s the one sponsored by the airport employees that’s open clock-round, that’s not enough. There’s the one at the county government center, all filled. Genentech runs a program, but there just aren’t enough."
— Business Leader

 

after-school care

Not only were community panel participants concerned with daycare needs for young children, they were also concerned with the need for after-school programs for children, particularly middle school children, who still need supervision but don’t need to be in daycare.

"When the kids are older, what happens to them after school? Particularly the group of kids where there is no child care, the parents feel they are old enough to be by themselves. We have children as young as third grade who are unsupervised and practically all middle school kids… So you have this whole group of kids at the most impressionable age, when they’re most apt to get into trouble – they really haven’t figured out what’s right and what’s wrong – and the peer pressure at the middle school age couldn’t be worse… We’ve got all these kids, unless they are in some kind of a sports program or their parents are wealthy enough to have them signed up for various activities, they’re unsupervised."
— Business Leader

"I think there’s a great need here, but I think the community can meet that need. I’m talking about the after-school and I think the area that this particular group is not addressing is what happens to the middle school population because there are very few after-school programs, tutorial programs. They’re the kids who are going to get expelled and suspended in high school and this is probably the last chance for them to do well and have enough self confidence that when they go to high school they’re not going to drop out. Mainly they’re dropping out because they can’t keep up with their school work, and they hang out with bad kids because they have an inferiority complex."
— Business Leader

On a positive note, this business representative mentioned an after-school tutoring program currently being considered in the area.

"One of the things we are going to be talking about tonight at our Council study session is a request from a church interfaith group in our city to provide after-school tutoring to kids who are bused out of North Central to other schools. I think they’ve really set up a good program, they are going to set it up at a school or church close to the community and it’s going to be very intensive by church volunteers. And you know that would be a safe, good place for kids to go."
— Business Leader

 

older dependents

older dependents

Another concern for families mentioned by social service panel participants was the difficulty families face in taking care of older dependents or elderly family members.

"A lot of managed care is limiting home care, too. It’s being pushed off onto the family member to provide home health care. We see elderly people who don’t even have families and who have major surgery and are sent home after two days. They certainly can’t take care of themselves and a visiting nurse coming for a couple hours isn’t going to take care of it."
— Social Services Representative

"There’s a tremendous amount of fallout in managed care on what happens to people after they’ve been discharged from a medical facility and what the expectation is for their care. Families are sometimes being forced to provide something that is well beyond custodial care, that’s really medical care. So you have the classic situation of a woman who has got minor children and who’s also taking care of an adult relative parent who has just been discharged from a hospital who works full-time. The sandwich generation is the right description of that because there’s just no way that people can do all that. Yet people’s managed care plans are saying you get two days and then you’re out, you’re home, and we’ll give you a little bit of this and a little bit of that, but you’ve got to have somebody to do all the rest."
— Social Services Representative

 

families in need

governmental assistance

A few individuals were concerned that changes in Welfare policies will create additional stress for families in need.

"A real concern I have is how the fallout is going to affect those on Welfare who will have their second year, their year to be off is 1999… I’m truly frightened at what is going to happen if we don’t have places for these people to get some of the help… How many jobs are going to be available at a salary that’s going to permit them to exist in this area and provide for themselves with the housing not being available? And what is the net result of that stress on all these families?"
— Social Services Representative

"When I think of when Welfare reform starts, families that are barely making it now are going to be even worse off."
— Social Services Representative

 

family violence

domestic violence

Community panels believed domestic violence rates in San Mateo County to be similar to rates in other areas.

"We probably have the same rates as just about anywhere in the state on domestic violence, and our services are much improved over 10 years ago."
— Business Leader

"Most of the calls that we get, they’re multi-family units and it’s a neighbor calling, or it’s a residential unit where everybody else can hear everybody’s business going on so they call us. We get more and more calls from children now who have been trained on the 911 system, and they understand it and touch the three digits in and say mommy and daddy are fighting."
— Business Leader

When questioned whether the domestic violence rates were increasing, participants said it is difficult to know because people have recently become more aware of domestic violence and are now more willing to report it than they were in the past. Moreover, law enforcement officers now have more authority to take action in domestic violence cases.

"As more and more information is coming out, we have more and more women who are coming forward or women who are willing to stand up because they realize they are not alone in the issue and there are support groups for them."
— Business Leader

"In domestic violence we have a hard time knowing whether there’s more or not because what we have clearly is far more reports and there’s more awareness and so we’re far more sensitive. We’re going back now and looking at deaths of women and actually uncovering deaths that probably have some relationship to domestic violence that weren’t reported that way. They weren’t known."
— Community Leader

"It hasn’t been until the last few years that there’s been a recognition that family violence begets family violence. And there hasn’t been the legislation. Really, police officers did not have the authority to do anything about it, so I think while we’ve seen an upsurge in domestic violence cases, it’s because it’s only in the last few years that we’ve actually had the power to do anything about it. Now we have considerable authority with restraining orders that we’re able to issue on the spot, we could never do that before. We used to have to talk the man out of the house and then arrest him for being drunk in public. He’d be out in a few hours. Now we’re able to do a lot more, so I think we’re much more effective in that area."
— Community Leader

"The other thing that we’ve done is we’ve changed the system on how we handle it from a law enforcement perspective, from providing service for families. It’s mandatory to make an arrest. We go into a situation and we make an arrest. Where in years past we’d say, ‘Why don’t you cool it off. Why don’t you take the night off and go to a hotel or something like that.’"
— Business Leader

As a positive, community leaders indicated that San Mateo County has recognized family violence as cyclical and has taken great strides in structuring a justice system to address it.

"I think one of the reasons we focus so much on domestic violence is that’s where you learn your coping skills, behavior. If you have violence in the home, family violence between husband and wife or between parents and children, that we believe gets translated potentially into criminal activity. That’s one of the reasons we believe that may be helpful in reducing gang
violence and violence in our society as a whole."
— Community Leader

"Actually [the handling of domestic violence is] a positive in the county. Between all the police agencies, the DA’s office, the courts have developed a pretty good system that would be a good model for other counties. From vertical prosecution to follow-through with probation officers, a good treatment program for batterers, and I think good programs at police agencies. We even have an emergency outreach program where, even though a case doesn’t rise to the level of a criminal activity, we still send a counselor out to the home to help that family, give advice to the victim and also to the batterer, abuser, about potential services."
— Community Leader

"We also have one of the first domestic violence courts
in the state, probably in the nation."
— Community Leader

While participants feel the county is doing a good job with most domestic violence cases, two areas they mentioned as disconcerting are dating violence and domestic violence in wealthy families.

"The other thing that I’m concerned about is that we have the same teen dating violence rate that most counties do, which is about one out of every 3 dating couples has violence as part of their dating relationship. That’s so high, and yet, those are girls who would need to ask their parents permission to borrow a car to go to a support group, so we don’t have services for that population."
— Business Leader

"One of the things that we run into is that we take calls from women who feel the shelter is for low-income, so what do the rich women do? We hear stories repeatedly about how they handle their domestic violence. One woman told me she made sure she got beat up early so the bruises would heal by the time she went to the parties and the cocktails during Christmas… These are people who will not call the shelter and for whom there really isn’t a good system."
— Business Leader

 

elder abuse

Elder abuse, physical, emotional, and financial, was another area of concern connected to family violence.

"One thing we haven’t talked about is the growing incidence of elderly abuse by members of the family. We’ve got some programs going, at least some studies on this, some departments are working on it. It’s something we never used to hear about – whether it existed or not, I don’t know – but certainly it’s present in many ways, not just physical abuse, but neglect. Much of it’s centering around the money and wondering what’s going to happen to these people when they’ve used up all their resources and not leaving us any…"
— Physician

"I think when you look at the senior community, you also have to realize how much abuse there is, both financial as well as physical. There’s a tremendous amount of financial abuse among people who are middle class and wealthier in the county. They’re being driven to financial ruin by someone who takes over and takes advantage of their vulnerability."
— Social Services Representative

"There’s a fair amount of people who are actually at physical risk from a family member, a caregiver. A lot of that is, I would say that elder abuse is maybe where domestic violence was about 10 years ago. It’s just now beginning to get some attention and people are looking at it and getting concerned and starting to put resources in it. What happens is that often because there isn’t enough support for taking care of people in the community, it creates so much stress that one of the possible outcomes of that is physical abuse. The caregiver snaps.
We see quite a bit of that."
— Social Services Representative

"It can be so hidden either because the person being abused has either not the mental awareness to even know it’s occurring or the ability to talk to somebody else about what’s occurring, especially when the alternative in their minds may be going to a nursing home. So they feel it’s better to stay at home and suffer the abuse than to be locked away in a nursing home."
Social Services Representative

 

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