| health in san mateo county overview
Overall, health status in San Mateo County
is quite good. Respondents give high ratings to local health care, and the county compares
favorably to national figures for utilization of routine medical care. Concerns with
health care services in San Mateo County are not so much issues of quality or
availability, but rather ones of access and disparity. San Mateo County residents are
particularly critical or ambiguous regarding access to specialized services such as mental
health care and substance abuse services.
Problems with access to these and other
services are only compounded for the county’s traditionally disenfranchised
populations – namely the significant proportion of the population without any type of
health care coverage, low-income residents, and communities of color. These populations
face limited access to the county’s public and private health care delivery systems
due to cost, as well as a variety of other barriers, and these limitations in access have
a discernible impact on the health status of these residents and in the way that health
care is delivered in the community.
public perception
Overall, 54.7% of San Mateo County adult respondents rate
local health care as "excellent" or "very good." In contrast, 12.8% of
respondents believe that local health care is "fair" or "poor." This
perception includes 25.7% of those living below the 185% poverty threshold, 21.7% of
African-Americans, and 16.8% of those with a high school education or less.86
The top five health problems perceived by survey
respondents (excluding uncertain responses) include: pollution and other
environmental concerns (mentioned by 12.9%); cost of health care and
insurance (11.5%); AIDS/HIV (10.5%); cancer (10.5%);
and elderly care (9.5%). 87
personal health evaluations
Most San Mateo County survey participants report
"excellent" (31.4%) or "very good" (35.8%) general health. Another
23.5% report that their general health is "good." In contrast, 9.2% said their
general health is "fair" or "poor" (somewhat lower than the state and
national averages, 15.3% and 14.3%, respectively). 88
During the month preceding the interview, survey
participants report an average 2.5 days on which their physical health was not good. This
is again lower than state (3.1) and national (3.3) averages. 89
routine medical care
A total of 84.6% of respondents have a doctor’s
office or clinic they regularly go to for medical care (just below the 88.5% recorded
nationwide). Among those who do not, most say it is because they have not needed one
(42.7%) or they cannot afford it (19.8%). 90
Most (72.8%) San Mateo County adults have visited a doctor
within the past year for routine medical care, lower among men (62.2%) and adults 18-39
(65.8%). The San Mateo County percentage is, however, higher than the 68.6% recorded
nationally. 91
Two-thirds (66.5%) of respondents report that they have
been to a dentist for a routine check-up in the past six months, compared to 53.7%
nationally. A total of 70.8% of respondents report that they have had a routine eye exam
in the past two years (close to the 68.4% U.S. average).92
A total of 12% of respondents have used alternative or
complementary health care in the past year. Of those, chiropractic (43.6%) was the most
common type used.93
access to health care services
Overall, 60.1% of San Mateo County survey respondents rate
the ease of accessing local health care as "excellent" or "very good."
Another 25.9% rate it as "good." In contrast, 14% of respondents believe that
access to local health is "fair" or "poor." 94
Of several tested health services, San Mateo County
respondents were most critical of access to mental health services (28.1%
rate this as "fair/poor," 38.2% among the uninsured). Access to substance
abuse services received the second-highest "fair/poor"
response among San Mateo County respondents (23.2% overall, 36.6% among uninsured). 95
Three out of four San Mateo County respondents aged 18 to
64 report that they have coverage through an employer, either their own (56.4%) or someone
else’s (17.9%). A total of 10.6% say they have a health insurance plan they purchase
on their own. Another 3.8% have a government-sponsored plan (e.g., Medi-Cal, Medicare,
military health benefits). 96
However, 11.3% of adults aged 18 to 64 do not have
job-based, privately purchased, or government-sponsored health insurance (representing
approximately 50,127 adults aged 18 to 64). Of these respondents, 75% say they have no
coverage at all (approximately 37,595 adults 18 to 64), while 17.4% cite some
"other" source, and 7.6% don’t know. [Note that these figures exclude
children, of whom a greater share may be uninsured.] Statewide, it is estimated that 22.7%
of adults 18-64 do not have health insurance coverage. 97
African-American respondents had the highest prevalence of
being uninsured (34%), followed by Hispanics (18.1%), Asians/Pacific Islanders (3.6%) and
Whites (3.1%). [Note, however, that the percentage for African-Americans carries a
relatively high error rate because the sample size was small.] 98
26.6% of survey participants aged 18 to 64 currently do
not have any type of insurance coverage for routine dental care (either full or partial
coverage). Lack of dental insurance is highest among those living below the 185% poverty
threshold (53.8%). 99
A total of 15.4% of survey respondents report that they
have had difficulty getting in to see a doctor in the past year. Furthermore, the
following percentages of adult acknowledged that other factors have prevented them from
seeing a doctor in the past year: inconvenient office hours
(15.2%); cost (6.2%); lack of transportation (5.6%); and
language/cultural differences (2.3%). In addition, 6.3% of respondents
report that cost has prevented them from purchasing a needed medication in the past year. 100
Uninsured respondents and households living below $28,000
per year more often report "fair" or "poor" health status than do
privately insured respondents or those at higher income levels. Also, uninsured
respondents are much less satisfied with the health care they receive (29.6% rate this as
"fair/poor") versus privately insured respondents (9.9%). A total of 42.3% of
uninsured respondents rate access to local health care services as "fair" or
"poor," compared to only 12.8% of those privately insured. 101
Over one-third of all San Mateo County respondents (34.1%)
have used a local emergency room in the past year (average of 1.9 visits). This percentage
increases to 50.7% among those living below the 185% poverty threshold. Note that 34.1% of
privately insured respondents have visited a local emergency room in the past year (with
an average of 1.8 visits each), while 38.3% of uninsured respondents have used a local
emergency room (with a higher average of 2.1 visits each). 102
maternal & infant
health
The receipt of timely prenatal care and
the rate of infant mortality have improved in San Mateo County, although prenatal care
indicators still fall short of the Year 2000 objective. Low-weight births and privately
funded Cesarean-section births also fall short of Year 2000 objectives.
Concerns for maternal and infant health in
San Mateo County lie primarily in the discrepancies found across racial/ethnic
populations. For example, the proportion of adolescent pregnancies among African-American
residents is rising. Across the board, birth outcomes are notably poorer for adolescent
pregnancies (largely a result of a lack of appropriate prenatal care). Overall,
African-American and Hispanic women also significantly trail White and Asian women in
receiving prenatal care.
Birth Rates
In 1996, there were 10,042 total births in San Mateo
County, resulting in a crude birth rate of 14.4 births per 1,000 population. Hispanic
residents have the highest crude birth rate (22.3 per 1,000 in 1996). Over the past
several years, the crude birth rate has declined, most notably among African-Americans
(from 18.6 per 1,000 in 1989 to 9.9 per 1,000 in 1996).103
In 1996, 70% of births were paid for by private insurance
or health maintenance organizations (HMOs), while 29% were covered under Medi-Cal. This
proportion of Medi-Cal births has remained constant for four years, following four years
of significant increase due primarily 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). Medi-Cal births increased from 17% of
births in 1989 to 28% in 1992.104
infant mortality
In 1996, there were 4.0 infant deaths in San Mateo County
for every 1,000 live births. This rate satisfies the Year 2000 objective of 7.0 or fewer
deaths per 1,000 births. Infant mortality in San Mateo County is highest among
African-Americans (7.9 per 1,000). 105
low-weight births
In 1996, 5.7% of San Mateo County births were of low
birthweight, weighing less than 2,500 grams (approximately 5 pounds, 8 ounces), failing to
satisfy the Year 2000 objective of 5% or fewer. San Mateo County low-weight births were
highest in 1996 among African-American residents (11.9%), who fail to satisfy the special
population target of 9% or less. 106
prenatal care
In 1996, 85.2% of pregnant women in San Mateo County
received prenatal care during the first trimester of their pregnancies. The 14.8% of San
Mateo County women who received care after the first trimester or not at all exceeds the
Year 2000 objective (10% or less). 107
Receipt of timely prenatal care is improving slightly in
San Mateo County (increasing from 80.7% first-trimester care in 1989 to 85.2% in 1996). At
this rate, however, we will not reach the objective by the Year 2000.108
The adequacy of prenatal care has a discernable impact on
birth outcomes. For example, in 1996, 5.5% of women receiving adequate prenatal care gave
birth to low birthweight babies; this compares to 7% among women not receiving adequate
prenatal care. 109 This gap was even wider among African-American women (10.3%
of those with adequate care had low birthweight babies, compared to 17.9% of those
receiving less than adequate care). 110
child & adolescent
health
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.
childhood immunization
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, however, remains below the Year 2000 objective which is 90% or higher. 111
pediatric obesity
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%). Rates are highest
among children of Hispanic origin.112
adolescent pregnancy
In 1996, 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. 113
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. 114
Only 60% of adolescent pregnancies in San Mateo County
received adequate prenatal care in 1996. While this improved significantly in the first
half of this decade, the 1996 proportion is a drop from the 66% recorded in 1995 and
remains significantly below the county average for all pregnancies (84.6%). 115
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. 116
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).117
youth risk behaviors
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 greater than 40% among White, Multi-Ethnic and Hispanic students. 118
52% of high school males and 43.2% of high school females
report that they have used marijuana; approximately one in five has used another illegal
drug. 119
Nearly one-third (31.5%) of high school males acknowledge
carrying a weapon at some time in the 30 days preceding the interview, compared to 7.7% of
females. Further, 20.4% of high school males report carrying a weapon at school in the
preceding 30 days. 120
Among survey respondents with a child between the ages of
10 and 17, 5.3% are aware that their child is sexually active. This percentage increases
to 10% among parents of 16- and 17-year-olds.121 This perception is
significantly different than the 36% of 9th through 11th graders reporting sexual
activity. 122
senior health
As they are the fastest growing segment of
the population, the health and social needs of older adults in San Mateo County will
demand greater attention. Compared to younger counterparts, seniors much more often suffer
from many chronic and disabling conditions, and half suffer an impairment that limits
their activities. As this population continues to age, there will be greater needs for
in-home supportive services, long-term care arrangements, and respite services for
informal caregivers.
demographic overview
Between 1990 and 2010, the San Mateo County population of
adults aged 55 and older is projected to increase 58.2%. The population of those aged 85
and older is projected to increase 129.5%. 123
senior health issues
71.6% of seniors in San Mateo County have received a flu
shot in the past year (compared to 65.5% statewide and 62.8% nationwide; the Year 2000
objective is 80% or more) 124 A total of 53.8% of seniors have ever had a
pneumonia vaccination (compared to 49.8% statewide; the Year 2000 objective is 80% or
more). 125
Compared to younger counterparts, seniors much more often
suffer from high blood pressure and high cholesterol, as well as many chronic and
disabling conditions (including arthritis, heart disease, sciatica/back pain, deafness,
cancer, blindness, and ulcers). 126
One-half (50.2%) of seniors report some physical
impairment that limits their activities (compared to 40.3% nationwide). Of those reporting
an impairment, arthritis was most commonly identified (31.6%), followed by neck or back
problems (10.5%) and fractures/bone/joint injuries (9.2%). 127
mortality
Overall, San Mateo County rates for most
causes of death compare favorably and meet Year 2000 objectives, with the exceptions of
stroke and drug-related deaths, which fail to satisfy Year 2000 objectives. Also, death
rates among African-American residents are much higher for most leading causes of death.
Cancer death rates in San Mateo County are
comparable to state levels and are below the Year 2000 objective. Still, cancer is the
number-one killer in San Mateo County, and incidence rates (new cases) are slightly above
state rates for some types. The leading causes of cancer deaths, by site, are lung cancer,
colorectal cancer and breast cancer. Screenings for cancer, however, compare favorably to
national testing levels, and generally meet Year 2000 objectives.
Heart disease is the second-leading cause
of death in San Mateo County, and stroke is the third. Modifiable risk behaviors continue
to contribute to premature death and morbidity in the county, with nearly three out of
four San Mateo County adults exhibiting at least one cardiovascular risk factor, such as
smoking, physical inactivity, high blood pressure, high cholesterol, or being overweight.
leading causes of death
In San Mateo County, cancer is the
number-one killer (accounting for 25.8% of 1996 deaths), followed closely by heart
disease (24.1%); these disease groupings account for roughly one-half of the
deaths in San Mateo County. In addition, stroke accounted for 10% of
deaths in 1996. 128
age-adjusted death rates for selected causes
San Mateo County experiences rather low death rates for
most leading causes of death and meets nearly all of the Year 2000 objectives. The
exceptions are the elevated stroke rate in San Mateo County (which is
slightly higher than the state rate and fails to satisfy the Year 2000 objective) and the
rate of drug-related deaths (which, although lower than the state rate,
fails to satisfy the Year 2000 objective). 129
Death rates among African-American residents are much
higher for most leading causes (with the exception of suicide, which is highest among
Whites).130
cancer deaths
In looking at 1992-1996 annual average cancer deaths by
site, lung cancer is clearly the leading cause of cancer
deaths (with an annual average of 323 deaths), followed by colon cancer
(110 annual average deaths), breast cancer (105 annual average deaths)
and prostate cancer (79 annual average deaths).131
heart disease deaths
Between 1994 and 1996, there was an annual average of 79.9
deaths due to heart disease per 100,000 population in San Mateo County. Heart disease
death rates have been declining since the beginning of this decade.132 However,
heart disease death rates have increased in recent years among African-Americans. 133
stroke deaths
Between 1994 and 1996, there was an annual average of 28.8
stroke deaths per 100,000 population in San Mateo County. Overall, stroke death rates have
declined slightly in recent years, except among African-American residents. 134
actual causes of death
It is estimated that one-half of deaths in San Mateo
County (translating to 2,459 deaths in 1996) were attributable to external factors,
including risk behaviors. Tobacco was the root cause for approximately 19% of all 1996
deaths; poor diet and physical inactivity were the root causes for 14%. 135
cardiovascular risk factors
Nearly three out of four San Mateo County adults (73%)
participating in the survey exhibit at least one cardiovascular risk factor (i.e.,
smoking, no leisure-time physical activity, high blood pressure, high cholesterol, or
being overweight).136
A total of 45.5% of San Mateo County respondents lead
sedentary lifestyles, meaning they exercise fewer than three times a week for at least 20
minutes on each occasion (lower than the 52.6% national average). 137
A total of 18.1% of San Mateo County adults have been told
more than once by a health care professional that they have high blood pressure (compared
to 15.4% nationwide and 21.3% statewide). 138
A total of 18.2% of San Mateo County adults report that
they have been diagnosed them with high cholesterol, compared to 21% nationwide and 22.5%
statewide. 139
Based on reported heights and weights, 25.2% of San Mateo
County respondents are overweight (compared to 29.1% statewide and 29.2% nationwide). The
Year 2000 goal is to reduce overweight prevalence to no more than 20% of the population. 140
Overweight prevalence among adults in San Mateo County is highest among African-Americans,
those with a high school education or less, low-income residents, and older residents. 141
In all, 46.8% of overweight persons are using both diet
modification and an exercise regimen in order to shed excess pounds. Nationwide, this
percentage is only 23.1%, yet the Year 2000 objective is 50% or higher.141
chronic &
communicable disease
As case rates and deaths attributed to
AIDS continue to decrease in San Mateo County, concerns now focus on the needs of the
growing number of persons living with AIDS as a chronic disease. Although their numbers
are also declining, African-American residents continue to exhibit the highest case rates.
Sexually transmitted infections seem to be
declining in the county and satisfy existing objectives for the Year 2000. Incidence rates
for gonorrhea are declining sharply, as they are both statewide and nationwide. Unlike
state and national rates, San Mateo County incidence rates for chlamydia have also shown a
consistent decline since 1990. The incidence of syphilis in San Mateo County is low and
remains steady.
In contrast, whereas U.S. and California
tuberculosis incidence rates are declining, San Mateo County TB incidence rates continue
to increase considerably. A very high percentage of TB cases are foreign-born, with
particularly strong representation among Asian residents.
Enteric diseases — those transferred
hand to mouth — remain unpredictable. San Mateo County salmonellosis incidence rates
have increased considerably in recent years. Recent case rates for Hepatitis A in San
Mateo County are the highest since 1990. In contrast, shigellosis case rates have
decreased.
diabetes
The survey sample revealed 3.9% of the adult population
with diabetes (excluding diabetes experienced only during pregnancy). This compares to a
statewide prevalence of 5.6% and a national prevalence of 6.6%.143
HIV/AIDS
For the year 2000, there are projected to be only 18 new
AIDS diagnoses and 627 persons living with AIDS in San Mateo County. There are an
estimated 2,500 to 3,500 people infected with HIV in the county. 144
Despite the dramatic decrease in the overall infection
rate, African-Americans disproportionally suffer from AIDS. San Mateo County AIDS case
rates continue to be much higher for African-American residents, although this rate is
also declining sharply and the gap between African-Americans and other races/ethnicities
is narrowing. 145
4.3% of San Mateo County adults aged 18 to 64 identify
themselves to be at "high" or "medium" risk for HIV infection (4.2%
nationwide). A total of 40.9% have been tested for HIV, apart from testing done when
donating blood (40.2% nationwide). 146
sexually transmitted diseases
In 1990, the San Mateo County incidence rate was 125.3
cases per 100,000; in 1997, the case rate was 18.6 per 100,000. The San Mateo County rate
has remained well below the state (59.0 per 100,000) and national (124.0 per 100,000)
rates, and continues to satisfy the Year 2000 objective by a wide margin (225 or fewer per
100,000). 147
Unlike state and national rates, San Mateo County
incidence rates for chlamydia have shown a consistent decline since 1990 (250.8 per
100,000 in 1990; 119.6 per 100,000 in 1997). Whereas San Mateo County once exceeded state
and national incidence rates for chlamydia, the county is now well below those rates and
satisfies the Year 2000 objective (170 or fewer per 100,000), as well. However, most
reported cases are in females and very little testing occurs in males. Aggressive testing
and control measures would find rates much higher than the Year 2000 objective. 148
The incidence of syphilis in San Mateo County is low and
remains steady (6.0 cases per 100,000 in 1996, 5.4 in 1997). State and national rates are
considerably higher (13.6 and 20.2 per 100,000, respectively, in 1996), but are sharply
declining. 149
tuberculosis
The 1997 San Mateo County incidence rate for tuberculosis
was 12.0 per 100,000 population. This rate is comparable to the state rate (11.8 per
100,000), but above the national rate (8.0 in 1996). The San Mateo County rate, however,
is far from reaching the Year 2000 objective (3.5 or fewer cases per 100,000 population).
150
Whereas U.S. and California rates are declining, San Mateo
County TB incidence rates continue to increase. The 1997 number of TB cases (85)
represents a 165% increase over the number of 1985 cases (32). 151
The majority of San Mateo County TB cases are foreign-born
— in 1997, 82.4% of cases were among persons born outside the United States; this is
the highest percentage recorded in more than a decade and significantly higher than the
California rate of 60%. 152
The incidence of tuberculosis in San Mateo County
disproportionately affects the non-White population. Asian/Other residents are
particularly hard hit: over one-half (54.9%) of tuberculosis cases between 1985 and 1997
have been among Asian/Other residents, while Asians/Others only comprise 16.6% of the
total county population. 153 Furthermore, the Asian TB rate appears to be
following a slight upward trend, although the rate has been rather steady for the past
three years.154
enteric disease
The 1996 salmonellosis case rate in San Mateo County (24
per 100,000) was well above both the state and U.S. rates and fails to satisfy the Year
2000 objective (16 or fewer cases per 100,000). 155 The 1997 case rate in San
Mateo County rose to 29.8 cases per 100,000 population.
While shigellosis case rates have decreased in San Mateo
County (from 21.3 in 1995 to 12.9 per 100,000 in 1996), the 1996 rate remained above both
state (12.2) and U.S. (9.8) rates. The San Mateo County rate, however, decreased to 11.5
per 100,000 in 1997. 156
In 1997, there were 331 campylobacter cases, down from a
high of 457 cases reported in 1994.157
The 1997 case rate for Hepatitis A in San Mateo County was
10.6 per 100,000 population. While this is lower than the 1996 rate, it is higher than any
other year since 1990. The 1996 San Mateo County rate was 15.2 per 100,000 population,
higher than the national rate (11.7 per 100,000), but lower than the state rate (20.5 per
100,000) and the Year 2000 objective (23 or fewer per 100,000).158
injury
Firearms were the leading cause of injury
deaths in San Mateo County, and are implicated in three out of four homicides —
nearly one out of five county adults acknowledges keeping a firearm in his or her home.
Motor vehicle crashes and overdoses were tied as the second-leading cause of injury
deaths.
For unintentional injuries, the San Mateo
County death rate satisfies the Year 2000 objective, although unintentional injury remains
the leading cause of death for residents aged 5 to 34. In terms of intentional injuries,
both homicide and suicide rates have decreased in recent years and currently satisfy Year
2000 objectives.
injury deaths
Firearms (24%), motor vehicle crashes (19%) and overdoses
(19%) accounted for nearly two-thirds of 1992-1996 injury deaths in San Mateo County (both
intentional and unintentional). 159
unintentional injuries
The 1994-96 annual average age-adjusted death rate for
unintentional injuries in San Mateo County was 18.2 per 100,000 population. This rate
satisfies the Year 2000 objective of 29.3 or fewer deaths per 100,000. Unintentional
injury deaths are higher among men, particularly men aged 85 and older (176.3 deaths per
100,000). 160
Between 1994 and 1996, there were an annual average of 6
deaths due to motor vehicle accidents per 100,000 residents in San Mateo County. This rate
is well below the Year 2000 objective of 18.8 or fewer per 100,000 population. 161 The
motor vehicle accident death rate is highest among the elderly (ages 75 and older),
followed by young adults (ages 15 to 24). 162
89.7% of surveyed adults report that they
"always" use seat belts when driving or riding in a car, close to the state
average (87.2%), much higher than the national average (70.4%), and satisfying the Year
2000 objective (85% or greater). 163
intentional injury
The homicide death rate has decreased in San Mateo County
in recent years (from 7.4 per 100,000 between 1991 and 1993 to 5.3 per 100,000 between
1994 and 1996), and currently satisfies the Year 2000 objective (7.2 or fewer per
100,000). While the homicide death rate remains highest among the African-American
population (18.2 per 100,000 between 1994 and 1996), this rate is less than half that
recorded between 1990 and 1992 (39.7 per 100,000). 164
1994-96 homicide death rates in San Mateo County are
highest among males 15 to 24 (14.7 per 100,000) and males 35 to 44 (8.3 per 100,000). 165
Nearly three-fourths (73%) of 1992-1996 homicides in San
Mateo County were committed with a firearm.166 Nearly one in five surveyed San
Mateo County adults (18%) reports keeping a firearm in or around their home (including
pistols, shotguns, rifles and other types of guns, excluding starter pistols, BB guns, or
guns that cannot fire).167
The suicide death rate in San Mateo County between 1994
and 1996 was 10 deaths per 100,000 population, just below the Year 2000 objective of 10.5
or fewer deaths per 100,000. Suicide death rates are significantly higher among males aged
15 and older, especially those aged 85 and older (62.7 per 100,000). 168
For most age groups, 1994-96 suicide rates were highest
among White residents. The exceptions are: Asians/Others had the highest rate among those
35 to 44; Hispanics had the highest rate among those 75 to 84.169
addictions &
substance use
Addictions and substance abuse are major
concerns. San Mateo County hospitalization rates for substance abuse increased since
1992-93, and in 1994-95 resulted in an annual average of more than $39 million in hospital
charges (a majority of which was publicly funded). Hospitalization rates are highest among
African-American residents. Furthermore, overall drug-related deaths in San Mateo County
remain above the Year 2000 objective.
Compounding the problem, San Mateo County
maintains a low number of treatment slots for substance abuse, leading to excessive wait
times, and many residents are uncertain how to obtain services, or see this as difficult.
substance abuse
In San Mateo County, 4.9% of surveyed adults acknowledge
having taken an illegal drug in the past year, higher than the U.S. finding (2.6%).
Responses were higher among adults 18 to 39 (8.6%) and men (6.5%). 170
A total of 2.6% report that they have ever sought
professional help for a drug-related problem. Among African-Americans in San Mateo County,
this percentage increases to 7.5%.171
alcohol use
A total of 5.1% of responding adults are
"chronic" drinkers, averaging more than two drinks per day (greater than 60
alcoholic beverages in the past month). This compares to a similar 5.3% response
nationwide. 172
A total of 14.1% are classified as "binge"
drinkers, having consumed five or more alcoholic beverages on a single occasion at least
once in the preceding month (identical to the national finding, and close to the 15.2%
found statewide). "Binge" drinking is highest among: men (21.6%); those aged 18
to 39 (21.5%); and Hispanics (18.8%). 173
The number of arrests for driving under the influence
(DUI) has significantly decreased in the past 10 years (a 38% decrease from 6,740 arrests
in 1995 to 4,200 arrests in 1996).174
substance abuse treatment
The 1994-95 substance use-related hospitalization rate in
San Mateo County was 637 per 100,000 from men, 402 per 100,000 for women. These rates are
higher among African-American residents for both men (1,033 per 100,000) and women (902
per 100,000). 175
In San Mateo County, there are 11 drug/alcohol treatment
slots for every 10,000 residents. This is considerably below the statewide average of 28
slots per 10,000 population. 176
Furthermore, the average wait time to receive substance
abuse services in San Mateo County is 50 days. This is more than twice the average for Bay
Area counties, and more than four times the median for all counties. 177
One-third (33.1%) of San Mateo County adults report that
they do not know where to access treatment for a drug-related problem if they or someone
in their family needed it. Higher responses are recorded among: those in households with
incomes less than $28,000 (53.3%); Asians/Pacific Islanders (50.2%); those aged 65 and
older (47.9%); those with a high school education or less (43.3%); and Hispanics (39.9%).178
mental health
Mental health is a general term used to
refer not only to the absence of mental disorders, but also to the ability of an
individual to negotiate the daily challenges and social interactions of life without
experiencing cognitive, emotional, or behavioral dysfunction. A large proportion of
individuals with mental disorders, including those with depression, do not receive
treatment. Early identification and specific treatment and rehabilitation measures can
significantly reduce the duration and level of disability associated with mental
disorders.
In San Mateo County, mental health
indicators addressed in the survey are generally comparable or slightly more favorable
than national benchmarks. However, area residents are often uncertain how to access mental
health services, or see it as difficult.
mental health status
A total of 5.1% of San Mateo County adults report a
history of mental or emotional problems (compared to 5.7% nationwide). This increases
among those in households with annual incomes less than $28,000 (11.8%) and among
African-Americans (9.4%). 179
depression
Nearly one out of five San Mateo County adults (19.5%)
reports that he or she has had a period of two years or longer in which he or she was sad
or depressed on most days. Nationwide, this prevalence is higher (22.8%). San Mateo County
residents expressing higher prevalence of prolonged depression include: those with annual
household incomes less than $28,000 (30.4%); those with a high school education or less
(30.1%); Hispanics (25.7%); and women (22.6%).180
stress
Respondents report an average 4.2 days in the preceding
month on which they felt worried, tense or anxious. 181
86 1998 San Mateo County Quality of
Life Survey. Healthy Community Collaborative of San Mateo County. September 1998.
87 Ibid.
88 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
89 Ibid.
90 Ibid.
91 Ibid.
92 Ibid.
93 1998 San Mateo County Quality of Life Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
94 1998 San Mateo County Quality of Life Survey. Healthy Community
Collaborative of San Mateo County. September 1998.
95 Ibid.
96 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
97 Ibid.
98 Ibid.
99 1998 San Mateo County Behavioral Risk Survey. Healthy Community
Collaborative of San Mateo County. September 1998.
100 1998 San Mateo County Quality of Life Survey. Healthy Community
Collaborative of San Mateo County. September 1998.
101 Ibid.
102 1998 San Mateo County Behavioral Risk Survey. Healthy Community
Collaborative of San Mateo County. September 1998.
103 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
104 Ibid.
105 Ibid.
106 Healthy San Mateo 2000: Health Status Indicators. San
Mateo County Department of Public Health. Summer 1998 Edition.
107 Ibid.
108 Ibid.
109 Ibid.
110 Ibid.
111 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
112 Ibid.
113 Ibid.
114 Ibid.
115 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
116 Ibid.
117 Ibid.
118 Ibid.
119 1998 San Mateo County Youth Risk Behavior Survey. San Mateo
County Department of Public Health.
120 Ibid.
121 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
122 1998 San Mateo County Youth Risk Behavior Survey. San Mateo County
Department of Public Health.
123 Coming of Age in the Bay Area: A Demographic Profile of the
Older Population. Bay Area Agencies on Aging. 1997.
124 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
125 Ibid.
126 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
127 Ibid.
128 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
129 County Health Status Profiles, 1998. Department of Health
Services and California Conference of Local Health Officers.
130 Ibid.
131 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
132 Ibid.
133 Ibid.
134 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
135 U.S Department of Health and Human Services, as Presented in the
Journal of American Medical Association (McGinnis & Foege, 1993)..
136 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
137 Ibid.
138 Ibid.
139 Ibid.
140 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
141 Ibid.
142 Ibid.
143 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
144 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
145 Ibid.
146 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
147 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
148 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
149 Ibid.
150 Ibid.
151 Ibid.
152 Ibid.
153 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
154 Ibid.
155 Ibid.
156 Ibid.
157 Ibid.
158 Ibid.
159 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
160 Ibid.
161 Ibid.
162 Ibid.
163 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
164 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
165 Ibid.
166 Ibid.
167 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
168 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
169 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
170 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
171 Ibid.
172 Ibid.
173 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
174 Indicators for a Sustainable San Mateo County: A Report Card of
Our County’s Quality of Life. Sustainable San Mateo County. May 1998.
175 Healthy San Mateo 2000: Health Status Indicators. San Mateo
County Department of Public Health. Summer 1998 Edition.
176 San Mateo County Human Services Agency.
177 Ibid.
178 1998 San Mateo County Quality of Life Survey. Healthy Community
Collaborative of San Mateo County. September 1998.
179 1998 San Mateo County Behavioral Risk Factor Survey. Healthy
Community Collaborative of San Mateo County. September 1998.
180 Ibid.
181 Ibid. |