Community Assessment - Health & Quality of Life in San Mateo
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Key Findings

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.

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. Overall, three-year averages of heart disease death rates have been declining since the beginning of this decade. ⁶⁰⁰

• Heart disease death rates are considerably higher among the African-American population in San Mateo County (121.8 deaths per 100,000 1994-96 annual average). Unlike the county overall, heart disease death rates have increased over the past several years among African-Americans. ⁶⁰¹

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, three-year averages of stroke death rates have declined slightly in recent years. ⁶⁰²
• Again, stroke deaths are markedly higher among African-Americans in San Mateo County (52.0 deaths per 100,000). Although the 1994-96 annual average is considerably lower than the 1993-95 average, the stroke death rate among African-Americans this decade is trending upward. ⁶⁰³

cardiovascular risk factors

• Nearly three out of four San Mateo County adults (73%) exhibits at least one cardiovascular risk factor (i.e., smoking, no leisure-time physical activity, high blood pressure, high cholesterol, or being overweight), as revealed in the 1998 San Mateo County Behavioral Risk Factor Survey. The presence of cardiovascular risk factors increases with age, but decreases with education and income level. In addition, there is variation by geography. ⁶⁰⁴

tobacco use

Tobacco use in San Mateo County is described in the Cancer section of this report.

physical activity

Regular physical activity increases life expectancy, can help older adults maintain functional independence, and enhances quality of life at each stage of life. The benefits of physical activity are numerous: an active lifestyle can help to prevent and manage coronary heart disease, being overweight, hypertension, diabetes, osteoporosis, and depression. Because more people are at risk for coronary heart disease due to physical inactivity than to any other single risk factor, it has an especially great public health impact. Note the following findings of the 1998 San Mateo County Behavioral Risk Factor Survey:

• 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). Sedentary behavior in San Mateo County is more common among:
• Those in households with annual incomes less than $28,000 (55.1%)
• Persons with a high school education or less (54%)
• Asians/Pacific Islanders (53.6%)
• Persons aged 65 and older (51.7%) ⁶⁰⁵

• In the past month, 86.1% of respondents report taking part in some type of physical activity outside their regular job duties, mostly walking (37.8%), running/jogging (8.4%), bicycling (6%) or using exercise equipment (5.3%). A total of 13.9% report no leisure-time physical activity in the past month (compared to 20.2% nationwide). ⁶⁰⁶

hypertension

Persons with hypertension, or high blood pressure, have three to four times the risk of developing coronary heart disease and as much as seven times the risk of a stroke as do those with normal blood pressure.

• 94.6% of San Mateo County adults responding to the 1998 San Mateo County Behavioral Risk Factor Survey report that they have had their blood pressure taken by a doctor, nurse or other health care professional within the past two years. This testing prevalence compares to 90.7% statewide and 93.8% nationwide, and satisfies the Year 2000 objective (90% or greater). ⁶⁰⁷

• A total of 18.1% of San Mateo County adults say they 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).⁶⁰⁸ 

• The prevalence of hypertension increases sharply with age, and shares a negative correlation with income. Also note that African-American respondents report a much higher prevalence of high blood pressure. ⁶⁰⁹

• Of those with high blood pressure, 70.3% are exercising more, 68.9% are taking medication, and 58% are changing their diet to help control their condition. Altogether, 88.4% of hypertensives are taking some type of action to control their blood pressure, higher than nationwide (77.4%) and close to the Year 2000 objective (90% or greater). ⁶¹⁰

high blood cholesterol

High cholesterol levels are also a contributor to heart disease:

• A total of 80.9% of surveyed adults report that they have had their cholesterol level checked in the preceding five years. This figure is just below the national average (83.6%), but is much higher than the statewide average (65.8%). It also satisfies the Year 2000 objective (75% or greater).  ⁶¹¹

• A total of 18.2% of San Mateo County adults report that a doctor or other health professional has diagnosed them with high cholesterol, compared to 21% nationwide and 22.5% statewide. ⁶¹²

• Prevalence of high cholesterol rises sharply with age, and varies greatly by race/ethnicity, with White and African-American residents reporting the highest prevalence. ⁶¹³

• Of those with high blood cholesterol, 75.8% are changing their diet, 74.6% are exercising, and 28% are taking medication to help control their cholesterol levels. Altogether, 89% are taking some type of action (higher than the 63.1% nationwide), satisfying the Year 2000 objective (60% or greater). ⁶¹⁴

overweight prevalence

• 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. ⁶¹⁵

• 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. ⁶¹⁶

• A total of 61.3% of overweight residents are trying to lose weight. Of these individuals:

*  80.9% are modifying diet
*  55.3% are increasing physical activity to lose weight
*  4.4% have taken pills prescribed by a doctor in order to lose weight ⁶¹⁷

• 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. ⁶¹⁸

cardiopulmonary resuscitation (CPR)

• A total of 55.7% of San Mateo County adult survey respondents relate that they have had first aid or CPR training. These responses are lower among:

*  Hispanics (49.9%)
*  Asians/Pacific Islanders (42.9%)
*  Those with a high school education or less (37.6%)
*  Persons in households with annual incomes less than $28,000 (37.2%)
*  Those aged 65 and older (34.6%) ⁶¹⁹

619   Ibid.

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