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

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). ⁶⁶⁴
• By county catchment area, the proportion of injury deaths attributable to firearms is higher in North County (28%) and South County (29.9%). The proportion of injury deaths attributable to motor vehicle crashes is highest in the Coastside (39%).⁶⁶⁵

unintentional injury

• 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. ⁶⁶⁶
• Unintentional injury deaths are higher among males at all age levels, and highest among men aged 85 and older (176.3 deaths per 100,000). ⁶⁶⁷

• Hospitalizations for unintentional injuries accounted for an average of 8.4% of all hospitalizations in San Mateo County in 1994 and 1995. The leading causes of unintentional injury hospitalization were: reactions to drug therapy (39%); falls (32%); motor vehicle crashes (8%); poisoning (3%); fire/burns (2%); and bicycle accidents (1%). ⁶⁶⁸

• In 1994 and 1995, unintentional injury-related hospitalizations resulted in annual average charges of $103,826,492 or 12.7% of all hospitalization charges. Nearly one-half (45%) of these charges were paid through Medicare. The distribution among other payment sources are as follows: private insurance (20%), HMO (16%), Medi-Cal (9%), self-payment (4%), worker’s compensation (3%), other government sources (2%) and other non-government sources (1%). ⁶⁶⁹

• Hospitalizations for unintentional injuries are highest among persons aged 65 and older; among those 75 and older, hospitalizations are higher for women (5,246 discharges per 100,000 for women 75 to 84; 9,245 discharges per 100,000 for women 85 and older). Furthermore, unintentional injury hospitalization rates among seniors (65 and older) increased between 1993 and 1995. ⁶⁷⁰
• By race, unintentional injury hospitalization rates are higher for African-Americans, except in the 15-24 and 75-and-older age groups, for which Whites experience higher hospitalization rates. ⁶⁷¹

motor vehicle accidents

• 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. ⁶⁷²

• The motor vehicle accident death rate is highest among the elderly (ages 75 and older), followed by young adults (ages 15 to 24 years).⁶⁷³

• Hospitalization rates attributed to motor vehicle accidents are likewise highest among the 75-84 age group (131 discharges per 100,000) and the 15-24 age group (116 discharges per 100,000).  ⁶⁷⁴

• In the 1998 San Mateo County Behavioral Risk Factor Survey, 89.7% of 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). ⁶⁷⁵

• Of San Mateo County respondents with children, 96.2% report that their child "always" wears a seat belt or uses a child restraint when riding in a car (compared to 85.1% nationally). ⁶⁷⁶

bicycle accidents

• Nearly one-fourth (23%) of parents surveyed say their child does not "always" wear a bicycle helmet when riding a bicycle (11.6% say he/she "never" wears one). This percentage is lower than the national average (31.9%). ⁶⁷⁷

Poisonings

• There was an annual average of 5 deaths per 100,000 attributed to poisoning in San Mateo County between 1994 and 1996 (there is no Year 2000 goal established for poisoning deaths). ⁶⁷⁸
• The poisoning death rate was highest among adults aged 35 to 44 years. ⁶⁷⁹

• However, hospitalization rates due to poisoning are highest among persons 65 and older (38 discharges per 100,000 among those 65-74; 55 discharges per 100,000 for those 75-85; 98 discharges per 100,000 among those 85 and older). Most of these were related to drug overdoses. ⁶⁷⁰

Falls

• The accidental death rate attributed to falls in San Mateo County was 1.4 per 100,000 population between 1994 and 1996. This rate satisfies the Year 2000 objective (2.3 or fewer per 100,000). ⁶⁸¹

• Deaths from falls are predominantly found among seniors (aged 65 and older), and the rate escalates to 74.8 per 100,000 among women aged 85 and older, and to 62.7 per 100,000 among men aged 85 and older. ⁶⁸²

• Likewise, hospitalization rates for fall-related injuries increase considerably among the senior population (642 discharges per 100,000 population among those 65-74; 2,021 per 100,000 among those 75-84; 5,438 per 100,000 among those 85 and older). ⁶⁸³

Intentional injuries (including homicide, suicide, assault, and self-inflicted injuries) are addressed on the Health in San Mateo County page.

Intentional Injury

homicide

• 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). ⁶⁸⁴
• 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). ⁶⁸⁵

• 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). ⁶⁸⁶

• Analyses of 1994-96 homicide death rates in San Mateo County by race and age reveal an exceptionally high rate of death among African-American children under the age of 5 years (47.1 deaths per 100,000). The next-highest rates are found among African-Americans aged 15 to 44. ⁶⁸⁷

• Hispanics also experience high homicide death rates in the 15-24 age group, and, to a lesser degree, in the 25-44 age group. ⁶⁸⁸

assault

• The 1994-95 annual average assault injury hospitalization rate in San Mateo County was 48 discharges per 100,000 population. This rate was highest among males 15 to 24 years old (138.1 discharges per 100,000 population), although this represents a decrease from the 1992-93 annual average for this age group (226 per 100,000). ⁶⁸⁹

• Assault injury hospitalizations are particularly high among young African-American and Hispanic men. By race/ethnicity and age, the highest hospitalization rate was for African-American men aged 25 to 34 (235 discharges per 100,000). ⁶⁹⁰

• For males in San Mateo County, the most common types of assaults resulting in hospitalization in 1994-95 include: firearm-related injuries (29%), unarmed fights (26%), cutting (18%) and being struck by an object (16%). For females, the most common types include: unarmed fights (35%), cutting (21%) and firearm-related injuries (14%). ⁶⁹¹

firearms

Firearms are a leading non-genetic external factor contributing to mortality.

• Nearly three-fourths (73%) of 1992-1996 homicides in San Mateo County were committed with a firearm. ⁶⁹²

The 1998 San Mateo County Behavioral Risk Factor Survey reveals that:

• Nearly one in five 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). ⁶⁹³

• The presence of firearms in the home is noted much more among men than among women. Higher indications are also noted among adults aged 40 to 64, persons at higher income levels, Whites, African-Americans, and Coastside residents. ⁶⁹⁴

• Of those keeping firearms:

*  62% say these are secured in a locked drawer, cabinet or closet. Most say that they keep a firearm for hunting or sport (50.1%) or for protection (24.9%). ⁶⁹⁵

^*  Only 1% say they have carried a loaded firearm on their person (outside of the home) for protection in the preceding 30 days (excludes persons carrying weapons for their job, such as police officers). ⁶⁹⁶

^*  Only 0.6% say they have confronted another person with a firearm in the past year (even if not fired) in order to protect themselves, their property or someone else. ⁶⁹⁷

weapons-carrying among adolescents

• 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. ⁶⁹⁸

Suicide

• 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. ⁶⁹⁹
• Suicide death rates are significantly higher among males aged 15 and older, and the highest rate is recorded among men aged 85 and older (62.7 per 100,000). ⁷⁰⁰
  
         

• 

• For most age groups, 1994-96 suicide rates were highest among White residents in San Mateo County. The exceptions are: Asians/Others had the highest rate among those 35 to 44; Hispanics had the highest rate among those 75 to 84.⁷⁰¹

• For males, the most common methods of suicide between 1992 and 1996 include: firearms (48%), suffocation (24%) and overdose (10%). For females, the most common methods were: overdose (33%), firearms (28%) and suffocation (19%). ⁷⁰²

self-inflicted injury

• 1994-95 non-fatal self-inflicted injury hospitalizations in San Mateo County were predominantly related to overdose (accounting for 70% of these hospitalizations for males, 80% for females).⁷⁰³

• Whereas suicide deaths are higher among males, self-inflicted injury hospitalization rates are higher among females at most age levels. The highest recorded rate is among women aged 15 to 24 in San Mateo County (167.5 per 100,000). The second-highest rate by gender and age is actually among males 85 and older.⁷⁰⁴

• By race/ethnicity, the highest self-inflicted injury hospitalization rate was recorded for White residents of San Mateo County between the ages of 15 and 24 (158 discharges per 100,000). Whites also have the highest rates among those 65 to 74 and those 85 and older. On the other hand, African-Americans have the highest rate of self-inflicted injury hospitalizations for those aged 5 to 14 and those aged 25 to 54. Asians have the highest rate for those aged 75 to 84. ⁷⁰⁵

705  Healthy San Mateo 2000: Health Status Indicators. San Mateo County Department of Public Health. Summer 1998 Edition.

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