Santa Clara County Highlights

Transcription

1 Santa Clara County Highlights Data and Partnerships: Pivotal Elements to Create Healthy Communities November 6th, 2009 David Hill, PhD, MPH

2 Cities of Santa Clara County 2

3 The pivotal elements Data evidence-based public health Epidemiology & data management at Santa Clara County Mountain View general planning as an example Partnerships cultivate relationships & build trust Chronic disease & injury prevention at Santa Clara County San Jose Strong Neighborhoods Initiative as an example 3

4 The department 4

5 The department Chronic Disease & Injury Prevention Affect behavioral, organizational, environmental change to: reduce impact of chronic disease and health costs, and eliminate health disparities Create healthier communities through: healthy food and physical activity initiatives tobacco prevention traffic safety Epidemiology & Data Management Roles: surveillance, outbreak investigation, vital stats management, create & conduct surveys, program planning & evaluation, analyses & presentations Databases: population & demographics, mortality/natality, reportable diseases, hospitalizations, tuberculosis, HIV/AIDS, cancer, traffic safety, community health status, maternal & child health, emergency preparedness 5

6 Demographics: population by race / ethnicity African American 3% Santa Clara County population: 1.8m [37% immigrants] Percentage Asian Hispanic 27% 26% White 42% 0% 13% 25% 38% 50% Race/ethnicity Source: Santa Clara County, Department of Finance population estimates, U.S. Census, American Community Survey, Note: Foreign born includes both naturalized U.S. citizens and not U.S. citizen residents 6

7 Leading causes of mortality in Santa Clara County Cancer Heart disease Stroke Alzhiemer's disease Chronic lower resp disease Accidents - unintentional injuries Diabetes Influenza & pneumonia Chronic liver dis & cirrhosis Suicide Top 2 causes, 50% of all deaths Total number of deaths = 8772 Source: California Department of Public Health, Death Records,

8 Community health status: BRFSS and California Healthy Kids Survey (CHKS) 8

9 Overweight and obesity - children California SCC White Hispanic Overweight Obesity 14.4% 13.3% 14.8% 11.5% 13.1% 8.4% 19.0% 17.5% HP 2010 objective for obesity is 5% More than 1 in 4 children in SCC are either overweight or obese (26.3%) Asian/ PI 12.2% 8.5% African American 16.4% 14.9% 0% 10% 20% 30% 40% Percentage Source: SCC CHKS (7 th, 9 th, 11 th graders). Overweight BMI = 85 th to <95 th percentile, Obesity BMI >= 95 th percentile, CHIS 2007 (12-17 years). Note: overweight is shaded area, obesity is plain area 9

10 Overweight and obesity - adults California SCC White Overweight 37.1% 37.7% 36.1% Obesity 24.3% 17.2% 19.4% HP 2010 objective for obesity is 15% More than half of the SCC adults are either overweight or obese (54.9%) Hispanic 44.2% 24.1% Asian/ PI 31.9% 5.5% African American 45.2% 17.8% 0% 20% 40% 60% 80% Percentage Source: SCC BRFS 2009, Overweight BMI= , Obesity BMI >=30.0, CDC BRFSS Note: overweight is shaded area, obesity is plain area 10

11 Overweight and obesity economic impact Dollars in billions $60 $45 $30 $15 $0 Reported total costs in California (in billions) $21.7 $41.2 $ (projected) Total costs due to overweight, obesity and physical inactivity in Santa Clara County: $2.1 billion Source: The Economic Costs of Overweight, Obesity, Physical Inactivity among California Adults, California Center for Public Health Advocacy 11

12 Overweight and obesity correlated to education Level of education attainment High school graduate Technical school graduate Some college College graduate Post grad / professional degree 47% 49% 57% 51% 68% Percent overweight or obese Source: SCC Behavioral Risk Factor Survey (BRFS)

13 Nutrition: access to healthy foods Source: California Nutrition Network, 2009 Created:10/19/ Santa Clara County Public Health Department 13

14 Nutrition: food mapping 14

15 Nutrition: access to healthy foods Searching for healthy food Distribution of retail food outlets, SCC Convenience stores 24% Fast-food restaurants 57% Farmers markets 2% Supermarkets 15% Produce stores 2% Retail Food Environment Index (RFEI) reflects availability of unhealthy foods as opposed to healthy foods Higher the RFEI, lower is the availability of healthy foods Higher number of fast-food restaurants are associated with higher rates of diabetes, cardiovascular disease, and cancer People living near supermarkets are more likely to eat more fruits & vegetables and less likely to be obese California RFEI = 4.18 Santa Clara County RFEI = 4.32 City of San Jose RFEI = 4.62 Source: Searching for Healthy Food, The Food Landscape in Santa Clara County, California Center For Public Advocacy, Jan

16 Nutrition: frequency of fast-food consumption 1-3 times/week 4 or more times/week California 50.6% 11.2% SCC 33.3% 7.1% White 29.5% 6.9% Hispanic 42.5% 6.5% Asian 29.5% 7.1% African American 32.0% 10.7% 0% 18% 35% 53% 70% Percentage Source: SCC BRFS 2009, CHIS Note: 1-3 times per week is shaded area, 4 or more times per week is plain area. Guthrie JF, Lin BH, Frazao E. Role of food prepared away from home in American diet, versus : changes and consequences. J Nutr Educ Behav. 202;34(3):

17 Physical activity: children engaging in vigorous activity* California SCC White Hispanic Asian/ PI African American 64.7% 73.2% 77.5% 72.3% 70.9% 73.7% HP 2010 objective is 85% 0% 20% 40% 60% 80% Percentage Source: HP 2010 ( 9-12 th grade), SCC CHKS (7 th, 9 th, 11 th graders), California Health Interview Survey (CHIS) 2007 *engaging in vigorous physical activity 3+ days per week for 20+ minutes per day 17

18 Tobacco use: initiating smoking before 15 years of age SCC 13.2% White 11.2% Hispanic 22.6% Asian/ PI 8.0% African American 16.0% 0% 8% 15% 23% 30% Percentage Source: SCC CHKS (High school only, 9 th, 11 th graders) 18

19 Data Highlights, and what to do 1 in 4 children and half of adults in SCC are overweight or obese Obesity costs and rates are increasing Racial and income disparities exist for many key health indicators Collective action and partnership at the community level are needed to reverse these trends 19

20 What is community level prevention? Interventions that promote healthy environments and behaviors - making it easier for people to make healthy choices, such as: Changing community norms and empowering communities Coalition and social network building Social marketing campaigns Changing the physical and social environments Organizational practices and government policies Facilities and programs Walkability lighting, sidewalks, signage Access to healthy foods 20

21 Community / Neighborhood: what improves wellness? Public park, bike trail or sidewalk Access to fresh produce/farmers markets Neighborhood safety Improve housing Vector control Animal control 26% 17% 15% 9% 8% 4% 6 in 10 think these changes will have most impact Clean hazardous waste sites 4% Source: SCC BRFS

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23 General plans and city partnerships Focus - to date - on: South County / Gilroy San Jose Mountain View Presentations: Envision 2040, March 2008, Public Health and Climate Change, Dec 2008 Workshops: Health and the Built Environment: Considerations for General Plans, Feb 2008 Technical Assistance: Gilroy Downtown Specific Plan, Mountain View Health Impact Assessment, City of San Jose data Data: BRFSS, YRBS (Youth Risk), EBLL (Lead) 23

24 Sampling of key partners & collaborative efforts Bay Area Regional Health Inequities Initiative California Center for Public Health Advocacy California Food Policy Advocates California Convergence California Pan Ethnic Health Network Healthy Silicon Valley Hospital Council of Santa Clara County Kaiser Permanente Parks and Recreation San Jose and Santa Clara County Santa Clara County Climate Action Team Partnership for the Public s Health Prevention Institute Public Health Law & Policy San Jose Strong Neighborhoods Initiative Santa Clara County Board of Supervisors Strategic Alliance for Healthy Food & Activity Environments The Health Trust United Way of Silicon Valley 24

25 Thank you! (408) Dedicated to the Health of the Whole Community 25

26 Climate action team Steering committee includes: County Executive s Office County Council Facilities and Fleet Environmental Health Roads & Airports Information Services Health & Hospital (Public Health) Purpose: Support implementation of various initiatives: green teams & sustainability committees Guide strategic planning Develop Climate Action Plan (greenhouse gas reduction) 26