He a lthie r Sa n Joa quin County Community Asse ssme nt 2008 Susan Brutschy, President Applied Survey Research May 14 th 2008 May 14 , 2008 S San Joaquin County’s Health Profile: J i C t ’ H lth P fil Useful Data to Improve Our Future Sponsored by the San Joaquin County Community Sponsored by the San Joaquin County Community Health Assessment Collaborative www.healthiersanjoaquin.org
B Background of the Project k d f h P � The San Joaquin County Community Health Assessment Collaborative formed in 2004. � Purpose: to produce a functional and comprehensive county health profile county health profile. � Overall goal: to inform and engage local stakeholders and community members in order to promote and develop collaborative efforts based on reliable data, community input and group consensus. 2
Community Assessment Project Form a Steering Committee Step 1 Update the Develop We a re Step 10 Step 2 Report Project Methodology he re ! Regularly Create Encourage Step 3 Step 9 Working Committees Community Action Sa n Joa quin County County Develop Community C i Identify Potential Goals and Benchmarks Step 4 Quality of Life Indicators Step 8 Publish and Publish and Collect Secondary Data Collect Secondary Data Step 7 Step 5 Promote the Report Conduct Community Surveys Step 6 Analyze Analyze Results
2008 A 2008 Assessment Focus Areas F A � Access to Health Care � Chronic Disease (Diabetes, Asthma and Obesity) � Early Entry into Prenatal Care 4
M Methodology h d l � English and Spanish telephone surveys were completed with over 400 randomly selected county residents. � Over 1,900 face-to-face surveys were collected at 37 different sites and community agencies throughout the diff t it d it i th h t th county. � Secondary (pre existing) data were collected for over � Secondary (pre-existing) data were collected for over 50 health indicators from a variety of sources. 5
County Demographics � In 2007, the population of the county was 679,687. � Since 2000, there was a 21% population increase. � In the next 10 years, 10% of residents will be age 65 or older. � According to the U.S. Census Bureau, 38% of San Joaquin g q County residents over age five spoke a language other than English in their home in 2006. � Of the total population 24% spoke Spanish/Spanish Creole � Of the total population, 24% spoke Spanish/Spanish Creole. � Currently in 2008, Caucasians make up 40% of the County population while Hispanics make up 37% population while Hispanics make up 37%. � After 2010, there will be a higher percentage of Hispanics than Caucasians. 2011: Hispanics (39%), Caucasians (37%) 2015: Hispanics (42%), Caucasians (33%) 6
Housing and Foreclosures g � San Joaquin County was among the top three counties that had the highest foreclosure rates in the United States in the fall of 2007. � The U.S. Department of Housing and Urban Development (HUD) defines affordable h housing as costing no more than 30% of a i i 30% f h household’s annual income. Spending much more than 30% impacts residents’ ability to afford other basic needs such as health care, food, and child care. � � In 2007 47% of telephone respondents and 74% of face-to-face In 2007, 47% of telephone respondents and 74% of face to face respondents reported spending more than 30% of their household income on housing costs . 7
Basic Needs In any given month, do you find you or your family having to go without basic needs such as food, housing, child care, health care or clothing? (Those responding “yes.”) 50% 34.6% 31.3% 25% 9.6% 9.6% 6 3% 6.3% N=428 N=429 N=1,960 N=1,985 0% Telephone Survey Face-to-Face Survey 2004 2007 So urc e : He a lthie r Sa n Jo a q uin Co unty Co mmunity Asse ssme nt, T e le pho ne a nd F a c e -to - F a c e Surve ys, 2004 a nd 2007. 8
Adult Health Insurance Coverage Adult Re sponde nts Who Curre ntly Ha ve He a lth Insura nc e Cove ra g e , 2004 a nd 2007 He a lthy Pe ople 2010 Obje c tive : 100% of r e side nts unde r 65 ye a rs will unde r 65 ye a rs will ha ve he a lth insura nc e . N=429 N=429 N=429 N=429 N=2 001 N=2,001 N=1,970 N=1 970 So urc e : Sa n Jo a q uin Co unty Co mmunity He a lth Asse ssme nt, T e le pho ne a nd F a c e -to -F a c e Surve ys, 2004. a nd 2007 9
Adult Health Insurance Coverage Pe rc e nta g e of Sa n Pe rc e nta g e of Sa n Joa quin County Adults without He a lth Insura nc e So urc e : He a lthie r Sa n Jo a q uin Co unty Co mmunity Asse ssme nt, T y e le pho ne a nd p F a c e -to -F a c e Surve ys, 2007; U.S. Ce nsus Bure a u, 2000. N = 534. 10
Youth Health Insurance Coverage Do your c hildre n ha ve he a lth insura nc e ? D hild h h lth i ? (T hose re sponding “ye s.”) 95.2% 92.6% 100% 84.8% 82.1% 75% 75% 50% 25% N=183 N=156 N=1,287 N=1,060 0% Telephone Survey Face-to-Face Survey 2004 2007 So urc e : Sa n Jo a q uin Co unty Co mmunity He a lth Asse ssme nt, T e le pho ne a nd F a c e -to - F a c e Surve ys, 2004. a nd 2007 11
Health Care Access and Utilization If you ne e de d he a lth c a re in the la st 12 months, we re you a ble to re c e ive it? (T hose re sponding “ye s.”) So urc e : Sa n Jo a q uin Co unty Co mmunity He a lth Asse ssme nt, T e le pho ne a nd F a c e -to -F a c e Surve ys, 2004 a nd 2007. 12
Access to Health Care T op 5 Re a sons Why Re sponde nts We re Una ble to Re c e ive He a lth Ca re in the Pa st 12 Months 2007 T elephone Survey 2007 Face-to-Face Survey No insurance 50.0% No insurance 69.0% Could not afford it 45.9% Could not afford it 33.9% Insurance would not cover it 37.5% Did not know where to go 16.3% Could not afford co-pay 29.1% Insurance would not cover it 13.9% Unable to find doctor to 20.8% Did not know what steps to p 13.9% accept insurance take to get health care Multiple re spo nse q ue stio n with 18 re spo nde nts Multiple re spo nse q ue stio n with 410 re spo nde nts o ffe ring 50 re spo nse s o ffe ring 898 re spo nse s So urc e : Sa n Jo a q uin Co unty Co mmunity He a lth Asse ssme nt, T e le pho ne a nd F a c e -to -F a c e Surve ys, 2007. 13
Emergency Department Use Do you use the e me rg e nc y de pa rtme nt for your ma in sourc e of c a re ? (T hose re sponding “ye s.”) N=425 N=429 N=1,843 N=1,856 So urc e : He a lthie r Sa n Jo a q uin Co unty Co mmunity Asse ssme nt, T e le pho ne a nd F a c e -to -F a c e Surve ys, 2004 a nd 2007. 14
Chronic Disease-Asthma Sa n Joa quin County Re side nts Who Ha ve Be e n Dia g nose d with Asthma , by Ag e , 2001- 2005 So urc e : 2001, 2003 a nd 2005 Ca lifo rnia He a lth I nte rvie w Surve y. 15
Chronic Disease-Diabetes Re side nts Who Ha ve Be e n Dia g nose d with Dia be te s, 2003 a nd 2005 10% 9.2% 9 2% 7.6% 8% He a lthy 7.0% 6.6% Pe ople 2010 Obje c tive : 6% 6% No mor e tha n 2.5% of 4% pe ople will ha ve diabe te s. 2% 2% 0% San Joaquin County California 2003 2005 So urc e : 2003 a nd 2005 Ca lifo rnia He a lth I nte rvie w Surve y. 16
Chronic Disease-Obese Adults Pe rc e nta g e of Adults Who Are Obe se , 2001- 2005 Re sponde nts’ BMI, 2007 50% 50% 39.2% 33.5% 28.8% 27.1% 25.6% 26.0% 21.2% 20.4% 25% 19.3% 25% 1.4% 0% 0% San Joaquin County California Low BMI Normal BMI Overweight Obese 2001 2003 2005 So urc e : 2001, 2003, 2005 Ca lifo rnia So urc e : He a lthie r Sa n Jo a q uin Co unty He a lth I nte rvie w Surve y. Co mmunity Asse ssme nt, T e le pho ne Surve y, 2007. 17
Early Entry into Prenatal Care Pe rc e nta g e of Wome n Re c e iving Pre na ta l Ca re P t f W R i i P t l C During T he ir F irst T rime ste r, 2000- 2006 He a lthy 100% 100% Pe ople 2010 Pe ople 2010 Obje c tive : 90% of 90% pre g na nt wome n will re c e ive e a rly re c e ive e a rly 85.8% 85.8% 80% 85.6% 85.2% 84.8% 83.1% a nd a de qua te 84.0% pre na ta l c a re . 70% 72.6% 72.2% 72.3% 70 0% 70.0% 69 4% 69.4% 69 1% 69.1% 68 6% 68.6% 60% 50% 2000 2001 2002 2003 2004 2005 2006 S an Joaquin County California So urc e : 2000-2004 da ta : Sta te o f Ca lifo rnia , De pa rtme nt o f He a lth Se rvic e s, Birth Re c o rds, 2007. 2005-2006 da ta : Sa n Jo a q uin Co unty Pub lic He a lth Se rvic e s, Birth Re c o rds, 2006. 18
Prenatal Care-Ethnicity P Pe rc e nta g e of Wome n Re c e iving Pre na ta l Ca re During T t f W R i i P t l C D i T he ir h i F irst T rime ste r, by Ra c e / E thnic ity, 2000- 2005 90% 82.2% 81.8% 80.9% 80.3% 79.3% 79.8% 80% 71.8% 69.9% 67.9% 69.0% 68.4% 70% 68.7% 68.2% 64.8% 68.0% 63.9% 67.2% 63.6% 65.3% 65.5% 62.8% 61.3% 60% 62.3% 60.0% 50% 2000 2001 2002 2003 2004 2005 Asian / Pacific Islander African American Latina Caucasian So urc e : 2000-2004 da ta : Sta te o f Ca lifo rnia , De pa rtme nt o f He a lth Se rvic e s, Birth Re c o rds, 2007. 2005 da ta : Sa n Jo a q uin Co unty Pub lic He a lth Se rvic e s, Birth Re c o rds, 2006. 19
Low Birth Weight Babies Pe rc e nta g e of L ow Birth We ig ht Ba bie s, 2000- 2006 So urc e : 2000-2004 da ta : Sta te o f Ca lifo rnia , De pa rtme nt o f He a lth Se rvic e s, Birth Re c o rds, 2007. 2005 da ta : Sa n Jo a q uin Co unty Pub lic He a lth Se rvic e s, Birth Re c o rds, 2006. 20
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