Dignity Health assessment about health and socioeconomic conditions of San Mateo residents

Key Findings about San Mateo community in areas of health and other aspects

• San Mateo County is among the most culturally and ethnically diverse counties.

• There are two San Mateo Counties: one for the economic “haves” and one for the economic “have nots.” The gap between these two is growing.
  • The actual causes of premature death are rooted in behavior, and it is estimated that as many as 50% of premature deaths are due to health risk behaviors such as tobacco use, poor diet, a lack of exercise, alcohol use, etc. Despite this, the vast majority of our community does not exhibit the most basic healthy behaviors.
    • Individual health behaviors are deeply influenced by public policy and place (i.e., neighborhood conditions) to a far greater degree than we recognize. The health of San Mateo County can be improved through a greater focus by all organizations on public policy changes and place-based strategies.
      • Quality health care services in the county are, for the most part, not a problem. Access and affordability are a significant problem. The lack of a comprehensive healthcare “system” is a failing, unsustainable model.
        • More than one out of four San Mateo County adults believe access to mental health, substance abuse, and dental services in the county are “fair” or “poor.”
          • The Internet is likely to replace physicians in the near future as the place where most people get most of their healthcare information.
            • The proportion of births with adequate prenatal care has risen steadily among Black and Hispanic women, lessening the racial health disparities that have persisted in prenatal.

• The rise in C-section rates is a disturbing trend.  [Connie: I can provide my childbirth ebook for free for pregnant women]
• Our children are not doing much better than adults in exhibiting healthy behaviors. This will severely impact their future health.
  • Adolescents engage in a variety of risky behaviors such as alcohol and drug use, tobacco use, violence, and sexual behavior. It is important to encourage in our children and adolescents those assets which will deter harmful behaviors and promote healthy

• Key adolescent assets where additional effort should be placed are: 1) increasing the amount of sustained caring and supportive adult/youth relationships; and 2) increasing meaningful participation of youth in community activities.
  • The proportion of adults aged 60 and older is expected to roughly double over the next four decades, and Hispanics and Asians are projected to increase their representation considerably in the older population. As the fastest-growing population segment, the health and social needs of older adults require increasing attention.
    • Falls are a key issue leading to hospitalization, loss of independence, and death among

• Looking at mortality rates, we are healthier now than any time in the past.
• Cancers are a leading cause of death in San Mateo County. Area incidence and mortality rates vary dramatically by race/ethnicity.
  • Few residents consume adequate amounts of fruits/vegetables, however, this appears to be slowly improving. Access to fresh fruits and vegetables is still an issue in some areas.
    • Heart disease and stroke death rates continue to decline, while reported prevalence  of high blood pressure and high blood cholesterol continues to rise.
      • Since 1998, there have been significant increases in the prevalence of asthma, chronic lung disease and diabetes among San Mateo County adults.
        • After decreasing for several years, we are beginning to see a disturbing rise in both gonorrhea and chlamydia.
          • Poisonings (including drug overdoses), firearms and motor vehicle accidents are the leading causes of injury deaths in San Mateo County.
            • Substance use (alcohol, tobacco and other drugs) is one of the most serious threats to the health of our community. Substance use carries a significant social impact, contributing to such social conditions as homelessness, violence, poverty and disease. Youth substance use is a particular concern.
              • Binge drinking among young adults, especially males aged 18 to 24, has increased significantly over the last several years.
                • Depression, isolation and loneliness are prevalent in San Mateo County. Mental health services to deal with depression are inadequate, as are the variety of community structures needed to deal with loneliness and isolation.
                  • While San Mateo County excels by most conventional measures, there are subgroups within the population who do not share the wealth. The prosperity of recent years has led to an extremely high cost of living that significantly impacts low- and middle-income

• A minimum-wage income in San Mateo County would be entirely consumed by child care costs for one infant. [Connie: Subsidized child care costs is needed?]
  • Nearly a third of youth aged 13 to 17 have no supervision after school [Connie: Need for free after school programs and food for the young to learn more and be supervised while parents are taking two jobs to survive the high housing costs].
  • Disparities in childhood opportunities lead to lifelong and even multi-generational disparities in health and economic success. There is a need to increase the access of high quality comprehensive early childhood education and care to low-income families and families of color.
    • More than one out of four Black and Hispanic respondents believe racial and cultural tolerance in San Mateo County is “fair” or “poor,” and these proportions are increasing.