HomeMy WebLinkAboutMINUTES - 11171992 - H.4 TOS HOARD OF SUPERVISORS
FROM: Public and Environmental Health Advisory Board ClJl lira
1 CWta
DATE'. November 3, 1992 0^
SUBJECT: REPORT ON STATUS OF HEALTH IN CONTRA COSTA IN 1991-92
AND RECOMMENDATIONS
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDATION•
1 . Accept the attached report from the Public and Environmental
Health Advisory Board (PEHAB) , °1992 Status of Health in Contra
Costa. "
2 . Direct the Health Services Department to distribute this report to
interested parties, specifically: hospitals, physicians, advisory
boards, and steering committees for - the "Partnership for a Drug
Free Contra Costa County. "
3 . Direct the Health Services Department to work with PEHAB and other
community groups and advisory boards to inform public about these
health issues.
4 . Request PEHAB to continue to identify and monitor important public
health trends in Contra Costa.
BACKGROUND:
The Public and Environmental Health Advisory Board (PEHAB) is a 12
member community-oriented board established in 1986 by the Board of
Supervisors to advise the Health Services Department on a broad
spectrum of health issues . PEHAB is comprised of representatives from
the following categories : Hazardous Materials Commission, State Health
Department, School of Public Health, volunteer health agencies, private
medical community, children's issues, seniors' issues, general consumer
issues, and other representatives . Its members have both knowledge and
experience in health issues pertinent to the county and reflect Contra
Costa' s geographic and ethnic diversity. PEHAB currently meets every
other month and is staffed by the Health Services Department.
On September 13, 1988 PEHAB presented a report to the Board of
Supervisors entitled "Report on Activities to Date/Recommendations for
Action. " This is a follow-up report on the current health status of
Contra Costa residents, with recommendations for future policy
directions and program development.
CONTINUED ON ATTACHMENT: - YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOAR COMMITTEE
APPROVE OTHER
SIGNATURE(S1:
ACTION OF BOARD ON November 17, 1992 APPROVED AS RECOMMENDED X OTHER X
DIRECTED Dr. Brunner to prepare for the Board's signature letter
of thank you to advisory board members
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
X UNANIMOUS (ABSENT II AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. .
Contact: Wen el Brunner, M.D.
cc: Countv Administrator ATTESTED November 17, 1992
Health Services Director PHIL BATCHELOR. CLERK OF THE BOARD OF
Director of Public Health SUPERVISORS AND COUNTY ADMINISTRATOR
Executive Assistant -to PEHAB
M382/7-83 BY -,DEPUTY DEPUTY
4 PUBLIC AND ENviRoNmENTAL
HEALTH ADVISORY BOARD
Members:
Scott Anderson TO: Members of the Board of Supervisors
Doris Copperman
Carlota Ounhower FROM: Public and Environmental Health Advisory
Joseph M. Hafey Board
Vicki Harrington
George Kaplan, PhD DATE: October 26, 1992
Edith Loewenstein, MD
Bessanderson McNeil
Julio Mendoza, DDS SUBJECT: 1992 REPORT ON STATUS OF HEALTH IN CONTRA
Carolyn Robinson COSTA AND RECOM ENDATIONS FOR ACTION
Jean Siri
Lawrence Wallack, DrPH '
Pete Williams
This report is a follow-up to the 1988 Report on the
Status of Health in Contra Costa County. It
Executive Assistant: examines the current state of health of Contra Costa
Mary Anne Morgan, MPH in six priority areas:
• Chronic disease prevention
• Substance abuse
• AIDS
• Perinatal care
• Trauma
• Family and adolescent issues
This report describes current demographic and
socioeconomic trends in the county and discusses how
specific populations and regions are differentially
impacted by the six priority areas of concern.
Contra Costa County
Health Services Department
597 Center Avenue, Ste. 200
Martinez, CA 94553
(510) 313-6715
FAX: (510) 313-6721
STATUS OF HEALTH IN CONTRA COSTA COUNTY
EXECUTIVE SUMMARY
CHANGING PROFILE OF CONTRA COSTA COUNTY
• Contra Costa County is experiencing a dramatic increase in
ethnic diversity: the Asian/Pacific Islander population has
grown 156%, and the Latino population 62%, while the Caucasian
population has grown only 11% in the last decade. The
majority of these ethnic groups reside in West and East
County.
• The county is also experiencing growing numbers of unemployed
and working poor residents. Contra Costa ranks second among
five urban Bay Area counties for number of homeless families,
and women and children are the fastest growing segment of the
county's homeless . Over 22,000 Contra Costa children live
below poverty.
• Growing numbers of teenage mothers, single parents, infants
and toddlers, and elderly comprise Contra Costa families .
There have been dramatic increases in the number of East and
West County families for whom English is a second language.
• Poverty, poor education and housing, and limited access to
health care place growing numbers of these families,
particularly those living in West and East County, at risk for
poor health status .
EMERGING HEALTH TRENDS
• Chronic diseases accounted for 70% of all deaths in the county
in 1988. Now they account for 78%, causing over 3,500 deaths
in Contra Costa each year. Cancer, cardiovascular disease,
and respiratory disease death rates are rising and are higher
than the state average. The county ranks first among the 15
largest. counties in breast _cancer incidence, and second in
ovarian and prostate cancer.
• Tobacco use accounts for 19% of all deaths in Contra Costa.
There are over 143,000 smokers in the county and nearly 16,000
of these are adolescents . Women and girls are the fastest
growing segment of new smokers.
• In 1988 it was estimated that between 400-700 cumulative cases
of AIDS would be diagnosed by 1990. To date, 819 residents
have been diagnosed with AIDS and an additional 3,600 are
estimated to be HIV-infected. There is a significant increase
in the proportion of new cases among IV drug users, women,
African Americans, and Latinos, and among West and East County
residents .
• Despite a 38% decline in the county's infant mortality rates
in the 19801s, poor perinatal health continues to be a problem
in certain communities. African American women in Contra
Costa are three times more likely to give birth to low birth
weight babies than White women, and African American newborns
die at almost twice the rate of White newborns. West County
residents continue to fare more poorly then other residents on
key perinatal health indicators .
• Injury is the primary contributor to years potential life lost
in Contra Costa, with injuries the top killer of children and
adolescents . Motor vehicle crashes account for nearly half of
.all unintentional injury deaths, while firearms are the major
killer of children aged 10-18 years old. One half of all
homicides occur in West County.
• Substance abuse accounts for the hospitalization of approxi-
mately 1,200 Contra Costans each year. Eighteen percent of
all AIDS cases in the county involve IV drug users . Nearly
2,000 women are estimated to use drugs during pregnancy each
year and the extent of use of alcohol by pregnant women is
unknown. Alcohol and other drugs are involved in 58% of all
deaths from traffic collisions, 64% of all suicides, and 85%
of homicides in the county.
RECOMMENDATIONS FOR ACTION
Local policy initiatives, prevention education, and community
organizing and coalition building activities have made significant
inroads in improving these public health problems . However,
political advocacy at all levels is also needed to address the
sources of poverty which lead to poor health status .
In terms of program development, future efforts need to focus on
data reporting, staff training and development,- policy and
advocacy, and collaborative interdisciplinary approaches in order
to augment and extend existing and new programs. Specifically, the
Public Health Division should:
• Work with communities to develop primary prevention programs
for the economically disadvantaged, women, youth, and the
African American, Latino and Asian/Pacific Islander
communities. Prevention services need to be located in West
and East Counties.
• Strengthen linkages between programs serving clients in the
six priority areas, and include schools, workplaces, the
criminal justice system, the private medical community, and
the religious community in the coordination of services .
• Provide cross-training within the Public Health Division and
with other divisions in the Health Services Department to
educate providers on these priority public health issues and
to enhance cultural sensitivity.
• Improve the existing data collection systems in order to
enhance the ability to monitor progress and plan future
interventions.
• Act as a conduit to secure funds and provide technical
assistance to local community-based organizations so that they
can provide prevention services within their communities .
• Facilitate communities organizing to advocate for responsible
media and advertising, particularly as it relates to violence,
alcohol use, tobacco use and nutrition.
STATUS OF HEALTH IN CONTRA COSTA COUNTY
INTRODUCTION
This report is a follow-up to the 1988 Report on the Status of
Health in Contra Costa County. It examines the current state of
health of Contra Costa in six priority areas:
• Chronic disease prevention
• Substance abuse
• AIDS
• Perinatal care
• Trauma
• Family and adolescent issues
Addressing these issues is a challenge in this time of fiscal
crises and shrinking resources. As medical care, social services,
and other support services are reduced, public health prevention
programs will become even more essential.
As a backdrop to this report, it is important to acknowledge the
overwhelming evidence linking socioeconomic factors to health
status . People in poverty experience higher incidence of disease,
suffer greater severity of disease, and die at greater rates from
most diseases . Women, children, the elderly, and certain racial
and ethnic groups are especially vulnerable to poverty and
subsequent poor health status . Growing numbers of Contra Costans
are at risk for serious health problems because of under and
unemployment, low education levels, inadequate housing and poor
access to health care.
This report describes current demographic and socioeconomic trends
in the county and discusses how specific populations and regions
are differentially impacted by the six priority areas. of concern.
PROFILE OF THE COUNTY
Contra Costa has become increasingly diverse over the last decade
(see Table 1-3) .
• In population size, Asian/Pacific Islanders grew the most
(156%) , followed by Latinos (62% ) and African Americans ( 22%) .
The population size of Caucasians in the county grew the least
( 11% ) .
• West County contains 70% of the county's African American and
43% of its Asian/Pacific Islander populations .
• East County is the region experiencing the largest overall
growth in population and is home to 33% of the county's Latino
community.
Despite having one of the highest household and per capita incomes
in the state, the county is experiencing growing numbers of
unemployed, homeless, and "working poor" residents and families:
Status of Health in Contra Costa County Page 2
• Unlike other Bay Area counties which experienced an increase,
.inflation-adjusted income for workers in certain sectors in
Contra Costa fell more than 12% during the last decade.
• Over 57,000 Contra Costans live below poverty.
• Contra Costa ranks second among five urban Bay Area counties
in number of homeless families, with women and children the
fastest growing segment of the county's homeless .
• Over 22,000 children in Contra Costa live in poverty. Of
children in poverty, four times as many are African American
than White.
The majority of the county's poor live in either West or East
County. West County is home to the largest number of female-headed
households and contains over half of the county's homeless
population. East County has the lowest average household income of
any region and contains one-third of all the county's AFDC
recipients, despite having only one-fifth of the total population.
As a result of the higher rates of poverty, residents in these
regions are at increased risk for serious health problems .
SI% PRIORITY AREAS
I . CHRONIC DISEASE PREVENTION
In the 1988 Report, chronic diseases were identified as
responsible for 70% of all deaths in Contra Costa. Today,
they account for 78% of deaths and result in over 3,500
deaths per year.
While the death rate for heart disease has declined, other
chronic diseases are a growing problem in the county:
• The county's cancer death rate is higher than the state
average (based on preliminary age-adjusted rates from the
Cancer Surveillance Section) . Among the 15 largest
counties, Contra Costa ranked first in incidence of breast
cancer and second in ovarian and prostrate cancers . While
incidence rates for breast cancer are highest among White
women, the rate of death from breast cancer is higher for
African American women.
• Rates of death from cardiovascular and respiratory diseases
are rising and are higher than statewide rates. The rates
for women dying of these diseases is increasing.
• Richmond, Pittsburg, and Antioch are experiencing
significantly higher hospitalization rates for chronic
diseases than other cities and the county overall .
Richmond's rate of hospitalization for female reproductive
cancers is more than double the county's overall rate.
Status of Health in Contra Costa County Page 3
Areas of Special Interest
Tobacco use remains one of the single most preventable causes
of death from chronic disease. In 1990, over 5,800 Contra
Costans died of smoking-related diseases, resulting in nearly
17 ,000 years of potential life lost (YPLL) . Years of
potential life lost refers to the number of years between the
age at which a person dies and his/her expected age at death.
Over 143,000 county residents still smoke and nearly 16,000 of
these smokers are adolescents . The fastest growing group of
smokers is young girls and women. Smoking during pregnancy
places approximately 18% of Contra Costa women at greater risk
for delivering premature or low birth weight babies. Approxi-
mately 164, 000 Contra Costa children are currently exposed to
second-hand smoke in the home, increasing their risk of
respiratory infections, lung cancer and other health problems .
Poor nutrition places approximately nine out of ten people at
increased risk of diet-related chronic disease such as heart
disease, diabetes, and certain cancers . Half of the elderly
are estimated to suffer from nutritional deficiencies .
Poverty places approximately 21,000 Contra Costa children at
risk for hunger and nutrition-related health problems . The
prevalence of iron deficiency anemia and growth retardation,
two strong indicators of nutritional problems, are
significantly higher in Contra Costa County than the state
average. A recent county study showed that fewer than 10% of
the 64 county teens surveyed ate nutritionally balanced meals .
Recommendations for Action - Progress has been made in
. combatting tobacco and nutrition issues through policy
initiatives, prevention education, and organizing and
advocacy. The Public Health Department needs to expand these
efforts by:
• Developing a comprehensive chronic disease prevention plan,
working with the local American Heart and Lung Associations
and the American Cancer Society.
• Involving communities in identifying priorities and
implementing appropriate chronic disease prevention
programs.
• Improving existing data collection and surveillance systems
to track incidence and prevalence of chronic disease
locally.
• Facilitating mobilization of communities in support of
policies that protect citizens from exposure to secondhand
smoke, eliminate public advertising targeting youth and
minorities, and restrict youth access to tobacco.
• Taking the lead in coordinating community-based and federal
nutrition programs to insure that they meet the needs of
underserved clients .
Status of Health in Contra Costa County Page 4
II . SUBSTANCE ABUSE - Contra Costa has a serious and growing
substance abuse problem. The National Institute on Alcohol
.Abuse and Alcoholism estimates that at least 25% of all
hospitalized persons have alcohol related problems alone. In
Contra Costa County, nearly 1,200 Contra Costans were
hospitalized in 1988 for medical complications induced by
alcohol and other drug use. Eighteen percent of all county
AIDS cases involve IV drug use. Nearly 2,000 women are
estimated to use drugs during pregnancy each year. The extent
of alcohol use among pregnant women is unknown. Alcohol and
other drugs are involved in 64% of the suicides, 85% of the
homicides, and 58% of the fatal motor vehicle crashes
occurring in the county.
Recommendations for Action - The county has been at the
forefront in responding to the substance abuse crises. In
1990 the local citizenry developed a County-Wide Action Plan
addressing substance abuse education and prevention, treatment
and law enforcement issues . Five regional planning groups
(corresponding to each supervisorial district) were formed to
implement the Plan's recommendations and are actively involved
in this process .
Public and private funding for alcohol programs has been
steadily declining. In terms of prevention, future planning
needs to emphasize collaboration with many sectors of the
community:
• Schools, the workplace, government, the criminal justice
system, the health care delivery system, the business and
religious communities, individuals and families, and the
political system must all be involved in developing a
coordinated response.
• Public health, substance abuse, HIV, social services and
mental health providers need to work together to develop
programs meeting the needs of underserved and at-risk
populations .
• Communities must organize and call for reforms in the
marketing practices of the alcohol industry.
• The county must continue to implement all facets of the
Action Plan including treatment and law enforcement needs .
III . AIDS PREVENTION - The 1988 Health Status Report projected that
between 400-700 cumulative cases of AIDS would be diagnosed by
1990. To date, 819 Contra Costans have been diagnosed as
having AIDS. An estimated 3,600 Contra Costa residents are
infected with HIV, the virus which causes AIDS. While the
majority of cases (69%) continue to be gay and bisexual men,
increasing proportions of the people with AIDS are injection
drug users, women, African Americans, and Latinos . The rate
of infection among women bearing children in Contra Costa is
significantly higher than the rate for the state. There has
Status of Health in Contra Costa County Page 5
been a geographic shift from most of the people with AIDS
.living in Central County to more new cases being diagnosed in
West and East County.
If the spread of HIV among injection drug users is not
dramatically curtailed soon, this population could be
saturated with HIV, approaching levels of infection found on
the East Coast of the United States (60-70%) by 1996 .
Currently the rate of infection among African Americans
injection drug users in Contra Costa County is 30% .
Recommendations for Action - The Public Health Division' s AIDS
Program has emphasized prevention education to groups at risk,
HIV testing and counseling, and case management for people
with HIV disease. Future efforts need to include:
• Strengthening the links between AIDS programs and substance
abuse, perinatal, adolescent, and homeless programs to make
AIDS education a priority in all programs which serve people
at risk for HIV.
• Educating and involving the entire community in fighting
AIDS and expanding efforts to involve city, community and
church leaders in delivering prevention messages to the most
affected population.
e Establishing a community-based "early intervention" program
combining prevention and education with centralized,
comprehensive case management and primary medical care.
• Developing programs geared to the needs of families of HIV-
infected clients, parents, infants and children.
IV. PERINATAL HEALTH - Although Contra Costa has experienced some
improvements in perinatal health since the 1988 report, areas
of extreme need remain. Overall infant mortality rates have
decreased by nearly 38% during the last decade and the
county's rate compares favorable with the state rate.
However, there has been no improvement in low birthweight
(LBW) and little progress in improving access to early
prenatal care.
Certain communities in the county remain at higher risk for
poor perinatal outcomes. Residents of West County continue to
fare more poorly than the other regions of the county on key
indicators of perinatal health, including low birthweight and
inadequate prenatal care. African American women residing in
the county are almost three times more likely to give birth to
a LBW baby than White women, and African American infants die
at almost twice the rate of White infants. The percentage of
African American women receiving inadequate care rose almost
290% from 3 . 9% in 1981 to 11 . 2% in 1989 . A drop in this rate
in 1990 may be the effect of new perinatal programs .
Status of Health in Contra Costa County Page 6
Recommendations for Action - Since 1988, a number of new
programs have been developed to promote early care and to
provide one-on-one support to underserved women, especially
African American women. . Progress is also being made in
developing special services for substance abusing women who
are pregnant or have young children. Rey issues for future
action include:
e Continuing to develop and improve perinatal outreach,
comprehensive prenatal care and perinatal substance abuse
programs .
• Integrating education and employment resources with
perinatal and other family-focused services .
V. TRAUMA - Over 400 Contra Costa residents died as a result of
unintentional injury or violence in 1990 . Since nearly one in
every three injury-related deaths are children and young
adults, unintentional injuries are the leading cause of years
of potential life lost (YPLL) in the county. African American
children are disproportionately represented in these
statistics; while making up only 12% of the population, they
comprised 19% of injury deaths. Children in West and East
County are twice as likely to be hospitalized due to injury
than children in other regions of the county.
Violence is also a serious concern in the county, with rape
the fastest growing crime in Contra Costa. Although the
county's suicide rate has declined since 1986, the homicide
rate has increased. One half of all homicides in the county
occurred in West County.
Intentional injuries comprised one-third of all injury deaths
to Contra Costa children between 1988-1990. Firearms were the
leading cause of injury-related death to children aged 10-18
years old; 86% of these deaths were intentionally inflicted.
The homicide rate for African American youths is more than
twenty times the county's overall rate; this distinction
disappears when socioeconomic factors are controlled for.
Recommendations for Action - Some of the most dramatic
successes in injury prevention have resulted from communities
organizing to support policy initiatives and demand changes in
organizational and institutional practices. Future efforts
should continue these approaches by:
• Working for the passage and stringent enforcement of local,
state and national legislation to prevent injury and
violence. Advocacy for passage of laws to restrict the
availability of firearms in the community should be a top
priority.
• Offering comprehensive education in the schools on violence,
abuse and injury prevention.
Status of Health in Contra Costa County Page 7
• Conducting parenting classes and creating support systems
for parents under stress.
• Monitoring and advocating for responsible media portrayal of
violence.
• Examining injury patterns among older adults and workers in
Contra Costa County and developing programs to respond to
their needs.
VI . FAMILIES & ADOLESCENT ISSUES - Contra Costa families and youth
are deeply affected by each of the health areas described in
this report, in ways that cut across racial, ethnic, religious
and socioeconomic lines . Women, children and adolescents are
at greater risk for substance abuse, unintentional injury and
violence, and tobacco use. Research has shown that these
groups are specifically targeted by the alcohol, tobacco and
fast food industries. Inadequate resources are available to
counter these forces and provide appropriate education,
support and intervention services .
The profile of the family in Contra Costa is also changing.
The 1990 census indicates that there are increasing numbers of
teenage mothers, single parents, female heads of household,
infants and toddlers, and senior citizens. More families for
whom English is a second language are moving here,
particularly to West and East County. Many of these groups
have limited resources and support systems and are at high
risk for poverty and multiple health problems . They may have
difficulty accessing health care due to barriers such as
language, limited education, differing social and cultural
norms, and lack of transportation and childcare.
Recommendations for Action - Responding to the multiple needs
of families requires innovative approaches . The Youth Service
Board Plan identifies key priorities for planning future
programs for children and families which include:
• Establishing a coordinated, community-based system that
provides a continuum of comprehensive services .
• Promoting an interagency planning and collaboration model,
involving schools, workplaces, the business community,
government and private agencies .
• Incorporating prevention approaches that respond to families
at risk.
ENVIROBEL?NTAL HEALTH
Although environmental health has not been a focus of its work,
PEHAB recognizes the important role the environment plays in
maintaining a community's health. As the third fastest growing Bay
• Status of Health in Contra Costa County Page 8
Area county in terms of housing and second in terms of job growth,
Contra Costa faces many challenges in balancing economic
development with maintenance of a healthy environment. .
Community concerns about pesticide drift from farmlands adjacent to
housing developments, building residential communities over toxic
waste sites, community and worker exposures to releases from
industries that handle hazardous materials, accidents during the
transportation and storage of toxic chemicals, and reduced air
quality from increased traffic congestion are a few key examples of
the overlap between land use planning and public health. PEHAB
encourages the Public Health Division to play a leadership role in
facilitating discussions that acknowledge and address the potential
health impacts of future land use decisions .
CONCLUSION
The six public health areas discussed here are frequently
interconnected. For example, substance abuse is linked to chronic
disease, accidental injury, unplanned pregnancy and pregnancy
complications, and increased risk for HIV exposure. Chronic
disease is associated with alcohol abuse, smoking and poor
nutrition. Certain underserved populations--women, youth, low
income, and specific ethnic groups--are at greater risk for poverty
and consequent poor health, more likely to experience multiple
health problems, and more likely to die from these conditions. The
health problems described in this report are occurring more
frequently in West and East Counties, where higher percentages of
low income families, single heads of household, homeless and other
disadvantaged and underserved groups reside. These areas and
subpopulations must be a priority for services .
The entire community is affected by these problems . Chronic
disease, alcoholism, motor vehicle accidents and child and spousal
abuse are a few examples of public health problems that cut across
social, economic and racial/ethnic boundaries . As more families
and youth are involved; the impacts become more widespread.
FUTURE ACTION STEPS
The most significant advances in addressing these public health
issues have resulted from local policy initiatives, prevention
education, community organizing and coalition building, and inter-
departmental collaboration and coordination. efforts . PEHAB
applauds the Health Services Department's commitment to facilitate
these activities and encourages it to continue emphasizing these
strategies . In addition, PEHAB recommends that the Public Health
Division increase its efforts to:
• Work with affected communities to develop comprehensive
prevention programs to meet the needs of women, youth, low
income, African American, Latino, and Asian/Pacific Islander
groups . Services should be located in East and West County
•• Status of Health in Contra Costa County Page 9
and must address barriers to care such as language, differing
social and cultural norms, educational limits, and
transportation and childcare needs.
• Evaluate the potential needs of older adults and workers,
particularly in the area of chronic disease, injury and
substance abuse prevention.
• Work jointly with local neighborhoods and regions to define
the major health problems and identify appropriate solutions .
• Act as a conduit to secure funds and provide technical
assistance to local community-based organizations so that they
can provide prevention services within their communities .
• Strengthen linkages between programs serving clients in the
six priority areas, and include schools, workplaces, the
criminal justice system, the private medical community, and
the religious community in the coordination of services.
• Improve and expand existing data collection and surveillance
systems to track health problems by census tract or zip code.
Use this information to monitor progress and plan future
interventions .
• Diversify staff and the memberships of county advisory boards
and commissions to reflect the county's ethnic and geographic
diversity. Provide cross-training within the Public Health
Division and with other divisions in the Health Services
Department to educate staff on these priority health concerns
and to enhance cultural sensitivity.
An effective response to the health needs described in this report
will require commitment from the entire community. The Board of
Supervisors must take the lead in identifying new and innovative
funding sources, and in supporting the development of comprehensive
approaches responsive to the needs of underserved populations .
PEHAB also issues a "call to action" to all county residents to get
involved in local organizing efforts and to advocate locally and at
the State and Federal levels for health protection policies .
Political advocacy at all levels is also needed to address the
sources of poverty' which lead to poor health status, including
unemployment, poor housing, limited educational opportunities, and
inadequate access to affordable health care.
For its part, the Advisory Board priorities for the next year are
to:
1) Work with county staff on local prevention policy initiatives .
2) Consult with the Public Health Division as it develops a long
range program plan.
3) Develop media packages on health issues facing county
residents .
4) Initiate chronic disease prevention activities particularly
targeting underserved populations in East and West County.
Status of Health in Contra Costa County Page 10
Table 1.
Contra Costa County Population Distribution, by Ethnicity
1980 and 1990
Ethnic Group 1980 2 1990 2 Z Cbange
White 505,921 77.1 560,146 69.7 10.7
African American 59,367 9.0 72,799 9.0 22.6
Latino 56,164 8.5 91,282 11.3 62.5
Asian/Pacific Isl. 28,805 4.4 73,810 9.2 156.2
Native American 4,993 0.8 4,441 0.6 -11.0
Other 1,130 0.2 1,254 0.2 16.0
Total* 656,380 100.0 803,732 100.0 22.4
source- i orn a Department of Finsucal 1990 Census, , 198U Census, Diane Read, Uousultant
Table 2.
Contra Costa County Percent Population Distribution
by Ethnicity and Region, 1990
African Asian/
Total White American Pacific Isl.
County Total 803,732 69.7 9.1 9.2
West 207,636 44.6 25.0 15.8
East 160,615 65.1 7.5 6.7
Central 249,166 81.4 2.1 7.1
South 141,080 87.2 1.0 7.3
ource: Department of Finance, MU Census, Diane Keed, Consultant.
Table 3.
Population by Age and Sex, Contra Costa County, 1980 and 1990
APrH 14 1980 APrs7 1, 19'90
Age CCAVUP Male Female . Total Male Female Total Chang
0.4 22,421 21,614 44,035 31,250 29,493 6V43 379
5-9 23,649 22,089 45,738 29,694 28,518 58,212 273
10-14 27,580 26,664 54,244 27,164 25,750 52,914 -24
15-19 30;136 29,752 59,888 26,211 24,228 54439 -15.8
20-24 26,400 26,335 52,735 26,525 25,514. 52,039 -13
25-34 54,357 57,943 112,300 69,600 71,447 141,047 25.6
35-44 43,936 45,596 89,532 68,763 72,361 141,123 57.6
45-54 35,385 36,529 71,814 47,005 47,482 94,487 3L6
55-59 17,771 18,987 36,758 .16,445 17,137 3382 -&6
60-64 13,M 14,804 28,392 14,930 16,719 31,649 1=
65+ 24875 35,969 60,844 35,861 51,635 87,496 43.8
Total 320,098 336282 1 656,380 JL393,448 410,284 803,732 22.4
'Totab may na add to 100%due W rounding.
Sour=1980 and 1990 Ccuum