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Home My WebLink AboutMINUTES - 12071999 - P2 P.2 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Date: December 7, 1999 Matter of Record Subject: Contra Costa County United Way/Hospital Council Collaborative Community Assessment On this date, the Board of Supervisors heard a presentation regarding the Contra Costa County Community Assessment that was commissioned jointly by the United Way of the Bay Area and the Hospital Council of Northern California. THIS IS A MATTER FOR RECORD PURPOSES ONLY NO BOARD ACTION WAS TAKEN A CONTRA COSTA COUNTY UNITED WAY / HOSPITAL COUNCIL COLLABORATIVE COMMUNITY ASSESSMENT EXECUTIVE SUMMARY: A CALL TO ACTION 1999 Commissioned by: The Hospital Council United Way of the Bay Area Prepared by: r,46%,q, ORTHERN VCALIFORNIA OUNCII.for the OMMUI�I'TY CONTRA COSTA COUNTY UNITED WAY/HOSPITAL COUNCIL COLLABORATIVE COMMUNITY ASSESSMENT Cabinet&Steering Committee Members r Janice Anderson Catherine Giacalone Darien Louie Yvette Radford Program Coordinator Project Supervisor Regional Director Community/Gov't Relations Leader Neighborhood Youth Corps,Contra CCC Office of Education East Bay Region Kaiser Permanente,and Member, Costa County Office of Education United Way of the Bay Area UWBA Contra Costa County Joe Goglio Leadership Board Mvrtle Ballard Community Services Director Etta Maitland Office Manager Contra Costa County Central Labor Executive Director Rebecca Rozen California Employment Development Council and Member,UWBA Contra Ombudsman Services of Community&Government Relations Department Costa County Leadership Boards Contra Costa County Kaiser Permanente Kitty Barnes Steve Graham Ginger Marsh Bertha Ruiz Consultant Director,Community Health Chair,Continuum of Care for Contra Program Manager Health and Human Services Partnerships Costa County and Member,UWBA East Bay Works Career Center- Kaiser Permanente Contra Costa County Leadership Board Brentwood Neil Barth President Teddi Grant-Adel Leila Marsh Robert Sessler Worldwide Educational Director Community Health Specialist Director Services/Private Industry Council John Muir/Mt.Diablo Health System Kaiser Permanente Contra Costa County Office on Aging Central County Regional Office Community Health Institute Josh Martin,LMFT Cyndi Simpson Lynn Baskett Janet Harden Administrative Programs Manager Director,Community Wellness& Regional Vice President West County Program Manager Contra Costa Mental Health Prevention Program,Contra Costa Hospital Council of Northern& Regional Occupational Program County Health Services Central California Contra Costa County Office of Robert McEwan Education Executive Director Belinda Smith Rosemarie Bell Housing Authority of CDBG Program Manager Deputy County Librarian Alana Hogan Contra Costa County Community Development Contra Costa County Library System Program Analyst Department. Department of Social Services Charlie McNeil County of Contra Costa Tom Berglund County of Contra Costa Executive Director Director/Consultant Alcohol and Drug Council of Isiah Turner Mental Health Association of Sharon Johnson Contra Costa County Deputy City Manager/ Contra Costa County Assistant Director Executive Director Contra Costra County Office on Nancy Monfort Private Industry Council of Richmond Linda Best Aging Administrative Director- Executive Director Community Health Affairs Ed Valladares Contra Costa Economic Partnership Malcolm Kaiser Sutter Delta Medical Center Newcomer Coordinator Executive Director Filipinos for Affirmative Action Brenda Blasingame Delta Community Services Ralph Murphy Homeless Program Director Managing Attorney Maria Teresa Viramontes Department of Health Services Ginny Keenan Contra Costa Legal Services Executive Director Contra Costa County Executive Director Foundation East Bay Public Safety Alcohol&Drug Council of Corridor Partnership Linda Chandler Contra Costa County Carol Newkirk Deputy Director Executive Director Mike Wall Private Industry Council of Contra Julie Kelley YWCA of Marin,SF&San Mateo President&CEO Costa County Assistant for Program&Policy Counties and Grantmaking Chair, John Muir/Mt.Diablo Health System Contra Costa County Health Services UWBA Contra Costa County Community Health Institute Linda Cherry Leadership Board Representative Jim Kennedy John Wolfe Contra Costa County Contractors' Director,Redevelopment Agency Kathleen Odne Executive Vice President Alliance Contra Costa County Community Executive Director Contra Costa County Taxpayers Development Department Dean&Margaret Lesher Foundation Association John Cullen Director Carolyn Krantz Yung Ouyang Bonita Woodson Contra Costa County Social Services Pastoral Associate Researcher Community Relations and Member,UWBA Contra Costa St.Peter Martyr Church Asian Pacific Environmental Network Business Development Department County Leadership Board Doctors'Medical Center Mark Lachman Joseph Ovick Eileen DeMaria Associate Director of Development County Superintendent of Schools Catherine Zaharko Executive Director Rubicon Programs,Inc. CCC Office of Education Director of Marketing/Corporate Child Abuse Prevention Council Development Yvette Leung Steve Peavler Doctors'Medical Center Wayne Ernstrom Food Security Project Coordinator Program Manager,Children's Chief,Social Work Services Contra Costa County Community Services,Contra Costa County Social Veteran's Outpatient Clinic Wellness&Prevention Program Services U.S.Veteran's Administration Christina Linville Kate Ertz-Berger Division Manager Executive Director Welfare Reform Planning Contra Costa Child Care Council Contra Costa County Social Services CONTRA COSTA COUNTY: STATUS REPORT Building Healthy, Safe and Self Sufficient Communities The table below contains an initial set of success indicators of healthy, safe and self-sufficient communities as illustrated by the characteristics of such communities. These indicators were developed by a working group of individuals from throughout the Bay Area. They represent an initial effort to demonstrate both the importance and feasibility of measuring success over time They are included here to provide people in the county with some initial tools to do this and as catalyst to raise questions about their use. Are there better measures? Are there ways to collect information about these and other success measures by neighborhood, by city, by population,etc? Here,at least is a start. Goals and Indicators for Building Healthy&Self-Sufficient Communities Year Contra Costa Bay Area 1 All Children Succeed in School and are Prepared for Lifelong Learning Percent of eligible children enrolled in Head Start 1997 52.1% 47.0% Percentage of 4th graders scoring>50%on reading element of STAR 1998 54.0% 50.5% Percentage of 8th graders>50%on reading element of STAR 1998 60.0% 57.1% High school graduation rates:percent graduating in four years 1997 75.5% 88.6% 2 Families of all Kinds are Strengthened,Preserved and Flourish Percentage of single-parent headed households with children 1990 12.0% 13.7% Number of children placed in foster homes for: 1996 Neglect 371 3,002 Physical abuse 82 949 Sexual Abuse 28 325 Other 8 454 Total 489 4,730 3 People Acquire and Retain Jobs and Achieve Economic Independence Number and percentage of knowledge-based industries by population group 1997 70,692 853,694 24.1%of All Jobs 30%of All Jobs 4 The Cycle of Violence is Ended # %of total Homicide 1996 71 18% 405 Rape 276 12% 2,257 Robbery 1,734 6% 27,528 Aggravated Assault 3,327 12% 28,193 Burglary 8,253 15% 53,352 Motor Vehicle Theft 4,452 12% 37,515 5 Frail,Disabled&Chronically-III are Ensured Independence and Dignity In-Home Supportive Services(IHSS)cases 8/1997 4,086 32,035 Supplemental Security Income(SSI) cases 8/1997 20,500 194,983 6 Discrimination and Inequality are Eliminated Income per capita by race/ethnicity: 1990 White $22,964 $22,051 African American $12,054 $11,760 Asian/Pacific Islander $16,451 $14,922 Native American $14,674 $14,126 Latino $12,412 $10,894 Other $10,967 $9,683 7 People Achieve and Maintain Optimum Mental and Physical Health Number of hospital discharges categorized as co-indigent 1996 1,003 11,181 Percentage of healthy birth-weight babies 93.8% 93.8% Percent who have health insurance 16% 15.8% 8 Individuals and Neighborhoods are Prepared to Respond to Emergencies and Disasters Number of people prepared to respond to emergencies and disasters 1997 719 7,004 9 People Play an Active Role in Community Life Percentage of people who volunteered in the last 12 months 1997 NA 14,788 Percentage of people eligible to vote who voted in local elections 1996 58.1% 56.2% 10 All People Access Affordable and Safe Housing Vacancy rate 1990 6.4% 4-6% Availabilty of housing for special needs populations: Elderly Units Needed 1995 NA NA Mentally III Units Needed NA NA Physically/Developmentally Disabled Units Needed NA NA Housing for people with AIDS Units Needed NA NA Percent of renters paying more than 30%of income on rent 1990 45.9% 45.2% Percent housing stock which is substandard 1993 2.1% 0.5-4.6% Estmated number of homeless people per year 1997 15,000 NA (Alameda:9,000-27,000;Marin:2,500;San Francisco 11,000-16,000 San Mateo:8,665;Santa Clara:9,000) 11 All People Enjoy the Benefits of Clean Air,Clean Water,and a Healthy and In Development Sustainable Environment 1-9'a p The Contra Costa County United Way/ Hospital Council Collaborative has adopted a set of goals and principles that represent the foundation for a more successful approach to building healthy and self-sufficient communities throughout Contra Costa County. They provide a framework for the assessment and a broad perspective around which we organize our work. BUILDING HEALTHY AND SELF-SUFFICIENT COMMUNITIES • All children succeed in school and are prepared for lifelong learning. • Families of all kinds are strengthened, preserved and flourish. • People acquire and retain jobs and achieve economic independence. • The cycle of violence is ended. • The frail, disabled and chronically-ill are ensured independence and dignity. • Inequality and discrimination are eliminated. • People achieve and maintain optimum mental and physical health. • Individuals and neighborhoods are prepared to respond to emergencies and disasters. • People play an active role in community life. • All people have access to affordable and safe housing. • All people enjoy the benefits of clean air, clean water and a healthy and sustainable environment. WHAT WORKS! PRINCIPLES FOR COMMUNITY BUILDING • Focus on outcomes. • Build on assets. • Involve and invest in communities and neighborhoods. • Provide comprehensive support for families and individuals. • Collaborate at all levels: policy, providers, community. • Be culturally competent. • Integrate services. • Rebuild systems-and bring model projects to scale. • Promote region-wide access to economic vitality. Source:Bay Area Partnership.Building Healthy and Self-Sufficient Communities:Principles for Designing and Delivering Successful Community Programs. 1"• v`2 Contra Costa County United Way/Hospital Council Collaborative Community Assessment Executive Summary: A Call to Action 1999 Prepared and distributed by: Northern California Council for the Community 50 California Street, Suite 200 San Francisco, CA 94111 Phone: 415.772.4430 Fax: 415.391.9929 www.ncccsf.org Contact the NCCC about other volumes of the Contra Costa County United Way/Hospital Council Collaborative Community Assessment Executive Summary Volume 1: Health, Social and Economic Indicators Report Volume 2: Inventory of Community Institutions Volume 3: Annotated Bibliography 5/99 Acknowledgments This publication was made possible with funding from The Hospital Council and United Way of the Bay Area. Yael Buchman, Judy Pope and Ellen Irie wrote the Executive Summary. Diane Reed, Tony Daysog, James Miller, Yael Buchman, Nancy Frank and Anne Frey researched, wrote, and edited Volume 1: Health, Social and Economic Indicators Report with the assistance of Community Assessment Team members Jennifer Balogh, Selina Toy, Robert Toyama and Reggie Valmores. Mary Suloway supervised and coordinated its production. Ed Schoenberger is the President of the Northern California Council for the Community. Special thanks to Lynn Baskett, Darien Louie, and the Community Assessment Cabinet and Steering Committee for their leadership, information sharing, and editorial contributions to this and other volumes of the community assessment. The United Way of the Bay Area 1998-99 Contra Costa County Leadership Board Jim Bouquin John Mason Executive Director Marketing New Connections Linda Brewer Carol Newkirk Executive Director Executive Director San Ramon Chamber of Commerce YWCA,Marin,SF&San Mateo Counties John Cullen Yvette Radford Director Community&Government Relations Leader Contra Costa County Social Services Kaiser Permanente Jon Deusenberry Mary Rocha NW Reg.Finance Manager Mayor of Antioch and Healthy Start Coordinator United Parcel Service East Bay Perinatal Council Joe Goglio Lou Rosas Director,AFL-CIO Public Affairs Director Contra Costa Central Labor Council Pacific Telesis&Pacific Bell Roger Henry,Jr. Theodore Schmidt Facility Compliance Coordinator Retired-J.C.Penney Chevron U.S.A. Paul Lewis Charles Stephenson MA/MFCC Consultant Youth Services Bureau-Richmond Robin MacGillivray Kathy Stout Vice President,Business Services Group Systems Director Pacific Bell Bank of America Ginger Marsh Dr.K.M.Tan Chair Asst.Physician&Chief Continuum of Care for Contra Costa County Kaiser Permanente The Hospital Council 1999 East Bay Section Executive Committee Chair Chair-Elect Tony Paap Gary Sloan President/CEO Chief Executive Officer Children's Hospital Doctors Medical Center Treasurer Past Chair Michael Smart Linda Horn Chief Executive Officer Administrator Alameda County Medical Center Sutter Delta Medical Center Marcy Feit Frank Puglisi,Jr. Chief Executive Officer Executive Director Valley Care Health System Contra Costa Regional Medical Center Sandi Small Kelly Mather Senior Vice President/Area Manager Chief Executive Officer Kaiser North East Bay CSA San Leandro Hospital Martin Diamond George Bischalaney Chief Executive Officer Chief Executive Officer John Muir Medical Center Eden Medical Center Table of Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Contra Costa County: The Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Equity, The Life Cycle, and Risk Factors: Understanding the Challenges to Building a Healthy Contra Costa County . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Equity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 TheLife Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Risk Factors and Prevention Opportunities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Appendix: Healthy People 2000 Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Introduction The Contra Costa County United Way/Hospital Council Community Assessment is the first broadly collaborative assessment produced in the county. Partners in the assessment include the Contra Costa County hospitals, the United Way of the Bay Area, Contra Costa Health Services, the Department of Social Services, other governmental agencies, health and social service providers, philanthropic foundations and a variety of business and community organizations. This community assessment reflects the diversity and broad scope of our collaborative effort and organizes data around the broadest definitions of health for people, families and neighborhoods. The data collection effort and this overview are founded on our commitment to make Contra Costa County healthy, safe and self-sufficient. Healthy communities offer their members economic, social, and emotional security. They are places where children grow up educated, healthy and prepared for the responsibilities of work, family and citizenship. They offer neighborhoods that are safe and welcoming places. Preceding this introduction is a listing of the Goals of Healthy, Safe, and Self-Sufficient Communities. These are goals against which communities can measure the success of our efforts and are representative of the way we organize our work. Healthy communities are the product of efforts that not only include but also transcend the design of specific programs and services. Perhaps most important, they are brought about through the articulation and achievement of agreed upon community goals; through the actualizing and mobilizing of existing community assets.' In addition, our commitment to action is founded on the understanding that such communities are created through institutions working together and the belief that no single sector, institution or agency can do it alone. This community assessment and executive summary offer a set of indicators in order to determine where some focal points for action can be taken in Contra Costa County. These documents do not propose prescriptions for solutions. They can be used as a tool for community residents, organizations and leaders to think and act collectively in addressing their areas of concern. The status report on the preceding page represents a general picture of healthy and self- sufficient communities, which can serve as a first list of success indicators. In the appendix is a set of Healthy People 2000 benchmarks-- national goals set by the U.S. Department of Health and Human Services for improvement in health by the year 2000. The reader can refer to both of these charts to get an initial sense of the quality of life in Contra Costa County as compared to the Bay Area as a whole and the national standards set by Healthy People 2000. The data from the community assessment provide a number of critical areas in which Contra Costa County varies: from other communities, from past Contra Costa County data, or from generally accepted benchmarks. While the data show that Contra Costa County is doing better than the state or Bay Area in a number of areas, the data also demonstrate significant intra- county differences based upon geography, socio-economic status, ethnicity and other measures. ' It is important to note that we have assembled in Volume 2:Inventory of Community Institutions an extensive listing of community assets:organizations, public institutions, service clubs,etc.This list is not a substitute for the variety, richness and diversity of the assets already found in neighborhoods,families and population groups. Northern California Council for the Community 1 9 17 This Executive Summary: A Call to Action is designed to offer a picture of the overall health of the County as a means to learn what most requires our concern and attention. We do this by employing three separate but related prisms to first examine and then present data. The sections which follow provide information that helps us to understand the health of individuals, families, and communities in our County based upon: • Geography, race, gender, ethnicity and income status: The Equity Section • Conditions related to infants, youth, adults, parents, seniors: The Life Cycle Section • Circumstances that are brought about by the behavior and practices of individuals and institutions: The Risk Factors and Prevention Opportunities Section Methodology In addition to this Executive Summary, this assessment work includes three volumes. They are: Volume 1: Health, Social and Economic Indicators Report, Volume 2: Inventory of Community Institutions and Volume 3: Bibliography. The primary organizing principle of this report are indicators of community health and well-being, as defined on page 1. Every attempt was made to include all relevant findings that impact specific populations. The content of the indicator report is a compilation of secondary data from various public and private sources. The scope of the assessment did not allow for personal interviews or focus groups. However, community organizations and hospitals were asked to provide such data for inclusion in the assessment. The data sources (e.g. Bureau of the Census, Department of Labor, Department of Health Services, Health Insurance Policy Program) are cited in the footnotes throughout Volume 1: Health, Social and Economic Indicators Report and highlighted in Volume 3: Bibliography. As new significant information becomes available, it will be included in subsequent editions. Geographic Boundaries in Contra Costa County Our approach uses two units of analysis for defining Contra Costa County's geographic boundaries: the census tract and the zip code. Most of the sub-county geographic analysis within this report is dependent upon zip codes for geographic boundaries, and divides the county into four regions: Central County, East County, South County and West County. For certain data sets, in order to accomplish a smaller unit of geographic analysis, we used seven areas by zipcode : Bay Point/EI Pueblo, Bethel Island, Iron Triangle/Coronado/North Richmond, Monument Corridor, Rodeo (Old Town Area), San Pablo/Bayview/Montalvin Manor, and Village Drive. For other data sets ten areas by census tract were used: Bay Point, Bay View/Montalvin Manor, Bethel Island, EI Pueblo, Iron Triangle/Coronado, Monument Corridor, North Richmond, Rodeo, San Pablo, and Village Drive. Northern California Council for the Community 2 9 1 Contra Costa County: The Context... Demographics • The county has an estimated population of 903,477, a 13% increase from 1990. This is faster than the rate of growth for California (9%) and the Bay Area (8%).2 • Both East and South County had high rates of growth between 1990 and 1998 (25% and 23% respectively), nearly double the county's rate. • In 1998, it is estimated that Central County made up 37% of the population of Contra Costa County, followed by East County (26%), West County (25%) and South County (12%). Age • The population is aging, with particularly large increases (58.4% between 1990 and 1998) in the number of residents ages 85 and older. This increase, while reflecting a statewide trend, is higher than the state rate of 49.9%. • Children also represent an increasing proportion of the population, with the percentage of 0-4 year olds (4.4%), 5-9 year olds (14.8%), 10-14 year olds (19.5%), and 15-17 year olds (19.3%) growing at a greater rate than in the Bay Area and the rest of California between 1990 and 1998. Ethnic Diversity • The county is becoming increasingly ethnically diverse. In 1998, the county's population was estimated to be 64% White, 15% Latino, 12% Asian/Pacific Islander, 9% African American. This compares to the 1990 population in the county which was 70% White, 11% Latino, 9% Asian/Pacific Islander, and 9%African American. • For regional comparison, West County's population in 1998 was estimated to be 35% White, 19% Latino, 19% Asian/Pacific Islander, and 26% African American while Central County's population in 1998 was estimated to be 77% White, 11% Latino, 10% Asian/Pacific Islander, and 2%African American. • In East County, EI Pueblo and Village Drive have twice the proportion of Latinos (46% and 44.5% respectively) of the total East County percentage (21.5%). Asian/Pacific Islanders are most concentrated in Bay Point (12%) and Bethel Island (13%), compared to the 8% regional proportion. • According to the 1990 Census, 3% of Contra Costa County residents speak a primary language in the home other than English, compared to 9% statewide. In some neighborhoods, such as El Pueblo and Village Drive, over 10% of residents are primarily Spanish speakers. 2 Sources for data or findings noted in the Executive Summary can be found in Volume 1: Health,Social and Economics Indicators Report. f Northern California Council for the Community 3 Income • According to the 1990 Census, median household income in Contra Costa County ($45,087) was 26% higher than the statewide median ($35,798). • In 1998, South County had estimated median incomes ranging from $83,083 to $136,376; East County had estimated median incomes ranging from $43,676 to $110,667; Central County had estimated median incomes ranging from $35,657 to $106,762; and West County had estimated median incomes ranging from $24,919 to $69,113. • The neighborhoods with the lowest range of median incomes in 1998 were North Richmond (ranging from $10,483 to $71,450), Iron Triangle (ranging from $14,717 to $48,378) and Monument Corridor(ranging from $19,139 to $42,857). Families • The proportion of families living in Contra Costa County has grown at twice the California rate (16% increase in the county; 8% increase in the state) from 1990 to 1998. The number of families settling in both South County and East County during the 1990s increased by 26%. • Subsidized child care programs serve only 5,936 children for an estimated 34,050 that are eligible for subsidized care in Contra Costa County. • In Contra Costa County, the average cost of full-time care for a child under 2 in a licensed care center is $159 a week, approximately 80% of the annual net wage of a person earning minimum wage. Education • Contra Costa residents have higher levels of education than do other Californians. Higher percentages (21%) of Contra Costa residents have graduated college and have a graduate or professional degree (10%) than do their statewide counterparts (15% and 8% respectively). • The county's high school dropout rates have been declining over the past ten years, to 1.5%, lower than California's rate of 3.9%. • African Americans (3.1%) and Latinos (2.7%) have the highest public high school dropout rates in the county. Environment • There are twenty-two Superfund cleanup sites in Contra Costa County, three of which are on the national priorities list. • Nineteen of twenty-two Superfund sites in Contra Costa County are located in West County--with eleven sites located in Richmond. Northern California Council for the Community 4 Equity, The Life Cycle, and Risk Factors: Understanding the Challenges to Building a Healthy Contra Costa County In order to give coherence and meaning to the complex, voluminous information presented in Volume 1: Health, Social and Economic Indicators Report, here is Contra Costa County's data presented from three different perspectives: (1) equity, (2) the life cycle, and (3) risk and prevention. Equity Not all people have equal access to conditions that promote health or to health care services. Some do not benefit from care that would ensure healthy and fully productive lives, or receive the assistance needed to treat chronic and acute illnesses. Differences based upon income, race/ethnicity, geography, and education can mean that poor people, people of color, and people with limited English language skills are more vulnerable to disease and less able to access services than other county residents. The following are a number of significant variables affecting an individual's access to conditions that promote health: Poverty • Although Contra Costa County shares in the economic recovery enjoyed by the rest of California, many of the jobs being created do not pay enough to allow families to become economically self-sufficient. Public subsidy programs based on federal poverty guidelines are inadequate to meet the costs of living in the county. • There are higher concentrations of people living in poverty in West County and in parts of East County. • Racially and ethnically diverse neighborhoods have the highest rates of poverty in the county. For example, more than 50% of all people living in census tracts in North Richmond and parts of San Pablo live below the poverty line. The population in North Richmond for 1998 was estimated to be 14% White, 13% Latino, 16% Asian/ Pacific Islander and 58%African American. The population in San Pablo for 1998 was estimated to be 23% White, 35% Latino, 19%Asian/Pacific Islander and 22%African American. • Children are disproportionately represented among the county's impoverished. In 1993, 41% of persons living in poverty were children. • In 1993, Contra Costa County had a 9% poverty rate, up from 7% in 1990. • On any given night, some estimate there are up to 6,000 homeless individuals in the county, with children representing 40-50% of this homeless population. Others estimate that between 13,000-15,000 people experience homelessness in a given year in the county. African Americans • African American infants in the county are almost twice as likely to die before their first birthday than infants in other groups. Northern California Council for the Community 5 • The asthma-related hospital discharge rate for African American children in Contra Costa County (551/100,000) is more than twice the Healthy People 2000 goal, while rates for other population groups come close to the target. • Over half of Contra Costa County's 1,983 children in foster care are African American. • The death rate (209.6/100,000) for African American youth is 2.5 times the national objective of 85/100,000. • From 1995-1996, the most significant increases in tuberculosis (TB) cases in the county were in African American women, ages 18-25, and in children, ages 7-18. All of the 25 African American women and 16 children with TB lived in West County. • African American men suffer from rates of hospitalizations for cardiovascular disease strokes, hypertension, heart diseases and diabetes that are significantly higher than the state rates, and have the highest rate of prostate cancer of all groups in the county. • African American families in Contra Costa County live in neighborhoods with far fewer physicians than the state and national averages. The state average is 266 physicians per 100,000 people, compared to East County with 21.2 per 100,000 people, and West County with 49.3 per 100,000 people. • African Americans are sharply over-represented in homicide data. While making up only 9.1% of Contra Costa County's 1998 population, African Americans accounted for 50.3% of homicide victims, and African American males made up 43.9% of all reports. A majority of these victims were between the ages of 15-24. • People of color make up increasing proportions of people with AIDS each year in Contra Costa County. In 1996 and 1997, people of color made up over half of all new cases reported--with African Americans making up the majority (44%) of these cases. Other Vulnerable Populations • The county has become increasingly more ethnically diverse in the 1990s. According to the population estimates, people of color now make up 36.5% of county residents, in comparison to 30% in 1990. • Latina teens (under age 20) had the highest number(397 of 1,070) of teenage births in 1997. This represented 37% of all births in this age group in the county. • Asian/Pacific Islander pregnant teens are less likely to receive prenatal care than are teenagers and women of other race/ethnicities in Contra Costa County. In 1997, 14% of Asian/Pacific Islander teens received late or no prenatal care, as compared to Latina teens (5%), White teens (5%), and African American teens (5%). • Gay and lesbian youth are reported to have higher suicide rates than other teenagers. • In California, Latina women with breast cancer are more likely to be diagnosed at a late- stage, regardless of socioeconomic status. • In 1996, 44% (186) of tuberculosis cases in the county were from foreign-born residents. Of these foreign-born cases, 37% (69) were from the Philippines and 15% (27) were from Mexico. • Fear of deportation, language barriers and cost prevent many undocumented individuals from seeking physical and mental health care. Children of immigrant families have fewer referral services, are less likely to seek care, and are more likely to be uninsured. • According to the 1990 Census, there are 9 persons between the ages of 16-64 who are mobility impaired for every 1,000 non-impaired individuals in the county. Northern California Council for the Community 6 Geography • West County is one of the most ethnically diverse areas in the Bay Area, with an estimated 65% of residents being people of color. In 1998, West County's population was 35% White, 19% Latino, 19%Asian/Pacific Islander, and 26% African American. • According to 1998 estimates, South County has the highest median incomes, ranging from $83,083 to $136,376, while West County has the lowest range of median incomes, (making only one-third to one-half of South County incomes) from $24,919 to $69,113. • Those living in poverty tend to be concentrated in West County and the northern area of East County. • Bethel Island is the only neighborhood with a higher percentage (22%) of adults ages 65 and over than percentage of children and youth ages 0-17 (15%). • Areas of Contra Costa County with the largest proportion of homeless include: Richmond, North Richmond, Bay Point, Pittsburg, San Pablo, and Pacheco. • One half of all Superfund sites in Contra Costa County are located in Richmond. • During the 1996-1997 school year, West Contra Costa Unified School District had the highest percentage of limited English proficiency students (21%) in the county. Education • Wages for California residents without a high school diploma declined by one-third between 1969 and 1997, while wages for residents with a bachelor's degree remained stable.3 • There were a total of 14,557 limited English proficiency (LEP) students enrolled in Contra Costa County public schools, representing 10% of all students. This is lower than the proportion of LEP students in Alameda County (18.5%) and the proportion of LEP students in California (24.6%). The greatest majority of LEP students in Contra Costa County speak Spanish (70%). • The county public high school graduation rate of(76%) is higher than the California rate (66%). • African Americans (53%) and Latinos (64%) have the lowest public high school graduation rates in the county. Graduation rates for African Americans and Latinos in other Bay Area counties follow a similar trend. For example, African American and Latino high school graduation rates in Alameda County are 46.9% and 58% respectively, as compared to the overall Alameda County rate of 66%. • In the 1996-1997 school year, many more Central County high school seniors took the Scholastic Aptitude Test (SAT), compared to West County high school seniors (e.g., 9 out of 10 students at Miramonte High School took the exam, while 1 in 5 students attending Richmond High School took the exam that same year). • The number of twelfth grade graduates in the county completing California State University and University of California required courses was at its highest level in 1997 3 Public Policy Institute of California."Income Inequality in the Golden State:Why the Gap has Widened Between Rich and Poor."February 1999. Northern California Council for the Community 7 / - , 9� (43% of all public high school graduates). The number of students throughout the state completing these courses was at its highest level in 1997 as well (36% of all public high school graduates). • Twenty-three percent of all jobs in Contra Costa County require a Bachelor's degree, a lower rate than California (24%) and the Bay Area (26%). It is estimated that the number of jobs requiring a Bachelor's degree or some college will increase. Family Abuse • Calls reporting possible child abuse, neglect, or abandonment in the county have increased 44% since 1990, while statewide the number of calls increased 28% in the same time period. • The rate of calls (20,382 reports or 61 per day) reporting possible child abuse is currently the second highest in the Bay Area. • The majority of child abuse calls (54%) in 1996 reported neglect, followed by physical abuse (28%) and sexual abuse (14%). • In 1998, Children's Protective Services in Contra Costa County received a total of 8,139 referrals including 1,173 immediate referrals (cases in which a child is at immediate risk). West County received 396 immediate referrals, Central County received 362 immediate referrals and East County received 415 immediate referrals for this time period. • Domestic violence-related arrests have more than doubled since 1992 (527 arrests in 1992; 1,218 arrests in 1997). Domestic violence-related arrests have also increased throughout the Bay Area. • The Contra Costa County cities with the most domestic violence calls to 911 in 1996 were: Concord, Richmond, and Antioch. • Reports of elder abuse in Contra Costa County have increased from 110 in 1990, to 514 in 1996.4 Increases in elder abuse reporting has also occurred in other Bay Area counties. • The most prevalent types of abuse inflicted upon the elderly in the county are physical abuse (31%), financial abuse (24%), and neglect (24%). Access to Health Care Services • Contra Costa County residents may find it difficult to access physical and mental health services because of economic, service, or social barriers to care. Among these barriers are: lack of service in poor communities, language and cultural barriers, immigrant status, transportation, lack of awareness of services. • Californians are disproportionately more likely to be uninsured than other Americans. • Approximately 18% of residents in West Contra Costa County do not have health insurance, with the majority of these households in Richmond and San Pablo. • The lack of health coverage in California is most prevalent among young adults, lower income families, Latinos, African Americans and Asian Americans. 4 See Life Cycle Section for more detail on the frail elderly. Northern California Council for the Community 8 ,,-2 �fo • Nearly 13% of California's children are uninsured, despite the fact that, as a federal study suggests, nearly 40% of them qualify for Medi-Cal. No local data on this topic are available. • Lack of transportation in Contra Costa County is reported to be a deterrent to receiving adequate care, especially for elderly and homebound people. • The Contra Costa County Mental Health Division reports that the majority of consumers who access mental health services are single or female heads of households between the ages of 25 and 56. Efforts are being made to improve services to the following populations who are underrepresented in the mental health system: Asians, Latinos, African Americans, and children under 18 years. • The need for diverse and culturally sensitive mental health services for immigrants in the county is especially apparent when language needs are considered. Asian, Pacific Islander and Latino immigrant clients often prefer to speak in their native language. The Life Cycle Major issues are clustered according to four age groups: 1) infants and children; 2) adolescents; 3) adults; and 4) seniors. When categorizing health issues according to stages in the life cycle, it is important to keep in mind that a number of the critical issues fit under more than one age category. For example, issues such as crime, transportation and physical health impact Contra Costa residents of all ages. This section of the summary looks at the data showing the strongest linkages between age and the critical health issues. Indicators of concern for infants and children include: • The level of early childhood immunizations in Contra Costa County (65%) is higher than the statewide level (57%) but still falls short of the Healthy People 2000 goal of 90%. • Sixteen percent of pregnant women in Contra Costa County begin prenatal care after their first trimester, while the Healthy People 2000 goal is to have no more than 10% of pregnant women beginning prenatal care after the first trimester. • Monument Corridor in Central County has the highest percentage of late prenatal care in the county (31%), followed closely by West County's Iron Triangle/North Richmond/Coronado area (29%). • The average cost of child care in the county is between $111-$159 a week per child. At this rate, a minimum wage earning worker with one child will pay 56% of annual take- home pay on child care. Additional child care opportunities are needed, particularly subsidized slots. Currently there are 5,936 children benefiting from subsidized care in Contra Costa County, satisfying approximately 25% of demand. It is estimated that the number of eligible children for subsidized care in East County alone increased from 8,145 in 1990 to 23,290 in 1998. For adolescents, critical issues deserving attention include sexually transmitted disease, death due to homicide and firearm injury and suicide: • Contra Costa County teenagers (ages 15-19) have a chlamydia infection rate over six times higher than all other age groups. This is similar to other Bay Area counties (San Francisco teenage rate is 5.5 times higher than other age groups, Solano County rate is over 6 times higher, Alameda County rate is 7 times higher than other age groups). Northern California Council for the Community 9 1`7 • Firearms are the leading cause of injury death among Whites, Latinos, and African Americans in the county, with the majority between the ages of 15-24 years old. • Homicide accounted for 30% of all deaths for adolescents/young adults ages 15-24 in 1995-1996 combined. This compares to the Solano County adolescent/young adult homicide death rate of 21% during the same time period. • Suicide accounted for 18 of 184 deaths (or 10% of all deaths) for adolescents/young adults ages 15-24 in 1995-1996 combined. For comparison, the suicide rate in Solano County was 14% (12 of 88 deaths) in 1995-1996 combined for this age group. Among all Contra Costa County adults: • Heart disease and cancer are the leading causes of death in the county. However, the county's heart disease mortality rate (83/100,000) is below both the California state rate and the Healthy People 2000 goal (100/100,000). The mortality rate for all cancers (116.5/100,000) in Contra Costa County is also below the Healthy People 2000 goal of 130/100,000. • Approximately one in five deaths in Contra Costa County is attributed to smoking. Since 1990, fewer people in the county smoke each year. • The rate of drug-related deaths (6.9 per 100,000 population) is more than twice the Healthy People 2000 goal of 3 deaths per 100,000 population. Deaths from drug overdose are highest among 35-44 year olds in Contra Costa County, as well as in Alameda, Solano, and Marin counties. • Contra Costa County's tuberculosis rate of 11.9/100,000 does not achieve the Healthy People 2000 goal of 3.5/100,000. • The overall crime rate (2,277/100,000) has declined somewhat in recent years in the county. • The homicide rate in Contra Costa County (12.7 deaths per 100,000 population) is nearly twice the Healthy People 2000 goal (7.2/100,000). • While new AIDS/HIV cases among White men who have sex with men are declining each year, the proportion of new AIDS/HIV cases among heterosexuals, women and people of color in Contra Costa County is increasing. The West County cities of Richmond and San Pablo have the highest cumulative incidences of AIDS in the county. Issues of concern for seniors include transportation and cancer: • Ninety percent of Contra Costa County's prostate cancer cases are among men over 60 years old. African Americans have significantly higher prostate cancer rates than do other groups. • Breast cancer is the leading form of cancer in the county, and nearly half of all breast cancer cases are among women ages 60 and older. The county's breast cancer incidence (118/100,000) is higher than the statewide average (105/100,000). • In all California and Contra Costa County Office on Aging surveys, transportation is listed as the top-ranking "serious" problem for seniors in the county. • A 1996 Contra Costa County Office on Aging survey showed marked increases in two problem areas for seniors: 1) communication about access to services and supports and 2) isolation and loneliness. Isolation and loneliness was found to be affected by frailty, Northern California Council for the Community 10 �0 . 2-91 disability, physical and language isolation, lack of transportation, living alone, and daytime isolation (even when living with extended family). Risk Factors and Prevention Opportunities There are a significant number and wide variety of circumstances negatively affecting the lives of individuals, families and communities that are the result of individual behaviors and community practices. The following describes conditions in Contra Costa County that could be addressed by changing behavior and practice. Risk Factors • Alcohol, Tobacco and Other Drugs • Lack of Prenatal Care • Lack of Immunizations • Sexually Transmitted Disease • Unemployment • High School Dropout Rates • Violence in the Community Alcohol, Tobacco and Other Drugs The effects of the use and abuse of alcohol, tobacco and other drugs are far-reaching. In addition, these substances affect not only the individuals who use them directly, but also those around them, and our communities (for example by increased violence due to drug-seeking behaviors). While there has been much public attention on the "war on drugs" in recent years, alcohol, and particularly tobacco, claim more lives than do other drugs. While it is encouraging that smoking among the general population has been declining in recent years, smoking prevalence among teens is up. This is of particular concern due to the fact that 90% of adult smokers begin smoking before their 19th birthday. • In 1993, smoking prevalence among youth in Contra Costa County was reported to be 9%, an increase from 8% in 1990. • Between 1991-1995, there was a steady increase in the rate of drug deaths in Contra Costa County. Twenty percent of drug deaths during this time period were due to opiates. Death due to opiates more than tripled from 7 deaths in 1991 to 25 deaths in 1995. • Heroin and other opiates made up 26% of drug-related hospital discharges during 1991- 1995, followed by cocaine (17%) and amphetamines (16%). • The number of persons killed or injured in alcohol-related automobile accidents has been steadily declining and remains below the statewide rate. • Alcohol and substance abuse is associated with significant percentages of juvenile crime, homicides, and motor vehicle accidents. Lack of Prenatal Care Early, comprehensive prenatal care can significantly reduce rates of infant and maternal illness and death. Contra Costa County is experiencing the adverse effects of having 16% of its pregnant women begin prenatal care after their first trimester. These effects are being felt Northern California Council for the Community 11 particularly in the county's African American communities where the low birthweight birth and infant mortality rates are twice that of other race/ethnic groups in the county. In addition, pregnant Asian/Pacific Islanders teens are less likely than other teens to seek early prenatal care, resulting in significantly higher low birthweight births among this group. Efforts to encourage greater usage of prenatal care must begin by examining and addressing the social, cultural and economic barriers which are preventing these women from seeking prenatal care. To the extent that the women not receiving prenatal care are low income, they should be encouraged to take advantage of Medi-Cal's and other public programs. • Contra Costa County showed a slight decline in the percentage of pregnant women beginning prenatal care after the first trimester, from 16.7% in 1991-1993 to 16.3% in 1994-1996. While well below state averages for those years (25.1% and 20.95% respectively), Contra Costa County experienced a much slower rate of decline than the statewide trend. • A higher proportion of teens (under 20 years old) received very late or no prenatal care (4.9%), than did women ages 20-34 (2.7%) or women 35 and over(2%) in the county. • The African American rate of low birthweight infants (11.3%) is higher than the rate for Asian/Pacific Islanders (6.4%), for Whites (5.6%), and for Latinas (5.1%). Lack of Immunizations Immunization is the most effective and inexpensive tool for the prevention of communicable diseases. Contra Costa County children, however, are not taking full advantage of this health prevention strategy, as demonstrated by the fact that only two-thirds (65%) of kindergartners in 1996 were fully up-to-date with their immunizations at two years of age. Lack of access to health care is a key reason why immunization levels are not higher, but this is not the only factor. Beliefs that immunization may actually be harmful also impede immunization efforts. These barriers must be better understood in order to initiate efforts which can help to break them down. In addition, low and/or no-cost access to immunizations must continue to be promoted so that the county can reach optimal levels of childhood immunizations. • African Americans (47%) and Latinos (50%) have lower early immunization rates than Whites and Asian/Pacific Islanders (both 71%). Sexually Transmitted Disease Sex education can improve the health of Contra Costa County residents by helping to prevent unsafe sexual practices and sexually transmitted diseases. Providing information on how to protect against sexually transmitted disease and increasing access to contraceptives can potentially lower these rates. • The chlamydia case rate among 15-19 year olds in 1997 (982/100,000) was over six times higher than the county's rate for all ages (159/100,000). • Gonorrhea and chlamydia are more prevalent among female adolescents and young adults than among males. Northern California Council for the Community 12 P- Unemployment The unemployment rate in Contra Costa County in 1998 was 3.6%, the lowest in ten years. However, a strategic plan (such as the one proposed by the Workforce Development Advisory Panel in Contra Costa County) can help ensure a continued low unemployment rate and individual economic self-sufficiency. In order to develop a strong economy, Contra Costa County benefits from a trained workforce that is able to find and keep jobs that pay a living wage. • Retail, finance, insurance and real estate (F.I.R.E.), and service jobs constitute a larger percentage of all current jobs in Contra Costa County. • Retail jobs are projected to become a greater proportion of all county jobs in the year 2000. • A significant gap exists between what is paid in fast growing occupations (such as retail sales) in Contra Costa County and the cost of living in the county. • A major challenge for policy makers is in devising a ladder for vocational advancement from entry-level positions to more permanent and benefit-ladden jobs. • Transportation costs and distances between home and workplace can pose as barriers to employment. According to the Contra Costa Transportation Alliance, the majority of entry level job opportunities are located in Central and South County, while many individuals seeking work live in West and East County. High School Dropout Rates For the past ten years, high school dropout rates have been decreasing in Contra Costa County and throughout the Bay Area. It is agreed that dropout rates have steadily decreased for all ethnic groups, although the rates are still disproportionately higher for African Americans and Latinos. Efforts to support all students to graduate from high school could be beneficial for future efforts at employment and self-sufficiency. For example, the Contra Costa County Office of Education provides programs for students who have needs that are not addressed by the traditional public school system. In varying degrees, these types of programs aim to increase self-esteem, break the pattern of failure, reduce high school drop-out rates, integrate students into the community, and introduce them to the work world. • The rise in income inequality in California is partially due to the fall in wages for workers without a high school diploma. Improving education and the opportunity to finish high school can help counteract this trend in the state.5 • There are greater job opportunities for persons in Contra Costa County with a high school degree or some college education. • High school dropout rates vary according to geography, with highest rates (3.0 in 1995- 1996) for Pittsburg Unified high school students and West Contra Costa Unified high school students (2.9 in 1995-1996). In comparison, high school dropout rates in Central County are low, with a 0.6 dropout rate in 1995-1996 for Martinez Unified school students, and a 0.1 dropout rate for Acalanes Union High School students. 5 Ibid. Northern California Council for the Community 13 Violence in the Community There are many aspects of violent or abusive behavior. One significant aspect includes homicide and gang activity in the county. Many are concerned that while conviction rates for gang members in the county are rising, the homicide rate for youth ages 15-24 still remains high. Another important aspect is the intergenerational nature of violence, particularly family violence. Not only do different forms of family violence such as child abuse and domestic violence frequently occur alongside one another within the same family, but victims of child abuse are at greater risk of committing violence themselves, thus perpetuating the cycle of violence. A 1992 U.S. Department of Justice Report found that a majority of youths arrested had a prior history of abuse and neglect. The same study reported that childhood abuse increased the odds of future delinquency and adult criminality overall by 40%. It also indicated that abused girls fare worse, with 77% of female child abuse victims more likely to be arrested as juveniles. Another study found that men who have witnessed their parents' domestic violence are three times more likely to abuse their own partners than children of non-violent parents. Programs and services aimed at breaking the cycle of violence in families before it reaches "crisis" levels can offer protection and a greater sense of security to residents in Contra Costa County. • In 1997-1998, more than five times as many domestic violence calls (27,222 calls by 11,675 women) were made to the Battered Women's Alternatives crisis hotline than to 911 in the county. Approximately 20% of all incoming domestic violence calls were from senior women. • Senior women currently comprise 15% of support group members at Battered Women's Alternatives in Contra Costa County. • All categories for child abuse Emergency Response System calls have increased since 1990, with neglect (7,482 calls in 1990; 11,009 calls in 1996) and physical abuse (3,852 in 1990; 5,726 in 1996) experiencing the largest net increases. • Homicide and gang-related violence are an increasing concern in Contra Costa County. For example, some estimate that over the past eight years, 100 of the murders committed in the city of Richmond were due to gang activity. Northern California Council for the Community 14 Contra Costa County United Way/ Hospital Council Collaborative Community Assessment Executive Summary Appendix Healthy People 2000 Goals Healthy People 2000 is a national effort involving professionals, citizens,private organizations and public agencies. National goals are set for improvement in health by the year 2000. Work on the report Healthy People 2000:National Health Promotion and Disease Prevention Objectives(published by the U.S. Department of Health and Human Services)began in 1987. The report lists 226 measurable objectives and that are possible to track progress towards achievement. The purpose of Healthy People 2000 is to increase the span of life, reduce health disparities and achieve access to preventative services for all Americans. This appendix tracks Contra Costa County's progress towards achievement of Healthy People 2000 goals in the areas of morbidity and mortality. Northern California Council for the Community 15 Morbidity. Contra Costa has achieved Healthy People 2000 goals to reduce morbidity in several areas, including AIDS incidence, gonorrhea, including among adolescents, chlamydia, measles, rubella, and asthma discharge rates for all ages and racial/ethnic groups with the exception of African Americans. Contra Costa has not yet met national goals for late prenatal care, low birthweight, immunizations, tuberculosis, and asthma hospitalization among African Americans of all ages. Table 1.Contra Costa County Morbidity Rates*(per 100,000 persons) Compared with California Rates and Healthy People 2000 Goals Contra Costa California Healthy People 2000 (1994-1996) (1994-1996) Objective Late prenatal care 16.3 20.9 10% Low birthweight 6.2 6.1 5% Black low birthweight 11.3 na 9% (1997) Immunization (1996) 65.1 57.3 90% up-to-date by 24 mo. AIDS incidence 27.7 29.4 39.2 (1993-1995) Gonorrhea (1997) 63.4 55.3 100 Gonorrhea 15-19 yr olds 312 207.7 750 Chlamydia 162.2 210.7 170 Tuberculosis(1993-1996) 11.9 14.4 3.5 Measles(1997) 0 na 0 Rubella (1997) 0 na 0 Asthma hospital discharges (1991-1994) White 96 112 160 African American 336 375 265 Latino 102 114 265 Asian/Other 115 119 265 Asthma hospital discharges(1991-1994) Children 0-14 White 152 185 225 African American 551 704 225 Latino 155 187 225 Asian/Other 203 209 225 Sources:Califomia Department of Health Services:County Health Status Profiles 1998; California County Asthma Hospitalization Chart Book,August 1997;Immunization Levels of Califomia Toddlers in Counties Conducting Expanded Kindergarten Retrospective Surveys,August 1996;and STD Control Program. Contra Costa County L Communicable Disease Control Section 21 Mortality. Contra Costa County has achieved national Healthy People 2000 goals to lower mortality in several areas, including overall infant mortality, deaths among adolescents and young adults, and deaths due to suicide, unintentional injuries, motor vehicle accidents, coronary heart disease, and all cancer deaths, including lung cancer. Contra Costa County has not met national goals to lower black infant deaths and deaths due to homicide, firearm injury, drugs, stroke and female breast cancer(indicated in bold). Table 2. Contra Costa County Mortality Rates* (per 100,000 persons) Compared with California Rates and Healthy People 2000 Goals California Healthy People 2000 (1994-1996) (1994-1996) Objective Infant Mortality Rate(IMR) 5.8 7.0 7/1,000 African American IMR** 11.5 15.4 11/1,000 Adolescent/young adult 84.3 na 85 (15-24)deaths Homicide 12.7 11.8 7.2 Suicide 8.9 10.7 10.5 Unintentional Injury 22.7 26.6 29.3 Firearm Injury 15.8 15.0 11.6 Motor Vehicle Related 10.5 13.2 14.2 Drug Related 6.9 8.0 3.0 Coronary Heart Disease 82.9 100.6 100.0 Cerebrovascular(stroke) 28.2 26.3 20.0 Cancers(all combined) 116.5 115.9 130.0 Female Breast Cancer 22.0 19.7 20.6 Lung Cancer 29.9 31.8 42.0 *Age-Adjusted rates were calculated using the 1940 United States population. "For all other raciallethnic groups, the Alameda County birth cohort infant death rates were lower than the California state rate. Source:California Department of Health Services, County Health Status Profiles 1998 $,IfM ,. �! n„ '�,,, � ..I...., r d h•• ,.i.. .....,. ', s m c ,n ,+Yr 1. w.r,. ,.., 4, n l.0 i 4 ,.:.... -�71 Mission: To help build healthy, safe and self-sufficient communities in the Bay Area by improving the public's return on its investment in children, families and neighborhoods. NORTHERN CALIFORNIA COUNCIL FOR THE COMMUNITY BOARD OF DIRECTORS CHAIR PAST CHAIR Sunne Wright McPeak (1994) Lydia Cameron (1993) President&CEO Bay Area Council SECRETARY TREASURER Stephen Graham (1993) Stuart McCullough (1993) Director, Community Health Partnerships Chief Financial Officer Kaiser Permanente Paradigm Innovations BOARD MEMBERS William Bent (1993) Dan C. Quigley (1998) Manager Corporate Contributions Pacific Gas&Electric Company Adele Corvin (1993) Steve Roberti (1997) Chair Secretary's Representative for Department of Labor San Francisco Adult Day Health Network Alison Davis (1998) Lou Rosas (1998) Vice President Director, External Affairs A.T. Kearney Pacific Bell Martin Diamond (1998) Don Rowe (1998) President&Chief Administrative Officer Director John Muir Medical Center Solano County Health&Social Services Dept. Louis N. Garcia (19951 Thomas A. Ruppanner Ex-Officio (1993) President&CEO The United Way Henry Izumizaki (1998) John Stafsnes (1998) Director Manager, Pacific Fleet Eureka Bay Area Chevron Shipping Company Arnold Perkins (1998) Director Alameda County Public Health Department MANAGEMENT TEAM Ed Schoenberger David Militzer President Bay Area Partnership Coordinator Northern California Council for the Community Northern California Council for the Community Mary Suloway Nancy Kimura Executive Vice President I&R Director Northern California Council for the Community Northern California Council for the Community