2012 santa clara county binational health week conference · binational health week conference...

1

2012 Santa Clara County Binational Health Week Conference

Pamela Stoddard, PhD October 4, 2012

This presentation presents selected findings from the Status of Latino/Hispanic Health: Santa Clara

County 2012. For more information on the findings highlighted in this presentation, please see the full

report and Methods and Tools, which can be downloaded from www.sccphd.org/statistics2.

http://www.sccphd.org/statistics2

Purpose

Provide a comprehensive picture of health in the Latino/Hispanic community, relative to other racial and ethnic groups

Identify socioeconomic factors that may influence Latino/Hispanic health

Assess neighborhood conditions related to obesity, nutrition, physical activity, and safety

2

What Determines Health?

3

Behavior 51% Smoking Obesity Stress Nutrition Blood Pressure Alcohol Drug Use Human Biology

20%

Environment 19% Social Economic Physical

Healthcare 10%

Source: Schroeder, Steven A., We Can Do Better -- Improving the Health of the American People, N Engl J Med 2007 357: 1221-1228

Methods

“Health profile” from existing data

Mapping of environment in neighborhoods countywide with higher vs. lower proportions of Latino/Hispanic residents

Environmental assessments in eight selected neighborhoods

Focus groups with residents in the eight neighborhoods Key informant interviews with Latino/Hispanic community

leaders

4

Sociodemographics

5

0%

10%

20%

30%

40%

50%

60%

70%

1990 2000 2010 2050, Projected

Perc

ent o

f Cou

nty

Popu

lati

on

Latino/Hispanic

White

African American

Asian/PI

Note: White, African American, and Asian/Pacific Islander categories do not include Latinos/Hispanics. Sources: U.S. Census Bureau, 1990, 2000, 2010 Census; State of California, Department of Finance, County Population Estimates and Projections, July 2007

6

Population Size and Growth by Race/Ethnicity

6

7

Source: U.S. Census Bureau, 2010 Census

10%

4% 5%

7% 7%

23%

12%

15% 16%

17%

0%

5%

10%

15%

20%

25%

Latino/Hispanic White African American Asian All SCC

Perc

ent

Under 5 Ages 5-17

Percent of Population <18 Years by Race/Ethnicity

Educational Attainment Among Adults by Race/Ethnicity

8

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Less than High School

High School Graduate

Some College or Associate's

Degree

Bachelor's Degree Graduate or Professional

Degree

Perc

ent Latino/Hispanic

White

African American

Asian/PI

SCC

9

Kindergarten Readiness

Scores

Santa Clara County 3.32

Latino/Hispanic 3.13

Non-Latino/Hispanic 3.47

Adjusted Overall Kindergarten Readiness Scores by Ethnicity

Sources: Applied Survey Research, Kindergarten Observation Form from Santa Clara County School Readiness Assessments, 2004, 2005, 2006 and 2008; Hispanic Foundation of Silicon Valley, Latino Report Card, 2011

10

Third Grade and Eighth Grade

Students Scoring Proficient or Higher in English/Language Arts (Third Grade) and Mathematics (Eighth Grade) on California Standards Tests (CST) by Race/Ethnicity

Source: California Department of Education, Standardized Testing and Reporting (STAR) Results, 2011

35%

23%

75%

51% 44%

27%

79%

57% 59%

33%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Third Grade English/Language Arts CST Eighth Grade Mathematics CST

Perc

ent

Latino/Hispanic White African American Asian SCC

11

23%

8%

19%

5%

14%

0%

5%

10%

15%

20%

25%

Latino/Hispanic White African American Asian/PI SCC

Perc

ent

High School Drop-out Rate by Race/Ethnicity

Source: California Department of Education, Educational Demographics Unit, 2009-10

High School

Lifestyle Risk Factors

12

Weight and Body Composition

13

Source: Santa Clara County Public Health Department, 2009 Behavioral Risk Factor Survey

Percentage Overweight or Obese Adults by Race/Ethnicity

Percentage of Fifth Graders Not in the Healthy Fitness Zone for Body Composition by Race/Ethnicity

*Standards changed in 2011. Results shown are for 2011 using 2010 HFZ Standards. Note: White, African American, and Asian categories may include Latinos/Hispanics. Source: California Department of Education, 2007-2011 FITNESSGRAM

44%

36% 32%

38%

24%

19%

7%

17%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Latino/Hispanic White Asian/PI SCC

Perc

ent

Overweight Obesity

37%

16%

26%

15%

25%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Latino/Hispanic White African American

Asian SCC

Perc

ent

Fruit and Vegetable Consumption

14

10%

18%

13% 14%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%


Perc

ent

Fruit and Vegetable Consumption Among Adults by Race/Ethnicity

Note: Results for African Americans not reported due to small sample size. White and Asian/Pacific Islander categories do not include Latinos/Hispanics. Source: Santa Clara County Public Health Department, 2009 Behavioral Risk Factor Survey

Fruit and Vegetable Consumption Among Middle and High School Students by Race/Ethnicity

Note: White and Asian/Pacific Islander categories do not include Latinos/Hispanics. Source: California Healthy Kids Survey, 2007-08

31%

35%

31%

40%

36%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


Asian/PI SCC Pe

rcen

t

Soda Consumption

15

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2001-02 2003-04 2005-06 2007-08

Perc

ent

Latino/Hispanic

White

African American

Asian/PI

SCC

Percentage of Middle and High School Students Who Drank Soda Pop in Past 24 Hours by Race/Ethnicity, 2001-2008

Note: White, African American, and Asian/Pacific Islander categories do not include Latinos/Hispanics. Source: California Healthy Kids Survey, 2001-08

Physical Activity

16

47%

59% 60% 57%

0%

10%

20%

30%

40%

50%

60%

70%


Perc

ent

Percentage of Adults Meeting CDC Recommendations for Aerobic Physical Activity by Race/Ethnicity

Note: Results for African Americans not reported due to small sample size. White and Asian/Pacific Islander categories do not include Latinos/Hispanics. Source: UCLA Center for Health Policy Research, 2007 California Health Interview Survey

52%

65%

59%

54% 56%

0%

10%

20%

30%

40%

50%

60%

70%


Asian/PI SCC

Perc

ent

Percentage of Middle and High School Students Who Engaged in Daily Physical Activity in Past Seven Days by Race/Ethnicity


Current Smoking

17

Current Smokers Among Adults by Race/Ethnicity

Note: Results for African Americans not reported due to small sample size. White and Asian/Pacific Islander categories do not include Latinos/Hispanics. Source: Santa Clara County Public Health Department, 2009 Behavioral Risk Factor Survey

Current Smokers Among Middle and High School Students by Race/Ethnicity


12%

8%

11%

5%

8%

0%

2%

4%

6%

8%

10%

12%

14%

Latino/Hispanic White African American Asian/PI SCC Pe

rcen

t

9%

11%

8%

10%

0%

2%

4%

6%

8%

10%

12%

14%


Perc

ent

Marijuana Use

18

Percentage of Middle and High School Students Who Used Marijuana in Past 30 Days by Race/Ethnicity

Note: Results for some categories not reported due to small sample size. White category does not include Latinos/Hispanics. Source: Santa Clara County Public Health Department, 2009 Behavioral Risk Factor Survey

Percentage of Adults Who Used Marijuana in Past 12 Months


18%

14%

17%

5%

12%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%


Asian/PI SCC

Perc

ent

7%

10%

7%

0%

2%

4%

6%

8%

10%

12%

Latino/Hispanic White SCC

Perc

ent

19

Violence

Gang Membership and Weapons-Related Activities

20

10%

5%

14%

5%

7%

0%

2%

4%

6%

8%

10%

12%

14%

16%


Asian/PI SCC

Perc

ent

Percentage of Middle and High School Students Who Reported Weapons-Related Activities on School Property by Race/Ethnicity


Percentage of Middle and High School Students Who Reported Gang Membership by Race/Ethnicity


13%

10%

6% 5%

13% 13%

6% 5%

9%

7%

0%

2%

4%

6%

8%

10%

12%

14%

Carried a Weapon Such as Knife or Club on School Property in Past

12 Months

Been Threatened or Injured with a Weapon at School in Past 12

Months

Perc

ent


Bullying

21

31%

45%

20%

25%

43%

20%

31%

44%

21%

26%

42%

21%

28%

44%

21%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Physically Bullied Psychologically Bullied Bullied Online

Perc

ent


Percentage of Middle and High School Students Who Reported Being Victims of Bullying by Race/Ethnicity

Note: White, African American, and Asian/Pacific Islander categories do not include Latinos/Hispanics. Source: California Healthy Kids Survey, 2009-10

Depressive Symptoms and Suicide

22

Percentage of Middle and High School Students Who Seriously Considered or Attempted Suicide in Past 12 Months by Race/Ethnicity

Note: White and Asian/Pacific Islander categories do not include Latinos/Hispanics. Sources: California Healthy Kids Survey, 2007-08 (attempted) and 2009-10 (considered)

31%

24%

30%

26% 28%

0%

5%

10%

15%

20%

25%

30%

35%


Asian/PI SCC

Perc

ent

Percentage of Middle and High School Students with Depressive Symptoms in Past 12 Months by Race/Ethnicity

18%

10%

15%

6%

22%

12%

17%

7%

17%

8%

0%

5%

10%

15%

20%

25%

Seriously Considered Suicide Attempted Suicide Pe

rcen

t


Source: California Healthy Kids Survey, 2009-10

Teen Birth

23

18.8 16.8 15.9 13.0

10.5 8.9 8.5 7.0 8.2 7.4 6.8 6.4 6.6 6.8

88.8

82.4 77.6 79.4 79.7

69.7

63.1 67.1 67.3 68.6

62.1 58.9

50.5

43.1

49.0

40.2

27.0 24.9

37.0

20.7 15.3

19.8 21.4

28.3 26.4

20.2 20.2 21.0

15.7 15.7 13.9 11.6 9.7 7.8 7.5 5.7 4.2 5.2 4.1 5.1 4.1 2.7

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Rate

per

1,0

00 F

emal

es A

ges

15-1

9

White Hispanic African American Asian

Teen Birth Rates for Females Ages 15 to 19 by Race/Ethnicity, 1997-2010

Source: California Department of Public Health, 1997-2010 Vital Statistics

Summary and Implications

24

School outcomes are worse for Latinos/Hispanics K-12

Latino/Hispanic youth experience disparities for many lifestyle risk factors

Some disparities (cigarette and substance use) are seen for Latino/Hispanic youth, but not adults

Teen births are declining but remain higher among Latinas/Hispanics

Findings suggest Latino/Hispanic youth are not entering adulthood with the foundation they need to lead long and healthy lives

25

Neighborhood Conditions

that Affect Health

Methods

26

Mapping of environment in neighborhoods countywide with higher vs. lower proportions of Latino/Hispanic residents

Focus groups with residents in the eight neighborhoods

Environmental assessments of eight selected neighborhoods: Retail food stores K-12 schools Mobile vendors around school Childcare centers Advertising around schools, parks and playgrounds Emergency food outlets (food bank and food pantry)

Streets

27

Where do Latinos/Hispanics Live in Santa Clara County?

What’s Changed Since 2000?

Source: U.S. Census Bureau, 2010 Census Source: U.S. Census Bureau, 2000, 2010 Census

Eight Neighborhoods Selected for In-Depth Assessment

28

Neighborhood Food Access

and Affordability

29

The average distance to the nearest supermarket or large grocery store is shorter

There is similar access to community gardens

Farmers markets are more likely to accept EBT

A smaller proportion of food retailers are considered “healthy”

In Neighborhoods Countywide with a Higher (versus Lower) Proportion of Latino/ Hispanic Residents…

30

What’s going well:

What needs improvement:

Of 120 stores surveyed, 18% were supermarkets or large grocery stores

Few stores (7%) meet standards for excellence (supermarkets more likely than convenience stores)

Only half of stores sell produce

Prices for produce tend to be higher than the county average

Food Retail Store Scan in Selected Neighborhoods

33





All food banks and emergency food outlets provide nutrition education

Few (33%) meet nutrition standards

Few (33%) offer fruits and vegetables at least once per week

Emergency Food Outlets (N=57) in Selected Neighborhoods

34

What’s going well: What needs improvement:

Most childcare centers offer a variety of healthy foods and beverages

Many facilities do not meet best practice standards in their nutrition policies and practices

Foods served outside of regular meals and snacks are not always healthy

Nutrition education for parents and staff is not always available

35

Childcare Facilities (N=11)

Only one school sells sweetened beverages

None have food or beverage advertisements on campus

Less than half offer healthy a la carte foods/beverages

More than a quarter of schools sell high-fat entrees like pizza a la carte

Many lack policies on nutritional quality of foods/beverages offered to students outside of regular meals

School Food Environments (12 elementary, 2 middle)

36



Mobile vendors are present at two-thirds of schools when classes are dismissed

94% sell mostly unhealthy foods

37

Mobile Food Vendors (N=34)

Ice cream, 50%

Chips or Candy, 21%

Prepared food

(tamales, corn on the

cob, etc), 3%

Fresh fruit, 3%

Other unhealthy

food (aguas frescas,

chicharron, etc.), 24%

Types of Foods Sold by Mobile Vendors near Schools

Source: Santa Clara County Public Health Department, Status of Latino/Hispanic Health 2012, CX3


38

Voices from the Community

“There are vendors that are selling chips and other fried

foods…It worries me how close these vendors are to children.

This food is cheap and not healthy for youth.”

“It's a little bit complicated to get affordable products, it takes effort and

shopping around. Things are more expensive where Latinos live.”

65% of Latinos/Hispanics compared to 89% of Whites report that they find it easy to locate a variety of good quality and affordable fresh fruits and vegetables in their neighborhoods.

“We are surrounded by liquor stores, fast food restaurants. All of this bad [food] is what our children see every day walking to school.”


38

Active Living Environments

39

Residents do not have to walk as far to reach grocery stores, restaurants, etc.

Distance to the nearest park is similar

There are more pedestrian and bicycle collisions

40

In Neighborhoods Countywide with a Higher (versus Lower) Proportion of Latino/ Hispanic Residents…




Streets are pleasant and attractive for walking

Sidewalks are in good condition

Many streets do not feel safe or attractive for bicycling

There are few amenities for pedestrians and bicyclists, such as benches or trash cans

Nearly 1 in 5 high-traffic streets do not have crosswalks

1 in 4 high-traffic streets do not have traffic lights or stop signs

44

Streets Scan in Selected Neighborhoods

45


“People aren’t careful when driving, especially around

schools.”

“There are many vacant lots…Besides the lighting, there are some parts where there are no sidewalks…The streets are a mess. You can easily get hurt.”

“When my children were young they were able to go play in the school that is two

blocks away from the house. Not anymore…It should be open certain hours so that children from the community can

go play [there]…”

77% of Latinos/Hispanics vs. 96% of whites report having access to safe spaces for physical activity. Fewer Latinos/Hispanics (55%) than Whites (78%) perceive sidewalks, parks and trails within their neighborhood to be very pleasant. Source: Santa Clara County Public Health Department, 2009 Behavioral Risk Factor Survey

45

Violence

46

The rate of violent crime in and around neighborhoods and nearby parks and schools is 6 times higher

47

47


In Neighborhoods Countywide with the Highest versus the Lowest Proportion of Latino/ Hispanic Residents…

0.3 0.5

0.7

0.9

1.8

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2.0

1.9% - 8.4%

8.5% - 18.2%

18.4% - 26.0%

26.1% - 41.7%

41.8% - 86.1%

Num

ber o

f Vio

lent

Cri

mes

ne

ar P

arks

and

Sch

ools

Percentage of Latino/Hispanic Residents in Neighborhood

Number of Violent Crimes Within 500 Feet of Parks, Accessible Open Space, and Schools in Neighborhoods Countywide

Source: Public Engines, Inc., August 1, 2010 to July 31, 2011

A quarter of food stores have bars or chains on the storefront windows or doors

20% of low-traffic streets and 10% of high-traffic streets have some buildings with bars on the windows

49

Neighborhood Retail Store and Street Scans in Selected Neighborhoods

About 10% of streets lack street or pedestrian lighting

About 10% of high traffic streets have “adult-use” businesses and abandoned lots or buildings


50


“On the streets we’ve started to see more gangs…It makes us scared....in the '60s and in the '70s we could go

out to walk at night. Now, I don’t dare to go for a walk, I don’t dare to

go out…”

“Unfortunately, we’re not safe in our own homes or apartments. There is vandalism, drugs, and other things. You can’t even go to your front door. The police don’t do anything.

“I live by a park, but what do I find when I get to this park? People drinking, swearing, and fighting. I do not want to take my son

there.”

Nearly half of Latinos/ Hispanics report concerns about neighborhood safety, compared to a third of Whites and a quarter of Asian/Pacific Islanders.


50

“A lot of Latino kids come from low-income families, and their environments are not conducive to exercise because at certain times they can’t even be out in the streets. They’re not by parks, they’re not by safe trails, and with two parents working…the parents can’t really take them out so they’re cooped up in their apartments…they have to stay inside.”

Voices from the Community: Income inequality keeps Latinos/Hispanics from spending more time with their children, eating healthier foods, and choosing to live in neighborhoods with less crime, safer streets and greater access to amenities.

“Sometimes it’s mental, all the pressure that families have. We aren’t documented. Kids hear about money problems. You don’t think this affects children? All of these problems add up…It’s easy to say, “oh you’re lazy,” but really it’s about all the stress that we have to deal with daily, and that’s why we don’t do certain things.”

51

51

Neighborhoods where many Latinos/Hispanics live have some features that support healthy eating and physical activity (living close to stores and parks)

There was little advertising of unhealthy foods around schools and parks, which may support parents’ efforts to avoid purchasing unhealthy foods for their children

Unhealthy foods are sold at and around schools, which makes it harder for Latino/Hispanic parents to ensure that their children eat right

Lack of safety (crime, collisions) makes Latino/Hispanic parents reluctant to let their children play and exercise in the neighborhood

Low income and long hours interfere with parents’ desire to help their children eat well and exercise

52

Summary and Implications


Next Steps

53

Analyze interviews with community leaders

Mobilize leaders to: Prioritize key issues

Come to consensus around evidence-based and promising policies, environmental change, and programs to address key issues

Integrate strategies into community health improvement plan

54

www.sccphd.org/statistics2

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2012 santa clara county binational health week conference · binational health week conference...

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