What fathers need: A countywide assessment of the needs of fathers of young children CityMatCH Annual Urban MCH Leadership Conference September 13, 2004 Anand Chabra, M.D., M.P.H. San Mateo County Health Services Agency

Thanks to … First 5 San Mateo County – funded the needs assessment Peninsula Community Foundation – funded the Fatherhood Coordinator position for ~ 3 years Herb Pierrie, RN, MS (Fatherhood Coordinator) – conducted data collection and expanded the text of needs assessment Sara Buckelew, MD, MPH (preventive medicine resident at the time) ran and analyzed data, and wrote initial paper

Why work with fathers? Nearly twenty-five million children in the United States, 36%, live apart from their biological fathers. Forty percent of children who live in households without a father never visited their father’s home.

Why work with fathers? Children who live without contact with their biological father, in comparison to children who have such contact are: Five times more lively to live in poverty Twice as likely to drop out of school More than twice as likely to abuse drugs and alcohol More likely to commit suicide Twice as likely to commit crimes More likely to exhibit learning difficulties More likely to become pregnant as teenagers

The Fatherhood Collaborative Started in October 1998 Consists of over 40 countywide agencies, community based organizations and individuals Mission: To engage parents, providers, employers and the broader community to better understand the importance of men and fathers as they relate to children

Top 5 Needs of Fathers As Previously Identified by the Collaborative Legal Assistance Personal Development Parenting Skills Family Health Employment and Job Readiness

Composition of Governing Board Non-Profit Entities * Founding members Child Care Coordinating Council of San Mateo County (child care R & R agency) * Family & Children Services (family counseling) Los Prados Neighborhood Partnership (neighborhood group) * Peninsula Library System (county and city libraries) San Mateo Perinatal Council (education and training for perinatal providers) * Service League of San Mateo County (services for incarcerated population) * Concerned Community Members *

Composition of Governing Board Government Organizations Board of Supervisors * Child Support Services * Health Services Agency * Human Services Agency * Office of Education * Probation Department Superior Court * Founding members

Fatherhood Needs Assessment Goal: To identify current services and programmatic strengths in the county To identify service gaps and barriers in the county To use this information to develop a strategic plan for the Collaborative

Needs Assessment Next Steps Use Data to Identify Problems And Needs High Risk Groups Areas of Service Deficiency Target Resources Develop Interventions

Fatherhood Needs Assessment 4 Main Strategies were used to collect primary data regarding fathers in San Mateo County in order to gain a better understanding of community assets and needs. These included: Focus Groups Key Stakeholder Interviews Case Reviews Fatherhood Surveys

Methods and Data Sources 9 focus groups were conducted with approximately 80 participants including fathers, and agency staff serving fathers and families. 20 case management records were reviewed 16 key informant one hour interviews were conducted

Fatherhood Survey 35 item confidential survey was developed and pilot tested About 1200 Surveys were distributed to 16 agencies across the county 240 surveys were returned from 12 agencies (response rate of approx. 20%) Data entered in Excel and analyzed in Intercooled Stata 7.0

Survey Results Demographics White 33.3% Hispanic 26.7% Asian 18.8% Multi/Other 10% Black 8.3% Native American 0.4% No Response 2.5% According to the San Mateo County Child Care Strategic Plan, the child population in SMC is 41% White 30% Hispanic 23% Asian/Pac. Islander 5% Black 1% Native American

Survey Results Demographics Age > % Ages % Ages % Ages % Ages % Ages % Ages % No response 12.1%

Survey Results The majority were married (76.7%) The majority live with their children (80%) Approximately 85% of those fathers surveyed had at least one child under the age of five Almost half (47%) of those surveyed had graduated from college

Family Health 78% Dads had private insurance, 10% had Medi-Cal, 9% were not insured 10% Dads had health conditions 7% Dads were in need of health care 79% Children had private insurance, 13% had Medi-Cal, 2% were not insured 9% Children had health conditions 3% Children were in need of health care

Mental Health 16% of Dads indicated that they were sad, depressed or overly stressed Only 22% of these indicated that they had seen a mental health specialist 12% of these indicated they were currently in need of counseling 5% of all Dads indicated that they currently were in need of counseling

Health 5% indicated that they were in need of family planning services 4% indicated they were in need of smoking cessation services 0% indicated they were in need of alcohol or drug counseling although 5% indicated that the community needed substance abuse services

Legal Assistance 5% of all Dads indicated that they currently were in need of legal assistance Among Dads who were not (or were sometimes) living with their children 9% needed legal assistance 19% needed child custody assistance 25% needed child support assistance

Personal Development 15% of Dads indicated that they were having current problems with their wife, partner or girlfriend 19% of Dads indicated that they currently had financial needs

Top 5 Prioritized Needs Financial (35%) Health Care (20%) Shelter/Housing (20%) Food (19%) Employment (18%)

Primary Role as Father Parenting (75%) Role Model (50%) Pay the Bills (43%) Disciplinarian (39%) Caregiver (38%) Head of the House (38%) Teacher (35%) Mother’s Support (28%) Provides Transportation (27%) No Role (3%)

The County 50% of Dads surveyed rated the county — the community — “excellent” or “good” as a place that supports fathers in raising children 29% rated it “fair”, and 10% rated it “poor”

Needed Support Services in the Community Father-Child Activities (47%) Parks or Recreational Activities (37%) Better Schools (35%) Parenting Classes (33%) Support Groups (25%) Violence Prevention (22%)

Bias Greater response rate from County employees than from non-profit agencies Sample probably not representative of lower-functioning fathers

Next Steps Implementation of the work plan developed in late 2003 Continual assessment of the needs of fathers in San Mateo County Continued efforts to develop new services for fathers (specifically case management and support groups)

Final Thoughts and Questions “The supreme test of any civilization is whether or not it can teach men to become good fathers.” -Margaret Mead