1. Community Health Assessment 2004 - 2005 San Joaquin County

2. Background of the Project San Joaquin Community Health Assessment Collaborative formed in 2004. Grown to over 25 agencies with 8 financial sponsors. Purpose: to produce a functional and comprehensive health profile. Overall goal: inform and engage local stakeholders and community members in order to promote and develop collaborative efforts based on reliable data, community input and group consensus.

3. Focus Areas Chronic disease (diabetes, asthma, obesity) Emergency services utilization Adolescent / youth health

4. Community Assessment Project Step 1 Form a Steering Committee Develop Project Methodology Create Working Committees Identify Potential Quality of Life Indicators Collect Secondary Data Conduct Community Surveys Analyze Results Publish and Promote the Report Develop Community Goals and Benchmarks Update the Report Regularly Encourage Community Action Step 2 Step 7 Step 6 Step 5 Step 4 Step 3 Step 10 Step 9 Step 8 San Joaquin County

5. Methodology English and Spanish telephone surveys were completed with over 400 randomly selected county residents. Face-to-face surveys with over 2,200 participants were collected at 46 different sites and community agencies throughout the county. Secondary (pre-existing) data were collected for over 15 heath indicators from a variety of sources.

6. Findings

7. Access to Health Care If you needed health care in the last 12 months, were you able to receive it? Source: San Joaquin County Community Health Assessment, Telephone Survey and Face-to-Face Survey, 2004.

8. Access to Health Care If you were not able to receive health care in the last 12 months, why not? (Top 5 responses) Source: San Joaquin County Community Health Assessment, Telephone Survey and Face-to-Face Survey, 2004. Telephone Survey No insurance82.6% Could not afford it73.3% Did not know where to go34.7% Insurance would not cover it 21.6% Transportation issues21.1% Multiple response question with 17 respondents offering 52 responses Face-to-Face Survey No insurance52.8% Could not afford it30.8% Didn’t know where to go17.9% Transportation issues16.8% Unable to communicate due to language differences 16.6% Multiple response question with 386 respondents offering 783 responses

9. Health Insurance Coverage Healthy People 2010 Objective: 100% of residents under 65 years will have health insurance. Residents who currently have health insurance coverage, by age, 2003 Source: 2003 California Health Interview Survey, 2005. San Joaquin County N (0-5 years): 57,000; San Joaquin County N (0-17 years): 187,000; San Joaquin County N (ages 18 and older): 422,000.

10. Adult Health Insurance Coverage Do you currently have health insurance coverage? 2004 Source: San Joaquin County Community Health Assessment, Telephone Survey and Face-to-Face Survey, 2004.

11. Adult Health Insurance Coverage Respondents who stated that their health insurance covered the following: Source: San Joaquin County Community Health Assessment, Telephone Survey and Face-to-Face Survey, 2004.

12. Adult Health Insurance Coverage Percentage of San Joaquin County Adults without Health Insurance Source: San Joaquin County Health Assessment, Telephone and Face- to-Face Survey, 2004; US Census Bureau, 2000.

13. Youth Health Insurance Coverage Source: San Joaquin County Community Health Assessment, Telephone and Face-to- Face Surveys, 2004.  Do your children have health insurance? 2004  Do your children have health insurance? 2004

14. Emergency Room Use Source: San Joaquin County Community Health Assessment, Telephone and Face-to- Face Surveys, 2004.  Do you use the emergency room for your main source of care?  Do you use the emergency room for your main source of care?

15. Emergency Room Use Percentage of Families Using the Emergency Room as Their Primary Source of Care Source: San Joaquin County Health Assessment, Telephone and Face- to-Face Survey, 2004; US Census Bureau, 2000.

16. Dental Insurance Coverage Percentage of respondents who have additional insurance coverage for dental care and whose children have dental insurance Source: San Joaquin County Community Health Assessment, Telephone Survey and Face-to-Face Survey, 2004.

17. Asthma Residents who have been diagnosed with asthma, by age, 2003 Source: 2003 California Health Interview Survey, 2005. San Joaquin County 2003 N (1 – 5 years): 49,000; San Joaquin County 2003 N (1 – 17 years): 179,000; San Joaquin County 2003 N (ages 18 and older): 422,000. * Statistically unstable due to low number of respondents. For 2003 for San Joaquin County children aged 1-5, the confidence interval was 6.5%-34.9%. Caution should be used with these data.

18. Asthma Percentage of Adults Who Have Ever Been Diagnosed With Asthma Source: San Joaquin County Health Assessment, Telephone and Face- to-Face Survey, 2004; US Census Bureau, 2000.

19. Diabetes Healthy People 2010 Objective: No more than 2.5% of people will have diabetes. Residents who have been diagnosed with diabetes, by age, 2003 Source: 2003 California Health Interview Survey, 2005. San Joaquin County 2003 N (ages 12-17): 67,000; San Joaquin County 2003 N (ages 18 and older): 422,000. * Statistically unstable due to low number of respondents. For 2003 for San Joaquin County children aged 12- 17, the confidence interval was 0.0%-14.8%. Caution should be used with these data. In this age group, most cases would be type 1.

20. Obese Adults Healthy People 2010 Objective: No more than 15.0% of people will report being obese. Age-adjusted percentage of adults who are obese (30.0 BMI or greater), 2001 Source: State of California, Department of Health Services, Center for Health Statistics, Prevalence of Obesity and Healthy Weight in California Counties, 2001, 2005. Note: Data based on data from the 2001 California Health Interview Survey.

21. Overweight Children Percentage of San Joaquin County children who are overweight (greater than or equal to the 95 th percentile for Body Mass Index), by ethnicity and age, 2002 Source: Centers for Disease Control and Prevention, 2002 Pediatric Nutrition Surveillance, Growth Indicators by Race/Ethnicity and Age, 2005.

22. Youth Nutrition Percentage of San Joaquin County 7 th, 9 th and 11 th grade students who reported consuming 5 or more portions of fruits or vegetables in the past 24 hours Source: San Joaquin County Office of Education, California Healthy Kids Survey, 2004.

23. Summary Most residents have health insurance, but some still use the ER for their primary source of care. These data suggest that even with health insurance coverage, access to medical care can be a problem for county residents. San Joaquin County has a higher percentage of asthma for youth (ages 1-17) and adults than the state. San Joaquin County and California have similar percentages of adult diabetes, but both are far higher than the Healthy People 2010 goal of 2.5%. Finally, too many local children and adults are overweight or obese, putting them at risk for further health related complications (e.g. diabetes).

24. Questions and Answers

25. Applied Survey Research For More Information Contact: Kelly Pleskunas or Susan Brutschy Phone: 831-728-1356 www.appliedsurveyresearch.org