Alameda County Health Data Profile, 2014 - ACPHD

1 Alameda County Health data profile , 2014 COMMUNITY Health STATUS ASSESSMENT FOR PUBLIC Health ACCREDITATIONA cknowledgmentsThis report was produced by:The Alameda County Public Health Department Community Assessment, Planning, and Education (CAPE) Unitand Division of Communicable Disease Control and PreventionComments and questions can be directed to:Community Assessment, Planning, and Education (CAPE) UnitAlameda County Public Health DepartmentHealth Care Services Agency1000 Broadway, Suite 500 Oakland, California 94607(510) 267-8020 McKetneyDirector, CAPEM untu Davis, MD, MPHH ealth Officer, Director, Alameda County Public Health DepartmentAlex BriscoeDirector, Health Care Services AgencyCopyright 2014 , Alameda County Public Health DepartmentReviewersSandra HuangKristen LightLiz MakerChuck McKetney Erica PanAuthorsElaine BautistaSamantha BellMatt BeyersJanet BrownSangsook ChoRoxanna GuideTammy LeeRichard LechtenbergJane MartinNicholas MossNeena MurgaiCONTENTSI ntroduction _____3 Using the on Alameda County Geographies.

2 4 Notes on Race and Demographics _____5 Changing Demographics ..5 Socioeconomics ..8 Immigration and Language ..10 Why Place Matters ..112. Major Determinants of Health and Health Equity _____11 Neighborhood Poverty ..13 Racial Residential Segregation ..15 Inequitable Neighborhood Conditions ..17 Inequitable Economic Conditions ..17 Inequitable Psycho-Social Conditions ..18 Inequitable Built Environment Conditions ..22 Interactions between Place, Race, and Neighborhood Poverty ..253. Summary Measures of Mortality _____27 Leading Causes of Death ..27 Life Expectancy ..33 Mortality Rates by Cause ..36 All-Cause Mortality ..36 Heart Disease Mortality ..38 Cancer Mortality ..39 Stroke Mortality ..40 Chronic Lower Respiratory Disease Mortality.

3 41 Alzheimer s Disease Mortality ..42 Unintentional Injury Mortality ..43 Years of Potential Life Lost ..444. Maternal, Child, and Adolescent Health _____45 The Importance of Maternal, Child, and Adolescent Health ..45 Summary ..45 Infant Birth Weight Babies ..47 First Trimester Prenatal Care ..48 Teen Birth Rate ..505. Chronic Disease _____53 Adult Risk Factors ..54 Alcohol ..54 Diet ..54 Tobacco ..54 Physical Activity ..54 Adolescent Risk Factors ..57 Diet ..57 Physical Activity ..57 Tobacco ..57 Prevalence of Chronic Diseases and Conditions ..60 Hypertension ..60 Obesity ..60 Diabetes ..60 Asthma ..63 Child and Adolescent Overweight and Obesity ..63 Chronic Disease Hospitalizations ..65 Diabetes ..65 Coronary Heart Disease.

4 68 Severe Mental Illness Related Hospitalizations ..70 Stroke ..72 Congestive Heart Failure ..74 Asthma ..76 Child Asthma ..776. Safety and Violent Crime _____81 Trends in Violent Crime ..81 Homicide and Assault ..81 Unintentional Injury ..87 Self-Inflicted Injury ..887. Access to Primary Care _____91 Access to Usual Source of Care ..91 Avoidable Emergency Department Visits ..92 Asthma Emergency Department Visits ..95 Mental Disorders Emergency Department Visits ..96 Preventable Hospitalizations ..988. Communicable Disease _____103 Tuberculosis ..103 HIV/AIDS ..105 Sexually Transmitted Gonorrhea ..113 Syphilis ..115 Technical Appendix _____119 Alameda County Community Health Assessment data Profile3 INTRODUCTIONW elcome to the Alameda County Health data profile , 2014 .

5 This document was completed as part of the larger Com-munity Health Assessment (CHA), one of the key deliverables required to achieve Public Health Accreditation. The pur-pose of the data profile is to provide Health statistics on the Alameda County population and identify subpopulations or geographic areas where the disease burden is highest. These populations bear a disproportionate burden of poor Health outcomes, also referred to as Health inequities. This data profile is designed to stand alone as a document; however, the information contained in it is intended to be used in conjunction with the other elements of the CHA aimed at elucidat-ing community assets and strengths through a community engagement process. Thus this data profile is best considered in the context of the larger CHA.

6 A second key deliverable needed for Public Health Accreditation, the Community Health Improvement Plan (CHIP), will draw on both the gaps and the strengths identified in the CHA to create and implement a plan for better community Health . Chapters one and two of the data profile present a demographic and socioeconomic picture of Alameda County fol-lowed by a description of how the social determinants of Health including income, education, and employment shape opportunities for Health and wellbeing. Special attention is paid in this section to the historical roots of racial residential segregation, as they have led to persistent poverty, lower income, and lower life expectancy. Neighborhood poverty is the lens through which Health outcomes and social determinants of Health are examined in this chapter.

7 We refer to this lens as the social gradient, comparing high-poverty neighborhoods with low poverty neighborhoods on a variety of three of the data profile examines trends in leading causes of death in Alameda County as well as other sum-mary measures of mortality, including life expectancy and premature death. These measures are presented through the lens of place and race, with graphics showing age-adjusted rates by race/ethnicity, gender, and four focuses on maternal and child Health , with emphasis on trends in low birth weight, infant mortality, and teen birth. Rates are also presented by race/ethnicity and city/place. Chapter five covers chronic disease, beginning with the prevalence of behavioral risk factors and common chronic con-ditions at the County level, and ending with data on key indicators of morbidity by race and place.

8 These include hospi-talization for diabetes, coronary heart disease, severe mental illness, stroke, congestive heart failure, and six covers safety and violence in Alameda County with a focus on unintentional injury, homicide, and assault by race/ethnicity and city. Chapter seven covers access to primary medical care, first focusing on usual source of care and then examining in more detail proxy measures of access, including overall avoidable emergency department (ED) visits and ED visits for asthma and severe mental illness. It concludes with some key indicators of preventable hospitalizations for acute and chronic Alameda County Community Health Assessment data Profile4illnesses. These will be important measures to track over time to monitor improvement in access to care with the imple-mentation of the Affordable Care Act.

9 Finally, chapter eight covers communicable diseases in Alameda County , including tuberculosis, HIV/AIDS, and the most common sexually transmitted diseases, gonorrhea, Chlamydia, and the ReportNotes on Alameda County GeographiesTwenty urban areas are covered in this report. These urban areas are 14 incorporated cities ( Alameda , Albany, Berkeley, Dublin, Emeryville, Fremont, Hayward, Livermore, Newark, Oakland, Piedmont, Pleasanton, San Leandro, and Union City) and six unincorporated census designated places as defined by the Census Bureau (Ashland, Castro Valley, Cher-ryland, Fairview, San Lorenzo, and Sunol). These urban areas are frequently referred to as cities in this report, even though not all are formally incorporated. Different data sources vary in terms of the geographic level of detail available; some are available at the census tract level and some only at the zip code is important to note that for some indicators, such as those based on births and deaths, the city charts and tables show data for places ( , in the unincorporated areas) such as Ashland, Cherryland, and Fairview.

10 And they also show data for Piedmont if there are sufficient numbers. This is possible because Alameda County Public Health Department has address-level information on record and these can be geocoded and aggregated to census tract or smaller geographic areas. For other indicators, such as those based on hospital or ED records, data are only available at the zip code level, and so zip codes are aggregated to approximate cities. In these cases we cannot achieve the same geographic resolution so the smaller places cannot be shown on Race and EthnicityThis report restricts descriptions of race and ethnicity to short words and phrases. It is recognized that individual pref-erence varies and that classification is not trivial. Considering the report s many text references, tables, and figures that make comparisons between races, readability and space require consistent and abbreviated usage.