Santa Clara County residents enjoy longer life expectancies and overall better health than the rest of the state and nation, but stark disparities based on wealth and race persist.
That’s according to a snapshot of public health released by the county as it tries to add a health element to its General Plan (a state-mandated map for a community’s future growth).
General plans usually include blueprints for housing growth, circulation, noise, public safety, land use, open space and conservation. But with public health affecting so many other parts of policy, the county wants to add a health element to prepare for future needs. It’s the first county in the nation to do so, says County Executive Jeff Smith.
The county, overall, is pretty healthy compared to the state and nation because its higher median income affords healthier lifestyle options and longer life expectancy (83.7 years against 80.1 for California; and 78.6 for the nation). But—as typical in Silicon Valley, land of diversity—dramatic racial, ethnic and age disparities exist. Forty-four percent of households earn at least six figures, while 29 percent make $50,000 or less.
A fifth of county residents live at the federal poverty level compared to 32 percent in the state. But the region’s higher cost of living renders a higher percentage prone to economic insufficiency. Education also affects a person’s well-being, leading to higher-paying jobs that afford healthier lifestyles. Countywide, more than 20 percent of residents have attained a bachelor’s degree or higher, versus 11 percent in the state.
Immigration affects the public health, too, so the county should plan accordingly. Thirty-seven percent of the region’s population is foreign-born, and this group is twice as likely to self-report poor health, as are households not fluent in English (12 percent of the county).
These demographic variations affect life expectancy and the type of diseases one is prone to contract.
San Jose, as home to 53 percent of the county’s nearly 2 million people, will have to lead the charge in developing public health policies, the county says.
People who live in the heart of San Jose have an average life expectancy of 79.5 years, compared to 86.7 years for denizens of Los Altos, Mountain View and Palo Alto.
More people die from heart disease and cancer than anything else in the county, accounting for half of all deaths. More than half of all adults here are overweight or obese, as are a quarter of middle school pupils.
Low-income students are 62 percent more likely to be obese compared to their higher-income counterparts. Latino students: 55 percent compared to whites. Overall, the poor, minority, less-educated and rural-living residents are prone to obesity.
Those who call midtown San Jose or South County home see higher rates of heart disease and diabetes.
Though low-income neighborhoods have higher violent crime rates, county residents overall see the region as safer than other Californians.
Drugs and alcohol
More middle and high school students reported marijuana use than the state average (12 percent here, 11 percent in California), but fewer said they’ve tried alcohol (23.4 percent versus 33.4).
Among adults, the county has fewer binge drinkers than the state (11.8 percent compared to 15.5 for the state). The region sees fewer drunken driving-related deaths than the state, but more in low-income neighborhoods where more people drink regularly and there’s more traffic on the streets.
Counties with better public health resources and more public transportation options see fewer negative effects from drug and alcohol use, the report says, a telling example of how a community’s health can affect other aspects of public policy.
Suicide rates in the county are lower than California’s (8.1 per 100,000 resident compared to 9.6 per 100,000).
Other mental health problems tend to go underreported, the study says. And the area’s population density and cost of living may lead to higher stress for people.
The number of Santa Clara County working-age adults without health insurance more than doubled, from 8 percent in 2000 to 18 percent in 2009. (Blame the Great Recession for that one.) Meanwhile, the rate dropped in California overall, from more than 20 percent to 19 percent. Among those aged 35 and younger in the county, 35 percent lack coverage.
Nine out of 10 white residents claim insurance, yet only 60 percent of Latinos.
Along with the growing number of uninsured, the region will also have to deal with a burgeoning elderly population. The number of residents 85 and older is expected to grow nearly 400 percent between 2010 and 2060, which means the county hospital system will have to prepare for the demands of caring for older patients (in part by encouraging healthy lifestyles now).
Accidental falls are the leading cause of death among older folks, as well as the leading cause of hospitalization.
“The Existing Conditions Report and the Countywide Health Element of the General Plan are important steps toward improving the physical and social environment in Santa Clara County,” says Board of Supervisors President Ken Yeager, who also chairs the Health and Hospital Committee. “The purpose of this planning process is to identify existing health conditions in the county, and to take steps now to anticipate and prevent injuries and diseases before they occur.”