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Health Outcomes

HSCI 610

Brailyn Bray

October 18, 2016

Highlighting community success, identifying causes of poor health, supporting policy

change, and engaging communities in health improvement are all factors of health outcomes in a

community. Based on data for each county, rankings are used to measure the overall health

outcomes. Measures range from high school graduation ranks, access to healthy foods, rates of

drug and alcohol use, obesity, teen births, and income. Rankings of health outcomes are used to

analyze where support and improvement from healthcare providers, community organizations,

government agencies, policy makers, and the public. The County Health Rankings and

Roadmaps program, illustrates what we know when it comes to what is making people sick or

healthy and the roadmaps show what we can do to create healthier places to live, learn, work,

and, play. Counties receive two ranks, Health Outcomes and Health Factors. County health

rankings 2014 defines health outcomes representing how healthy a county is, while health factors

represent what influences the health of the county. Data for San Bernardino county ranks health

outcomes number 40 out of 57 countys in California, and ranks 45 in health factors out of all 57

countys in California. San Bernardino County health outcomes indicate the populations length

and quality of life to be lower than normal due to the health factors for health behaviors, clinical

care, social and economic factors and physical environment.

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Community health and wellness indicators in San Bernardino county include a variety of

chronic disease. Some of these include: diabetes, high blood pressure, and heart disease. County

comparison, 2013 indicate (70%) of deaths contribute to chronic illnesses in the United States

each year. Mortality and morbidity rates due to these indicators are highly influenced by health

behaviors, social factors, health care quality and access, and built environment. The death rate is

determined by the ratio of deaths to the population of the area during a particular time, and is

usually calculated as the number of deaths per one thousand people per year. In 2013, San

Bernardino Countys death rate due to heart disease was 189.6 age-adjusted deaths per 100,000

residents (cdph.gov). Compared to the previous years the death rate has declined while the

countys residents who were diagnosed with heart disease increased. Compared to other countys

in 2013, San Bernardino County had the highest prevalence rate for heart disease. Other diseases

like the prevalence of diabetes and death continue to rise.

Diabetes is a common chronic disease for San Bernardino County residents. Ethnic

backgrounds and being overweight contribute to the high rates of deaths. The California

Department of San Bernardino County Health Status profiles indicate the crude death rate for

California was 20.7 deaths per 100,000 population. The risk of dying from diabetes is equivalent

to approximately one death for every 4,823.1 persons. The rates were based on a three- year

average of 2011 through 2013. San Bernardino county rates included 555.3 deaths with a

population of 2,065,016 and had a 26.9 crude death rate. Compared to the state statistics San

Bernardino county has a higher death rate.

Other health indicators in San Bernardino county that contribute to poor health outcomes

is Coronary Heart Disease. Coronary Heart Disease is build up plaque around the arteries that

supply the oxygen rich blood to the heart over several years. San Bernardino Health Status
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Profile 2016, reports 1,810.7 deaths on average in the years of 2012-2014, calculated by

mortality rates. Mortality determines the number of deaths that occurred in a particular time

divided by the total size of the population. Coronary heart disease is commonly found in

individuals whose sedentary lifestyle involves poor eating behaviors like highly saturated foods.

San Bernardino county is primarily a food dessert, and has has very few grocery stores that are

convenient and accessible for residents, thus resulting in poor health outcomes. According to the

San Bernardino county Department of Public Health 2011-2013, San Bernardino had 1,912

deaths due to coronary heart disease and a crude death rate of 92.6. Deaths of Coronary Heart

disease for California was 104.3 deaths per 100,000 populations.

. The sedentary lifestyle of poor eating and dieting contribute to the large percentage of

people who are overweight and consider obese. Obesity in children and Adults is on a rise and is

the primary risk factor for health problems and premature death. San Bernardino County and

California Statistics estimate almost three-quarter of adults are overweight. In 2014, (38%) of

adults were considered overweight and (34.0%) obese. In comparison, (35.8%) of adults in

California were considered to have had a healthy body weight. Weight status of adults and

children rely heavily on healthcare access and access to alternative healthy foods. With children

become overweight at an early age, they are more likely to become overweight or obese when

they become adults. Improving food programs in the schools and implementing local food

markets at an affordable price ran by community members, residents can have a greater

opportunity to improve their health.

Poor health outcomes due to AIDS is another contributing factors to the deaths in the

county. AIDS among the population of 13 years of age and older indicate 8.1 cases per 100,000

of the age population, and approximately one reported AIDS case for every 12,309.3
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populations, aged 13 years of age and older. Analyzing San Bernardino county demographics,

102 cases were reported with a population of 1,657,663. The crude case rate was 6.2 cases per

100,000. Compared to other counties, San Bernardino had the second to lowest crude case rate.

Reported Incidence of AIDSAmong Population of 13 years of Age and Older

Three year Avergae 2011-2013 Crude Case Rates
8.1
2542

6.4
116

12.1
1002

5.8
147

9.5
249

6.2
102

Cases per 100,000 pop Crudecase rate

Morbidity rates are defined as the frequency with which a disease appears in a

population. In San Bernardino the most common diseases found are Chlamydia, Gonorrhea, and

AIDS. Those who have acquired Chlamydia or Gonorrhea specifically in this county are most

likely unable to seek treatment due to the lack of financial abilities, education, and transportation

to reach these health care facilities for treatment. Having health care access to seek early

treatment and educational programs for the community on safe practices could reduce the

prevalence rate of those who have acquired the disease. To calculate the morbidity rate, the

number of new cases is divided by the number of people at risk in the same time period,

multiplied by 100. The California Department of Public Health report 11, 227 case of Chlamydia

and a crude case rate of 543.7. Compared to the state Statistics, the crude case rate of Chlamydia
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cases was 442.6 case per 100,000 populations. This means approximately 1 case for every 225

persons in the 2011 through 2013 were reported. The crude case rate for Gonorrhea cases among

females aged 15-44years old, for California was 152.8 cases per 100,000 female population.

Males aged 15 through 44 years old, for California was 213 cases per 100,000 male population.

The San Bernardino Health Status Profile for 2016 morbidity rates an average of 11,191.0

Chlamydia Incidence, 1,068.0 Gonorrhea incidence of female ages 15-44, 969.3 Gonorrhea

incidence male age 15-44, and 100.7. This shows an increase over the years of cases of both

Gonorrhea and chlamydia in San Bernardino County. Analysis of health indicators show females

having a higher prevalence rate in Both State and County statistics.

California reported incidences GONNORHEA FEMALES AND MALES AGES

15-44 2011-2013

Gonnorhea cases Females; 41%

Gonnorhea cases Male; 59%
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San Bernardino County Reported Incidences Gonnorhea Females and Males, Ages 15-33 2011-2013

Gonnorhea Cases Male; 46%

Gonnorhea Cases Females; 54%

Infant mortality and low birth rates are a huge contributor to poor health outcomes, it

represents the overall health outcomes of the community. Seeking early pre-natal care and

adequate diet, an increase in life expectancy can be achieved. Poverty rates and ethnic

backgrounds are also to be considered when looking at health outcomes. Demographics show

that the number of residents in poverty 18 years of age and older results in approximately (28%)

in San Bernardino, compared to the state 24% in 2012. Demographics of San Bernardino County

show African Americans, Hispanic and Latinos, and Whites as the majority of the population.

Analyzing the infant mortality rates, Blacks have the highest rate compared to the states and

neighboring counties.
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Infant Mortality Rate of Different Race/Ethnic Backgrounds In California and San Bernardino 2011-2013
11.4
9.8

5.5 5.4
4.7
3.6 4 3.9

Asian Pacific Islander Black Hispanic White

California Infant Mortality San Bernardino Infant Mortality

Alcohol and other drug abuse contribute to the high prevalence of disease and deaths in

San Bernardino County. Substance abuse, drug addiction, traffic accidents, crime, unintended

pregnancies, liver disease, and HIV/AIDS are linked to public health concerns and health

outcomes in each county. People who engage in alcohol, drugs, and crime at a younger age are

less likely to live long healthy life. Indicators present a variety of trends in San Bernardino

County residents with alcohol and drug abuse that result in serious injuries or death. A survey of

1,927 youth was conducted by San Bernardino County Department of Behavioral Health. The

survey focused on the perception of youth and binge drinking. Binge drinking is defined as

drinking five or more alcoholic drinks at one setting on the the same day. 75 percent of

participants agreed that binge drinking is dangerous and another (25%) believed that it was ok.

Preventing potential injurious and deaths of youth and those who abuse alcohol and other drug

start with prevention and education with community leaders to educate the youth on alcohol and

binge drinking in social functioning.

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Alcohol and other drug abuse has resulted in a high percentage of AOD related

admissions to county treatment facilities. San Bernardino county 2010-2014 indicate an increase

of (29%) growth in admissions in alcohol abuse, (26%) growth in admissions of

methamphetamine addiction. Alcohol and drug addition rates are high in San Bernardino County

because of the crime rates and a low percentage of individuals who graduated with a High

School diploma or higher. In 2014, 1,073 reported alcohol-involved serious collision incidences

in San Bernardino and 16,960 in California. Between 2013 and 2014, alcohol-involved collisions

rose 10% compared to a 1% decline statewide. And in 2010, alcohol-involved collisions rose

11% in San Bernardino County compared to a 6% decline statewide according to San Bernardino

County Department of Behavioral Health. Alcohol and drug addiction has resulted in poor health

outcomes of the youth and has contributed to the low socioeconomic status of a high percentage

of San Bernardino County residents.

Analyzing the community demographics, I learned the health outcomes of San

Bernardino County are highly influenced by health behaviors, social and economics, and

healthcare access. San Bernardino county geographic area is diverse with various racial/ethnic

backgrounds. I learned that race and and gender differences influence community health. In San

Bernardino county, those in poverty are more susceptible to poor health outcomes. African

Americans and Hispanics have a higher prevalence rate of chronic diseases and mortality rates.

Their quality of life is below the State statistics and neighboring counties. Poverty rates

contribute to poor health outcomes because it limits those to healthcare access, and healthier
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foods. Obesity rates and those who are considered overweight result in 38% of Adults in the

population. Because of the lack of food markets, and adequate food programs implemented into

the schools, the rate of those overweight in the county continue to rise.

Health outcomes of San Bernardino also have to high rates of crime, alcohol, and other

drug abuse are poor health behaviors that are influenced by the social environment. Social and

economic factors influence the community safety, income, employment, education, and family

and social support. Just like the class text book stated social support exists at the community and

societal level. Some of these include support groups and social capital. Children learn behaviors

from family and family characteristics and functions affect health. The positive and negative

health behaviors contribute to individual health outcomes. Analyzing San Bernardino County. I

learned that the sexual activity of the population has lead persons to be more susceptible to

Chlamydia, Gonorrhea, HIV/AIDS. Coronary Heart Disease and Diabetes are top diseases in the

county. The reason for this, is primarily due to the lack of education, health care access, and

quality of care. These health indicators suggest that the health outcomes in the county need a

favorable amount of help from community partners and healthcare professionals to improve their

overall health and quality of life.

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References

Centers Disease Control and Prevention. Centers For Disease Control and Prevention, n.d. Web.

23 Oct. 2016.

County Health Status Profiles 2015. (2015). Retrieved October 23, 2016, from

https://www.cdph.ca.gov/programs/ohir/Documents/OHIRProfiles2015.pdf