Nicholas Perona

Into to Public Health

11/12/12

5 Trends in the Contra Costa County of California

                This past week, I had the opportunity to speak with Ben Shure(?) or Shultz, who had something to do with the Assistant to Health Services Director and I was able to gather some of the following information about local trends in the area that I’m from in California.

1.      Chronic disease is the leading killer in Contra Costa and the single biggest cause of diminished quality of life:

While it is commonly believed that chronic disease affects mostly the elderly, cancer alone, for example, is second only to unintentional injury in the years of potential life lost to Contra Costa residents 65 years and younger.  Researchers have identified several factors that place someone at greater risk for chronic disease, including: tobacco exposure, high-fat diet, lack of regular physical activity, poverty, and for some chronic diseases, air pollution or long-term exposure to certain cancer-causing substances.

2.      Cardiovascular diseases are the leading cause of death for those over 40 years of age.

Most chronic diseases can be prevented or managed with early diagnosis and appropriate education and treatment. Although chronic diseases account for about two-thirds of all medical expenditures nationally, a recent study showed that state health departments allocate only about 3% of their budgets to prevention and control efforts. Local health departments typically spend even less. Those concerned with the public's health have an obligation to inform and educate themselves on this key public health issue and to work toward making chronic disease prevention and early intervention a priority.

Experience has shown that many chronic disease prevention efforts are not particularly effective, especially in high-risk, low income, ethnically diverse communities. The greatest success has been achieved using comprehensive systems approaches. Hence, this Framework goes beyond traditional approaches, which either focus on individual diseases or on single risk factors, to focus on creating an overall healthier environment that supports a spectrum of healthy choices.

3.      Cancer

The county's cancer death rate is higher than the state average.  Among the 15 most populous counties in California, Contra Costa ranked second in incidence rate for breast, ovarian, and prostate cancers. Although incidence rates for breast cancer are highest among White women, the death rate from breast cancer is higher for African American women.

4.      Tobacco Usage

Tobacco use and second-hand smoke exposure are among the leading preventable causes of premature death due to cancer and cardiovascular disease. Contra Costa County adults currently smoke at a slightly higher rate (16%) than the state average (just over 15%). Of all groups compared, non-Hispanic white adolescents have the highest rate of smoking prevalence in the county, at 25%. Use of smokeless tobacco is also more prevalent among 18 to 30 year old males in Contra Costa, with prevalence rates of 8.5%. There is also a new trend toward smokeless tobacco use among Hispanic males in the county.  Despite considerable gains in other areas in the last seven years, smoking prevalence among youth has increased, and the average age of first tobacco use has declined to age nine. Current problems include tobacco use portrayed by the media and advertisers as glamorous behavior, neighborhoods targeted for billboards advertising tobacco, and tobacco that is frequently more accessible than healthy foods in these areas.

5.      Poor Diet

Many factors contribute to a poor diet. First, low nutrient, high calorie foods are heavily advertised and readily accessible, particularly in low income neighborhoods. Second, many people lack access to accurate and culturally appropriate nutrition information. Third, a large number of Contra Costa residents are "food insecure" - that is, they must resort to charitable emergency food sources for sufficient healthy food, often because food and cash assistance benefits are insufficient and/or because affordable, nutritious food is lacking in their neighborhoods. In 1991, only 59% of those eligible for food stamps in this county were being served, indicating that many people eligible for food stamps did not receive them. Also, the number of people requiring food assistance has grown dramatically. Between 1987 and 1992, service at charitable emergency food pantries nearly doubled.