OCh

2013
COMMUNITY HEALTH
NEEDS ASSESSMENT
OCONNOR HOSPITAL
PUBLISHED MAY 2013
TableofContents
1. ExecutiveSummary.......................................................................................................................1
CommunityHealthNeedsAssessment(CHNA)Background...........................................................1
Process&Methods..........................................................................................................................1
PrioritizedNeeds..............................................................................................................................1
NextSteps........................................................................................................................................3
2. Introduction/Background..............................................................................................................4
PurposeofCHNAReportandAffordableCareActRequirements..................................................4
SB697andCaliforniasHistorywithPastAssessments...................................................................4
3. AboutOConnorHospital...............................................................................................................5
CommunityServed...........................................................................................................................5
MapofCommunityServedbyHospitalFacility...............................................................................6
4. AssessmentTeam..........................................................................................................................7
HospitalsandOtherPartnerOrganizations.....................................................................................7
IdentityandQualificationsofConsultants......................................................................................7
5. ProcessandMethods.....................................................................................................................9
SecondaryDataCollection...............................................................................................................9
PrimaryData(CommunityInput)...................................................................................................10
CommunityLeaderInput...............................................................................................................10
ResidentInput................................................................................................................................14
InformationGaps&Limitations.....................................................................................................16
6. IdentificationandPrioritizationofCommunityHealthNeeds......................................................17
IdentificationofCommunityHealthNeeds...................................................................................17
SummarizedDescriptionsofPrioritizedSantaClaraCountyCommunityHealthNeeds..............19
PrioritizationofHealthNeeds........................................................................................................22
7. CommunityAssetsandResources................................................................................................24
8. Conclusion...................................................................................................................................26
9. ListofAttachments......................................................................................................................27
Attachment1:SecondaryDataSources........................................................................................28
Attachment2:IRSChecklist..........................................................................................................35
Attachment3:MapofSantaClaraCounty....................................................................................37
Attachment4:ListofCommunityLeadersandTheirCredentials.................................................38
Attachment5:ListofIndicatorsonWhichDataWereGathered..................................................44
Attachment6:CrossCuttingDriversMentionedDuringPrimaryDataGathering.......................54

Attachment7:HealthNeedsProfiles............................................................................................55
Attachment8:HealthNeedsPrioritizationScores:BreakdownbyCriteria..................................56
Attachment9:CommunityIndicatorDashboard..........................................................................57
2013CommunityHealthNeedsAssessment(CHNA)
1. EXECUTIVESUMMARY
CommunityHealthNeedsAssessment(CHNA)Background
TheAffordableCareAct(ACA),enactedbyCongressonMarch23,2010,stipulatesthatnonprofithospital
organizationscompleteacommunityhealthneedsassessment(CHNA)everythreeyearsandmakeitwidely
availabletothepublic.Thisassessmentincludesfeedbackfromthecommunityandexpertsinpublichealth,
clinicalcare,andothers.ThisCHNAservesasthebasisforimplementationstrategiesthatarefiledwiththe
InternalRevenueService.
TheIRSrequiresthatthehospitalconductaCHNAandadoptanimplementationstrategyforeachofits
facilitiesbythelastdayofitsfirsttaxableyearbeginningafterMarch23,2012.ForOConnorHospitalthat
taxyearisJuly1June30.TheCHNAmaybeconductedinthatsameyear,orinthetwoyearsimmediately
precedingtheyearinwhichthesebecomeeffective.
ThisCHNAreportdocumentshowtheCHNAwasconducted,aswellasdescribestherelatedfindings.
Process&Methods
TheSantaClaraCountyCommunityBenefitCoalition(theCoalition)members,acoalitionofeightlocal
nonprofithospitalsandotherpartners,begantheCHNAprocessin2012.TheCoalitionsgoalwasto
collectivelygathercommunityfeedback,understandexistingdataabouthealthstatus,andprioritizelocal
healthneeds.
Communityinputwasobtainedduringthefallof2012viakeyinformantinterviewswithlocalhealthexperts,
focusgroupswithcommunityleadersandrepresentatives,andresidentfocusgroups.Secondarydatawere
obtainedfromavarietyofsourcesseeAttachment1foracompletelist.
InNovember2012,healthneedswereidentifiedbysynthesizingprimaryqualitativeresearchandsecondary
data,andthenfilteringthoseneedsagainstasetofcriteria.NeedswerethenprioritizedbytheCoalition,
usingasecondsetofcriteria.Seetheresultsofprioritizationincludedonthenextpage.
TheCoalitionmetagaininDecember2012toidentifyresourcesinthecommunity,includinghospitalsand
clinics,andspecialhealthandwellnessprograms.
PrioritizedNeeds
Basedoncommunityinputandsecondarydata,theCoalitiongeneratedalistofhealthneedsandthen
prioritizedthemviaamultiplecriteriascoringsystem.Theseneedsarelistedbelowinpriorityorder,from
highesttolowest.Notethatthecrosscuttingdriver,AccesstoHealthCare,wasnotincludedinthe
prioritizationprocessbutispartofthesetofhealthneeds.
SantaClaraCountyHealthNeedsIdentifiedbyCHNAProcess,inOrderofPriority
1. DiabetesisahealthneedasmarkedbyhighratesofdiabetesamongadultsinSantaClaraCounty.
Forexample,countywide,diabetesprevalenceisat8%(nobetterthanthestateaverage),butfor
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thecountysAfricanAmericanpopulationdiabetesprevalenceis14%.Driversofdiabetesrates
includepoornutritionandlackofexercise,andphysicalenvironmentsuchasavailabilityoffresh
foodandfastfood.
2. Obesityisahealthneedasindicatedbyhighratesofobeseyouth(2431%)andadults(21%)inSanta
ClaraCounty,andhighratesofoverweightyouthandadultsaswell(14%and36%respectively).
OverallratesmisstheHealthyPeople2020targets.LatinoandBlack/AfricanAmericanresidents
havethehighestratesofoverweightandobesity.Driversofobesityarepoornutritionandlackof
exercise,andphysicalenvironmentsuchasavailabilityoffreshfoodandfastfood.
3. Violenceisahealthneedbecausetherateofyouthhomicide(7.4)inSantaClaraCountyishigher
thantheHealthyPeople2020target.Inaddition,thecountyhasseenalargeincreaseinhomicides
intheyears2011and2012.Domesticviolenceandchildabuseratesalsomissthebenchmarkfor
someethnicsubgroups.Driversofthishealthneedincludementalhealthandsocialdeterminantsof
healthsuchaspovertyandunemployment.
4. PoorMentalHealthisahealthneedbecauseofselfreportedpoormentalhealth(17%)among
SantaClaraCountyresidents,higherthanthestateaverage.Also,youthofcolorare
disproportionatelydepressedandsuicidal.Communityinputindicateshighconcernaboutstressand
depressionspecifically.
5. PoorOral/DentalHealthisahealthneedasindicatedbythepercentageofSantaClaraCountyyouth
reportingtheirteethwereinfairorpoorcondition(16%),whichisworsethanthestateaverage
(12%).Also,someethnicsubgroupsarelesslikelytohavedentalinsurance,whichisadriverofpoor
oralhealth.
6. CardiovascularDisease,HeartDisease,andStrokeareahealthneed,astheyareamongthetopten
causesofdeathinSantaClaraCountyandCalifornia.Theoverallrateofhighcholesterolinthe
county(29%)ishigherthantheHealthyPeople2020target(17%),asaretheratesforallethnic
populations.Relatedtopoorcardiovascularhealtharethehealthbehaviorsofsmoking,drinking,
poornutritionandlackofexercise.
7. SubstanceAbuse(Alcohol,Tobacco,andOtherDrugs)isahealthneedbecauseSantaClaraCounty
youthandadultshavehigherratesofbingedrinking(12%and25%respectively)comparedwith
HealthyPeople2020targets.Youthmarijuanauseisalsohigh.Driversofsubstanceabuseinclude
poormentalhealthandlackoftreatment/accesstocare.
8. Cancerisahealthneed;SantaClaraCountyincidenceratesforbreast,cervical,liverandprostate
cancersarehigherthanbenchmarks/stateaverages.Certainethnicsubgroupsexperiencedifferent
incidenceandmortalityrates.Forinstance,theoverallcountylivercancermortalityrateis6.8,
comparedwith5.6forthestate,andevenworseforcountyLatinos(9.0)andAsian/PacificIslanders
(11.9).Contributingfactorstocancerarehealthbehaviorssuchassmokinganddrinking,andlackof
screeningcontributestomortalityrates.
9. RespiratoryConditionsareahealthneedasindicatedbythehighasthmahospitalizationrateof
SantaClaraCountychildrenages04(24.5per10,000).Asthmaprevalenceamongcountyadultsis
nobetterthantheHealthyPeople2020targetof13%andshouldbemonitored.Thehealthneedis
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likelybeingimpactedbysmokingamongyouth/adultsaswellaspoorairqualitylevels.Community
inputdemonstratedaconcernaboutthecostsofasthmatreatmentduetolackofmedicalinsurance.
10. STDs/HIVAIDSareahealthneedinSantaClaraCountyasindicatedbydisproportionatelyhighHIV
incidenceratesamongAfricanAmericans(50.4,comparedwith10.3overall).Thehealthneedis
likelydrivenbylowscreeningratesandlackofhealtheducation.
11. BirthOutcomesareahealthneedbecauseofthepercentageoflowbirthweightbabiesinSanta
ClaraCounty,whichisnobetterthanthestateaverage(approximately7%).CountyAfrican
Americansaredisproportionatelyaffectedbylowbirthweight(9%),pretermbabies,andinfant
mortality.Adriverofthishealthneedisinadequateearlyprenatalcare.
12. Alzheimer'sisahealthneedbecauseoftheincreasingproportionofSantaClaraCountyresidents
livingwithAlzheimersdisease,andbecauseitisoneofthetoptenleadingcausesofdeathinthe
county.
13. (Notincludedinprioritizationprocess)CrossCuttingDriver:AccesstoHealthCareServicesisa
healthneedinSantaClaraCountybecausesocioeconomicconditions(poverty,lowlevelsof
education,lackofhealthinsurance)aswellasfactorssuchasthesizeofthehealthcareworkforce,
linguisticandtransportationbarriersallaffectaccesstocare,whichnegativelyimpactshealth.
NextSteps
AftermakingthisCHNAreportpublicallyavailableinJune2013,OConnorHospitalwilldevelopan
implementationplanbasedonthisdata.
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2. INTRODUCTION/BACKGROUND
PurposeofCHNAReportandAffordableCareActRequirements
EnactedonMarch23,2010,federalrequirementsincludedintheAffordableCareAct(ACA)stipulatethat
hospitalorganizationsunder501(c)(3)statusmustadheretonewregulations,oneofwhichisconductinga
communityhealthneedsassessment(CHNA)everythreeyears.TheCHNAReportmustdocumenthowthe
assessmentwasdone,includingthecommunityserved,whowasinvolvedintheassessment,theprocessand
methodsusedtoconducttheassessment,andthecommunityshealthneedsthatwereidentifiedand
prioritizedasaresultoftheassessment.SeeAttachment2IRSchecklist.
AspartofthetriannualCHNAassessment,hospitalsmust:
Collectandtakeintoaccountinputfrompublichealthexpertsaswellascommunityleadersand
representativesofhighneedpopulationsincluding:minoritygroups,lowincomeindividuals,
medicallyunderservedpopulationsandthosewithchronicconditions
Identifyandprioritizecommunityhealthneeds
DocumentaseparateCHNAforeachindividualhospital
MaketheCHNAreportwidelyavailabletothepublic
AdoptanImplementationStrategytoaddressidentifiedhealthneeds
SubmittheImplementationStrategywiththeannualForm990
Paya$50,000excisetaxforfailuretomeetCHNArequirementsforanytaxableyear
SB697andCaliforniasHistorywithPastAssessments
ComparedtoSB697,theCaliforniaspecificlegislationrequiringacommunityhealthneedsassessment,the
ACAregulationsaremorestringentonhowtoconductanddocumenttheneedsassessment.Acomparisonis
showninthetablebelow.
ComparisonofACAandSB697CHNARequirements
Activity or Requirement
Required by ACA
Required by SB 697
Yes
Yes
Conductacommunityhealthneeds
assessmentatleastonceevery3years
CHNAidentifiesandprioritizes
communityhealthneeds
Yes
(Prioritizationofallhealthneedsrequired
beforeimplementationplanning)
Yes
Yes
No
Yes
No
Yes
Yes
FileanImplementationPlanwithIRS
Yes
No
(CBPlanwithOSHPD)
$50,000excisetaxforfailuretomeet
CHNArequirementsforanytaxableyear
Yes
No
Inputfromspecificgroups/individuals
aregathered
CHNAfindingswidelyavailabletothe
public
Implementationstrategyisadoptedto
meetneedsidentifiedbyCHNA
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3. ABOUTOCONNORHOSPITAL
OConnorHospitalisa358bedacutecare,communityhospitallocatedintheheartofSanJose,the
largestcityinSantaClaraCounty.Weprovidecarefortheyouth,adultsandelderlylivinginSantaClara
County.Ourkeyservicesinclude:Cardiac,Stroke,Emergency,OrthopedicandJointReplacement,
Women&Children,andWoundCare.Inanefforttoprovideservicestopatientswhoarelessfortunate,
OConnorsponsorsprogramssuchastheHealthBenefitsResourceCenterandtheStanfordaffiliated
FamilyMedicineResidencyProgram.
CommunityServed
Towns,Counties,and/orZipCodes
OConnorHospitalservesallofSantaClaraCounty,whichiscomprisedofthefollowingcities:Campbell,
Cupertino,Gilroy,LosAltos,LosAltosHills,LosGatos,Milpitas,MonteSereno,MorganHill,Mountain
View,PaloAlto,SanJose,SantaClara,SaratogaandSunnyvale.
DemographicProfileofCommunityServed
With1.78millionresidents,SantaClaraCounty(SCC)isthesixthmostpopulatedofCalifornias58
countiesandthemostpopulatedoftheBayAreasninecounties.Thecountys15citiescontain95%of
thepopulation;morethanhalfofthecountysresidents(53%)liveinthecityofSanJose.
Diversity
SantaClaraCountyiswithinthetop1%ofallU.S.countiesintermsofracialandethnicdiversity.
Accordingtothe2010U.S.Census,SCCsracialandethniccompositionis35%White,32%Asian,27%
Latino,2%AfricanAmericanand3%indicatedtheyweretwoormoreraces.Nooneracialorethnic
classificationisamajoritywithinthecounty.OfthosewhoselectedAsian,thepredominatesubgroups
are27%Chinese,22%Vietnamese,21%AsianIndianand18%Filipino.Thevastmajorityofthosewho
selectedHispanicareMexican(84%).
Thirtysevenpercentofthecountyspopulationisforeignborn,comparedto27%ofCalifornias
population.Ofthoseforeignborn,61%wereborninAsiaand27%wereborninLatinAmerica.InSCC,
50%ofthepopulationspeaksalanguageotherthanEnglishathome.
GenderandAge
Accordingtothe2010U.S.Census,women(49.8%)andmen(50.2%)makeupequalproportionsofthe
SCCpopulation.Themedianageofacountyresidentis36yearsold,whichisslightlyyoungercompared
totheoverallagecompositionoftheU.S.
Youngpeople(ageszeroto19)makeupabout26%ofthecountyspopulationand38%ofhouseholds
haveindividualsunder18livinginthem.Theyoungerpopulationismorediversethantheoverall
countypopulation:37%isHispanic,31%isAsian,24%isWhiteand5%isMultiracial.
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Residentsaged65andovermakeup12%ofthecountyspopulation.Thefastestgrowingagegroupin
thecountyis85andover;theagingresidenttrendisexpectedtocontinue.InSCC,23%ofhouseholds
haveindividualsover65livinginthem.
Poverty
AlthoughthemedianannualincomeinSantaClaraCountyishighatapproximately$89,064,9.2%ofthe
populationlivesbelowthefederalpovertylevel.In2013,thefederalpovertylevelforafamilyoftwo
adultsandtwochildrenwas$23,550.
Lookingatthenumberofindividualslivinginpovertybasedonthefederalpovertylevelisaninaccurate
representationofeconomicwellbeinginSCC.Theselfsufficiencystandardisamoreaccurate
calculationofincomeadequacyandtakesintoconsiderationcountyspecificcostsforhousing,food,and
healthcare,aswellascostsassociatedwithworkincludingtransportation,childcare,andtaxes.ForSCC
theselfsufficiencystandardin2011foroneadultandtwochildrenis$77,973,astarkcontrasttothe
federalpovertylevel.Workingmorethanfourfulltimeminimumwagejobsisrequiredtomeetthe
mostbasicexpensesforafamilyofthreeinSantaClaraCounty.
Accordingtothefederalpovertylevel,only6%ofseniorsareconsideredpoorwithanindividualannual
incomebelow$10,201.ButaccordingtotheCaliforniaElderEconomicSecurityStandardIndex,nearly
halfofSCColderadults(48.4%)areeconomicallyinsecure.TheIndexmeasureshowmuchincomeis
neededforaretiredadultage65andoldertoadequatelymeethisorherbasicneedincludinghousing,
food,outofpocketmedicalexpenses,andtransportationinSCC.
MapofCommunityServedbyHospitalFacility
SeeAttachment3MapofSantaClaraCounty.
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4. ASSESSMENTTEAM
HospitalsandOtherPartnerOrganizations
TheSantaClaraCountyCommunityBenefitCoalition(thecoalition),acoalitionofeightlocalnonprofit
hospitalsandotherpartners,collaboratedtocompletetheCHNA.Coalitionparticipantsincluded:
BarbaraAvery,ElCaminoHospital
JoCoffaro,RegionalVicePresidentofHospitalCouncilofNorthern&SouthernCalifornia
ColleenHaesloop,LucilePackardChildrensHospitalatStanford
SharonKeatingBeauregard,StanfordHospital&Clinics
RocioLuna,SantaClaraCountyPublicHealthDepartment
CandaceRoney,LucilePackardChildrensHospitalatStanford
ElizabethSills,KaiserPermanente
JoanneSeaveyHultquist,KaiserPermanente
SisterRachelaSilvestri,SaintLouiseRegionalHospital
AnandiSujeer,SantaClaraCountyPublicHealthDepartment
JenniferThrift,OConnorHospital
PatrickSoricone,UnitedWaySiliconValley
ThisteamcontractedwithAppliedSurveyResearchtoconducttheCommunityHealthNeedsAssessmentin
2012.
IdentityandQualificationsofConsultants
ThecommunityhealthneedsassessmentwascompletedbyAppliedSurveyResearch(ASR),anonprofit
socialresearchfirm.Forthisassessment,ASRconductedprimaryresearch,synthesizedprimaryand
secondarydata,facilitatedtheprocessofidentificationandprioritizationofcommunityhealthneedsand
assets,anddocumentedtheprocessandfindingsintoareport.
ASRwasuniquelysuitedtoprovidetheCoalitionwithconsultingservicesrelevanttoconductingtheCHNA.
TheteamthatparticipatedintheworkLisaColvigAmir,Dr.JennifervanStelle,AngieAguirre,andMelanie
Espinobroughttogetherdiverse,complementaryskillsetsandvariousschoolsofthought(publichealth,
anthropologyandsociology).
Inadditiontotheirresearchandacademiccredentials,theASRteamhasa32yearhistoryofworkingwith
vulnerableandunderservedpopulationssuchasyoungchildren,teenmothers,seniors,lowincomefamilies,
immigrantfamilies,familieswhohaveexperienceddomesticviolenceandchildmaltreatment,thehomeless,
andchildrenandfamilieswithdisabilities.
ASRsexpertiseincommunityassessmentsiswellrecognized.ASRwonafirstplaceawardin2007forhaving
thebestcommunityassessmentprojectinthecountry.Theyaccomplishsuccessfulassessmentsbyusing
mixedresearchmethodstohelpunderstandtheneeds,andbyputtingtheresearchintoactionthrough
designingandfacilitatingstrategicplanningeffortswithstakeholders.
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CommunitiesrecentlyassessedbyASRincludeArizona(sixregions),Alaska(threeregions),theSanFrancisco
BayAreaincludingSanMateo,SantaClara,SantaCruzandMontereyCounties,SanLuisObispoCounty,the
CentralValleyareaincludingStanislausandSanJoaquinCounties,MarinCounty,NevadaCounty,Pajaro
Valley,SolanoandNapaCounties.
TheCoalitioncontractedwithResourceDevelopmentAssociates(RDA)tocreateacompendiumof
secondarydata.RDAisa28yearoldBayAreaconsultingfirmsupportinggovernmentagenciesand
communitybasedorganizationsthroughassessment,planning,evaluation,datasystemdevelopmentand
analysis,andgrantwriting.LocatedinOakland,CA,RDAisaprivatelyheld,womanownedconsultingfirm.It
employsafulltimestaffof24professionalswithcredentialsinpublichealth,clinicalservices,socialwelfare,
organizationaldevelopmentandplanning.
Sinceitsinception,RDAhasservedsomeofthelargestandmostinnovativehumanserviceinitiativesinthe
nation.Ittargetsitseffortstowardstheimprovementofoutcomesforpublichealthandbehavioralhealth
agencies,schooldistricts,earlychildhoodprograms,adultandjuvenilejusticeorganizations,andcommunity
basedorganizations.RDAconsultswithawidearrayoforganizationsrangingfromfederalagencies(e.g.,
CenterforSubstanceAbusePrevention(CSAP),CentersforDiseaseControlandPrevention(CDC),the
DepartmentofHousingandUrbanDevelopment(HUD),andtheOfficeofJuvenileJusticeandDelinquency
Prevention(OJJDP))tosmaller,communitybasedorganizations.Itconductscomprehensiveassessmentsand
evaluationsforlocalcities,publichealthdepartments,Maternal,ChildandAdolescentHealth(MCAH)
divisions,andFirst5commissions,aswellasalcoholanddrugservices,juvenilejusticeinitiatives,violence
preventionefforts,andeducationalinitiatives.RDAhasestablishedandprovencompetenciesinassembling
andinterpretinglargeamountsofpublicdatatoinformandstructureitseffortsincommunityneeds
profiling.
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5. PROCESSANDMETHODS
TheSantaClaraCountyCommunityBenefitCoalitionworkedincollaborationontheprimaryandsecondary
datarequirementsoftheCHNA.TheCHNAdatacollectionprocesstookplaceoversixmonths,and
culminatedinareportwrittenfortheCoalitioninJanuary2013.
SantaClaraCountyCommunityBenefitCoalitionCHNAProcess
Secondary
Data
PrimaryData
Collection
HealthNeeds
List
Prioritization
Assets
Review
Report
Writing
JanDec2012
OctNov2012
Nov2012
Nov2012
Dec2012
JanApr2013
SecondaryDataCollection
TheCoalitioncontractedwithResourceDevelopmentAssociates(RDA)tocreateacompendiumof
secondarydata.Workingcollaborativelyonbehalfofitsmemberhospitals,theCoalitionmadeavailable
toRDAaselectionofthemostrecentandcomprehensivepublichealthrelatedreportsanddocuments
aswellasdemographicdata.Onereportinparticular,theSantaClaraCountyHealthProfile,2012,
servedasthefoundationalreportfortheCHNAduetoitscomprehensivecompilationofrecent
Countywidepublichealthdata.PleaseseeAttachment1foralistofdatasourcesutilized.
Asafurtherframeworkfortheassessment,theCoalitionrequestedRDAusethefollowingfilters:
Whathealthareasofferthemostcurrentandconsistentdata?
Whatarethemostsalient/meaningfulindicators?
Howdotheseindicatorsperformagainstacceptedbenchmarks?
Aretheredisparateoutcomesandconditionsforpeopleinthecommunity?
Arethereopportunitiesforthecountyshospitalstopositivelyimpactoutcomestoimprovethe
healthandqualityoflifeforcountyresidents?
RDAcompiledtheresearchandprovidedcomparisonswithexistingbenchmarks(HealthyPeople2020,
statewideandnationalaverages)initscompendium.Thecompendiumwasintendedtoprovidearichpicture
ofthehealthofthecounty.Secondarily,itwascreatedwithanunderstandingofhowhospitalscouldmake
useofthesedatatoplantheircommunitybenefitpriorities,outreachandeducationefforts,andtodevelop
strategiesforengagingpartnerstoaddressidentifiedneeds.
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PrimaryData(CommunityInput)
TheCoalitioncontractedwithAppliedSurveyResearch(ASR)toconducttheprimaryresearch.Theyused
threestrategiesforcollectingcommunityinput:keyinformantinterviewswithhealthexperts,focusgroups
withcommunityleadersandstakeholders,andresidentfocusgroups.
Eachgroupandinterviewwasrecordedandsummarizedasastandalonepieceofdata.Whenallgroupshad
beenconducted,theteamusedqualitativeresearchsoftwaretoolstoanalyzetheinformationandtabulate
allhealthconditionsthatwerementioned,alongwithhealthdriversdiscussed.ASRthenmadealistofallof
theconditionsthathadbeenmentionedbyafocusgrouporkeyinformant,countedhowmanygroupsor
informantslistedthecondition,andhowmanytimestheyhadbeenprioritizedbyafocusgroup.
CommunityLeaderInput
Inall,ASRconsultedwithmorethan54communityrepresentativesofvariousorganizationsandsectors.
Theserepresentativeseitherworkinthehealthfield,orimprovehealthconditionsbyservingthosefromthe
targetpopulations.Inthelistbelow,thenumberinparenthesesindicatesthenumberofparticipantsfrom
eachsector.
SantaClaraCountyPublicHealth(6)
OtherSantaClaraCountyHealth&HospitalSystem(3)
Privatehospitalsystems(3)
HealthInsuranceproviders(4)
Mental/Behavioralhealthorviolencepreventionproviders(4)
Schoolsystemrepresentatives(3)
Communitycenterrepresentatives(10)
Nonprofitagenciesprovidingbasicneeds(5)
Othernonprofitagenciesservingchildren,seniorsandfamilies(15)
SeeAttachment4forthenames,titlesandexpertiseofkeystakeholdersalongwiththedateandmodeof
consultation(focusgrouporkeyinformantinterview).
KeyInformantInterviews
ASRconductedprimaryresearchviakeyinformantinterviewswithnineSouthBayexpertsfromvarious
organizationsinthehealthsector.InOctoberandNovember2012,expertsincludingpublichealthofficers,
communityclinicmanagers,andclinicianswereconsulted.Theseexpertshadcountywideexperienceand
expertise.
Healthexpertswereinterviewedbytelephoneforapproximatelyonehour.Informantswereaskedtodiscuss
indetailoneoftheareasoffocusfortheCHNA:Healthdelivery,healthaccess,socioeconomicfactors,
healthbehaviors,environmentalconditions,qualityoflife(morbidity),andmortality.
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DetailsofKeyInformantInterviews
Name
Position
Agency
Conducted
1. Ren Santiago
Deputy County Executive
Santa Clara Valley Health &

Hospital System
Oct 2nd 1:00 pm
2. Shamima Hasan
CEO
Mayview Community Health Center
Oct 2nd 2:00 pm
3. Dan Peddycord
Director
Santa Clara County Public Health
Oct 3rd 11:00 am
4. Dr. Marty Fenstersheib
Health Officer
Santa Clara County Health/Hospital
Oct 3rd 3:00 pm
5. Reymundo Espinoza
CEO
Gardner Health Center
Oct 4th 10:00 am
6. Michelle Lew
Executive Director
Oct 4th 1:30 pm
7. Dolores Alvarado
Executive Director
Asian Americans for Community

Involvement
Community Health Partnership
Oct 17th 1:00 pm
8. Dr. Kent Imai
Medical Director
Nov 6th 12:00 pm
9. Dr. Thad Padua
Medical Director
Santa Clara Family Health Plan
Nov 9th 1:00 pm
StakeholderFocusGroups
FocusgroupswithstakeholderswereconductedinOctoberandNovember2012.Thediscussioncentered
aroundfourquestions,whichweremodifiedappropriatelyfortheaudience.
1.
2.
3.
4.
Howhealthyisourcommunity(onascaleof15)?
Whatarethehealthneeds(conditions)thatyouseeinthecommunity?
Whatarethemostpressinghealthneedsonthislist?(threeselected)
Whatarethedriversoftheseprioritizedconditions?
GroupswereencouragedtodiscussdriversfrommultipleKPdomains:healthaccess,healthdelivery,social
economicfactors,environmentalfactorsandhealthbehaviors.
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DetailsofStakeholderFocusGroups
Focus
Location
Date
Number of
Participants
1. Community Health
Organizations
Sobrato Center for NonProfits (San Jose)
10/24/2012
11
2. Community Health
Organizations
10/24/2012
13
3. Community Health
Organizations
10/24/2012
11
4. South County
Organizations
Valley Health Center (Gilroy)
11/1/2012
11
5. Basic Needs Organizations
ASR (San Jose)
11/6/2012
6. Chronic Condition
Organization
ASR (San Jose)
11/7/2012
7. Senior Organizations
ASR (San Jose)
11/7/2012
8. Child Serving
Organizations
ASR (San Jose)
11/9/2012
9. Youth Organizations
ASR (San Jose)
11/9/2012
PleaseseeAttachment4forafulllistofcommunityleaders/stakeholdersandtheircredentials.
Stakeholder Participant Demographics

AppliedSurveyResearchconductedninefocusgroupswith79stakeholdersintheSouthBayregion.Three
groupswereheldwithcommunitybasedgrantees(35participants).Theremainingsixwereheldwith44
stakeholdersfromacrossthecountywithexpertiseinvariousfieldsandwithvariouspopulations.Focus
groupparticipantswereaskedtofilloutabriefdemographicsurvey.Wereceived76surveystotal.
ProfessionalExperience:Thestakeholderssurveyedhadacombined172yearsofclinicalpractice
and348yearsofhealthadministrationexperience.Forthosewhoreportedexperienceinthese
fields,clinicianshadanaverageof11yearsexperience,andhealthadministratorshadanaverageof
14yearsexperience.
ProfessionalRole:Nearlytwothirdsofrespondentswerefromnonprofitorganizations.
Stakeholdersalsoworkinpublichealth,clinicalcare,andadministrativepositions.
SpecialPopulationExpertise:Nearlyalloftherespondentsindicatedthattheyhadworkedintensely
withthelowincomepopulationinthelastfiveyears.Therewasgoodrepresentationofstakeholders
fromalltargetpopulations.
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StakeholderExpertisewithSpecialPopulations
Area of Expertise
Low Income
69
90%
Children
58
75%
Youth
55
71%
Women
45
58%
Uninsured
43
56%
Monolingual
42
55%
Older Adults
31
40%
Chronically Ill
24
31%
RegionalExperience:Stakeholdershadworkedallacrossthecounty,withthemostcombined
numberofyearsexperienceinCentralandWestSanJose.
StakeholderExpertiseinMunicipalRegions
Combined
Years
Average
Years
Number
Providers
East San Jose
239
26
Central & West San Jose
255
35
South San Jose / Los Gatos
74
14
South County
204
25
Milpitas
54
11
Palo Alto/Los Altos/Mountain View
174
23
Campbell/Saratoga
100
16
Sunnyvale/Cupertino
145
18
Region
Page13
Otherstakeholderdemographics:
EthnicityandLanguage:Almosttwothirdsarewhite(64%)andonequarter(25%)areLatino.
EighteenreportedusingSpanishatwork.Onlyonerespondentreportedusingalanguageotherthan
EnglishorSpanishatwork.
AgeRange:Themajorityofstakeholderswereovertheageof45buttherewererepresentativesof
allagegroups,includingthe1824yearsandover65yearsranges.
NumberofStakeholders
StakeholderAge
20
15
10
5
0
1824
2534
3544
4554
5564
65+
AgeRange
ResidentInput
ResidentfocusgroupswereconductedinOctoberandNovember2012.Thediscussioncenteredaroundfour
questionswhichweremodifiedappropriatelyfortheaudience.
1.
2.
3.
4.
Howhealthyisourcommunity(onascaleof15)?
Whatarethehealthneeds(conditions)thatyouseeinthecommunity?
Whatarethemostpressinghealthneedsonthislist?(threeselected)
Whatarethedriversoftheseprioritizedconditions?
InordertoprovideavoicetothecommunityitservesinSantaClaraCounty,thestudyteamtargeted
participantswhoweremedicallyunderserved,inpoverty,sociallyorlinguisticallyisolated,orthosewho
hadchronicconditions.Eightfocusgroupswereheldwithcommunitymembers.Theteamheldtwo
groupswithaspecialpopulationfocus:seniorsandparentsofyoungchildren.
Theseresidentgroupswereplannedinvariousgeographiclocationsaroundthecounty.Residentswere
recruitedbynonprofithosts,suchasCommunityHealthPartnership,whoservesuninsuredresidents.
Page14
ResidentFocusGroups
Population Focus
Hospital
Area
Location
Date
Number of
Participants
1. Uninsured adults
All
Community Health Partnership, San

Jose
10/9/12
2. Uninsured adults
All
Community Health Partnership, San

Jose
10/9/12
3. Older adults
All
Indian Health Center, East San Jose
10/10/12
4. Youth
All
Fresh Lifelines for Youth (FLY),

Milpitas
10/22/12
Santa Clara
Columbia Neighborhood Center,

Sunnyvale
10/23/12
Kaiser Permanente, Gilroy
10/24/12
Rosemary Elementary School,

Campbell
11/13/12
Catholic Charities, North San Jose
11/20/12
5. North County parents

6. South County residents
7. Campbell parents (Spanish)
8. Milpitas/North San Jose
Immigrants
San Jose
Santa Clara
All
Resident Participant Demographics

Fiftycommunitymembersparticipatedinthefocusgroupdiscussionsacrossthecounty.Allparticipants
completedananonymousdemographicsurvey,theresultsofwhicharereflectedbelow.
90%ofparticipantswereethnicminorities.Englishwasasecondlanguageformostparticipants.
44%ofresidents(22)wereunder40yearsold,includingsevenyouthunder20yearsofage.36%
weremiddleaged(40yearsto50yearsold)and16%wereolderadults(age60andover).
Almostathirdoftheparticipantswereuninsured,while46%hadbenefitsthroughMediCal,
Medicareoranotherpublichealthinsuranceprogram.
Almosttwothirdsofthecommunityresidentslivedinmedicallyunderservedareasofthecounty:
SouthcountycitiesofMorganHill,GilroyandSanMartin,EastSanJose,andtheMayviewareaof
Sunnyvale.
Mosthouseholdswerecomprisedofmultipleadultsoverage25(65%)andachildoryouthunder
age25.Abouthalf(48%)oftheparticipantshadchildrenundertheageof18inthehouse.Among
theparticipantswholivedinahouseholdwithchildren,theaveragenumberofchildrenwastwo.A
thirdofrespondentsreportedhavingatleastoneyoungadultage1824intheirhouseholds.
Ofthosewhorespondedtothequestionaboutannualhouseholdincome,allbuttworespondents
reportedhavinganannualhouseholdincomeofunder$45,000peryear.Thevastmajority(79%)
earnedunder$25,000peryear,whichisnearFederalPovertyLevelforafamilyoffour,andbelow
theCaliforniaSelfSufficiencyStandardfortwoadultswithnochildren($45,609).Thisdemonstrates
Page15
ahighlevelofneedamongparticipantsinanareawherethecostoflivingisextremelyhigh
comparedtootherareasofCalifornia.
IncomeofCommunityMembersParticipatinginFocusGroups
Participants
% of participants
including missing
% of participants
without missing
Under$25,000
37
74%
79%
$25,000$44,000
16%
17%
$45,000$64,000
2%
2%
$65,000$84,000
2%
2%
Missing
6%
GrandTotal
50
100%
100%
Annual household Income
InformationGaps&Limitations
ASRandtheCoalitionwerelimitedintheirabilitytoassesssomeoftheidentifiedcommunityhealthneeds
duetoalackofsecondarydata.Suchlimitationsincludeddataonoral/dentalhealth,substanceabuse
(particularly,useofillegaldrugsandmisuseofprescriptionmedication),dementia,andmentalhealth.More
specificlimitationsincludedlackofcountydataonbullying;ethnicsubgroupsaffectedbyHepatitisB;suicide
amongLGBTQyouth;diabetesamongchildren;andlackofextendeddataonbreastfeeding(datacoveronly
thedaysamotherandchildareinthehospital).
TherewerealsolimitationsonhowASRandtheCoalitionwasabletounderstandtheneedsofspecial
populationsincludingLGBTQ,undocumentedimmigrants,andBlacks/AfricanAmericans.Duetothesmall
numbersofthesecommunitymembers,manydataarestatisticallyunstableanddonotlendthemselvesto
predictability.
Page16
6. IDENTIFICATIONANDPRIORITIZATIONOFCOMMUNITYHEALTHNEEDS
Toidentifythecommunityshealthneeds,ASRandtheCoalitionfollowedthesesteps:
1. Gathereddataon80+healthindicators
usingtheUniversityofMissouris,
CenterforAppliedResearchand
EnvironmentalSystem(CARES)Data
PlatformdevelopedforKaiser
Permanente(CARESPlatform),
HealthyPeople2020objectives,the
RDAcompendiumofsecondarydata,
andqualitativedata.SeeAttachment5
foralistofindicatorsonwhichdata
weregathered.
101CARESPlatformIndicators,22Focus
GroupsandKeyInformantInterviews
Mustfitthedefinitionof
a"healthneed"
Mustbesuggestedby
morethanonedata
source
Mustmissanational
benchmarkorstate
average
2. Narrowedthelisttohealthneedsby
applyingcriteria
13Health
Needs
3. Usedcriteriatoprioritizethehealth
needs
Thesestepsarefurtherdefinedbelow.
IdentificationofCommunityHealthNeeds
AsdescribedinSection5,awidevarietyofexpertsandcommunitymemberswereconsultedaboutthe
healthofthecommunity.Communitymemberswerefrankandforthcomingabouttheirpersonal
experienceswithhealthchallengesandtheirperceptionsabouttheneedsoftheirfamiliesandcommunity.
Collectively,theyidentifiedadiversesetofhealthconditions(seetablebelow)anddemonstratedaclear
understandingofthehealthbehaviorsandotherdrivers(environmentalandclinical)thataffectthehealth
outcomes.Theyspokeaboutprevention,accesstocare,clinicalpracticesthatworkanddontwork,andtheir
overallperceptionofthecommunityshealth.Crosscuttingdriversthatfrequentlyaroseduringprimary
datacollectionarelistedinAttachment6.
Page17
AllHealthConditionsNamedDuringPrimaryDataGathering
Arose10ormoretimesininterviewsorfocusgroups:
Substanceabuse(ATOD)/behavioralhealth(incl.prescriptionmeds)/addiction
Diabetes/poornutrition
Cardiovasculardisease(heartdisease,stroke,CHF,HBP,hypertension)
Poormentalhealth/trauma/suicide/depression/anxiety/stress/cutting
Obesity/overweight/poornutrition
Violence(incl.abuse/bullying)
Arose59timesininterviewsorfocusgroups:
Respiratoryconditions(asthma, allergies,bronchitis,COPD)
Cancers
Poororal/dentalhealth
Teenpregnancy
Aroseatleastoncebutlessthan5timesininterviewsorfocusgroups:
Acute/episodicissues(ulcers,skindiseases,etc.)
ADD/ADHD/learningdisabilities
Anemia
Arthritis
Autism/Asperger's
Chronicdiseases
Deformitiestetarogenic
Dementia/Alzheimer's
Drowning
Emphysema
Falls/injury
Fatigue
HepatitisB/C
Highcholesterol
Infantmortality
Jaundice
Kidneystones
Lowbirthweight
Parkinson's
Pregnancyrelatedconditions
Prematurebirths
Sciatica
Sleepapnea/disorders
Social/emotionaldevelopment
STDs/unhealthysexualbehavior
Stroke
Thyroid
Trauma
Viruses
Vision/Glaucoma/Cataracts
Page18
Inordertogeneratealistofhealthneeds,ASRuseda
spreadsheet(knownasthedatacullingtool)tolist
indicatordataandevaluatewhethertheywerehealth
needs.TheindicatordatacollectedincludedCARES
Platformdata,secondarydata,andqualitativedatafrom
focusgroupsorkeyinformantinterviews.
InordertobecategorizedasaprioritizedCommunity
HealthNeed,allthreeofthefollowingcriterianeededto
bemet:
1. Theissuemustfitthedefinitionofahealth
need.
2. Theissueissuggestedorconfirmedbymore
thanonesourceofsecondaryand/orprimary
data.
3. Atleastonerelatedindicatorperformspoorly
againsttheHealthyPeople2020(HP2020)
benchmarkor,ifnoHP2020benchmark
exists,againstthestateaverage.
Thirteenhealthconditionsordriversfitallthreecriteria
andwereretainedascommunityhealthneeds.Thelistof
needs,inpriorityorder,isfoundbelow.
DEFINITIONS
Ahealthneedisapoorhealthoutcomeandits
associatedhealthdriver,orahealthdriver
associatedwithapoorhealthoutcome
wheretheoutcomeitselfhasnotyetarisen
asaneed.
Ahealthdriverisabehavioral,environmental,
orclinicalcarefactor,oramoreupstream
socialoreconomicfactorthatimpacts
health.
Ahealthindicatorisacharacteristicofan
individual,population,orenvironment
whichissubjecttomeasurement(directly
orindirectly)andcanbeusedtodescribe
oneormoreaspectsofthehealthofan
individualorpopulation.
Ahealthoutcomeisasnapshotofdiseasesina
communitythatcanbedescribedinterms
ofbothmorbidity(qualityoflife)and
mortality(deathrates).
Ahealthconditionisadisease,impairment,or
otherstateofphysicalormentalillhealth
thatcontributestoapoorhealthoutcome.
SummarizedDescriptionsofPrioritizedSantaClaraCountyCommunityHealthNeeds
AccesstohealthcareisahealthneedinSantaClaraCountyasmarkedbytheproportionofthecommunity
whoarelinguisticallyisolated.Inaddition,thereareareaswithloweducationalattainment,whichalso
impactshealthoutcomes.Thecommunityinputindicatesthatunderinsuranceandlackofinsurancecoverage
isanissue.Lackoftransportationisalsoanaccessbarrierthataffectsthoseinpoverty.Stigmaandlackof
knowledgebothimpacttheseekingofpreventativecareortreatment.Also,toofewgeneralandspecialty
practitioners,especiallyincommunityclinics,resultsinlongwaittimesforappointments.Theseissues
aroundlackofaccesscontributetocommunitymembersusingurgentcareandemergencyroomsfor
treatmentofconditionsthathaveworsenedduetolackoftreatmentorpreventativecare.
AlzheimersdiseaseisahealthneedinSantaClaraCountyasmarkedbyAlzheimersdiseasebeingthethird
leadingcauseofdeath.ItisthefastestgrowingcauseofdeathinCaliforniaandthenumberofpeopleliving
withAlzheimersdiseaseisalsogrowingrapidly.Communityinputsuggeststhattheimpactoncaregivers
whohavefewresources(especiallyfortransportation)willaffectqualityoflifeforthoselivingwith
Alzheimers.Qualitativeresearchalsosuggeststhatthereisalackofgerontologistsandthosewhocanhelp
coordinatecare.
Page19
BirthoutcomesareahealthneedinSantaClaraCounty,asmarkedbythepercentageoflowbirthweight
babies,whichisnobetterthanthestateaverage(thoughbelowtheHP2020benchmark).AfricanAmericans
aredisproportionatelyaffected,withthepercentageofAfricanAmericanbabiesoflowbirthweighthigher
thanthestateaverageandHP2020benchmark.Whileinfantmortalityisnotaconcerncountywide,itis
possiblethatsomesubgroups(e.g.,AfricanAmericaninfants)aredisproportionatelyaffected;however,the
dataaretoosparsetorelyupon.Thehealthneedislikelybeingimpactedbycertainsocialdeterminantsof
health,andbythepercentageofwomenreceivingearlyprenatalcare.Whilethisisnotanissueonthe
countywidelevel,adisproportionatelysmallerpercentageofNativeAmericanwomenreceiveearlyprenatal
careincomparisontootherethnicgroups.Communityfeedbackindicatesthatthehealthneedisaffectedby
concernsaboutthecostofcare,andpooraccesstoprimarycareprovidersandspecialistsduetolackof
insurance,particularlyamonglowincomeresidents.Inaddition,communityinputsuggestedthatlimited
prenatalvisitsmaybedrivenbylackofknowledgeoftheimportanceofprenatalcare,languagebarriers
betweenpatientsandspecialists,culturalissuessuchasbodymodesty,aswellasthecostofcare.
CancerisahealthneedinSantaClaraCountyasmarkedbyincidenceratesofbreast,cervical,liver,and
prostatecancerthataretoohighcomparedtoHP2020benchmarks/stateaverages,andalivercancer
mortalityratethatistoohighcomparedtothestateaverage.Breastandprostatecancerdisproportionately
affectWhites;lungandprostatecancerdisproportionatelyaffectAfricanAmericans.Latinosand
Asian/PacificIslandershavehigherincidenceratesofcervicalandlivercancerthanotherethnicgroups,and
disproportionatelyhighmortalityratesduetolivercanceraswell.Latinosadditionallyareundulyburdened
bymortalityfromcolorectalcancer.Thehealthneedislikelybeingimpactedbyhealthbehaviorssuchas
ratesofscreeningthatdonotmeetestablishedbenchmarks,andlowfruitandvegetableconsumptionthat
arenobetterthanaverage(asdiethasbeenshowntohaveanimpactonmanytypesofcancer).Community
inputindicatesthatthehealthneedisalsoaffectedbylackofknowledgeaboutcancerpreventionand
treatment,fearanddenial,lackofstafftimeforfollowupwiththosewhoareatriskandshouldbescreened,
concernsaboutthecostsoftreatment,andpooraccesstoprimarycareprovidersandspecialistsduetolack
ofinsurance,particularlyamonglowincomeresidents.Therewasalsosomeconcernaboutyouthtobacco
use(assmokinghasalsobeenshowntohaveanimpactonvarioustypesofcancer).
CardiovascularDisease,HeartAttack,andStrokearehealthneedsinSantaClaraCountyasmarkedbyhigh
overallpercentagesofhighcholesterolandhypertension,bothofwhichfailHP2020benchmarks.African
AmericansandthosewhoidentifyasmultiracialhaveahigherstrokemortalityratethantheHP2020
benchmark.AfricanAmericansandWhitesdisproportionatelyexperiencehypertensionandhighcholesterol.
HeartdiseasedeathsareworstintheSouthCountyareaandinEastSanJose.Poornutrition,whichisrelated
tocardiovasculardisease,isofconcerninthecounty.Adultandyouthconsumptionoffruitsandvegetables,
andhouseholdexpendituresonthesame,isnobetterthanthestateaverage,andinsomecasesisworse.
Therearealsomorefastfoodrestaurants,andfewergrocerystoresandWICauthorizedstores,thanthe
stateaverage.Communityinputreflectedthis,aswellasaconcernaboutlackofexercise.Thecommunity
alsoindicatedthatthehealthneedisbeingaffectedbystressandlackofknowledgeaboutstrokeandheart
disease.
DiabetesisahealthneedinSantaClaraCountyasmarkedbyrelativelyhighratesofdiabetes.Theoverall
adultratemeetstheHP2020benchmark,butLatinoandAfricanAmericanresidentsaredisproportionately
diabetic,andworseoffincomparisonwiththecountyandstateaveragesandbenchmark.Ofallethnic
groups,AfricanAmericansexperiencethehighestpercentageofhospitalizationsduetodiabetes.Community
inputaboutdiabeteswasstrong,andexpressedtheconnectionbetweenthediseaseandrelatedhealth
Page20
behaviorssuchaspoornutritionandlackofphysicalactivity.Thehealthneedislikelybeingimpactedby
healthbehaviorssuchaslowfruitandvegetableconsumption,sodaconsumption,theproximityoffastfood
establishments,andalackofgrocerystoresandWICauthorizedfoodsources.
MentalhealthisahealthneedinSantaClaraCountyasmarkedbyapercentageofselfreportedpoormental
healththatishigherthanthestateaverage.LatinoandAfricanAmericanyouthdisproportionatelyexhibit
symptomsofdepression,andAfricanAmericanyouthadditionallyexperiencesuicidalideationrateshigher
thanthecountywideaverage.Communityinputindicatesthatthehealthneedislikelybeingaffectedby
stress(drivenbyfinancial/economicconcerns)andthelackofeducationabouthowtocopewithstress,
stigmaaboutmentalillnessleadingtofearanddenial,lackofknowledgeaboutmentalhealthtreatment,and
pooraccesstomentalhealthcareprovidersandspecialistsduetolackofinsuranceand/ormentalhealth
benefitsamongthosewhoareinsured,and/orduetoalackofproviders(i.e.,workforcedevelopment
issues).Relatedtopoormentalhealtharethehealthneedsaroundviolenceandsubstanceabuse.
ObesityisahealthneedintheSantaClaraCountyasmarkedbyhighratesofoverweightandobesityamong
bothyouthandadults.Overallratesarejustbelowstateaverages,buttheadultoverweightratemissesthe
HP2020benchmark.LatinoandAfricanAmericanresidentsaredisproportionatelyoverweightandobese,
andworseoffincomparisonwithCalifornia(andinsomecases,U.S.)averages.Thehealthneedislikelybeing
impactedbyhealthbehaviorssuchaslowfruitandvegetableconsumption,sodaconsumption,theproximity
offastfoodestablishments,andalackofgrocerystoresandWICauthorizedfoodsources.
Oral/dentalhealthisahealthneedSantaClaraCountyasmarkedbythepercentageofyouthreportingtheir
teethinfairorpoorcondition,whichishigherthanthestateaverage.LatinoandAsian/PacificIslanderyouth
aredisproportionatelyaffected.Whileadultdentalhealthisnotidentifiedasaconcerncountywide,some
subgroups(Latinos,NativeAmericans,Asian/PacificIslanders)aremorelikelythanothersnottohavedental
insurance,atratesnearingthestatewideaverage.Thehealthneedislikelybeingimpactedbycertainsocial
determinantsofhealth,andbythecostofdentalcare.Communityfeedbackindicatesthatthehealthneedis
affectedbyconcernsaboutpooraccesstodentalcareprovidersandspecialistsduetolackofinsurance,
particularlyamongresidentswithchronicconditions.
RespiratoryconditionsareahealthneedinSantaClaraCountyasmarkedbyhospitalizationratesofchildren
ages04.Asthmahospitalizationratesofyouthages017showgeographicaldisparities,withtheworstrates
inSaratoga,SouthSanJose,partsofLosGatosandCampbell.Thehealthneedislikelybeingimpactedby
healthbehaviorssuchasthepercentageofyouthsmoking,andbyissuesinthephysicalenvironmentsuchas
airqualitylevels.Communityinputindicatesthatthehealthneedisalsoaffectedbyconcernsaboutthe
costsoftreatment(includingprescriptionmedicationandequipment)duetounderinsuranceorlackof
insurance,particularlyamonglowincomeresidents.
STDsincludingHIVandAIDSareahealthneedinSantaClaraCountyasmarkedbyhighincidenceratesof
HIVamongAfricanAmericansandLatinos,aswellashighprimaryandsecondarysyphilisincidencerates
amongmalescountywide.TherateofHIVhospitalizationsisworstincentralSanJose.Thehealthneedis
likelybeingimpactedbylowscreeningratesforHIV(countywide,thepercentageofteensandadultsever
screenedforHIVislowerthanthestateaverage),aswellascertainsocialdeterminantsofhealth.Community
feedbacksuggeststhatthehealthneedisperceivedasprimarilyaffectingyouth,andisimpactedbypoor
outreach,lackofknowledge/healtheducationabouttransmission,risk,andscreening,thefearof
stigmatizationbyothers,accesstoandcostsofprevention(e.g.,condoms),andpeerpressure.
Page21
SubstanceabuseisahealthneedinSantaClaraCountyasmarkedbylevelsofbingedrinkingamongyouth
andadultsthatarehigherthanHP2020benchmarks.Communityfeedbackindicatesthatthehealthneedis
impactedbystressandpoorcopingskillsacrossallsubpopulations,concernsaboutthecostoftreatment,
fearofbeingstigmatized,andpooraccesstoprimarycareproviders,specialists,andothersupportoptions
duetolackofinsuranceorunderinsurance,particularlyamonglowincomeresidents.Medicationmisuseand
mismanagementwasalsodiscussed,andwasthoughttobeduetoalackofknowledgeaboutmedications
andtheirassociatedrisks.Inaddition,communityinputsuggestedthatadolescentsareespeciallyvulnerable
tothishealthneed,asitwasbelievedtheyaremoreaffectedbypeerpressure,curiosity,mediaportrayals,
accessibilityofalcohol,tobacco,andotherdrugs,andparentalpermissiveness.
ViolenceisahealthneedinSantaClaraCountyasmarkedbyratesofyouthhomicidethatarehigherthan
theHP2020benchmarkforhomicideoverall.Ratesofbullyingarealsohigh,thoughnostatewidedataare
availableforcomparison.Inaddition,whilecountywidelevelsofchildabuseanddomesticviolencedonot
failagainststateaverages,thepercentageofchildabuseamongAfricanAmericansismuchhigherthanthe
stateaverage.Thehealthneedislikelybeingimpactedbyhealthbehaviorssuchasbingedrinking(wherethe
countyadultrateishigherthanthestateaverage)andgangmembership(percentagesofgangidentification
amongAfricanAmerican,NativeAmerican,andLatinoyoutharehigherthanthecountywidelevels).
Communityinputindicatesthatthehealthneedisalsoaffectedbythecostofand/orlackofactivityoptions
foryouth,financial/economicstress,lackofpolicyenforcement,poorfamilymodels,unaddressedmental
and/orbehavioralhealthissuesamongperpetrators,cultural/societalacceptanceofviolence,lackof
awarenessofsupportandservicesforvictims,andlinguisticisolation.Communitymembersalsosuggested
thatviolenceisunderreportedbyvictims,possiblyduetostigmaand/orculturalnorms.
Forfurtherdetails,pleaseconsulttheHealthNeedsProfilesappendedtothisreportasAttachment7.
PrioritizationofHealthNeeds
Beforebeginningtheprioritizationprocess,theCoalitionchoseasetofcriteriatouseinprioritizingthelistof
healthneeds.Thecriteriawere:
1.
2.
3.
4.
Cleardisparities/inequitiesexistamongsubpopulationsinthecommunity.
Anopportunitytointerveneatthepreventionorearlyinterventionlevel.
Asuccessfulsolutionhasthepotentialtosolvemultipleproblems.
Thecommunityprioritizestheissueoverotherissues.
ScoringCriteria13:Thescorelevelsfortheprioritizationcriteriawere:
3:Stronglymeetscriteria,orisofgreatconcern
2:Meetscriteria,orisofsomeconcern
1:Doesnotmeetcriteria,orisnotofconcern
Asurveywasthencreated,listingeachofthehealthneedsinalphabeticalorderandofferingthefirstthree
prioritizationcriteriaforrating.Coalitionmembersratedeachofthehealthneedsoneachofthefirstthree
prioritizationcriteriaduringaninpersonmeetinginNovember2012.
Page22
ScoringCriteria4(Communityprioritization):ASRgavecommunityprioritizationscoresbasedonthe
resultsoftheprimarydatagatheringprocess.(SeeSection5forprimarydatacollectionmethodology.)
Thescorelevelsforthefourthprioritizationcriterionwere:
3:Healthneedwasprioritizedbymorethanhalfofthekeyinformantsandfocusgroups
2:Healthneedwasprioritized,butbyhalforfewerofthekeyinformantsandfocusgroups
1:Healthneedwasmentionedbyatleastonekeyinformantorfocusgroup,butnotprioritizedbyany
CombiningtheScores:Forthefirstthreecriteria,Coalitionmembersratingswerecombinedandaveraged
toobtainacombinedcoalitionscore.Then,themeanwascalculatedbasedonthefourcriterionscoresforan
overallprioritizationscoreforeachhealthneed.
ListofPrioritizedNeeds
Theneedscoresrangedbetween1.4and3.0,with3beingthehighestscorepossibleand1beingthelowest
scorepossible.Theneedsareorderedbyprioritizationscoreinthetablebelow.Thespecificscoresforeach
ofthefourcriteriausedtogeneratetheoverallcommunityhealthneedsprioritizationscoresmaybeviewed
inAttachment8.NotethatwhiletheCoalitionprioritizedaccessrelateddrivers,thecrosscuttingdriver,
AccesstoHealthCareServices,wasnotscoredduringtheprioritizationprocess.
HealthNeedsbyPrioritizationScore
Health Need
Overall Average Priority Score
Diabetes
3.0
Obesity
2.9
Violence
2.6
PoorMentalHealth
2.6
PoorOral/DentalHealth
2.5
CardiovascularDisease,HeartDisease,Stroke
2.4
SubstanceAbuse(Alcohol,Tobacco,andOtherDrugs)
2.4
Cancers
2.2
RespiratoryConditions
2.0
STDs/HIVAIDS
2.0
BirthOutcomes
1.6
Alzheimer's
1.4
Page23
7. COMMUNITYASSETSANDRESOURCES
Thefollowingresourcesareavailabletorespondtotheidentifiedhealthneedsofthecommunity.
ExistingHospitals
ElCaminoHospitalLosGatos
ElCaminoHospitalMountainView
GoodSamaritanHospital
KaiserPermanenteSanJose
KaiserPermanenteSantaClara
LucilePackardChildrensHospitalatStanford
OConnorHospital
RegionalMedicalCenterofSanJose
SantaClaraValleyMedicalCenter
SaintLouiseRegionalHospital
StanfordHospital&Clinics
ExistingHealthClinics
AsianAmericansforCommunityInvolvement
FoothillCommunityHealthCenter
o MedicalandDentalClinic
o SanJoseFoothillFamilyCommunityClinic
o SchoolBasedClinicPrograms
AndrewHillHighSchool
IndependenceHighSchool
Mt.PleasantHighSchool
SilverCreekHighSchool
YerbaBuenaHighSchool
GardnerFamilyHealthNetwork
o AlvisoHealthCenter
o CompreCareHealthCenter
o GardnerHealthCenter
o GardnerSouthCounty
o HealthcarefortheHomeless
o St.JamesHealthCenter
IndianHealthCenterofSantaClaraValley
o MainMedicalClinic
o MedicalClinicatSilverCreek
o OConnorFamilyHealthCenter
MayViewCommunityHealthCenter
Page24
o MountainView
o PaloAlto
o Sunnyvale
NorthEastMedicalServices
PlannedParenthoodMarMonte
o BlossomHillHealthCenter
o EastsideHealthCenter
o GilroyHealthCenter
o MarMonteCommunityClinic
o MountainViewHealthCenter
o SanJoseHealthCenter
o SunnyvaleHealthCenter
RotaCareBayArea,Inc.
o Gilroy
o MountainView
o SanJose
SantaClaraValleyHealth&HospitalSystem
o ValleyHealthCenterBascom
o ValleyHealthCenterEastValley
o ValleyHealthCenterGilroy
o ValleyHealthCenterMilpitas
o ValleyHealthCenterMoorpark
o ValleyHealthCenterSunnyvale
o ValleyHealthCenterTully
SchoolHealthClinicsofSantaClaraCounty
o FranklinMcKinley
o Gilroy
o Overfelt
o SanJoseHigh
o Washington
Otherexistingcommunityresourcesandprograms
PleaseseetheHealthNeedsProfiles(Attachment6),whichidentify:
1. Programs/resourcesinwhichCoalitionmembersinvestcommunitybenefitfundsandprovide
resourcestothecommunity;and
2. Programs/resourcesinwhichotherhealthcaresystems,andnonprofitorganizationsprovideservices
tothecommunity.
Page25
8. CONCLUSION
TheSantaClaraCountyCommunityBenefitCoalitionpartnersworkedincollaborationtomeetthe
requirementsofthenewfederallyrequiredCHNAbypoolingexpertise,guidanceandresourcesfora
sharedassessment.Bygatheringsecondarydataanddoingnewprimaryresearchasateam,the
Coalitionpartnerswereabletocollectivelyunderstandthecommunitysperceptionofhealthneeds,
andprioritizehealthneedswithanunderstandingofhoweachcomparesagainstbenchmarks.
Inthespiritofcollaboration,theCoalitionhascommittedtoworkingtogethertocontinuallymonitor
theseprioritizedhealthneeds.WiththeassistanceoftheSantaClaraCountyPublicHealthDepartment
andAppliedSurveyResearch,theCoalitioncreatedaCommunityIndicatorDashboard(Attachment9),
whichincludesthekeyindicatorsforeachoftheprioritizedhealthneeds.Manyoftheseindicatorsare
alsoincludedintheattachedHealthNeedsProfiles,whichthehospitalpartnersplantousetoeducate
andinformadvisoryboardsandcommunitystakeholders.
AftermakingthisCHNAreportpublicallyavailableinMay2013,eachhospitalwilldevelopindividual
implementationplansbasedonthisshareddata,andtheCoalitionmayprioritizesomecoordinated
interventionsaroundsharedhealthneeds.
Page26
9. LISTOFATTACHMENTS
1. SecondaryDataSources
2. IRSChecklist
3. MapofSantaClaraCounty
4. ListofCommunityLeadersandTheirCredentials
5. IndicatorList
6. CrossCuttingDrivers
7. HealthNeedsProfiles
8. HealthNeedsPrioritizationScores:BreakdownbyCriteria
9. CommunityIndicatorDashboard
Page27
Attachment1:SecondaryDataSources
AguirreA,AppliedSurveyResearch.SiliconValleyLatinoReportCard:HispanicFoundationofSilicon
Valley;2011.
AreaPlanonAging,July1,2012June30,2016:CouncilonAging,SiliconValley;2012.
Brightfutures:Guidelinesforhealthsupervisionofinfants,children,andadolescentsIn:HaganJF,Shaw
JS,DuncanPM,eds.3rded.ElkGroveVillage,IL:AmericanAcademyofPediatrics;2008:
http://brightfutures.aap.org/pdfs/Guidelines_PDF/1BFIntroduction.pdf.
BurnsE,McgloinJ,WestfallJM.HospitalizationforAmbulatoryCareSensitiveConditions;AccesstoCare
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Page29
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CentersforDiseaseControlandPrevention.ChronicHepatitisC:WhyBabyBoomersShouldGetTested.
Publicationno.220401.2012.http://www.cdc.gov/knowmorehepatitis/Media/PDFs/FactSheet
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HealthandHumanServices,AdministrationforChildrenandFamilies,AdministrationonChildren,
Youth,andFamilies,ChildrensBureau.2006.http://www.childwelfare.gov/pubs/usermanuals/neglect/.
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populations:Reviewandrecommendations.JournalofHomosexuality.2010;58(1):1051.
HealthandSocialInequalityinSantaClaraCounty:SantaClaraCountyPublicHealthDepartment;2011.
InsightCenterforCommunityEconomicDevelopment.TheFamilyEconomicSelfSufficiencyStandard.
2011;http://www.insightcced.org/communities/cfess/casssold/SSSSantaClara12.html,2012.
InsightCenterforCommunityEconomicDevelopment.WhatSeniorsNeedtoMakeEndsMeet:Elder
IndexinSantaClaraCounty.http://www.insightcced.org/communities/cfess/eesiDetail.html?ref=44.
AccessedMarch2013.
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Institute,SanJoseUniversity;20122012.
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KerkCommunications;July2012.
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AdministrationforChildrenandFamilies,AdministrationonChildrenYouthandFamiliesChildrens
Bureau;2008.http://www.childwelfare.gov/pubs/factsheets/long_term_consequences.pdf
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DiseaseControlandPrevention,NationalCenterforInjuryPreventionandControl.2008.
http://www.cdc.gov/ncipc/pubres/pdf/Childhood_Stress.pdf.
NationalCenterforInjuryPreventionandControl,CentersforDiseaseControlandPrevention.
Understandingteendatingviolence.2009.
http://www.cdc.gov/violenceprevention/pdf/TeenDatingViolence2009a.pdf.
NockMK,PrinsteinMJ.Contextualfeaturesandbehavioralfunctionsofselfmutilationamong
adolescents.JournalofAbnormalPsychology.2005;114(1):140146.
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OfficeofStatewideHealthPlanningandDevelopment.PatientDischargeData2009.
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Page31
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87:13281334.
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SantaClaraCountyCommunityAssessmentProject.SecondaryDataCommitteeSummaryFindings2012.
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Department;updatedApril4,2011.
SantaClaraCountyPublicHealthDepartment.BehavioralRiskFactorSurvey2009.
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SantaClaraCountyPublicHealthDepartment.CaliforniaReportableDiseaseInformationExchange
database2010.
SantaClaraCountyPublicHealthDepartment.SantaClaraCountyHealthProfileReport,2010.
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SantaClaraCountyPublicHealthDepartment.StatusofLatino/HispanicHealthSantaClaraCounty2012
2012.
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Page32
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Page34
Attachment2:IRSChecklist
FederalRequirementsChecklist
Report
IRSNotice Reference
I.CHNAReportRequirements
A.PreAssessment

CHNAReportincludesidentificationofalloftheorganizations
withwhichthefacilitycollaboratedinpreparingtheCHNA(s)

CHNAReportincludesidentityandqualificationsofanythird
partiescontractedtoassistinconductingaCHNA

CHNAReportincludesadefinitionofthecommunityserved
andadescriptionofhowthecommunitywasdetermined*

Demographicsandotherdescriptorsofthehospitalservice
area

Notice3.03 Section4
B.DataCollection
SecondaryData
CHNAincludesthefollowingdocumentationofsecondarydatausedfor
theassessment:

Sourcesanddatesofdataandotherinformationused

Informationgapsthatimpacttheabilitytoassesshealth
needs

PrimaryData
CHNAincludestheindividualsconsultedwhohavespecialknowledgeof
orexpertiseinpublichealth:

Name

Title

Notice3.03 Section4
Notice3.03 Section3
IRSForm
990
ScheduleH
PartV1.b
Section3
Notice3.03 Attachment1
Notice3.03 Section5
Notice3.03
Affiliation
Attachment3
Attachment3
Attachment3
Briefdescriptionofindividual'sspecialknowledgeor
Attachment3
expertise
Ifnotpublichealthexperts,reportprovidesnameandtitleof
Attachment3
atleastonesuchindividualineachorganizationwhowas
consulted
CHNAincludesinputfrompersonswhorepresentthebroadinterestsof Notice3.06 Section5and

thecommunity:
attachment3
Personswithspecialknowledgeoforexpertiseinpublichealth
Section5and
attachment3
Federal,tribal,regional,State,orlocalhealthorotherdepartmentsor
Attachment3
agencieswithcurrentdataorotherrelevantinformation
Leaders,representatives,ormembersofmedicallyunderservedpopulations Attachment3
Leaders,representatives,ormembersoflowincomepopulations
Attachment3
Leaders,representatives,ormembersofminoritypopulations
Attachment3
Page35
Leaders,representatives,ormembersofpopulationswithchronicdisease
needs
Reportdescribeswhentheorganizationconsultedwiththese Notice3.03
persons
Reportdescribeshowmodeofconsultation(focusgroups,
keyinformantinterviews,other)
Leader/representatives'names
Attachment3
Leader/representatives'leadershiporrepresentativeroles
Attachment3
C.CHNAMethodology
Adescriptionofprocessandcriteriausedtoprioritizethe
healthneeds

D.Assets
CHNAReportincludesdescriptionoftheexistinghealthcarefacilities
andresourceswithinthecommunitythatareavailabletorespondtothe
healthneedsofthecommunity

Existinghealthcarefacilities
Otheravailableresources

Section5
Section6
Section6and
Attachment6
Section6
Section7
Assetsattachment
(relatedtospecific
needs)
Notice3.07
E.FinalizingtheCHNA
CHNAreportshavebeenmadewidelyavailabletothepublicin2013
accordingtorequirements
H Writtenreport(s)postedvisiblyonfacility website
H Iffacilityhasnowebsite,report(s)postedvisiblyonwebsiteforthe
organization
H InstructionsforaccessingCHNAreportareclear
H Postedreportsexactlyreproduceanimageofeachreport
H IndividualswithInternetaccesscanaccess andprintreportswithout
specialsoftwareandwithoutpaymentofafee
H Individualsrequestingacopyofthereport(s)areprovidedtheURL
Attachment3
Notice3.03
CHNAReportincludesthefollowinginformationrelatedtocommunity
healthneeds

Criteriaandanalyticalmethodsappliedtoidentifythe
communityhealthneeds

Prioritizeddescriptionofallhealthneedsidentified
Attachment3
H ReportsremainwidelyavailableuntilasubsequentCHNAismade
widelyavailabletothepublic
Page36
Attachment3:MapofSantaClaraCounty
Page37
Attachment4:ListofCommunityLeadersandTheirCredentials
Thefollowingleaderswereconsultedfortheirexpertiseinthecommunity.Theywereidentifiedbasedontheirprofessionalexpertiseandknowledgeoftarget
groupsincludingchildren,youth,olderadults,lowincomepopulations,minorities,themedicallyunderserved,andthoselivingwithchronicconditions.The
coalitionincludedleadersfromhealthsystemsincludingtheSantaClaraCountyHealth&HospitalSystemincludingtheDepartmentofPublicHealth,non
profithospitalrepresentatives,localgovernmentemployees,healthcareconsumeradvocateorganizations,andnonprofitorganizations.
NAME
TITLE
AFFILIATION
ShamimaHasan
CEO
MayviewCommunityHealthCenter
EXPERTISE
Health CareProvider
RenSantiago
DanPeddycord
Dr.Marty
Fenstersheib
DeputyCountyExecutive
Director
SantaClaraCountyHealth&Hospital
System
SantaClaraCountyPublicHealthDept
PublicHealth
PublicHealth
SantaClaraCountyHealth&Hospital
System
TARGET
GROUP(S)
Medically
Underserved
(uninsured)
Medically
Underserved
ChronicConditions
TARGET
GROUP
ROLE
Leader
HealthCareAdvocacy
MarcBaker
GrantsManager
SecondHarvestFoodBankofSantaClara
andSanMateoCounties
FoodAccess
AliBarekat
ExecutiveDirector
SundayFriends
ViolencePrevention
Lowincome,Minority
Leader
PattyBennett
ProgramDirector
NextDoorSolutionstoDomestic
Violence
Lowincome,Minority
Leader
SadieSponsler
SouthBayFoodSystems
RegionalManager
CommunityAlliancewithFamilyFarmers
DomesticViolence,Violence
Prevention
FoodAccess
Lowincome,Minority
Leader
DeeDemitri
ProgramCoordinator
CommunitySolutions
Leader
LisDuBois
DirectorofCommunity
Engagement
BayAreaWomen'sSportsInitiative
CommunityWellnessServices
Children/Youth,South
County
Children/Youth
WhitneyEvans
ProgramManager
GirlScoutsofNorthernCalifornia
ViolencePrevention
Youth,Minority
Leader
MichelleLew
ExecutiveDirector
AsianAmericansforCommunity
Involvement
Health CareProvider
ReymundoEspinoza
DoloresAlvarado
CEO
GardnerHealthCenter
MentalHealth
Page38
10/2/12
Interview
10/2/12
Interview
10/3/12
Interview
10/3/12
Interview
10/4/12
Interview
10/4/12
Interview
10/17/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
Leader
CommunityHealthPartnership
Health CareProvider
Interview
Leader
ExecutiveDirector
PublicHealth
DATE
CONSULTED
Leader
Medically
Underserved
Minority(Asian),
Medically
Underserved
(uninsured)
Minority(Latino),
Medically
Underserved
(uninsured)
Medically
Underserved
(uninsured)
Lowincome,Minority
HealthOfficer
CONSULTATION
METHOD
Leader
Leader
Leader
Leader
Leader
NAME
TITLE
AFFILIATION
EXPERTISE
MarisolFernandez
OutreachManager
CountyofSantaClaraParks&
Recreation
ElizabethFranco
DevelopmentDirector
ProjectCornerstone
LindaFranklin
ProgramManager
AlumRockCounselingCenter
DorisFredericks
ExecutiveDirector
CDI/ChoicesforChildren
AimeeFrisch
ExecutiveDirector
Veggielution
EmilyHennessy
DirectorofFinance
SantaClaraFamilyHealthFoundation
JenniferShelton
ProgramAssociate
ViolencePrevention
SubstanceAbusePrevention
StanfordUniversityPacificFreeClinic
MaritzaMaldonado
ProgramDirector
SomosMayfair
MarianneMarafino
Johnson
ProgramDirector
CommunitySolutions
DanMcClure
ExecutiveDirector
GenerationsCommunityWellness
PatriciaNarciso
DirectorofDevelopment
andMarketing
Children'sDiscoveryMuseum
ElisaOrona
GrantsCoordinator
JomaBriones
ProgramManager
Involvement
Involvement
ClinicManager
AllisonRobinson
Casemanager
InnVisionShelterNetwork
FoodAccess
Lowincome,Minority
Leader
HealthInsurance
Medically
Underserved
(uninsured)
Leader
Medically
Underserved
(uninsured)
Medically
Underserved
(uninsured),Minority
(Asian&Latino)
Leader
MentalHealth
CommunityWellness
Services
CommunityServices
Homeless
Leader
EarlyChildhood
HealthCareProvider
SoniaPadula
GROUP
ROLE
Leader
Leader
HealthCareProvider
ExecutiveDirector
Youth,Minority
(Latino)
Children,Lowincome
TARGET
Youth,Lowincome,
Minority(Latino)
ChronicConditions
HealthInsurance
RhondaMcClinton
Brown
TARGET
GROUP(S)
Page39
Leader
CONSULTATION
METHOD
DATE
CONSULTED
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
Leader
Minority(Latino),
Lowincome
Youth,Lowincome,
SouthCounty
ChronicConditions
Leader
Leader
Youth,Minority
Leader
Youth,Minority
(Asian)
Youth,Minority
(Asian)
Medically
Underserved
(uninsured),Low
Income
Medically
Underserved,Low
income
Leader
Leader
Leader
Leader
Leader
NAME
TITLE
AFFILIATION
EXPERTISE
MarcSabin
DirectorofMontgomery
StreetInn
StephanieSanchez
FamilySupportServices
Manager
NextDoorSolutionstoDomestic
Violence
JulieSmithReid
DirectorofEducation
PlannedParenthood
VictorHernandez
ProgramCoordinator
BreatheCaliforniaoftheBayArea
MyrnaZendejas
CSHOutreachSpecialist
SantaClaraCountyOfficeofEducation
MarkBalcher
ProgramCoordinator
FullCircleFarm
LaurelBlankenship
GrantsManager
HappyHollowPark&Zoo
LorenaMadrid
DirectorofHealth
CoverageInitiatives
TammyJanosik
ExecutiveDirector
RotaCareBayArea
ZeliaRodriguez
ProgramManager
SIREN
CindyClawsen
ProgramManager
CommunitySolutions
PhaikTeoh
GrantsManager
BayAreaWomen'sSportsInitative
CommunityWellness
Services
SisterRachela
Director,Community
Health
LillianCastillo
Nutritionist
EileenObata
Homeless
DomesticViolence,Violence
Prevention
HealthCareProvider
TARGET
GROUP(S)
Medically
Underserved,Low
income
TARGET
GROUP
ROLE
Leader
Lowincome,Minority
Leader
Medically
Underserved
(uninsured)
Leader
CommunityServices
Lowincome
Leader
Education
Lowincome
Leader
FoodAccess
ChronicConditions
Leader
CommunityServices
Children/Youth,
Minority
Medically
Underserved
(uninsured)
Medically
Underserved
(uninsured)
Medically
Underserved
(uninsured)
Lowincome,South
County
Youth
Leader
Medically
Underserved&Low
Income,SouthCounty
Leader
HealthCareProvider
PublicHealth
ChronicConditions
DistrictNurse
GilroyUnifiedSchoolDistrictSchool
Nurse
PublicHealth
CeliaShanley
HealthServicesManager
RebekahsChildrenServices
MentalHealth
LynnMagruder
GrantsAdministrator
CommunitySolutions
MentalHealth
HealthCareAdvocacy
HealthCareProvider
HealthCareAdvocacy
MentalHealth
Page40
Medically
Underserved&Low
income, South County
County
County
CONSULTATION
METHOD
DATE
CONSULTED
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
10/24/12
FocusGroup
11/1/12
FocusGroup
11/1/12
FocusGroup
11/1/12
FocusGroup
11/1/12
FocusGroup
11/1/12
Leader
Leader
Leader
Leader
Leader
Leader
Leader
Leader
Leader
NAME
TITLE
AFFILIATION
MarilynRoaf
HCDGrantsCoordinator
CityofGilroy
MaureenDrewniany
SusanFent
CommunityServices
Manager
Director,Senior
Programs&Services
CityofMorganHill
MorganHillSeniorCenter
EXPERTISE
CommunityServices
CommunityServices
CommunityServices
TARGET
GROUP(S)
Underserved&Low
income,SouthCounty
Underserved&Low
income,SouthCounty
ChronicConditions,
SouthCounty
Underserved&Low
income,SouthCounty
Underserved&Low
income,SouthCounty
TARGET
GROUP
ROLE
Leader
Leader
Leader
Leader
SusanValenta
President&CEO
CityofGilroyChamberofCommerce
CommunityServices
ClaudiaRossi
Trustee
MorganHillSchoolBoard
Education
ArtBarron
Chair,AdvisoryBoard
CARAS
CommunityServices
Medically
Underserved&Low
income,SouthCounty
NaomiNakano
Matsumoto
ExecutiveDirector
WestValleyCommunityServices
CommunityHealth
Lowincome
Leader
HealthCareAdvocacy
Medically
Underserved
(uninsured)
Leader
HealthInsurance
Medically
Underserved
(uninsured)
Dr.KentImai
KathleenKing
CarolLeighHutton
JillDawson
MarieBernard
MaureenWadiak
PatriciaGardner
PonchoGuevara
MedicalDirector
CEO
President&CEO
ProgramDirector
ExecutiveDirector
AssociateDirector
ExecutiveDirector
ExecutiveDirector
UnitedWaySiliconValley
SunnyvaleCommunityServices
MountainViewCommunityServices
SiliconValleyCouncilofNonprofits
SacredHeartCommunityService
AimeeReedy
SCCDivisionDirector
BonnieBroderick
Director,ChronicDisease
andInjuryPrevention
FredFerrer
ExecutiveDirector
TheHealthTrust
CommunityServices
Homeless
Lowincome
Lowincome
CommunityServices
Lowincome
CommunityServices
Lowincome,North
County
HealthcareAdvocacy
CommunityServices
PublicHealth
PublicHealth
CommunityHealth
Page41
Lowincome
Lowincome,
Minority(Latino)
ChronicConditions,
Lowincome,Minority
ChronicConditions,
Lowincome,Minority
ChronicConditions,
Lowincome
Leader
CONSULTATION
METHOD
DATE
CONSULTED
FocusGroup
11/1/12
FocusGroup
11/1/12
FocusGroup
11/1/12
FocusGroup
11/1/12
FocusGroup
11/1/12
FocusGroup
11/1/12
Leader
Leader
FocusGroup
Interview
11/6/12
11/6/12
FocusGroup
11/6/12
Leader
Leader
Leader
Leader
Leader
Leader
Leader
Leader
Leader
FocusGroup
FocusGroup
FocusGroup
FocusGroup
FocusGroup
FocusGroup
11/6/12
11/6/12
11/6/12
11/6/12
11/6/12
11/6/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
TARGET
NAME
TITLE
AFFILIATION
EXPERTISE
TARGET
GROUP(S)
EllenCorman
Supe.InjuryPrevention
&CommtyOutreach
HealthCareProvider
ChronicConditions
BruceCopley
Director
SantaClaraCountyDrugandAlcohol
Services
BehavioralHealth
Lowincome
SherriTerao
DivisionDirector
SantaClaraCountyMentalHealth
MentalHealth
Children,Lowincome
VivianSilva,MSW
CareManager
CityofSunnyvale
CommunityServices
ChronicConditions
Leader
PamGudio
ProgramManager
SomosMayfair
Minority(Latino)&
Lowincome
Leader
CindyMcGown
SeniorDirector
SecondHarvestFoodBank
FoodAccess
Lowincome
ConnieCorrales
Director,HICAP
CouncilonAging
OlderAdults
LoriAndersen
Director,HealthyAging
TheHealthTrust
MariaSolis
MikeTorres
SocialServices
Administrator
Director,Contracts&
Planning
YuAiKai
CouncilonAging
Leader
OlderAdults
ChronicConditions
Leader
OlderAdults
ChronicConditions
Leader
OlderAdults
ChronicConditions
Leader
PublicHealth
Medically
Underserved
Leader
Medically
Underserved
(uninsured),Youth
Leader
Medically
Underserved
(uninsured),Youth
Leader
Dr.DorothyFurgerson
ChiefMedicalOfficer
PlannedParenthood
JodiKazemini
ClinicManager
LucliePackardChildrensHospital
AdolescentClinic
GeraldoCadenas
SeniorOfficeAssistant
ColumbiaNeighborhoodCenter
PaulSchutz
AssociateDirectorof
Development
CommunityHealthAwarenessCouncil
CommunityServices
Youth,NorthCounty
PetraRiguero
ProgramSupervisor
CityofSanJoseMayor'sGang
PreventionTaskForce
ViolencePrevention
Youth
ElaineGlissmeyer
ExecutiveDirector
YMCA
MarleneBjornsrud
ExecutiveDirector
RhoHenryOlaisen
Director
Health CareProvider
Leader
Leader
ProgramDirector
AbilitiesUnited
Leader
ChronicConditions
SusanSilveira
BayAreaWomensSportsInitiative
GROUP
ROLE
Leader
HealthCareProvider
CommunityServices
Page42
Children
Youth
Youth
Disabled
Leader
Leader
Leader
Leader
Leader
Leader
CONSULTATION
METHOD
DATE
CONSULTED
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/7/12
FocusGroup
11/9/12
FocusGroup
11/9/12
FocusGroup
11/9/12
FocusGroup
11/9/12
FocusGroup
11/9/12
FocusGroup
11/9/12
FocusGroup
11/9/12
FocusGroup
11/9/12
FocusGroup
11/9/12
NAME
TITLE
AFFILIATION
EXPERTISE
TARGET
GROUP(S)
MelindaLandau
Manager
SanJoseUnifiedSchoolDistrict
Education
Children
Dr.ThadPadua
MedicalDirector
SantaClaraFamilyHealthPlan
HealthInsurance
Medically
Underserved
(uninsured)
AnneEhresman
ExecutiveDirector
ProjectCornerstone
ViolencePrevention
Children
DanaBunnett
ExecutiveDirector
KidsinCommon
ChildrensAdvocacy
Children
Foradescriptionofmembersofthecommunitywhoparticipatedinfocusgroups,pleaseseeSection5ResidentInput.
Page43
TARGET
GROUP
ROLE
Leader
CONSULTATION
METHOD
DATE
CONSULTED
FocusGroup
11/9/12
Leader
11/9/12
Interview
Leader
Leader
FocusGroup
11/9/12
FocusGroup
11/9/12
Attachment5:ListofIndicatorsonWhichDataWereGathered
Indicator
DataSource
AbsenceofDentalInsuranceCoverage
CaliforniaHealthInterviewSurvey(CHIS),2007
AccesstoPrimaryCare
U.S.HealthResourcesandServicesAdministrationArea
ResourceFile,2009(asreportedinthe2012County
HealthRankings)
AdequateFruit/VegetableConsumption
(Youth)
AdequateSocialorEmotionalSupport
CentersforDiseaseControlandPrevention,Behavioral
RiskFactorSurveillanceSystem,20062010
AlcoholExpenditures
NielsenClaritasSiteReports,ConsumerBuyingPower,
2011
AsthmaHospitalizations(Adult)
CaliforniaOfficeofStatewideHealth,Planningand
Development(OSHPD),PatientDischargeData,2010
AsthmaHospitalizations(Youth)
AsthmaPrevalence
BreastCancerIncidence
TheCentersforDiseaseControlandPrevention,andthe
NationalCancerInstitute:StateCancerProfiles,20052009
BreastCancerScreening(Mammogram)
DartmouthAtlasofHealthcare,SelectedMeasuresof
PrimaryCareAccessandQuality,20032007
Breastfeeding(Any)
CAonly:CaliforniaDepartmentofPublicHealth,In
HospitalBreastfeedingInitiationData,2011;OutsideCA:
NationalSurveyofChildren'sHealth,2007
Page44
Indicator
DataSource
Breastfeeding(Exclusive)
CAonly:CaliforniaDepartmentofPublicHealth,In
HospitalBreastfeedingInitiationData,2011;OutsideCA:
CancerMortality
CAonly:CaliforniaDepartmentofPublicHealth,Death
StatisticalMasterFile,20082010;OutsideCA:Centersfor
DiseaseControlandPrevention,NationalCenterfor
HealthStatistics,UnderlyingCauseofDeath,20052009..
AccessedthroughCDCWONDER
CervicalCancerIncidence
CervicalCancerScreening(PapTest)
ChangeinTotalPopulation(from2000to
2010)
U.S.CensusBureau,2010CensusofPopulationand
Housing,SummaryFile1;U.S.CensusBureau,2010Census
ofPopulationandHousing,SummaryFile1
ChildreninPoverty
U.S.CensusBureau,20062010AmericanCommunity
Survey5YearEstimates
ChlamydiaIncidence
CentersforDiseaseControlandPreventionandthe
NationalCenterforHIV/AIDS,ViralHepatitis,STD,andTB
Prevention,2009
ColonandRectumCancerIncidence
ColonCancerScreening
(Sigmoid/Colonoscopy)
Page45
Indicator
DataSource
DentalCareAffordability
DentalCareUtilization(Adult)
DentalCareUtilization[Youth]
DiabetesHospitalizations(Adult)
DiabetesHospitalizations(Youth)
DiabetesManagement(HemoglobinA1c
Test)
DartmouthAtlasofHealthcare,SelectedMeasuresof
PrimaryCareAccessandQuality,20032007
DiabetesPrevalence
CentersforDiseaseControlandPrevention,National
DiabetesSurveillanceSystem,2009
FacilitiesDesignatedasHealthProfessional
ShortageAreas(HPSA)
U.S.HealthResourcesandServicesAdministration,Health
ProfessionalShortageAreaFile,2012
FastFoodRestaurantAccess
CAonly:U.S.CensusBureau,ZIPCodeBusinessPatterns,
2009;OutsideCA:U.S.CensusBureau,CountyBusiness
Patterns,2010
FederallyQualifiedHealthCenters
U.S.HealthResourcesandServicesAdministration,
CentersforMedicare&MedicaidServices,Providerof
ServiceFile,2011
FreeandReducedPriceSchoolLunch
Eligibility
U.S.DepartmentofEducation,NationalCenterfor
EducationStatistics(NCES),CommonCoreofData,Public
SchoolUniverseFile,20092010
Fruit/VegetableExpenditures
2011
Page46
Indicator
DataSource
GroceryStoreAccess
U.S.CensusBureau,CountyBusinessPatterns,2010
HeartDiseaseMortality
StatisticalMasterFile,20082010;outsideCACentersfor
HeartDiseasePrevalence
CAonly:CaliforniaHealthInterviewSurvey(CHIS),2009;
OutsideCA:CentersforDiseaseControlandPrevention,
BehavioralRiskFactorSurveillanceSystem,20062010
HeavyAlcoholConsumption
HighBloodPressureManagement
HighSchoolGraduationRate
U.S.DepartmentofEducation,NationalCenterfor
EducationStatistics(NCES),CommonCoreofData,Local
EducationAgency(SchoolDistrict)UniverseSurvey
DropoutandCompletionData,20082009
HIVHospitalizations
HIVPrevalence
CentersforDiseaseControlandPreventionandthe
NationalCenterforHIV/AIDS,ViralHepatitis,STD,andTB
Prevention,2008
HIVScreenings
Page47
Indicator
DataSource
Homicide
InadequateFruit/VegetableConsumption
(Adult)
InfantMortality
CentersforDiseaseControlandPrevention,NationalVital
StatisticsSystem,20032009
LackofaConsistentSourceofPrimaryCare
LackofPrenatalCare
CAonly:CaliforniaDepartmentofPublicHealth,Birth
ProfilesbyZIPCode,2010;OutsideCA:Centersfor
DiseaseControlandPrevention,NationalVitalStatistics
Systems,20072009.AccessedthroughCDCWONDER
LinguisticallyIsolatedPopulation
LiquorStoreAccess
CAonly:CaliforniaDepartmentofAlcoholicBeverage
Control,ActiveLicenseFile,April2012;OutsideCA:U.S.
CensusBureau,CountyBusinessPatterns,2010
LowBirthweight
CAonly:CaliforniaDepartmentofPublicHealth,Birth
ProfilesbyZIPCode,2010;OutsideCA:CentersforDisease
ControlandPrevention,NationalVitalStatisticsSystems,
20032009.AccessedthroughtheHealthIndicators
Warehouse
Page48
Indicator
DataSource
LungCancerIncidence
MedianAge
MotorVehicleCrashDeath
StatisticalMasterFile,20082010;OutsideCA:National
HighwayTrafficSafetyAdministration,FatalityAnalysis
ReportingSystem,20082010
Obesity(Adult)
DiabetesSurveillanceSystem,2009
Obesity(Youth)
CAonly:CaliforniaDepartmentofEducation,Fitnessgram
PhysicalFitnessTestingResults,2011;OutsideCA:
Overweight(Adult)
Overweight(Youth)
CAonly:CaliforniaDepartmentofEducation,Fitnessgram
PhysicalFitnessTestingResults,2011;OutsideCA:
ParkAccess
U.S.CensusBureau,2010CensusofPopulationand
Housing,SummaryFile1;Esri'sUSAParkslayer
(compilationofEsri,NationalParkService,andTomTom
sourcedata),2012.
PedestrianMotorVehicleDeath
StatisticalMasterFile,20082010;OutsideCA:National
HighwayTrafficSafetyAdministration,FatalityAnalysis
ReportingSystem,20082010
Page49
Indicator
DataSource
PhysicalInactivity(Adult)
PhysicalInactivity(Youth)
CaliforniaDepartmentofEducation,FitnessgramPhysical
FitnessTestingResults,2011
PneumoniaVaccinations(Age65+)
PoorAirQuality(Ozone)
EnvironmentalPublicHealthTrackingNetwork,2008
PoorAirQuality(ParticulateMatter2.5)
EnvironmentalPublicHealthTrackingNetwork,2008
PoorDentalHealth
PoorGeneralHealth
PoorMentalHealth
PopulationBelow200%ofPovertyLevel
PopulationLivinginaHealthProfessional
ShortageAreas(HPSA)
U.S.HealthResourcesandServicesAdministration,Health
ProfessionalShortageAreaFile,2012
PopulationLivinginFoodDeserts
U.S.DepartmentofAgriculture,FoodDesertLocator,2009
PopulationReceivingMedicaid
PopulationwithAnyDisability
PopulationwithNoHighSchoolDiploma
Page50
Indicator
DataSource
PovertyRate(<100%FPL)
PrematureDeath
StatisticsSystem,20082010(AsReportedinthe2012
CountyHealthRankings)
PreventableHospitalEvents
CAonly:CaliforniaOfficeofStatewideHealth,Planning
andDevelopment(OSHPD),PatientDischargeData,2010;
outsideCA:DartmouthAtlasofHealthcare,Selected
MeasuresofPrimaryCareAccessandQuality,20032007
ProstateCancerIncidence
RecreationandFitnessFacilityAccess
CAonly:U.S.CensusBureau,ZIPCodeBusinessPatterns,
2009;OutsideCA:U.S.CensusBureau,CountyBusiness
Patterns,2010
SoftDrinkExpenditures
2011
StrokeMortality
StudentReadingProficiency(4thGrade)
States'DepartmentofEducation,StudentTestingReports,
2011
Page51
Indicator
DataSource
Suicide
SupplementalNutritionAssistanceProgram
(SNAP)Recipients
U.S.CensusBureau,SmallAreaIncomeandPoverty
Estimates(SAIPE),2009
TeenBirths
StatisticsSystems,20032009.Accessedthroughthe
HealthIndicatorsWarehouse
TobaccoExpenditures
2011
TobaccoUsage(Adult)
TotalFemalePopulation
TotalMalePopulation
TotalPopulation
TotalPopulationAge04
Page52
Indicator
DataSource
TotalPopulationAge65orOlder
UnemploymentRate
U.S.BureauofLaborStatistics,July,2012LocalArea
UnemploymentStatistics
UninsuredPopulation
ViolentCrime
U.S.FederalBureauofInvestigation,UniformCrime
Reports,2010
Walkability
WalkScore.Com(2012)
WICAuthorizedFoodStoreAccess
U.S.DepartmentofAgriculture,FoodEnvironmentAtlas,
2012
Page53
Attachment6:CrossCuttingDriversMentionedDuringPrimaryDataGathering
Accessissues,includinginsurance/coverageissues(includingMediCal),lackof
transportation/transportationissues,issueswithlocation,andlanguagebarriers
Accessingprimarycareprovidersandthesupplyofpractitioners&specialists(workforce
development)
Beingtoobusy
Beingunemployed
Caregiverissues
Concernsaboutdeliveryofprevention
Culturalissues
Denial/fear
Disabilities/existingmedicalconditionsexacerbatingotherdrivers
Eatingfastfood
Environmentalissues,especiallyschools,neighborhoods(walkability&personalsafety),housing,and
lackofgrocerystoresorotherplacestobuyfreshfood
Experiencingstigma
Gangs,crime
Havinglowincomeorbeinginpoverty
Healthbehaviors,includingutilizationofhealthcare
Heredity/geneticpredisposition
Issuesofcoordinationofcare
Issueswithprescriptiondrugs(medicationmanagement,accesstomedication,sharing)
Issueswithtreatment
Lackofawareness
Lackofhealtheducation
Lackofknowledge
Lackofmotivation
Lackofphysicalactivity
Lackofservices
Lackof/pooroutreach
Media
Needforapatientcenteredmedicalhome/warmhandshake
Needforbestpracticestobeemployed
Needforpartnershipsormoreeffectivepartnerships
Poornutrition,includingtoomuchsugar,notcookingathomeorcookingunhealthyfood,eating
processedfood
Socialissues,especiallypoor/norolemodels,parenting&familyissues,peerpressure,andsocial
isolation
Specialpopulations:Children;youth;olderadults;thoseofparticularethnicities(includingbeing
undocumented);adults
Specifichospitalrelateddeliveryissues
Thecostofhealthcare/insurance/prescriptions/activities/freshfood
Page54
Attachment7:HealthNeedsProfiles
Seeseparateattachments.
Page55
Attachment8:HealthNeedsPrioritizationScores:BreakdownbyCriteria
Overall
Healthneed/
average
condition
score
Diabetes
Obesity
Violence
Poormentalhealth
Poororal/dentalhealth
Cardiovasculardisease,
heartattack,stroke
Substanceuse(ATOD)
Cancers
Respiratoryconditions
STDs/HIVAIDS
Birthoutcomes
Alzheimer's
AverageScoresofPrioritizationCriteria
Community
UsedbyGroup
PriorityScore
Disparities Prevention/ SolutionHas
Basedon
Exist
Intervention Multiplier
PrimaryData
Opportunity
Effect
3.0
2.9
2.6
2.6
2.5
3.0
2.9
2.9
2.3
2.7
3.0
2.8
2.6
2.6
2.8
2.9
2.9
2.9
2.4
2.3
3.0
3.0
2.0
3.0
2.0
2.4
2.3
2.8
2.4
2.0
2.4
2.2
2.0
2.0
1.6
1.4
2.4
2.1
2.4
2.3
2.0
1.8
2.8
2.8
2.6
2.5
1.6
1.6
2.3
1.8
1.9
2.0
1.6
1.3
2.0
2.0
1.0
1.0
1.0
1.0
Notes:AccesstoHealthCarenotscoredduringprioritizationprocess.
Codingof"CommunityPriorityScoreBasedonPrimaryData":Coded3ifissuewasidentifiedasatop
need/conditionbymorethan10keyinformantinterviews/focusgroups(KIIs/FGs);coded2ifby19
KIIs/FGs;coded1ifmentionedbutnotasatopneed/condition.
Page56
Attachment9:CommunityIndicatorDashboard
Need
ShortDescription
Population/
Denominator
SCCData
Source
SCCData
Year
SCCData
CA
Data
Nat'l
Benchmark
BreastCancerScreening
%offemalesages5074who
hadamammograminthepast
twoyears
allfemales5074
CHIS
2009
83%
86%
81.1%
BreastCancerIncidence
Ageadjustedbreastcancer
incidencerate
100,000females
CACancerReg
2009
161.4
154.1
100,000females
CACancerReg
2009
20.0
22.1
20.6
allfemales2165
CHIS
2007
91%
90%
93.3%
100,000femaleadults
CACancerReg
2009
7.2
7.8
7.1
100,000femaleadults
CACancerReg
200709
1.4
2.3
2.2
100,000adults50+
SCCBRFS;Citedby
SCCHealthProfile
2009
65%
60%
70.5%
100,000adults
CACancerReg
2009
40.9
43.2
45.4
100,000adults
CACancerReg
2009
13.9
14.5
14.5
100,000adults
CACancerReg
2009
10.9
8.6
100,000adults
CACancerReg
2009
6.8
5.6
100,000adults
CACancerReg
2009
41.8
50.6
100,000adults
CACancerReg
2009
28.2
37.8
45.5
Ageadjustedmortalityrateof
femalesforbreastcancer
%offemalesages2165who
CervicalCancerscreening
hadPaptest3yrsagoorless
(neverhadahysterectomy)
Ageadjustedcervicaloruterine
CervicalCancerIncidence
cancerincidence
Threeyearageadjusted
CervicalCancerMortality
mortalityrateduetocervixuteri
cancer
%ofadults50+whoeverhada
Colorectalcancerscreening
sigmoidoscopy/colonoscopy
Ageadjustedcolonandrectum
Colorectalcancerincidence
cancerincidencerate
Ageadjustedcolonandrectum
Colorectalcancermortality
cancermortality
Ageadjustedlivercancer
Livercancerincidence
incidencerate
Ageadjustedlivercancer
Livercancermortality
mortality
Lung/bronchuscancer
Ageadjustedlung/bronchus
incidence
cancerincidencerate
Lung/bronchuscancer
Ageadjustedlung/bronchus
mortality
mortality
BreastCancerMortality
Cancer
Detailedindicator
Page57
Prostatecancerscreening
Prostatecancerincidence
Prostatecancermortality
Cancermortality(alltypes)
%ofadultmenages50and
olderwhoreportedthatthey
hadeverhadaprostatespecific
antigentest
Ageadjustedprostatecancer
incidencerate
Ageadjustedprostatecancer
mortalityrate
Ageadjustedmortalityratedue
toallcancers
menage50+
SCCBRFS;Citedby
SCCHealthProfile
2009
72%
100,000men
CACancerReg
2009
145.9
131.0
100,000men
CACancerReg
2009
15.8
22.4
21.2
2009
137.6
158.3
160.6
100,000adults
Veteran'sHealthAdminhospitalsdidnotreporttoCCRin20052009.Therefore,casecountsandincidenceratesformalesareunderestimated.
Need
ShortDescription
Heartdiseasemortality
Strokehospitalizationrate
Cardio/Heart/Stroke
Strokedeathrate
Highcholesterol
Hypertension
Population/
Denominator
rawnumber(age
Heartdiseasedeaths
adustedrateN/F)
Hospitaldischargesduetoacute rawnumber(age
ischemicstroke
adustedrateN/F)
SCCData
Year
SCCData
CDPHVitalStats
Table520
2010
Ageadusted
rateN/F
OSHPD061063
2010
Ageadusted
rateN/F
rawnumber(age
adustedrateN/F)
CAVitalStatsTable
520(2010)
2010
Ageadusted
rateN/F
adults
SCCBRFS(citedSCC
HealthProfile'10)
2009
29%
14%
adults
SCCBRFS(citedSCC
HealthProfile'10)
2009
26%
27%
Detailedindicator
Strokedeaths
%adultseverdiagnosedwith
highcholesterol
hypertension
SCCDatasource
CA
Data
Nat'l
Benchmark
CAVital
Stats
2010,
Table57
Heartattack
%adultseverhadheartattack
adults
SCCBRFS(citedSCC
HealthProfile'10)
2009
3%
3%
Heartdiseaseprevalence
coronaryheartdisease/angina
adultsinSan
Jose/Sunnyvale/Santa
ClaraArea
CDCBRFSS(online
query)
2010
3.2%
3.6%
US:4.3%
adults
CDCBRFSS2006
1010
2009
2%
2.20%
Strokeincidence
%ofadultswhohaveeverhada
stroke
Page58
Respiratory
Need
ShortDescription
Detailedindicator
Population/
Denominator
SCCDatasource
SCCData
Year
SCCData
CA
Data
Nat'l
Benchmark
Asthma:childrendiagnosed
%children017diagnosedwith
children017
asthma(basedonparentreport)
OSHPD;Citedby
CABreathing
SCCAsthma
Profile
2009
12%
14%
Asthma:adultsdiagnosed
asthma(lifetime)
CHIS
2009
11%
14%
CAtarget:13%
Asthma:infant/toddler
hospitalizations
Ageadjustedasthma
hospitalizationrateforkids04
10,000residents
2010
24.5
22.3
18.1
Asthma:child
hospitalizations
Ageadjustedasthma
hospitalizationrateofkids517
10,000residents
2010
4.3
6.9
Asthma:adult
hospitalizations
Ageadjustedrateofadult1864
hospitalizationsforasthmaper
10,000residents
10,000residents
2010
3.2
5.7
8.6
Asthma:senior
hospitalizations
Ageadjustedrateofadults65+
hospitalizationsforasthma
10,000residents
2010
19.3
20.7
20.3
COPDprevalence
%ofadultseverdiagnosedwith
COPD
adults
COPDhospitalizations
HospitaldischargesduetoCOPD
rawnumber(age
adjustedrateN/F)
OSHPD190192
2010
Ageadusted
rateN/F
adults
Page59
OSHPD;Citedby
CABreathing
SCCAsthma
Profile
OSHPD;Cited
California
BreathingSCC
AsthmaProfile
OSHPD;Cited
California
BreathingSCC
AsthmaProfile
OSHPD;Cited
California
BreathingSCC
AsthmaProfile
OralHealth
Need
SCCDatasource
SCCData
Year
SCCData
Numberofgeneralpractice
dentistofficesinthecountywho
acceptDentiCal
Denticalwebsite
2013
102
N/A
Dentaldecay(adult)
%adultswithtoothlossdueto
gumproblemsortoothdecay
adults
SCCBRFS;Cited
bySCCHealth
Profile
2009
33%
%ofchildrenwithcaries
%ofelem.kidsthathavea
historyoftoothdecay
"elementaryschool
children"
HealthTrustOral
HealthStatus2001
NeedsAsst;Citedby
SCCHealthProfile
2001
50%(D)
49%
CHKS,20072008;
CitedbySCCHealth
Profile
200708
80%(D)
adults
SCCBRFS;Citedby
SCCHealthProfile
2009
26%
ShortDescription
Detailedindicator
DentistsinSCCwhoaccept
MediCal(TBD)
Schoolabsencedueto
dentalissues
Dentistutilization(children)
Dentistutilization(adult)
Diabetes
Emergencydentalvisits
Obesity
Need
%ofchildrenwhohavemissed
schoolduetodentalissues
%ofmiddleandhighschool
studentswhovisitedthedentist
inthepast12months
%adultswhodidNOTgotothe
dentistinthelastyear
NumberofERvisitsperyeardue
todentalproblems
Population/
Denominator
CA
Data
Nat'l
Benchmark
Diabetesprevalence
(children)
%ofadultswhowereage010
whendiagnosedwithdiabetes
adults
SCCBRFS;Data
tablesprovidedby
SCCPHD
2009
4%
Diabetesprevalence(adult)
%adultswhohavediabetes
adults20+
SCCBRFS;Citedby
SCCHealthProfile
2009
8%
>8%
US8%(ADA
'07)
Diabeteshospitalization
(child)
Diabeteshospitalizations(child)
OSPHD
Diabeteshospitalization
(adult)
Diabeteshospitalizations(adult)
OSPHD
ShortDescription
Detailedindicator
Population/
Denominator
SCCDatasource
SCCData
Year
SCCData
Obesity(youngchildren)
%ofkids25yearsold
consideredoverweight(85
95th%)
kids05years
CDCPEDSTable
6B
(Growth/Anemia
200709
16%
Page60
CA
Data
16%
Nat'l
Benchmark
10%
byCounty)
Obesity(youngchildren)
Overweightorobese(5th
gradeyouth)
gradeyouth)
gradeyouth)
%ofkids25yearsold
consideredobese(>=95th%)
%ofstudentsin5thgrade in
"NeedsImprovement"or"At
Risk"zone
%ofstudentsin 7thgrade in
Risk"zone
%ofstudentsin 9thgrade in
Risk"zone
kids25years
CDCPEDSTable
6B
(Growth/Anemia
byCounty)
200709
17%
17%
10%
5thgraders
CDEFitnessgram
(BMI)
201112
42%
48%
611yrs:15.7%
7thgraders
CDEFitnessgram
(BMI)
201112
39%
45%
9thgraders
CDEFitnessgram
(BMI)
201112
35%
41%
200708
10%
1219yrs:
16.1%
2009
55%
60%
2009
18%
23%
31%
Obesity(youth)
%MS/HSstudentsconsidered
obese
5th/7th/9thgraders
Overweight/Obese(adult)
%adultsconsideredoverweight
orobese(BMI>25)
adults
Obesity(adult)
%adultsconsideredobese
adults
CHKS0708;
overallrateby
SCCHealth
Profile
SCCBRFS;Cited
bySCCHealth
Profile
SCCBRFS;Cited
bySCCHealth
Profile
Population/
Denominator
ShortDescription
Detailedindicator
Highbirthweight
%infantsbornathigh
birthweight(>4000grams)
livebirths
Babieslowbirthweight
%babiesbornlessthan
2,500grams(5.5pounds)
livebirths
Birth
Need
SCCDatasource
CDCPEDSTable
6B
(Growth/Anemia
byCounty)
Overall:CDPH,
2010Vital
StatisticsTable
220;Byrace:
KidsData
Page61
CA
Data
Nat'l
Benchmark
SCCDataYear
SCCData
200709
8%
8%
2010
7%
7%
8%
Motherswithprenatal
care
%infantswhosemothers
received1sttrimester
prenatalcare
livebirths
CDPHVitalStats
2010
85%
84%
78%
Infantmortalityrate
Deathsofinfantsunder1
year
rawnumber(age
adustedrateN/F)
Overall:CDPH
VitalStatistics;
BySCCEthn:
Table413
2010
Calculated
rateN/F
4.7
Detailedindicator
Population/
Denominator
SCCDatasource
CA
Data
Nat'l
Benchmark
TB
Need ShortDescription
SCCPHDTBInfo
MgmtSystem
20002009;CA
Reportable
Disease
Information
Exchange,2010;
eHARS 2011;
analyzedbySCC
PHD
TBinfections
TBcaserateper100,000
100,000people
HIVscreenings
%ofadultsscreenedforHIV
adults
HIVincidencerate
NewHIVinfections
100,000people
Chlamydiaincidencerate
(female)
(male)
female
male
Chlamydiaincidence(cases) rawnumber(age
allages&genders
adustedrateN/F)
SCCDataYear
SCCData
2010
10.8
6.0
17%
2011
10.3
Ratenotcalc
SexuallyTransmittedDiseases
(youth)
Gonorrheaincidencerate
(youth)
Syphilisincidencerate
Chlamydiaincidence(cases)
youth1524
Gonorrheaincidence(cases)
allages&genders
Gonorrheaincidence(cases)
youth1524
Primary/secondarysyphilis
incidence(cases)allages&
100,000females
2011
430.9
569.9
100,000males
2011
169.1
257.8
CDPHSTDCprelim
datathru8/07/12;
DOFRace/EthnicPop
ProjectionsJul'07
2011
31150%
438
2011
2011
2011
2011
rawnumber(age
adustedrateN/F)
rawnumber(age
adustedrateN/F)
rawnumber(age
adustedrateN/F)
rawnumber(age
adustedrateN/F)
Page62
AgespecificrateN/F
3550%
73.1
AgespecificrateN/F
380%
6.5
genders
UnintentionalFalls
Alzheimer'sDisease
Alzheimer'sprevalence
Alzheimer'sprevalence
Alzheimer's
hospitalizations
Detailedindicator
numberadults55+withAlz
Rateofolderadults
diagnosedwithAlzheimer's
Ageadjustedrateof
Alzheimer'shospitalizations
Alzheimer'smortality
AgeadjustedAlzheimer's
mortalityrate
Fatal,unintentionalfalls
olderadults6584
Fatal,unintentionalfalls
85+
Rateoffatal,unintentional
fallsage6584
Rateoffatal,unintentional
fallsage85+
Nonfatalfalls
hospitalizations
Rateofnonfatalhospitalized
fallinjuries
Population/
Denominator
SCCDatasource
SCCDataYear
SCCData
adults55+
AlzheimersDisease;
FactsandFiguresin
California:Current
StatusandFuture
Projections,Alz
Assoc,CACouncil,
Feb2009
2008
27,658
588,208
adults55+
100,000population
N/FOSHPD
100,000population
AlzheimersDisease;
FactsandFiguresin
California:Current
StatusandFuture
Projections,Alz
Assoc,CACouncil,
Feb2009
200305
20.8
22.1
100,000adults6584
CADPHEpicenter
2010
26.6
21.7
100,000adults85+
CADPHEpicenter
2010
268.8
148.5
2011
292.4
370.4
100,000adults18+
CDPHEPIcenter"top
5causesofinjury"
query;CADOF
Estimates20002010
updated11/2012
CA
Data
Nat'l
Benchmark
Nonfatalfalls
hospitalizations6584
Nonfatalfalls
hospitalizations85+
Rateofhospitalizationsdue
tofallsforolderadultsage
6584
Rateofhospitalizationsdue
tofallsforolderadultsage
85+
100,000adults6584
2011
1,015
1167.0
100,000adults85+
2011
4,527
5087.0
Page63
Detailedindicator
Population/
Denominator
SCCDatasource
Recentdomesticviolence
%adultswhoexperiencedphysical
orsexualviolencebyintimate
partnerinpastyear
allgendersage1865
Recentdomesticviolence
%adultwomenwhoexperienced
physicalorsexualviolenceby
intimatepartnerinpastyear
Domesticviolencehelp
police
Violence
CA
Data
Nat'l
Benchmark
SCCDataYear
SCCData
CHIS
2009
1.7%
3.5%
femalesage1865
CHIS
2009
2.3%
4.0%
Numbercallstolawenforcement
fordomesticviolencerelated
assistance
allgendersandages
CADOJCriminal
ProfilesTable14
2010
4738
Domesticviolencehelp
CBOs
Numbercallstocommunitybased
agenciesfordomesticviolence
relatedassistance
allgendersandages
Physicalbullying(youth)
%MS/HSStudentsWhoReported
BeingPhysicallyBulliedonschool
propertyinthelast12months
7th,9th,and11thgraders
CHKSA6.2bygrade;
OverallcitedbySCC
Violencereport
200910
28%
18%
Psychologicalbullying
(youth)
%ofyouthreportingbeing
psychologicallybulliedonschool
propertyinlast12months
CHKSA6.2bygrade;
OverallcitedbySCC
Violencereport
200910
44%
18%
Gangmembership(youth)
%ofMS/HSstudentswhocurrently
considerthemselvesagangmember
CHKSp.42Table
A.62bygrade;
overallcitedbySCC
Violencereportp.19
200910
7%
Violentcrime(youth)
Juvenilefelonyarrestratefor
violentoffenses
100,0001017years
CDJ,CriminalJustice
ProfileTable3C
2010
253.2
294.9
AdultFelonyArrestRateforViolent
Offenses
100,000adults
CDJ,CriminalJustice
Profile
2010
287.8
394.2
Homicide(youth)
Homiciderateyouth
100,0001524yrs
CDPHVitalStats;
citedbyRDA
2009
7.4
10.8age18
29
Homicide(adults)
Homiciderateoverall
100,000adults
2010
1.3
5.5
Childabuse
Rateofsubstantiated
allegationsofchild
maltreatment
1,000children/youth020
yrs
2011
4.3
9.6
8.5
Violentcrime(adult)
CAOAGCrimesand
CrimeRates2001
2010(Table1)
CADeptSocSvc/UC
BerkeleyCtrforSoc
SvcResearch;CA
DeptFin20002010
Page64
MentalHealth
Mentalhealthproblems
(adult)
Mentalhealthproblems
(youth)
%ofadultsreportingpoor
mentalhealthinlast30days
%ofMS/HSstudentswho
feltsadorhopelessalmost
everydayfor2weeksor
moreinthepast12months.
Population/
Denominator
SCCDatasource
SCCDataYear
SCCData
CA
Data
Nat'l
Benchmark
adults
SCCBRFS2009;Cited
bySCCHealthProfile
2009
33%
7th,9th,and11th
graders
CHKSMentalHealth
Module;citedbySCC
Vietreport
200910
28%
28%7th
gradersN/A
overall
Suicideattempts(adult)
Nonfatalselfinflictedinjury
hospitalizationsadults20+
rawnumber
CADPHEpicenter
InjuryDataSummary
byCauseandAge
2011
AgespecificrateN/F
Suiciderate(adults)
Suicides(adults20years+)
rawnumber
CADPHEpicenter
2010
AgespecificrateN/F
Suicideattempts(youth)
Nonfatalselfinflictedinjury
hospitalizationsyouth15
19
rawnumber
CADPHEpicenter
InjuryDataSummary
byCauseandAge
2011
AgespecificrateN/F
Suicide(youth)
Suicides(youthage1519)
rawnumber
CADPHEpicenter
2010
AgespecificrateN/F
CHKSA5.3;;Citedby
SCCHealthProfile
adults
Smoking(youth)
SubstanceAbuse
Detailedindicator
Smoking(adults)
Bingedrinking(youth)
Bingedrinking(adults)
Marijuanause(youth)
Druguse(adult)
%MS/HSkidssmoked
cigaretteslast30d
%ofadultswhoarecurrent
smokers
%ofMS/HSbingedrinking
last30days
%ofadultsbingedrinking
last30days
%usedmarijuanaatleast
oncepast30d
%adultsuseddrugspast12
months
200910
8%
16%
SCCBRFS;Citedby
SCCHealthProfile
2009
10%
12%
CHKSA4.7;Citedby
SCCVietProfile
200910
8%
9%
adults
SCCBRFS;Citedby
SCCHealthProfile
2009
25%
16%
24%
CHKSA4.3;;Citedby
SCCHealthProfile
200910
12%
11%
6%
adults
SCCBRFS2009;Cited
bySCCHealthProfile
2009
8%
7%
Dataisredisstatisticallyunstableandshouldbeinterpretedwithcaution.
D=Developmental
Adultis18+unlessotherwisespecified
NationalBenchmarkisHealthyPeople2020unlessotherwisespecified.
Page65
SantaClaraCountyHealthNeedProfileSpecialSection
AccesstoHealthCare
In2012,theSantaClaraCountyCommunityBenefitCoalitionconductedacountywideassessmentofhealth
needs.Basedonthisscanofquantitativeandqualitativedata,AccesstoHealthCarewasprioritizedasoneofthe
13tophealthneedsinthecounty.Thiscategoryincludedinsurance,education,andpoverty.
Thestatusofhealthaccessisdescribedinthisprofile,intermsof:
Keyindicators
Geographicregionsorsubpopulationsinwhichtheneedisgreatest
Communityinput
Assetswithinthecommunitythatcanmakeadifference
StatusofKeyIndicators,2012
ThetableofindicatorsbelowincludesSantaClaraCountydatathatcanbecomparedtostatewide(CA)dataand
HealthyPeople2020(HP2020)indicatorswhereavailable.
Indicator
Santa
Clara
County
CA
US
22%
20%
9%
U.S.CensusBureau,2006
2010AmericanCommunity
8%
10%
7%
U.S.BureauofLaborStatistics,
July,2012LocalArea
UnemploymentStatistics
11%
18%
15%
13%
18%
16%
Linguisticallyisolatedpopulation
%aged5andolderwhospeaka
languageotherthanEnglishat
homeandspeakEnglishlessthan
"verywell"
Unemployment
%oftheciviliannon
institutionalizedpopulationage16
andolderthatisunemployed
(nonseasonallyadjusted)
Insurance
Uninsured
%ofthetotalciviliannon
institutionalizedpopulation
withouthealthinsurancecoverage
Medicaidrecipients
%ofthepopulationthatis
enrolledinMedicaid
HP2020
DataSource
Benchmark
Page1
AccesstoHealthCare
Indicator
Santa
Clara
County
CA
US
Education
14%
19%
15%
Educationalattainment
%ofthepopulationaged25and
olderwithoutahighschool
diploma(orequivalency)orhigher
HP2020
DataSource
Benchmark
Highschoolgraduationrate
averagefreshmangraduationrate
(basedon%ofstudentsreceiving
theirhighschooldiplomawithin
fouryears)
82%
82%
82%
TheUniversityofWisconsin,
PopulationHealthInstitute,
CountyHealthRankings,2012;
theU.S.Departmentof
Education,NationalCenterfor
EducationStatistics(NCES),
CommonCoreofData,Public
SchoolUniverseSurveyData,
200506,200607and2007
08,andNCESLocalEducation
Agency(SchoolDistrict)
UniverseSurveyDropoutand
CompletionData,20082009
Grade4readingproficiency
%ofchildreningrade4whose
readingskillstestedatorabove
the"proficient"levelfortheCST
EnglishLanguageArtsportionof
theCaliforniaSTARtest
64%
71%
64%
States'Departmentof
Education,StudentTesting
Reports,2011
9%
14%
14%
11%
19%
19%
21%
33%
32%
Poverty
Populationbelow100%FPL
%ofthepopulationlivingbelow
100%oftheFederalPovertyLevel
(FPL)
Childrenbelow100%FPL
%ofchildrenaged017living
below100%oftheFederalPoverty
Level(FPL)
Populationbelow200%FPL
%ofthepopulationlivingbelow
200%oftheFederalPovertyLevel
(FPL)
Free/reducedlunch
%ofpublicschoolstudentseligible
forfreeorreducedpricelunches
37%
54%
48%
U.S.DepartmentofEducation,
NationalCenterforEducation
Statistics(NCES),Common
CoreofData,PublicSchool
UniverseFile,20102011
SNAPrecipients
%ofthepopulationreceivingthe
SupplementalNutritionAssistance
Program(SNAP)benefits
5%
8%
13%
U.S.CensusBureau,Small
AreaIncomeandPoverty
Estimates(SAIPE),2009
Note:AllstatisticsinthistablefromCARESPlatform.
Redfontindicatesthatanindicatorfailstomeetabenchmarkorisworsethanthestateaverage.
Page2
AccesstoHealthCare
GeographicAreasofGreatestNeed
Linguisticisolationisworseinsomeareasofthecountythaninothers,asdisplayedinthemapoflinguistically
isolatedpopulationsbelow.EastSanJoseistheworstoff,whereupto45%ofarearesidentsarelinguistically
isolated.InpartsofGilroy,SantaClara,Sunnyvale,andSanJose,over30%ofresidentsexperiencelinguistic
isolation.
Page3
AccesstoHealthCare
Educationalattainmentisalsoworseinsomeareasofthecountythaninothers,asdisplayedinthemapof
populationswithoutahighschooldiplomabelow.CentralSanJoseistheworstoff,whereover56%ofresidents
havenotearnedahighschooldiploma.InotherpartsofSanJoseandGilroy,over40%ofresidentshavelow
educationalattainment.
CommunityInput
Thehealthneedsassessmentprocesswouldbeincompletewithoutcommunityinputaboutthehealthneed.Key
informantinterviewswereconductedwithlocalhealthexperts,aswellasfocusgroupswithcommunityleaders,
representatives,andresidents.Themesfromdiscussionsregardingthehealthneedareidentifiedbelow.
Povertyhasanegativeimpactonhealthinthatindividualscannotaffordthecostofclinicalcare,copays
andmedication,andcannotaffordhealthyfoodsandactivities.
Lackoforalhealthandmentalhealthinsurancecoverage,andhealthinsurancefortheundocumented,all
impacttheabilityofindividualstoaccessneededhealthcare,andpreventativecareinparticular.
Similarly,beingunderinsuredhasanimpactonaccess(notallservicesarecovered,includingpreventative
careorscreening,certainmedicationsandtreatments).
Page4
AccesstoHealthCare
Waittimesfordoctorappointments(evenforsevereconditions)andlackoffollowupbycliniciansresult
inoveruseofurgentcare/emergencyroomwhenconditionsworsen.Healthcareleadersexpressedalack
ofgeneralandspecialtycarepractitioners.
Lackoftransportationimpactsthecommunity,especiallywhenitcomestopreventativecare(suchas
frequentvisitsfordiabetescheckups).Italsoimpactstheabilitytogettogrocerystoreswithfreshfoods,
andcarrygrocerieshome.Publictransportationcanalsobedifficultforfamilieswithsmallchildren.
Linguisticisolation:Patientswhodonotunderstandthemedicalconditionsordirectionsforcompliance
mayexperiencenegativeoutcomes.Also,thosewhodonotspeakEnglishmayperceivethatpractitioners
donotunderstandthemortheircultureandthereforemaytrustthemless.
Povertyandunemploymentarecausingstressforyouthandadults,andthusaremajordriversofpoor
healthoverall,andpoormentalhealthinparticular.
Lackofknowledge/awarenessofhealthconditions,theircauses,symptoms,andtreatments,cankeep
individualsfromaccessingneededcare.
Stigma,whichisexperiencedacrossallpopulations,preventspeoplefromseekingtreatmentdueto
embarrassment,shame,orfear,andcausesstress.Stigmacanresultinlessenedsocialsupportand
increasedsocialisolation.
AssetstoAddresstheNeed
TheSantaClaraCountyCommunityBenefitCoalitionmembersandarepresentativefromtheSantaClaraCounty
PublicHealthDepartmentwereconsultedtoidentifyexistinginternalandcommunityassetsthatcouldbe
accessedtoaddressthehealthneed.Theseinclude:
OConnorHospital:
o
Charitycare
HealthBenefitsResourceCenterprovidesinsuranceandCalFreshenrollmentassistanceand
referralsforsocialservicestoloveincome,underinsuredoruninsuredindividuals
FamilyMedicineResidencyProgramtrainsresidentstocareforunderservedpopulations
o
AsianAmericanforCommunityInvolvement
IndianHealthCenterofSantaClaraCounty
MayViewCommunityHealth
SanJoseFoothillHealthCenter
ElCaminoHospital
First5SantaClaraCounty
Page5
AccesstoHealthCare
HealthInsuranceCompanies(BlueCross,Atena,etc.)
HospitalCouncilofNorthern&CentralCalifornia
KaiserPermanente
NurseFamilyPartnershipinSantaClaraCounty
SantaClaraFamilyHealthPlan
TRANSPORTATIONSERVICES:
Avenidas
CalTrain
CityTeamMinistries
CommunityServicesAgency
LoveInc.
Outreach&Escort,Inc.
SantaClaraValleyTransitAuthority(VTA)
HOUSINGSERVICES:
BillWilsonCenter
CasadeClara
CommunitySolutions
EHCLifeBuilders
HousingAuthorityoftheCountyofSantaClara
InnVisiontheWayHome
SantaClaraCountySocialServicesAgency
SacredHeartCommunityServices
Summary
AccesstohealthcareisahealthneedinSantaClaraCountyasmarkedbytheproportionofthecommunitywho
arelinguisticallyisolated.Inaddition,thereareareaswithloweducationalattainment,whichalsoimpactshealth
outcomes.Thecommunityinputindicatesthatunderinsuranceandlackofinsurancecoverageisanissue.Lackof
transportationisalsoanaccessbarrierthataffectsthoseinpoverty.Stigmaandlackofknowledgebothimpactthe
seekingofpreventativecareortreatment.Also,toofewgeneralandspecialtypractitioners,especiallyin
communityclinics,resultsinlongwaittimesforappointments.Theseissuesaroundlackofaccesscontributeto
Page6
AccesstoHealthCare
communitymembersusingurgentcareandemergencyroomsfortreatmentofconditionsthathaveworseneddue
tolackoftreatmentorpreventativecare.
Page7
SantaClaraCountyHealthNeedProfile
AlzheimersDisease
needs.Basedonthisscanofquantitativeandqualitativedata,Alzheimersdiseasewasprioritizedasoneofthe13
tophealthneedsinthecounty.
ThestatusofAlzheimersdiseaseisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Thetableofindicatorsbelowincludeslocaldatathatcanbecomparedtostatewide(CA)dataandHealthyPeople
2020(HP2020)indicatorswhereavailable.
Santa
Clara
County
CA
DataSource
2008estimate
27,658
588,208
2015estimate
32,988
678,446
IncreaseinAlzheimersprevalence
Estimated%increaseinpeople55+livingwith
Alzheimers20082015
19%
15%
Alzheimersmortality
Ageadjusteddeathrateper100,000population
20.8
23.4
Alzheimers
Disease;Factsand
FiguresinCalifornia:
CurrentStatusand
FutureProjections,
AlzheimersAssoc.,
CA;2009
Basedonpublished
prevalencerates
(2003and2006)and
CADepartmentof
FinanceRace/Ethnic
PopulationwithAge
andSexDetail,2000
2050;2007
AlzheimersDisease;
FactsandFiguresin
California:Current
StatusandFuture
Projections,
AlzheimersAssoc.,
CA(200305data)
Indicator
EstimatedAlzheimersprevalence
Estimatednumberofadults55+withAlzheimers
Note:Sta s csfromCARESPlatform.
Page1
AlzheimersDisease
AdditionalData:
In2010,AlzheimersdiseasewasthethirdleadingcauseofdeathinSantaClaraCounty,andthefifth
leadingcauseinCalifornia.(TenLeadingCausesofDeath;CaliforniaCountiesandSelectedCityHealth
Departments,CaliforniaDepartmentofPublicHealth,2010).
TheAlzheimersAssociationestimatesthatthenumberofthosediagnosedwithAlzheimersdiseasein
Californiawilldoubletoover1.1millionbytheyear2030.(AlzheimersDisease;FactsandFiguresin
California:CurrentStatusandFutureProjections,AlzheimersAssociationofNorthernCalifornia).
SUBPOPULATIONSEXPERIENCINGTHEGREATESTIMPACT:
The2005ageadjustedAlzheimersmortalityratesforAfricanAmericansandCaucasiansweretheworst
(27.3and27.8,respectively)whencomparedwithotherethnicgroups,andworsethantheoverall
Californiarateof23.4deathsper100,000.
CommunityInput
Alzheimersordementiawasmentionedin4outof25groups/interviews.
Thelackofgerontologistsandrelatedspecialistswasmentionedseveraltimes.
Issuesoflocation(isolation)andrelatedlackoftransportationweredescribedascombiningtoexacerbate
theimpactofAlzheimers.
Concernsaboutcaregivers(burnout,lackofknowledge/healtheducation,lackofawarenessofsupportive
servicessuchasrespite)surfacedseveraltimes.
Lackofcoordinationofcareandconcernsaboutcaretransitionswereofparticularconcernforpatients
withAlzheimers.
Costs(ofhealthcare,activities,freshfood)makealargerdentinthebudgetsofolderindividualswhoare
onafixedincomethanthosewhoarenotonafixedincome.
Issueswithmedicationmanagement
Relativelackofservices;needforprogramstopartnerformoreeffective/efficientprovisionofservices
Relativelackofgovernmentalsupport/funding
Seedataregardingadditionalcrosscuttingdriversinfluencingthishealthneed(suchaspovertyandlackofhealth
insurancecoverage)intheAccesstoHealthCareprofilereport.
Page2
AlzheimersDisease
AlzheimersAssociation
Avenidas
CatholicCharitiesofSantaClaraCounty
CouncilonAgingSiliconValley
TheHealthTrust
Respite&ResearchforAlzheimersDisease
Stanford/VeteransAdministrationAlzheimersResearchCenter
Summary
AlzheimersdiseaseisahealthneedinSantaClaraCountyasmarkedbyAlzheimersdiseasebeingthethird
leadingcauseofdeath.ItisthefastestgrowingcauseofdeathinCaliforniaandthenumberofpeoplelivingwith
Alzheimersdiseaseisalsogrowingrapidly.Communityinputsuggeststhattheimpactoncaregiverswhohavefew
resources(especiallyfortransportation)willaffectqualityoflifeforthoselivingwithAlzheimers.Qualitative
researchalsosuggeststhatthereisalackofgerontologistsandthosewhocanhelpcoordinatecare.
Page3
BirthOutcomes
needs.Basedonthisscanofquantitativeandqualitativedata,birthoutcomeswereprioritizedasoneofthe13
tophealthneedsinthecounty.
Thestatusofbirthoutcomeneedsisdescribedinthisprofile,intermsof:
Keyindicators
Keydriversorfactorsaffectingthecondition
Communityinput
Indicator
Lowbirthweight
%ofbabiesbornwithlow
birthweight:lessthan
2,500grams(5.5pounds)
SantaClara
County
CA
HP2020
Benchmark
US
7%
7%
8%
White
6%
AfricanAmerican
10%
Latino
6%
Asian/PacificIslander
8%
Multiracial
7%
2.8
(66deaths)
4.7
6.71
6.0
White
0.71
AfricanAmerican
0.13
Latino
1.13
0.75
Multiracial
0.04
Infantmortality
Infantmortalityrateper
1,000livebirths
Note:Sizeofnistoosmalltorelyupon.Sta s csfromCARESPlatform.
Page1
DataSource
CDPHVital
Statistics
Table220,
2010
CDPHBirth
FilesCDC
Natality,
2010;
WONDER
database
CDPHVital
Statistics,
2010
BirthOutcomes
Thecountyspercentageoflowbirthweightbabiesisnobetterthanthestateaverage,thoughitislower
thanthenationalbenchmark.
AfricanAmericanshavethehighestpretermbirthrate(15%)comparedwithotherethnicgroups(Santa
ClaraCountyPublicHealthDepartment,HealthProfileReport,2010).
AfricanAmericanshavethehighestratesoflowbirthweightbabies(10%)comparedwithotherethnic
groups.
FactorsInfluencingtheHealthNeed
Fullunderstandingofthehealthneedrequiresareviewofotherelementsthatcanhaveanimpactonit,suchas
individualsbehaviors,socioeconomicfactors,thephysicalenvironment,ortheprovisionofpreventativecareor
earlyintervention.Suchfactorsrelevanttothishealthneedareidentifiedinthetablebelow.
Category
Santa
Clara
County
CA
HP2020
Benchmark
%infantswhosemothers
receivedfirsttrimester
prenatalcare
85%
84%
78%
White
AfricanAmerican
Latino
NativeAmerican
Multiracial
92%
80%
79%
89%
73%
81%
Driver/indicator
DataSource
Prenatalcare
Clinicalcare
CDPHVital
Statistics,
2010;
KidsData
Sta s csfromCARESPlatform.
ThepercentageofNativeAmericanwomenreceivingearlyprenatalcarewasthelowestcomparedwithother
ethnicgroups,andfailstomeetthebenchmark.NotethatpercentagesofAfricanAmerican,Latino,andmulti
ethnicwomenreceivingearlyprenatalcarealsofallbelowthestateaverage,thoughtheydomeetthebenchmark.
Seedataregardingadditionalcrosscuttingdriversinfluencingthishealthneed,suchaspovertyorlackofhealth
insurance,intheAccesstoHealthCareprofilereport.
CommunityInput
representativesandresidents.Themesfromdiscussionsregardingthehealthneedareidentifiedbelow.
Poorbirthoutcomeswerementionedin2outof25groups/interviews.
Page2
BirthOutcomes
Itwasofconcernthatmotherswhoarelowincome,unemployed,orlivinginpovertyaremuchmore
likelytohavepoorbirthoutcomesthanmotherswhoarenot.
Concernsaboutlimitedprenatalvisitssurfaced,potentiallydrivenbylackofknowledgeofthe
importance,bylanguagebarriers,culturalissuessuchasbodymodesty,orbythecostofcare.
Accesstoandcostoffreshfoodandofactivitiesaroseinthinkingaboutpregnantmothersoverallhealth.
Relativelackofparentingsupportserviceswasofconcern.
AmericanCancerSociety
MarchofDimes
Summary
BirthoutcomesareahealthneedinSantaClaraCounty,asmarkedbythepercentageoflowbirthweightbabies,
whichisnobetterthanthestateaverage(thoughbelowtheHP2020benchmark).AfricanAmericansare
disproportionatelyaffected,withthepercentageofAfricanAmericanbabiesoflowbirthweighthigherthanthe
stateaverageandHP2020benchmark.Whileinfantmortalityisnotaconcerncountywide,itispossiblethat
somesubgroups(e.g.,AfricanAmericaninfants)aredisproportionatelyaffected;however,thedataaretoosparse
torelyupon.Thehealthneedislikelybeingimpactedbycertainsocialdeterminantsofhealth,andbythe
percentageofwomenreceivingearlyprenatalcare.Whilethisisnotanissueonthecountywidelevel,a
disproportionatelysmallerpercentageofNativeAmericanwomenreceiveearlyprenatalcareincomparisonto
otherethnicgroups.Communityfeedbackindicatesthatthehealthneedisaffectedbyconcernsaboutthecostof
care,andpooraccesstoprimarycareprovidersandspecialistsduetolackofinsurance,particularlyamonglow
incomeresidents.Inaddition,communityinputsuggestedthatlimitedprenatalvisitsmaybedrivenbylackof
knowledgeoftheimportanceofprenatalcare,languagebarriersbetweenpatientsandspecialists,culturalissues
suchasbodymodesty,aswellasthecostofcare.
Page3
Santa Clara County Health Need Profile
Cancers
In 2012, the Santa Clara County Community Benefit Coalition conducted a county-wide assessment of health
needs. Based on this scan of quantitative and qualitative data, cancers were prioritized as one of the 13 top health
needs in the county. This category included breast cancer, cervical cancer, colorectal cancer, liver cancer, lung
cancer, prostate cancer, and all cancers.
The status of cancer needs is described in this profile, in terms of:
Key indicators
Key drivers or factors affecting the condition
Community input
Assets within the community that can make a difference
Status of Key Indicators, 2012

The table of indicators below includes Santa Clara County data that can be compared to statewide (CA) data and
Healthy People 2020 (HP 2020) indicators where available.
Indicator
Santa Clara
County
CA
US
HP2020
Target
137.6
158.3
--
160.6
CA Cancer
Registry 2009
154.1
122
--
CA Cancer
Registry 2009
Data Source
All Cancers
Mortality
Age-adjusted mortality rate due to all
types of cancer per 100,000 people
White
151.8
African American
219.2
Latino
121.2
Asian/Pacific Islander
110.0
Breast Cancer
Incidence (New Cases)
Age-adjusted breast cancer incidence
rate per 100,000 females
161.4
White
190.0
African American
143.9
Latino
116.9
134.6
Page 1
Cancers
Indicator
Breast Cancer Mortality
Age-adjusted mortality per 100,000
females
Santa Clara
County
CA
US
HP2020
Target
20.0
22.2
--
20.6
CA Cancer
Registry 2009
7.8
7.1
CA Cancer
Registry 2009
1.41
2.31
--
2.2
CA Cancer
Registry 2007-09
40.9
43.2
40.2
45.4
CA Cancer
Registry 2009
14.5
--
14.5
CA Cancer
Registry 2009
8.6
--
--
CA Cancer
Registry 2009
White
22.8
Latino
14.9
17.4
Data Source
Cervical Cancer
Age-adjusted incidence per 100,000
females
White
African American
7.2
5.8
0
Latino
8.8
9.2
Mortality
3-year age-adjusted mortality rate per
100,000 females
Colorectal Cancer
White
42.7
African American
44.7
Latino
37.3
39.0
Mortality
13.9
White
13.3
Latino
15.5
12.2
Liver Cancer
10.9
White
6.2
Latino
17.5
17.1
Page 2
Cancers
Indicator
Liver Cancer Mortality
Santa Clara
County
CA
US
HP2020
Target
6.8
5.6
--
--
CA Cancer
Registry 2009
50.6
67.2
--
CA Cancer
Registry 2009
37.8
--
45.5
CA Cancer
Registry 2009
131.0
151.4
--
CA Cancer
Registry 2009
22.4
--
21.2
CA Cancer
Registry 2009
White
3.6
Latino
9.0
11.9
Data Source
Lung Cancer
Age-adjusted lung cancer incidence
rates per 100,000 adults
41.8
White
46.4
African American
68.9
Latino
26.7
31.3
Lung Cancer Mortality

Age-adjusted lung mortality per
100,000 adult
28.2
White
32.6
Latino
19.1
23.0
Prostate Cancer
Age-adjusted prostate cancer
incidence rates per 100,000 men
145.9
White
170.8
African American
222.0
Latino
118.3
101.7
Mortality
Age-adjusted mortality rate of men
due to prostate cancer per 100,000
males
15.8
White
19.4
10.5
Note: Statistics from CARES Platform.

Data in red indicates that it fails to meet a benchmark or is worse than the state average.
Page 3
Cancers
In Santa Clara County, the following indicators are failing to meet overall benchmarks (or state averages, if no
benchmarks are available):
Breast cancer incidence rate
Cervical cancer incidence rate
Liver cancer incidence rate
Liver cancer mortality rate
Prostate cancer incidence rate
Factors Influencing the Health Need

Full understanding of the health need requires a review of other elements that can have an impact on it, such as
individuals behaviors, socioeconomic factors, the physical environment, or the provision of preventative care or
early intervention. Such factors relevant to this health need are identified in the table below.
Category
Driver/indicator
Behaviors
Colorectal, Liver, Lung

& Prostate Cancers
Inadequate
fruit/vegetable
consumption (adults)
% of adults aged 18 and
older who self-report
consuming less than 5
servings of fruits and
vegetables each day
Adequate
fruit/vegetable
consumption (youth)
% of children aged 2 and
older who are reported
to consume 5 or more
servings of fruits and
vegetables each day
Santa
Clara
County
CA
HP 2020
Benchmark
70%
70%
47%
Page 4
48%
Data Source
CDC BRFSS
2003-2009
California
Health
Interview
Survey
(CHIS), 2009
Cancers
Category
Driver/indicator
Breast Cancer Screening

% of females ages 50-74
who had a mammogram
in the past 2 years
Clinical Care
Cervical Cancer
Screening
% of females ages 21 65 who had Pap test in
past 3 years
Colorectal Cancer
Screening
% of adults age 50+ who
ever had sigmoidoscopy
or colonoscopy exam
Prostate Cancer
Screening
% of men age 50+ who
ever had a prostatespecific antigen test
Santa
Clara
County
CA
HP 2020
Benchmark
Data Source
62%
59%
81%
Dartmouth
Atlas of
Healthcare,
Selected
Measures of
Primary Care
Access and
Quality,
2003-2007
91%
90%
93%
CDC BRFSS
2004-2010
62%
52%
71%
CDC BRFSS
2004-2010
72%
--
--
SCC PHD
BRFS 2009
Note: * Statistic is unstable and should be used with caution.

Statistics from CARES data platform.
Data in red indicates that it fails to meet a benchmark or is worse than the state average.
Additional Data:
Countywide, the percentage of adults consuming inadequate servings of fruits/vegetables (a contributing

factor in colorectal, liver, lung, and prostate cancers) is no better than the state average.
See data regarding additional cross-cutting drivers such as lack of health insurance in the Access to Health Care
profile report.
SUBPOPULATIONS EXPERIENCING THE GREATEST IMPACT:
Mortality (overall): Overall, Santa Clara County mortality rates due to cancer are lower than that of the
state, and meet benchmarks. However, the rate for African Americans is highest among any ethnicity, and
misses the benchmark.
Page 5
Cancers
With regard to breast cancer:

-
With regard to cervical cancer:

-
Latinos and Asian/Pacific Islanders have the highest incidence and mortality rates compared with
other ethnic groups, and their rates are higher than the state and national averages for these
indicators.
With regard to lung cancer

-
Latinos have the highest mortality rate compared with other ethnic groups, and their rate is too high
compared to the state average and Healthy People 2020 benchmark for this indicator.
With regard to liver cancer:

-
Latina and Asian/Pacific Islander women have the highest incidence rates compared with other ethnic
groups, and their rates are too high compared to the state average and Healthy People 2020
benchmark for this indicator.
With regard to colorectal cancer:

-
White women have the highest incidence and mortality rates compared with other ethnic groups,
and their rate is higher than the statewide average and Healthy People 2020 benchmark for these
indicators.
African Americans have the highest incidence rates compared with other ethnic groups, and their
rate is higher than the county, state and national averages for this indicator.
Key informants expressed concern that smoking rates are not dropping among youth.
With regard to prostate cancer:

-
White and African American men have the highest incidence rates compared with other ethnic
groups, with African Americans by far the highest, and the rates for both Whites and African
Americans are higher than the county, state and national averages for this indicator.
Community Input
The health needs assessment process would be incomplete without community input about the health need. Key
informant interviews were conducted with local health experts, as well as focus groups with community leaders,
representatives and residents. Themes from discussions regarding the health need are identified below.
Cancer was of high concern in 3 out of 25 groups/interviews, and was mentioned in many others.
Costs of health care and cancer treatments were of concern, particularly for uninsured and underinsured,
low-income persons, the unemployed, and those living in poverty.
Fear of cancer and/or of the treatments can lead people to denial and/or to avoidance of check-ups.
Relative lack of alternative treatments from radiation/chemotherapy
Lack of knowledge and lack of education about prevention was mentioned.
Concern about environmental toxins (PCBs, pesticides, etc.).
Page 6
Cancers
Cancer screenings (breast, cervical, colon) require staff time for effective follow-up.
Tobacco use (related to lung and oral cancers) not dropping among youth; social environment (ads,
TV/movies, easy access, peer pressure) pushing minors to smoke; education not working, need better
prevention efforts (e.g., increase tobacco taxes, restrict smoking in public places, support policy changes,
law enforcement).
Assets to Address the Need

The Santa Clara County Community Benefit Coalition members and a representative from the Santa Clara County
Public Health Department were consulted to identify existing internal and community assets that could be
accessed to address the health need. These include:
OConnor Hospital:
o
Cancer support groups meet onsite
Hepatitis B awareness campaign to prevent liver cancer in Asian/Pacific Islanders
American Cancer Society
Cancer Support Community

o
Asian American for Community Involvement
Indian Health Center of Santa Clara County
Gardner Family Health Network
MayView Community Health
North East Medical Services
Planned Parenthood Mar Monte
RotaCare Bay Area, Inc.
San Jose Foothill Health Center
El Camino Hospital
Good Samaritan Hospital
Hospice of the Valley
Kaiser Permanente
Latinas Contra Cancer
Leukemia & lymphoma Society
Lucile Packard Childrens Hospital at Stanford
Pathways Home Health & Hospice
Regional Medical Center of San Jose
Saint Louise Regional Hospital
Santa Clara Valley Health & Hospital System
Stanford Hospital & Clinics
Vietnamese Reach for Health Coalition
Page 7
Cancers
Summary
Cancer is a health need in Santa Clara County as marked by incidence rates of breast, cervical, liver, and prostate
cancer that are too high compared to benchmarks/state averages, and a liver cancer mortality rate that is too high
compared to the state average. Breast and prostate cancer disproportionately affect Whites; lung and prostate
cancer disproportionately affect African Americans. Latinos and Asian/Pacific Islanders have higher incidence rates
of cervical and liver cancer than other ethnic groups, and disproportionately high mortality rates due to liver
cancer as well. Latinos additionally are unduly burdened by mortality from colorectal cancer. The health need is
likely being impacted by health behaviors such as rates of screening that do not meet established benchmarks, and
low fruit and vegetable consumption that are no better than average (as diet has been shown to have an impact
on many types of cancer). Community input indicates that the health need is also affected by lack of knowledge
about cancer prevention and treatment, fear and denial, lack of staff time for follow-up with those who are at risk
and should be screened, concerns about the costs of treatment, and poor access to primary care providers and
specialists due to lack of insurance, particularly among low-income residents. There was also some concern about
youth tobacco use (as smoking has also been shown to have an impact on various types of cancer).
Page 8
Santa ClaraCountyHealthNeedProfile
CardiovascularDisease,HeartAttack,Stroke
needs.Basedonthisscanofquantitativeandqualitativedata,cardiovasculardisease,heartattack,andstroke
wereprioritizedasoneofthe13tophealthneedsinthecounty.Thiscategoryincludedcerebrovasculardisease.
Thestatusofcardiovascularneedsisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Santa
Clara
County
CA
US
HP2020
Benchmark
29%
17%
White
36%
AfricanAmerican
31%
Latino
20%
30%
Hypertension
%adultstoldtheyhave
hypertension
26%
16%
White
33%
AfricanAmerican
37%
Latino
15%
24%
Highcholesterol
%adultseverbeentoldbya
healthprofessionalthatthey
havehighcholesterol
Page1
DataSource
SantaClara
CountyPublic
Health
Department,
BRFS2009
SantaClara
CountyPublic
Health
Department,
BRFS2009
Santa
Clara
County
Heartdisease
CA
US
HP2020
Benchmark
Prevalenceofheartdisease
%ofadultsevertoldthey
haveanykindofheartdisease
5%
6%
Heartattack
%adultsevertoldtheyhada
heartattack
3%
3%
2%
2%
27.4
48.4
41.8
33.8
25.7
AfricanAmerican
41.3
Latino
27.0
30.6
37.1
Stroke
Prevalenceofstroke
%ofadultswhohaveever
hadastroke
Strokemortality
Ageadjusteddeathratedue
tocerebrovasculardiseaseper
100,000adults
White
Multiracial
Note:Sta s csfromCARESPla orm.
DataSource
California
Health
Interview
Survey(CHIS)
2009
SantaClara
CountyPublic
Health
Department,
BRFS2009
SantaClara
CountyPublic
Health
Department,
BRFS2009
CDPH,Death
Statistical
MasterFile,
2010
(Providedby
SantaClara
CountyPublic
Health
Department)
Whitesexperiencethehighestpercentageofhighcholesterolcomparedwithotherethnicgroups,
followedbyAfricanAmericansandAsian/PacificIslanders.
AfricanAmericansexperiencethehighestpercentageofhypertensioncomparedwithotherethnic
groups,followedbyWhites.
AfricanAmericanshadthehighestratesofstrokemortalitycomparedwithotherethnicgroups,followed
bythosewhoidentifyasmultiracial.
Page2
SantaClara
County
CA
73%
70%
CDCBRFSS
200610
13%
17%
CDCBRFSS
200410
10%
14%
CDCBRFSS
200410
13%
CAHealthyKids
(CHKS),200910
70%
70%
CDCBRFSS2003
2009
47%
48%
CaliforniaHealth
InterviewSurvey
(CHIS),2009
18%
22%
CDCBRFSS200410
28%
37%
CADeptof
Education,
FitnessgramPhysical
FitnessTesting
Results,2011
Fastfoodrestaurantaccess
Establishmentsper100,000pop
72.0
69.5
Grocerystoreaccess
20.4
22.2
WICauthorizedfoodstoreaccess
9.45
15.8
Recreationandfitnessfacilityaccess
12.7
8.9
Category
Driver/indicator
Health
Behaviors
Highbloodpressuremanagement
%ofadultsaged18andolderwhoself
reportthattheyaretakingmedication
fortheirhighbloodpressure
Alcoholconsumption(adult)
%ofadultsreportingheavyalcohol
consumption
Smoking(adult)
%ofadultswhocurrentlysmoke
Smoking(youth)
%of11thgraderswhosmoked
cigarettespast30days
Inadequatefruit/vegetable
consumption(adult)
%ofadultswhoconsumelessthanfive
servingsoffruitsandvegetablesdaily
Adequatefruit/vegetable
consumption(youth)
%ofkids2+whoconsumefiveormore
Physicalinactivity(adult)
%ofadults18+reportingnoleisure
timeforphysicalactivity
Physicalinactivity(youth)
%of5th,7th&9thgradersranking
withinthe"HighRisk"orNeeds
Improvementzonesforaerobic
capacityontheFitnessgramphysical
fitnesstest
Physical
Environment
DataSource
U.S.CensusBureau,
ZIPCodeBusiness
Patterns,2009
U.S.CensusBureau,
CountyBusiness
Patterns,2010
U.S.D.A.Food
EnvironmentAtlas,
2012
U.S.CensusBureau,
ZIPCodeBusiness
Patterns,2009
Sta s csfromCARESPla orm.

Page3
CommunityInput
Heartdiseasewasmentionedinatleasthalfofthegroups/interviews,thoughonlyrosetothetopfortwo
interviewees.
Highbloodpressureandhypertensionwerethemostcommonconditions/driversnamedbyresidents
relatedtocardiovasculardisease.
Seetherelatedhealthneedofobesityfordriversrelatedtopoornutritionandlackofexercise.
Lackofeducationaboutthesignsofheartdiseaseandhighbloodpressure
Lackofrecognitionbecauseitisaninvisibledisease
Canbecaused/exacerbatedbystress,smokinganddrinkingalcohol
OConnorHospital:
o
Bloodpressure,cholesterolandglucosescreeningsprovidedathealthfairs
CardiacRehabilitationCenterprovidesfreebloodpressurescreeningsweekly
ICDsupportgroupmeetsonsiteandisfacilitatedbyOConnoremployees
LivingWellClasses
StrokesupportgroupmeetonsiteandisfacilitatedbyOConnoremployees
AmericanHeartAssociationandAmericanStrokeAssociation
o
Page4
ElCaminoHospital
KaiserPermanente
PacificStrokeAssociation
StrokeAwarenessFoundation
YMCA
Summary
CardiovascularDisease,HeartAttack,andStrokearehealthneedsinSantaClaraCountyasmarkedbyhighoverall
percentagesofhighcholesterolandhypertension,bothofwhichfailHP2020benchmarks.AfricanAmericansand
thosewhoidentifyasmultiracialhaveahigherstrokemortalityratethantheHP2020benchmark.African
AmericansandWhitesdisproportionatelyexperiencehypertensionandhighcholesterol.Heartdiseasedeathsare
worstintheSouthCountyareaandinEastSanJose.Poornutrition,whichisrelatedtocardiovasculardisease,isof
concerninthecounty.Adultandyouthconsumptionoffruitsandvegetables,andhouseholdexpendituresonthe
same,isnobetterthanthestateaverage,andinsomecasesisworse.Therearealsomorefastfoodrestaurants,
andfewergrocerystoresandWICauthorizedstores,thanthestateaverage.Communityinputreflectedthis,as
wellasaconcernaboutlackofexercise.Thecommunityalsoindicatedthatthehealthneedisbeingaffectedby
stressandlackofknowledgeaboutstrokeandheartdisease.
Page5
Diabetes
needs.Basedonthisscanofquantitativeandqualitativedata,diabeteswasprioritizedasoneofthe13tophealth
needsinthecounty.
Thestatusofneedsassociatedwithdiabetesisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Indicator
Diabetesprevalence(adults)
%adultswhohaveeverbeentoldbya
doctorthattheyhavediabetes
Santa
Clara
County
CA
State
HP2020
Benchmark
8%
8%
White
7%
Latino
11%
AfricanAmerican
14%
5%
Diabetichospitalization
Rateofdischargeper10,000
hospitalizations
7.9
White
0.7%
0.8%
Latino
AfricanAmerican
1.5%
1.6%
0.4%
0.6%
Other
0.8%
.09%
Note:Sta s csfromCARESPla orm.

Page1
DataSource
SantaClara
CountyPublic
Health
Department,BRFS
2009
CAOfficeof
StatewideHealth
Planning&
Development
(OSHPD)201011
CAOfficeof
StatewideHealth
Planning&
Development
(OSHPD)201011
Diabetes
KeyindicatorsfordiabetesindicatethatSantaClaraCountyratesareverysimilartoCaliforniaoverall,andvery
neartheHealthyPeople2020benchmarkof8%prevalence.However,someethnicsubgroupsare
disproportionatelydiagnosedwith,andhospitalizedfor,diabetes.
AfricanAmericansandLatinosexperiencethehighestratesofdiabetescomparedwithotherethnic
groups
AfricanAmericansrepresentahigherpercentageofthosehospitalizedfordiabetesthananyotherethnic
group.
Category
Behaviors
Physical
Environment
Santa
Clara
County
Driver/indicator
Softdrinkexpenditures
%oftotalhouseholdexpenditures
Adequatefruit/vegetableconsumption
(youth)
%ofkids2+whoconsumefiveormore
consumption(adult)
%ofadultswhoconsumelessthanfive
th th
th
%of5 ,7 &9 gradersrankingwithin
the"HighRisk"orNeeds
capacityontheFitnessgramphysical
fitnesstest
%adultswhoselfreportnot
participatinginanyphysicalactivitiesor
exercises
Page2
CA
State
DataSource
.37%
.46%
NielsenClaritas
SiteReports,
ConsumerBuying
Power,2011
47%
48%
CaliforniaHealth
InterviewSurvey
(CHIS),2009
70%
70%
CDCBRFSS2003
2009
28%
38%
CADeptof
Education,
Fitnessgram
PhysicalFitness
TestingResults,
2011
18%
22%
CDCBRFSS2004
2010
69.4
U.S.Census
Bureau,ZIPCode
BusinessPatterns,
2009
72.0
Diabetes
Category
Delivery
Santa
Clara
County
Driver/indicator
CA
State
Grocerystoreaccess
20.4
22.2
WICauthorizedfoodstoreaccess
9.5
15.8
Recreationandfitnessfacilityaccess
12.7
8.9
Olderadultdiabetesmanagement
%ofdiabeticMedicarepatientswho
hadahemoglobinA1c(hA1c)testin
pastyear
77%
76%
DataSource
U.S.Census
Bureau,County
BusinessPatterns,
2010
U.S.D.A.Food
Environment
Atlas,2012
U.S.Census
Bureau,ZIPCode
BusinessPatterns,
2009
DartmouthAtlas
ofHealthcare,
Selected
Measuresof
PrimaryCare
Accessand
Quality,200307
Sta s csfromCARESPla orm.

insurancecoverage)intheAccesstoHealthCareprofilereport.Inaddition,overweightandobesityareseenas
driversofdiabetes.SeetheObesityhealthprofilefordetailsonobesityasahealthneedanditsassociateddrivers.
CommunityInput
Diabeteswasofhighconcernin8outof17groupsandin6of9keyinformantinterviews,andwas
mentionedinalmostallofthem.
Lackofgrocerystoresorfarmers'marketswasmentionedasadriverfordiabetesorpoornutritionin
sevenseparategroups/interviews;itwasnotedthatfoodstamps/EBTwerenotacceptedatfarmers'
markets;thatpoorneighborhoodsweredisproportionatelylackingstoresthatsoldfreshproduceand
otherhealthyfood("moreliquorstoresthangrocerystoresinsomeneighborhoods");thatlackof
transportationaffectedaccesstogrocerystores;thatAsian&Latinofamiliesaremorelikelytochoose
freshoverprocessedfood.Itwassuggestedthatpolicies/ordinancesbesupportedthatincreasedthe
qualityofthefoodthat"cornerstores"wouldcarry,andincreasedthenumberoffarmers'markets.
Page3
Diabetes
OnegroupmentionedthatgrocerystoresdecidehowWomen,InfantsandChildren(WIC)benefitscanbe
used.OneWICbeneficiarynotedthatconsumerscan'tbuylowsugaroptionsbecausetheyhaveartificial
sweetener.(USDAstates:"FederalWICregulationsdonotprohibitfoodsthatcontainartificial
sweeteners.However,WICStateagenciesareresponsiblefordeterminingthebrandsandtypesoffoods
toauthorizeontheirStateWICfoodlists.SomeStateagenciesmayallowfoodssweetenedwithartificial
sweetenersontheirfoodslists,butthiswillvarybystate").
Sixgroups/interviewsmentionedthecostofhealthyfood.Manygroups/interviewsdiscussedtheneedfor
morehealthy/goodqualityfood,butonlyonegroupspecificallymentionedfruitsandvegetables,saying
that"childrenandparentsneed..tounderstandthebenefitsofeatingfruitsandvegetables"anddiscussed
accessissuesrelatedtothis(i.e.Distributionchannelsnotestablishedtoenablefarmerstogettheir
producetostores,schoolsandfamilies).
Fastfoodmentionedasadriverfordiabetesorpoornutritionineightgroups/interviews;beliefthatfast
foodischeaper,moreaccessible("availableoneverycorner"),faster,andprovidesmorecaloriesper
dollarthanhealthyfood,butismoreunhealthy(fatty,"starchy",hasasitscompanion"sugarydrinks");is
beingpushedbythemedia,foundonschoolcampuses,andmakesportionsizeanissue("supersized").
Lackofhealthyeating:
-
Lackofexercise:
-
Lackofeducationabouthealthyeating
Decreaseinfamiliespreparingmealsathome
Largeportionsize(restauranttrendshavinganinfluenceonhomecooks)
Busylifestyles
Unsafeneighborhoods
Highcostofphysicalfitnessprograms
Socialfactors:
-
Parentsmaybepoormodelsforchildren
Familiesusedtoovereating,eatingunhealthyfoods
SantaClaraCountyPublicHealthhasshowncommitmenttoobesitypreventionthroughitsCommunitiesPutting
PreventiontoWork(CPPW)ObesityPreventionprogram,fundedthroughSeptember2012.Itisunclearwhetheror
notthegrantswillcontinuein2013.TheSantaClaraCountyCommunityBenefitCoalitionmembersanda
representativefromtheSantaClaraCountyPublicHealthDepartmentwereconsultedtoidentifyexistinginternal
andcommunityassetsthatcouldbeaccessedtoaddressthehealthneed.Theseinclude:
OConnorHospital:
o
BreastfeedingsupportgroupmeetsonsiteandisfacilitatedbyOConnoremployees
Diabetessupportgroupmeetsonsite
Familymedicineresidencytrainingprogramwhereresidentslearnhowtocareforindividuals
livingwithdiabetesandteachselfcaremanagement
Page4
Diabetes
HealthBenefitsResourceCenterprovideshealthinsuranceandCalFreshenrollmentassistance
LivingWellClasses
BayAreaNutrition&PhysicianActivityCollaborative
o
ElCaminoHospital
FIRST5SantaClaraCounty
SanJoseDepartmentofParks,Recreation&NeighborhoodServices
SantaClaraCountyOfficeofEducationCoordinatedSchoolHealthProgram
SantaClaraCountyPublicHealthDepartment
o
Breastfeedingsupport
ChildhoodFeedingCollaborative
EatHealthy,EatSmartInnovativeNutritionEducationProgram
WICprogram
SecondHarvestFoodBankofSantaClaraandSanMateoCounties
SiliconValleyHealthCorps
SomosMayfair
Page5
Diabetes
Summary
DiabetesisahealthneedinSantaClaraCountyasmarkedbyrelativelyhighratesofdiabetes.Theoveralladult
ratemeetstheHP2020benchmark,butLatinoandAfricanAmericanresidentsaredisproportionatelydiabetic,and
worseoffincomparisonwiththecountyandstateaveragesandbenchmark.Ofallethnicgroups,African
Americansexperiencehighestpercentageofhospitalizationsduetodiabetes.Communityinputaboutdiabetes
wasstrong,andexpressedtheconnectionbetweenthediseaseandrelatedhealthbehaviorssuchaspoor
nutritionandlackofphysicalactivity.Thehealthneedislikelybeingimpactedbyhealthbehaviorssuchaslowfruit
andvegetableconsumption,sodaconsumption,theproximityoffastfoodestablishments,andalackofgrocery
storesandWICauthorizedfoodsources.
Page6
MentalHealth
needs.Basedonthisscanofquantitativeandqualitativedata,mentalhealthwasprioritizedasoneofthe13top
healthneedsinthecounty.
Thestatusofmentalhealthneedsisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Santa
Clara
County
CA
State
Ave
HP2020
Benchmark
DataSource
17%
14%
California
HealthInterview
Survey(CHIS)
2009
28%
28%
White
24%
AfricanAmerican
30%
Latino
31%
26%
16%
19%
White
15%
AfricanAmerican
22%
Latino
17%
17%
7.9
9.8
10.2
Indicator
Poormentalhealth(adults18+)
%whofelttheymightneedtoseea
professionalbecauseofproblemswiththeir
mentalhealth,emotions,nerves,oruseof
alcoholordrugsinlast12months
Depression(youth)
%ofmiddle/HSstudentswithdepressive
symptomsinpast12months
Suicidalideation(youth)
%ofmiddle/HSstudentswhoseriously
consideredsuicideinpast12months
Suiciderate
Ageadjustedsuiciderateper100,000pop
Page1
CAHealthyKids
Survey(CHKS)
200910
CDC200509
MentalHealth
AdditionalData:
TheoverallsuicideratedoesnotfailHP2020benchmark.Althoughthelownumberofsuicides(146totalinthe
county)makesitdifficulttocalculatereliablerates,itisworthnotingthenumberofsuicidesbyagegroup.While
thereseemstobeaperceptionthatteensuicideisthemostcommon,therawnumbersshowusthatmost
suicidesarecommittedbymiddleagedadultsages4564.
SantaClaraCountySuicides2010
byAgeGrou
70
Numberofsuicides
60
50
40
30
20
10
0
1024
2544
4564
6584
85+
LatinoandAfricanAmericanyouthexhibitdepressioninhigherproportionsthanthestateaverage.
ThepercentageofAfricanAmericanyouthwhoexperiencesuicidalideationishigherthanboththe
countyandthestatewideaverages.
Page2
MentalHealth
Category
Behaviors
Driver/indicator
Santa
Clara
County
CAState
Ave
USAve
78%
75%
80%
Adequatesocialoremotional
support(adults)
%adultswhoreportreceiving
sufficientsocial/emotional
supportall/mostofthetime
DataSource
CDCBRFSS,
20062010
Seedataregardingadditionalcrosscuttingdriversinfluencingthishealthneed(suchaspoverty,linguisticisolation,
andlackofhealthinsurancecoverage)intheAccesstoHealthCareprofilereport.Also,seedataregardingrelated
healthneedsofSubstanceAbuseandViolence.
CommunityInput
MentalHealthwasofhighconcernin16outof22groups/interviews,andwasmentionedinalmostallof
them.Residentsidentifiedspecificconditionsofstress,depression,suicide,andabuse(trauma).
Social/emotionalsupportasadriverofmentalhealthwasmentionedinatleasthalfofthe
groups/interviewsthatidentifiedmentalhealthasapriority.
Bullying,abuseandoverworkcancausestressandmentalhealthissues.
Lackofknowledgeabouttheeffectsofstressandhowtocope.
Poormentalhealth(stress)cancausephysicalproblemssuchasheartissues,insomniaandpoordiet.
Highstigmapreventspeoplefromidentifyingpoormentalhealthinthemselvesandingettingtreatment.
Lackofmentalhealthinsurancebenefits.
Lackofaffordabletreatmentresources.
Lackoftreatmentforepisodicmentalhealthissuessuchasdepressionandstress.
Inabilitytoqualifyforenoughresources,especiallyaftercare.
Page3
MentalHealth
ACTforMentalHealth
AsianAmericanRecoveryServices,Inc.
BillWilsonCenter
BillyDeFrankLGBTCommunityCenter
CentralWellness&BenefitCenter
ChamberlainsMentalHealth
ChildrensShelterMentalHealthClinic
CityofSanJoseParks,Recreation&NeighborhoodServices
o
CommunitySolutions
DowntownMentalHealth
EastValleyMentalHealth
EHCLifeBuilders
EMQFamiliesFirst
ElCaminoHospital
FairOaksMentalHealth
Family&ChildrensServices
HOPERehabilitationServices
HospitalCouncilofNorthernandCentralCalifornia
o
MedicalRespiteProgram
Page4
MentalHealth
NewDirectionsProgram
KaiserPermanente
JohnF.KennedyUniversitySunnyvaleCommunityCounselingProgram
MekongCommunityCenter
MomentumforMentalHealth
PaloAltoUniversityTheGronowskiCenter
ProjectCornerstone,aYMCAofSiliconValleyInitiative
RebekahsChildren'sServices
SantaClaraCountyMentalHealthDepartment
SouthCountyMentalHealth
Summary
MentalhealthisahealthneedinSantaClaraCountyasmarkedbyapercentageofselfreportedpoormental
healththatishigherthanthestateaverage.LatinoandAfricanAmericanyouthdisproportionatelyexhibit
symptomsofdepression,andAfricanAmericanyouthadditionallyexperiencesuicidalideationrateshigherthan
thecountywideaverage.Communityinputindicatesthatthehealthneedislikelybeingaffectedbystress(driven
byfinancial/economicconcerns)andthelackofeducationabouthowtocopewithstress,stigmaaboutmental
illnessleadingtofearanddenial,lackofknowledgeaboutmentalhealthtreatment,andpooraccesstomental
healthcareprovidersandspecialistsduetolackofinsuranceand/ormentalhealthbenefitsamongthosewhoare
insured,and/orduetoalackofproviders(i.e.,workforcedevelopmentissues).Relatedtopoormentalhealthare
thehealthneedsaroundviolenceandsubstanceabuse.
Page5
Obesity
needs.Basedonthisscanofquantitativeandqualitativedata,obesitywasprioritizedasoneofthe13tophealth
needsinthecounty.
Thestatusofneedsassociatedwithobesityisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Indicator
Overweightadults
%whoselfreportaBMI
between2530
Obeseadults
%whoselfreportaBMI
over30
Overweightorobese
adults
%withBMIover25
Santa
Clara
County
CA
US
36%
36%
36%
21%
23%
27%
55%
White
55%
Latino
68%
AfricanAmerican
63%
39%
HP2020
Benchmark
31%
overweight
orobese
adults
31%
overweight
orobese
adults
DataSource
CDCBRFSS20062010
CDCBRFSS20062010
SCCPHDBRFS2009
Page1
Obesity
Additionaldata:
Lowincomechildrenhavehighproportionsofoverweightandobesity,asdemonstratedbythetable
below.
SantaClaraCountyChildren25YearsOldfromLowIncomeFamilies
Asian
Latino
Overweight
AfricanAm
White
Obese
Overall
0%
5%
10%
15%
20%
25%
30%
35%
40%
Source:Dept.HealthCareServices,ChildHealth&DisabilityPreventionProgram,PediatricNutritionSurveillanceSystem,2009
LatinosandAfricanAmericanshavehigherproportionsofoverweightorobeseadultscomparedwith
otherethnicgroups.
Page2
Obesity
Obesityamongelementaryschoolchildrenisworseinsomeareasofthecounty,asdisplayedinthemapof
elementaryschooldistrictsbelow.MountPleasantElementarySchoolDistrictinEastSanJoseistheworstoff,with
41.65%ofstudentstestinginthehighriskzoneforbodycomposition.
GilroyUnified,SanJoseUnified,OakGroveElementary,SantaClaraUnified,andCampbellUnionElementary
SchoolDistrictsreported30%40%ofitsstudentsoutsideofthehealthyzone.
Certainhealthdriversofobesityarealsoworseinsomecommunitiesthaninothers.
Fruit/vegetableexpenditures:WorstinMorganHill,SouthSanJose,Saratoga,LosGatos,andthewestern
partsofSunnyvale.
Youthobesity:WorstinGilroyandSouthwestSanJose
Page3
Obesity
Category
Santa
Clara
County
Driver/indicator
%oftotalhouseholdexpenditures
Behaviors
Behaviors
Physical
environment
Adequatefruit/vegetable
consumption(youth)
%ofkids2+whoconsumefiveor
moreservingsoffruitsand
vegetablesdaily
consumption(adult)
%ofadultswhoconsumelessthan
fiveservingsoffruitsand
vegetablesdaily
CA
DataSource
NielsenClaritas
SiteReports,
Consumer
BuyingPower,
2011
California
Health
Interview
Survey(CHIS),
2009
0.4%
0.5%
47%
48%
70%
70%
CDCBRFSS
20032009
%of5th,7th&9thgradersranking
withinthe"HighRisk"orNeeds
capacity
28%
37%
CADeptof
Education,
Fitnessgram
PhysicalFitness
TestingResults,
2011
%adultswhoselfreportnot
participatinginanyphysical
activitiesorexercises
18%
22%
CDCBRFSS
20042010
72
69
Grocerystoreaccess
20
22
WICauthorizedfoodaccess
9.5
15.8
Recreation/fitnessaccess
12.7
8.9
U.S.Census
Bureau,
Business
Patterns,2009
U.S.Census
Bureau,County
Business
Patterns,2010
U.S.D.A.Food
Envir.Atlas,
2012
U.S.Census
Bureau,ZIP
CodeBusiness
Patterns,2009
Page4
Obesity
Seedataregardingadditionalcrosscuttingdriversinfluencingthishealthneed(suchaspovertyandinsurance
coverage)intheAccesstoHealthCareprofilereport.
CommunityInput
Obesity/overweightwasofhighconcernin13outof22groups/interviews,andwasmentionedinalmost
allofthem.
Lackofgrocerystoresorfarmers'marketswasmentionedasadriverforobesityorpoornutritionin
sevenseparategroups/interviews;itwasnotedthatfoodstamps/EBTwerenotacceptedatfarmers'
markets;thatpoorneighborhoodsweredisproportionatelylackingstoresthatsoldfreshproduceand
otherhealthyfood("moreliquorstoresthangrocerystoresinsomeneighborhoods");thanlackof
transportationaffectedaccesstogrocerystores;thatAsian&Latinofamiliesaremorelikelytochoose
freshoverprocessedfood.Itwassuggestedthatpolicies/ordinancesbesupportedthatincreasedthe
qualityofthefoodthat"cornerstores"wouldcarry,increasedthenumberoffarmers'markets.
OnegroupmentionedthatgrocerystoresdecidehowWomen,InfantsandChildren(WIC)benefitscanbe
used.OneWICbeneficiarynotedthatconsumerscan'tbuylowsugaroptionsbecausetheyhaveartificial
sweetener.(USDAstates:"FederalWICregulationsdonotprohibitfoodsthatcontainartificial
sweeteners.However,WICStateagenciesareresponsiblefordeterminingthebrandsandtypesoffoods
toauthorizeontheirStateWICfoodlists.SomeStateagenciesmayallowfoodssweetenedwithartificial
sweetenersontheirfoodslists,butthiswillvarybystate").
Sixgroups/interviewsmentionedthecostofhealthyfood.Manygroups/interviewsdiscussedtheneed
formorehealthy/goodqualityfood,butonlyonegroupspecificallymentionedfruitsandvegetables,
sayingthat"childrenandparentsneed...tounderstandthebenefitsofeatingfruitsandvegetables"and
discussedaccessissuesrelatedtothis(i.e.Distributionchannelsnotestablishedtoenablefarmerstoget
theirproducetostores,schoolsandfamilies).
Fastfoodmentionedasadriverforobesityorpoornutritionineightgroups/interviews;beliefthatfast
foodischeaper,moreaccessible("availableoneverycorner"),faster,andprovidesmorecaloriesper
dollarthanhealthyfood,butismoreunhealthy(fatty,"starchy",hasasitscompanion"sugarydrinks");is
beingpushedbythemedia,canbefoundonschoolcampuses,makesportionsizeanissue("supersized").
Lackofhealthyeating:
-
Lackofexercise:
-
Lackofeducationabouthealthyeating
Decreaseinfamiliespreparingmealsathome
Largeportionsize(restauranttrendshavinganinfluenceonhomecooks)
Busylifestyles
Unsafeneighborhoods
Highcostofphysicalfitnessprograms
Page5
Obesity
Socialfactors:
-
Parentsmaybepoormodelsforchildren
Familiesusedtoovereating,eatingunhealthyfoods
SantaClaraCountyPublicHealthhasshowncommitmenttoobesitypreventionthroughitsCommunitiesPutting
PreventiontoWork(CPPW)ObesityPreventionprogram,fundedthroughSeptember2012.Itisunclearwhetheror
notthegrantswillcontinuein2013.TheSantaClaraCountyCommunityBenefitCoalitionmembersanda
representativefromtheSantaClaraCountyPublicHealthDepartmentwereconsultedtoidentifyexistinginternal
andcommunityassetsthatcouldbeaccessedtoaddressthehealthneed.Theseinclude:
OConnorHospital:
o
Accesstoprimarycareservices
Breastfeedingsupportgroup
Diabetessupportgroup
Familymedicineresidencytrainingprogramwhereresidentslearnhowtocareforindividuals
livingwithobesityandteachselfcaremanagement
HealthBenefitsResourceCenterprovideshealthinsuranceandCalFreshenrollmentassistance
LivingWellClasses&Resources
BayAreaNutrition&PhysicianActivityCollaborative
BayAreaWomensSportsInitiative
o
ElCaminoHospital
FIRST5SantaClaraCounty
KaiserPermanente
SanJoseDepartmentofParks,Recreation&NeighborhoodServices
Page6
Obesity
SantaClaraCountyOfficeofEducationCoordinatedSchoolHealthProgram
o
Breastfeedingsupport
ChildhoodFeedingCollaborative
EatHealthy,EatSmartInnovativeNutritionEducationProgram
WICprogram
SecondHarvestFoodBankofSantaClaraandSanMateoCounties
SiliconValleyHealthCorps
SomosMayfair
Veggielution
Summary
ObesityisahealthneedintheSantaClaraCountyasmarkedbyhighratesofoverweightandobesityamongboth
youthandadults.Overallratesarejustbelowstateaverages,buttheadultoverweightratemissestheHP2020
benchmark.LatinoandAfricanAmericanresidentsaredisproportionatelyoverweightandobese,andworseoffin
comparisonwithCalifornia(andinsomecases,U.S.)averages.Thehealthneedislikelybeingimpactedbyhealth
behaviorssuchaslowfruitandvegetableconsumption,sodaconsumption,theproximityoffastfood
establishments,andalackofgrocerystoresandWICauthorizedfoodsources.
Page7
OralHealth
needs.Basedonthisscanofquantitativeandqualitativedata,oralhealthwasprioritizedasoneofthe13top
healthneedsinthecounty.
Thestatusoforalhealthneedsisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Santa
Clara
County
CA
US
8%
11%
16%
16%
12%
CaliforniaHealth
InterviewSurvey
(CHIS),2007
White
12%
Black
0%
Latino
20%
17%
Multiethnic
11%
Indicator
Poordentalhealth(adult)
%ofadultsreportinghavinghad6ormoreof
theirpermanentteethhavebeenremoveddue
totoothdecay,gumdisease,orinfection
Conditionofteeth(youth)
%ofteensreportingtheconditionoftheirteeth
wasfairorpoor
DataSource
CDCBRFSS200610
AlthoughadultsinSantaClaraCountyfarewellcomparedtothestatewithregardtodentalhealth,a
greaterpercentageofSantaClaraCountyyouthreportthattheirteethareinfair/poorcondition,
comparedtoyouthinthestateoverall.
LatinoandAsian/PacificIslanderyouthhavethehighestpercentagesoffair/poorteethcomparedwith
otherethnicgroups.
Page1
OralHealth
Category
Driver/indicator
Santa
Clara
County
CA
28%
34%
DataSource
Absenceofdentalinsurance
%ofadultswhohadnodental
insurance
Access
California
Health
Interview
Survey(CHIS),
2007
25%
20%
32%
31%
32%
17%
White
AfricanAmerican
Latino
NativeAmerican
Multiethnic
Dentalcareutilization
%reportingtheyhavevisiteda
dentist,dentalhygienistordental
clinicwithinthepastyear
Behaviors
Teens
10%
Adults
81%
70%
.37%
0.46%
estimatedexpendituresforcarbonated
beverages,asapercentageoftotal
householdexpenditures
CHIS2009
CDCBRFSS
200610
Nielsen
Claritas
SiteReports,
Consumer
BuyingPower,
2011
AlthoughtheabsenceofdentalcoverageinSantaClaraCountyisnotashighasinthestateoverall,several
subpopulationsfareworsethanothersinthecounty.Inparticularly,thepercentagesofNativeAmericans,Latinos,
andAsian/PacificIslanderswithoutdentalinsurancevergeonthestateaverage(andworsethanthecounty
average).
Seedataregardingadditionalcrosscuttingdriversinfluencingthishealthneed(suchaspoverty)intheAccessto
HealthCareprofilereport.
Page2
OralHealth
CommunityInput
Oral/dentalhealthwasmentionedin6outof25groups/interviews.
Therewasconcernparticularlyaboutdentalcareforadultswhoareuninsuredandwhomayalsohave
chronicconditions.
ItwasnotedthatMedicaiddiscontinueditsdentalcareforadults.
Gettingannualdentalcheckupsislowpriorityamongthosewhohavetopayoutofpocket.
Desireapatientcenteredmedicalhomewithapatientnavigatortohelpconnectpatientstodentalcare
options.
CarringtonCollegeCaliforniaSanJoseDentalHygiene
FoothillCollegeDentalHygieneClinic
TheHealthTrustsChildrensDentalCenters
RonaldMcDonaldCareMobileUnit
SantaClaraCountyHealth&HospitalSystem
ToothMobile
Summary
Oral/dentalhealthisahealthneedSantaClaraCountyasmarkedbythepercentageofyouthreportingtheirteeth
infairorpoorcondition,whichishigherthanthestateaverage.LatinoandAsian/PacificIslanderyouthare
disproportionatelyaffected.Whileadultdentalhealthisnotidentifiedasaconcerncountywide,somesubgroups
(Latinos,NativeAmericans,Asian/PacificIslanders)aremorelikelythanothersnottohavedentalinsurance,at
ratesnearingthestatewideaverage.Thehealthneedislikelybeingimpactedbycertainsocialdeterminantsof
health,andbythecostofdentalcare.Communityfeedbackindicatesthatthehealthneedisaffectedbyconcerns
aboutpooraccesstodentalcareprovidersandspecialistsduetolackofinsurance,particularlyamongresidents
withchronicconditions.
Page3
SantaClaraCountyProfileofHealthNeeds
needs.Basedonthisscanofquantitativeandqualitativedata,respiratoryconditionswereprioritizedasoneof
the13tophealthneedsinthecounty.Thiscategoryincludesasthma,andwillbedevelopedtoincludeChronic
ObstructivePulmonaryDisease(COPD).
Thestatusofrespiratoryhealthneedsisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
SantaClara
County
Indicator
Asthma
Lifetimeprevalence(youth)
%ofchildrenages017ever
diagnosed(parentreport)
Lifetimeprevalence(adult)
%ofadults18+everdiagnosed
Hospitalizations(children)
rateofasthmahospitalizations
forchildrenage04
Hospitalizations(youth)
rateofhospitalizationsper
10,000childrenage017
Hospitalizations(adult)
rateofhospitalizationsper
10,000adult18+
CA
HP2020
12%
14%
11%
14%
24.5
22.3
18.1
9.7
11.0
6.0
8.3
8.6
Page1
DataSource
CHIS2009;citedby
BreatheCA
OSPHD2010;cited
byBreatheCA
Asthmahospitalizationsamongyouthages017isworseinsomeareasofthecountythaninothers,asdisplayed
inthemapofzipcodetabulationareas.TheoutlyingareaofSaratoga/LosGatosistheworstoff,withayouth
asthmahospitalizationrateof71.4.
Saratogaitself,aswellaspartsofSouthSanJoseandCampbellallreportedasthmahospitalizationratesof30or
higheramongyouth.
Page2
Category
Driver/indicator
Santa
Clara
County
CA
US
DataSource
10%
14%
18%
CDCBRFSS
20042010
CAHealthy
Kids(CHKS),
200910
Smoking(adult)
%ofadultswhocurrently
smoke
Behaviors
Smoking(youth)
%ofmiddleandhigh
schoolyouthwhosmoked
cigarettesinpast30days
Physical
environment
8%
Poorairquality
%ofdayswithparticulate
matter2.5levelsabovethe
NationalAmbientAir
QualityStandard
3.7%
4.2%
1.2%
CDCNational
Environmental
PublicHealth
Tracking
Network,2008
CommunityInput
Respiratoryconditions,includingasthma,COPD,andallergieswerementionedin6outof25
groups/interviews.
Therewasconcernaboutlackofinsuranceandunderinsurancegenerallyforthosedealingwithchronic
respiratoryconditions
Environmentalcauseswerealsomentioned,suchaspollution.
Thecostofprescriptionmedicationandequipmentfortheun/underinsuredandthosewhoarelow
income,unemployed,orlivinginpovertywasnoted.
Page3
Allergy&AsthmaAssociatesofSantaClaraValleyResearchCenter
AmericanCancerSociety
AmericanLungAssociation
BreatheCalifornia
CaliforniaSmokersHotline
ElCaminoHospital
KaiserPermanente
OConnorHospital
TobaccoFreeCoalitionofSantaClaraCounty
StanfordHealth&Clinics
VietnameseReachforHealthCoalition
Summary
RespiratoryconditionsareahealthneedinSantaClaraCountyasmarkedbyhospitalizationratesofchildrenages
04.Asthmahospitalizationratesofyouthages017showgeographicaldisparities,withtheworstratesin
Saratoga,SouthSanJose,partsofLosGatosandCampbell.Thehealthneedislikelybeingimpactedbyhealth
behaviorssuchaspercentageofyouthsmoking,andbyissuesinthephysicalenvironmentsuchasairquality
levels.Communityinputindicatesthatthehealthneedisalsoaffectedbyconcernsaboutthecostsoftreatment
(includingprescriptionmedicationandequipment)duetounderinsuranceorlackofinsurance,particularlyamong
lowincomeresidents.
Page4
STDs,includingHIV/AIDS
needs.Basedonthisscanofquantitativeandqualitativedata,sexuallytransmitteddiseaseswereprioritizedas
oneofthe13tophealthneedsinthecounty.ThiscategoryincludedHIV/AIDSandothersexuallytransmitted
diseases.
Thestatusofsexuallytransmitteddiseasesisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Indicator
CA
HP2020
Benchmark
HIVprevalence
prevalencerateofHIVper
100,000population
191.6
345.5
HIVhospitalizations
hospitalizationratedueto
HIVper100,000pop
0.89
1.67
10.3
8.7
HIVincidence
newHIVinfectioncaserate
per100,000population
White
AfricanAmerican
Latino
Chlamydiaincidence
per100,000population
Female
Male
Syphilisincidence
Primary&Secondary
syphilisincidencerateper
100,000
Female
Male
Santa
Clara
County
50.4
15.6
4.9
312.0
438.0
430.9
169.1
569.9
257.8
Percentonly
Percentonly
3.8
6.5
0.4
6.8
0.5
11.8
1.4
6.8
Page1
DataSource
NationalCenterfor
HIV/AIDS,ViralHepatitis,
STD,andTBPrevention,
2008
CAOfficeofStatewide
HealthPlanning&
Development(OSHPD),
2011
eHARS2011;citedbySanta
ClaraCountyPublicHealth
DepartmentLatinoReport
CDPHSTDCprelimdatathru
8/07/12
8/07/12
Indicator
Gonorrheaincidence
per100,000
Female
Male
Santa
Clara
County
CA
HP2020
Benchmark
35.5
73.1
24.7
43.5
54.5
83.7
257
198
DataSource
8/07/12
Note:Sizeofnistoosmalltorelyupon.Sta s csfromCARESPlatform.
AfricanAmericansandLatinoshavethehighestincidencerateofHIVcomparedwithotherethnicgroups,
farhigherthanthecountyaverage.Nostateaverageornationalbenchmarkisavailableforcomparison.
Mencountywideappeartohaveanincidencerateofprimaryandsecondarysyphilisthatisnobetter
thanthenationallybenchmarkedmaximumformales,althoughthenumberofcasesonwhichthis
statisticiscalculatedistoosmalltorelyupon.
Category
Driver/indicator
SantaClara
County
CA
DataSource
56%
49%
CaliforniaHealth
InterviewSurvey
(CHIS),2005
LackofHIVscreening
Clinicalcare
%ofteensandadultsage
1270neverscreenedfor
HIV
ThecountywidepercentageofteensandadultsbeingscreenedforHIVislowerthanthestateaverage.
Seedataregardingadditionalcrosscuttingdriversinfluencingthishealthneed(suchaspovertyandinsurance
coverage)intheAccesstoHealthCareprofilereport.
Page2
CommunityInput
STDs,includingHIV/AIDS,werementionedin3out25groups/interviews.
Therewasconcernaboutpooroutreach,lackofknowledgeandlackofhealtheducationaffecting
preventioneffortsandtreatment(i.e.,manypeoplearenotawareofhowSTDscanbetransmittedand
whentheymightbeatriskormightbeputtingothersatrisk,donotknowwhatthesymptomsare,orthat
theycanandshouldbetestedforSTDs).
SomementionedthatthosewithSTDsfeeltheywillbestigmatized(byfamily,peers,orevenphysicians)if
theycomeforwardtoobtainadiagnosisand/ortreatment.
Issueswithaccessto/costofcondomsandothermeansofSTDprevention,particularlyforadolescents,
thoseinpoverty,andtheuninsured.
Peerpressurewasmentionedinrelationtoadolescents.
Needforprogramstopartnerformoreeffective/efficientprovisionofservices.
BillWilsonCenter
BillyDeFrankLGBTCommunityCenter
CollegeHealthCenters(publicandprivateuniversities,communitycolleges)
o
ElCaminoHospital
Page3
TheHealthTrust
KaiserPermanente
Summary
STDsincludingHIVandAIDSareahealthneedinSantaClaraCountyasmarkedbyhighincidenceratesofHIV
amongAfricanAmericansandLatinos,aswellashighprimary&secondarysyphilisincidenceratesamongmales
countywide.TherateofHIVhospitalizationsisworstincentralSanJose.Thehealthneedislikelybeingimpacted
bylowscreeningratesforHIV(countywide,thepercentageofteensandadultseverscreenedforHIVislower
thanthestateaverage),aswellascertainsocialdeterminantsofhealth.Communityfeedbacksuggeststhatthe
healthneedisperceivedasprimarilyaffectingyouth,andisimpactedbypooroutreach,lackofknowledge/health
educationabouttransmission,risk,andscreening,thefearofstigmatizationbyothers,accesstoandcostsof
prevention(e.g.,condoms),andpeerpressure.
Page4
SubstanceAbuse(ATOD)
needs.Basedonthisscanofquantitativeandqualitativedata,substanceusewasprioritizedasoneofthe13top
healthneedsinthecounty.Thiscategoryincludedsmoking,alcoholandotherdrugs.
Thestatusofsubstanceuseneedsisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Santa
Clara
County
Indicator
Smoking
CA
10%
14%
18%
12%
Youth
%of11thgraderswhosmoked
cigarettespast30days
13%
16%
(highschool
youthonly)
13%
17%
16%
Adultheavyuse
consumption
DataSource
Adult
%ofadultswhocurrentlysmoke
Alcohol
SantaClara
CountyPublic
Health
Department,
BRFS,2009
CAHealthyKids
(CHKS),200910
CDCBRFSS
200410
Adultbingedrinking
%ofadultsreportingbingedrinking
inlast30days
25%
16%
24%
SantaClara
CountyPublic
Health
Department,
BRFS,2009
Youthbingedrinking
%ofyouthreportingbingedrinking
inlast30days
12%
9%
CAHealthyKids
(CHKS),200910
Otherdrugs
Anydruguse(adult)
%adultswhoreporteddrugusein
thepast12months
8%
Page1
HP2020
Benchmark
US
SantaClara
CountyPublic
Health
Department,
BRFS,2009
Indicator
Marijuanaabstinence(youth)
%11thgradersinpublicschool
reportedneverusingmarijuana
Santa
Clara
County
CA
US
HP2020
Benchmark
DataSource
64%
61%
CAHealthyKids
(CHKS),200910
SeeMentalHealthandAccesstoHealthCareprofilereportsforadditionalcrosscuttingdriversinfluencing
SubstanceAbuse(suchaspovertyandlackofhealthinsurancecoverage).
CommunityInput
Substanceuse(addictiontoalcohol,tobacco,orotherdrugs[ATOD],misuseofprescriptionmedication)
andoverallpoorbehavioralhealthwereofhighconcernin8outof25groups/interviews,andwere
mentionedinmanyothers.
Itwasacknowledgedthatlegalandillegaldrugsarerelativelyeasytoobtain.
Medicationmismanagement(includingsharingprescriptionswithothers)andlackofknowledgeabout
medications(appropriatedosages,risksofoverdose,risksofaddiction,appropriateuse)werementioned.
Somerespondentsfocusedonadolescentsandyoungadults,describingconcernssuchaspeerpressure,
stressandpoorcopingskills,curiosity,mediaportrayals,andparentalpermissiveness(uptoandincluding
supplyingATODtotheirchildren).
OtherrespondentsfocusedonadultATODuse/abuse,identifyingstressandpoorcopingskillsasdrivers.
Manyexpressedconcernsaboutcoordinationofcareandtheneedforapatientcenteredmedicalhome;
awarmhandshakeisabettertransferofcareofapatientfromoneprovidertoanotherwhenreferring
patientsforsensitiveissuessuchasATODuse/abuseormentalhealthmatters.
Behavioralhealthsupportnotcoveredbyallinsuranceplans
Lackofsupportgroupsandpractitionerswhospecializeinbehavioralhealth/addiction.
Familymodeling
Selfmedicatingwithalcoholorillicitdrugsinsteadofdealingwithrootissues.
Lifeworries(financial,family[includingseparationamongtheundocumented],highexpectations,major
losses)andbeingtoobusy(workingmultiplejobs,longhours,lengthycommutes)drivestress.
Impactonthosewhoareun/underinsuredandcannototherwiseaffordtreatment.
Unsafeneighborhoods(wheregangsorothersaredealingdrugs)
Page2
Stigmaofaddiction,especiallyinsomecultures,canextendtofamilyanddoctors,leadingthosewhoare
addictedtoremainuntreated.
Relativelackofservices;needforprogramstopartnerformoreeffective/efficientprovisionofservices.
TheSantaClaraCountyCommunityBenefitsCoalitionmembersandarepresentativefromtheSantaClaraCounty
HospitalCouncilofNorthernandCentralCalifornia
o
MedicalRespiteProgram
NewDirectionsProgram
Summary
SubstanceabuseisahealthneedinSantaClaraCountyasmarkedbylevelsofbingedrinkingamongyouthand
adultsthatarehigherthanHP2020benchmarks.Communityfeedbackindicatesthatthehealthneedisimpacted
bystressandpoorcopingskillsacrossallsubpopulations,concernsaboutthecostoftreatment,fearofbeing
stigmatized,andpooraccesstoprimarycareproviders,specialists,andothersupportoptionsduetolackof
insuranceorunderinsurance,particularlyamonglowincomeresidents.Medicationmisuseandmismanagement
wasalsodiscussed,andwasthoughttobeduetoalackofknowledgeaboutmedicationsandtheirassociated
risks.Inaddition,communityinputsuggestedthatadolescentsareespeciallyvulnerabletothishealthneed,asit
wasbelievedtheyaremoreaffectedbypeerpressure,curiosity,mediaportrayals,accessibilityofalcohol,tobacco,
andotherdrugs,andparentalpermissiveness.
Page3
Violence
needs.Basedonthisscanofquantitativeandqualitativedata,violencewasprioritizedasoneofthe13tophealth
needsinthecounty.
Thestatusofviolenceisdescribedinthisprofile,intermsof:
Keyindicators
Communityinput
Indicator
Santa
Clara
County
CA
HP2020
Benchmark
2%
4%
DataSource
Domesticviolence(recent)
%experiencedphysicalorsexual
violencebyintimatepartnerin
pastyear
CaliforniaHealth
InterviewSurvey
(CHIS)2009
Domesticviolence(ever)
%females1864everexperienced
sexual/physicalviolenceby
intimatepartnersinceage18
16%
21%
4.3
9.6
3.0
13.5
7.9
1.3
8.3
0
Childabuse
Rateofsubstantiatedallegations
ofchildmaltreatment
White
AfricanAmerican
Latino
NativeAmerican
Multiracial
Page1
CADept.Social
Services/UCBerkeley
CenterforSocial
ServiceResearch
(2011)
Violence
Santa
Clara
County
CA
HP2020
Benchmark
28%
victimsofhomicideper100,000
population
2.7
White
AfricanAmerican
Latino
Asian
Homicide(child/youth)
1.2
9.5
3.9
2.5
victimsofhomicideages014per
100,000ofthatage
0.80
5.5all
ages
Indicator
DataSource
Bullying
%ofmiddleandhighschool
studentswhoreportedbeing
physicallybulliedonschool
propertyinthelast12mos
CAHealthKids
(CHKS),200910
Homicide
Homicide(youth/youngadult)
victimsofhomicideages1524per
100,000ofthatage
7.4
5.5
5.5all
ages
CDPHVitalStatistics,
2009
CDPHVitalStatistics,
2009
Additionaldata:
Since2009,SantaClaraCountyhasseenanincreaseinhomicides.AccordingtotheSanJoseMercury
News,therewere40homicidesinSanJosealonein2011,and46inSanJosein2012,whichwould
substantiallyincreasehomiciderates.Dataontheagesofvictimswasnotavailable.
AfricanAmericanshavethehighestrateofsubstantiatedchildabuseallegationscomparedwithother
ethnicgroups,andthisrateishigherthanthestateaverage.
HomicideratesamongAfricanAmericansandamongyouth/youngadultbothfailagainsttheHealthy
People2020benchmarkforoverallhomiciderate.
Page2
Violence
Category
Santa
Clara
County
CA
%of7th/9th/11thgraderswho
considerthemselvesagangmember
7%
White
AfricanAmerican
Latino
NativeAmerican
Violentcrime
5%
14%
10%
5%
11%
Driver/indicator
DataSource
Gangmembership(youth)
Behaviors
Violentfelonyarrestrateper100,000
Adults
Youth(ages1017)
287.8
253.2
394.2
294.9
13%
17%
Alcoholconsumption(adult)
consumption
%ofadultsreportingbingedrinkingin
last30days
CADept.Justice
Profile,2010
CDCBRFSS
20042010
25%
16%
SantaClara
CountyPublic
Health
Department
BRFS2009
12%
CHKS,200910
8%
SCCPHD,BRFS
2009
Alcoholbinging(adult)
Alcoholbinging(youth)
%ofyouthreportingbingedrinkingin
last30days
AnyDrugUse(Adult)
%adultswhoreporteddruguseinthe
past12months
Physical
environment
CAHealthyKids
(CHKS),200910
Recreationalfacilities
numberper100,000populationof
recreationandfitnessfacilitiesas
definedbyNAICSCode713940
11
8.7
U.S.Census
Bureau,ZIPCode
Business
Patterns,2009
Seedataregardingadditionalcrosscuttingdriversinfluencingthishealthneed(suchaspovertyandlinguistic
isolation)intheAccesstoHealthCareprofilereport.Also,seedataregardingrelatedhealthneedsofSubstance
AbuseandMentalHealth.
CommunityInput
representativesandresidents.Themesfromdiscussionsregardingthehealthneedareidentifiedbelow.
Violencewasofhighconcernin7outof22groups/interviews,andwasmentionedinothers
Page3
Violence
Withregardtogangviolence,frequentthemesincludedthecostofand/orlackofhealthyoutletsand
activityoptionsforyouth;notfeelingtheyhavebetterlifealternatives;gangmembershipasawayto
belong,orasprotectionfromotherformsofviolence/abuse;andunsafecommunities.
Withregardtodomesticviolence,themesincludedunderreporting;lackofawarenessofsupportand
services;socialisolation;financial/economicstress;andunaddressedmentaland/orbehavioral(e.g.,
ATODabuse)healthissuesonthepartoftheperpetrator.
Withregardtobullying,themesincludedunderreporting;lackofpolicyenforcement;theriseinsocial
mediaasavenueforbullying;andconcernaboutbullyingasagatewaytogangsandotherformsof
violence.
Unemployment
Highstigmapreventspeoplefromreportingdomesticviolenceandgettinghelp.
Poorfamilymodels;canbegenerational.
Lackofparentingsupport.
Cultural/societalacceptanceofviolence,includingmediapromotion
Lackofeducationaboutcopingskills,conflictresolution
Languagebarrierstoseeksupport/protection.
Incarceration,whichcanforeclosefuturelifeoptions,promotegangmembership.
Easyaccesstoweapons.
OConnorHospital
o
AhospitalassociateisthechairoftheMembershipCommitteeoftheChildAbuseCouncilof
SantaClaraCounty
ThehospitalsponsorstheAnnualChildAbuseSymposium
ChildAbuseCouncilofSantaClaraCounty
CommunitySolutions
EMQFamiliesFirst
Page4
Violence
KidsinCommon,aprogramofPlannedParenthoodMarMonte
NextDoorSolutionstoDomesticViolence
RebekahsChildren'sServices
ProjectCornerstone,aYMCAofSiliconValleyInitiative
SantaClaraCountyOfficeofHumanRelations
SantaClaraCountyOfficeofWomensPolicy
YWCA
Summary
ViolenceisahealthneedinSantaClaraCountyasmarkedbyratesofyouthhomicidethatarehigherthantheHP
2020benchmarkforhomicideoverall.Ratesofbullyingarealsohigh,thoughnostatewidedataareavailablefor
comparison.Inaddition,whilecountywidelevelsofchildabuseanddomesticviolencedonotfailagainststate
averages,thepercentageofchildabuseamongAfricanAmericansismuchhigherthanthestateaverage.The
healthneedislikelybeingimpactedbyhealthbehaviorssuchasbingedrinking(wherethecountyadultrateis
higherthanthestateaverage)andgangmembership(percentagesofgangidentificationamongAfricanAmerican,
NativeAmerican,andLatinoyoutharehigherthanthecountywidelevels).Communityinputindicatesthatthe
healthneedisalsoaffectedbythecostofand/orlackofactivityoptionsforyouth,financial/economicstress,lack
ofpolicyenforcement,poorfamilymodels,unaddressedmentaland/orbehavioralhealthissuesamong
perpetrators,cultural/societalacceptanceofviolence,lackofawarenessofsupportandservicesforvictims,and
linguisticisolation.Communitymembersalsosuggestedthatviolenceisunderreportedbyvictims,possiblydueto
stigmaand/orculturalnorms.
Page5

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2013

Deputy County Executive

Santa Clara Valley Health &

Oct 2nd 1:00 pm

Mayview Community Health Center

Oct 2nd 2:00 pm

Santa Clara County Public Health

Oct 3rd 11:00 am

4. Dr. Marty Fenstersheib

Santa Clara County Health/Hospital

Oct 3rd 3:00 pm

Gardner Health Center

Oct 4th 10:00 am

Oct 4th 1:30 pm

Asian Americans for Community

Oct 17th 1:00 pm

8. Dr. Kent Imai

Community Health Partnership

Nov 6th 12:00 pm

9. Dr. Thad Padua

Santa Clara Family Health Plan

Nov 9th 1:00 pm

Sobrato Center for NonProfits (San Jose)

Sobrato Center for NonProfits (San Jose)

Sobrato Center for NonProfits (San Jose)

Valley Health Center (Gilroy)

5. Basic Needs Organizations

ASR (San Jose)

ASR (San Jose)

ASR (San Jose)

ASR (San Jose)

ASR (San Jose)

Stakeholder Participant Demographics

East San Jose

Central & West San Jose

South San Jose / Los Gatos

Palo Alto/Los Altos/Mountain View

Community Health Partnership, San

Community Health Partnership, San

Indian Health Center, East San Jose

Fresh Lifelines for Youth (FLY),

Columbia Neighborhood Center,

Kaiser Permanente, Gilroy

Rosemary Elementary School,

Catholic Charities, North San Jose

5. North County parents

Resident Participant Demographics

Annual household Income

Overall Average Priority Score

CHNAincludesinputfrompersonswhorepresentthebroadinterestsof Notice3.06 Section5and

Santa Clara County Health Need Profile

Key drivers or factors affecting the condition

Assets within the community that can make a difference

Status of Key Indicators, 2012

Santa Clara County Health Need Profile

Santa Clara County Health Need Profile

Lung Cancer Mortality

Note: Statistics from CARES Platform.

Santa Clara County Health Need Profile

Breast cancer incidence rate

Cervical cancer incidence rate

Liver cancer incidence rate

Liver cancer mortality rate