Cha

Community Health Assessment for Pima County
Health Education Council B
University of Arizona
October 25, 2018

2
COMMUNITY HEALTH ASSESSMENT FOR PIMA COUNTY
Contributors to the Community Health Assessment
Learning Team 6: Richelle Ainza, Sandra Gorayeb, Lily Jaeger, Peter Ma, Gabby Vosburgh,
Corelle Wickramasekera
Learning Team 7: Yasmine Arias, Cassandra Corrington, ToniAnne Gray, Carly Knolles,
Kiara Lopez, Lindsey Murphy, Carlye Robertson
Learning Team 8: Olivia Bucho, Chandler Everett, Diana Grijalva, Brittney Milnor, Calista
Rocha, Ciara Walden
Learning Team 9: Jaylene Arvizu, Kelsey Camps, Alison Johnson, Sarah Leahy, Ashleigh
Pendleton, Francesca Scardino
Learning Team 10: Ibtihal Amailou, Saby Castillo, Lauren Krebs, Taylor McQuillin, Luke
Roberts, Jayati Sharma
3
Table of Contents
List of Tables ..................................................................................................................................4
List of Figures .................................................................................................................................5
Introduction ....................................................................................................................................6
Geography and Environment of Pima County ...........................................................................7
Demographic Information...........................................................................................................12
Socioeconomic Stratification .......................................................................................................14
Health Statistics ............................................................................................................................19
Local Health Resources ...............................................................................................................24
Cultural Factors ...........................................................................................................................27
The County’s Governmental Organization/Function...............................................................30
Housing .........................................................................................................................................34
Food Supply ..................................................................................................................................38
Education ......................................................................................................................................40
School Health and Nutrition Programs .....................................................................................47
Social Welfare Programs .............................................................................................................51
Transportation .............................................................................................................................54
Occupational Data .......................................................................................................................59
Other Community Factors Impacting Health ...........................................................................61
Summary .......................................................................................................................................66
References .....................................................................................................................................70
4
List of Tables
Table 1. Pima County Population Demographics. .........................................................................13

Table 2. Leading Causes of Morbidity in Pima County. ...............................................................20
Table 3. Cancer Incidence Rates in Pima County by Race. ..........................................................21
Table 4. Yearly Cost of Housing in Pima County ........................................................................35
Table 5. Educational Attainment in Pima County by Race, Gender, and Level of Education. .....41
Table 6. Student Meal Prices for the 2017-2018 School Year. ....................................................47
Table 7. After School Meal & Snack Programs: Meal Sites. ........................................................49
Table 8. After School Meal & Snack Programs: Snack Sites. .....................................................50
Table 9. After School Meal & Snack Programs: Snack Sites. .......................................................1
5
List of Figures
Figure 1. Map of Pima County. .......................................................................................................7
Figure 2. TCE Contamination ..........................................................................................................9
Figure 3. Pima County Demographics ...........................................................................................13
Figure 4. Poverty Statistics ............................................................................................................15
Figure 5. Poverty Rate by Age (2016).. .........................................................................................16
Figure 6. Poverty Rate by Race & Ethnicity (2016). .....................................................................16
Figure 7. Poverty Rate Comparisons between Tucson, Arizona, and the U.S. (2016). .................17
Figure 8. Pima County Employment Statistics ..............................................................................17
Figure 9. Median Household Income. ...........................................................................................18
Figure 10. Pima County Occupations. ...........................................................................................19
Figure 11. Percent of Reported Cases of Communicable Diseases. ..............................................20
Figure 12. Total Mortality Rates from All Causes. .......................................................................23
Figure 13. Health Reports for Arizona, by County.. ......................................................................24
Figure 14. Poverty by Age and Gender in Pima County. ..............................................................29
Figure 15. Pima County Organizational Chart. .............................................................................30
Figure 16. Monthly Cost of Housing in Pima County. ..................................................................36
Figure 17. Zip Code Project Data. .................................................................................................44
Figure 18. Increasing Diversity in Arizona Charter Schools Over Time. .....................................44
Figure 19. Common Methods of Transportation in Pima County .................................................55

6
Introduction
A Community Health Assessment (often known as a community health needs assessment
or a CHA) is a thorough assessment of a community’s health status, needs, and issues “through
systematic, comprehensive data collection and analysis,” according to the Centers for Disease
Control and Prevention (CDC, 2015). A CHA allows for a deep and all-inclusive evaluation of a
community’s strengths and weaknesses and characterizes areas in which the community can
improve its ability to promote individual and population health. The publication of the CHA
allows for the development and eventual implementation of policies, laws, and regulations that
promote public health awareness and improve or establish health promotion initiatives in the
community of interest.
Pima County is the second largest population in Arizona, and is home to unique
dynamics in that it borders Mexico and is home to a large Latino population. Within the
following document is a holistic examination of several factors influencing the general health
status of Pima County, these including: geography, demographic information, socioeconomic
stratification, health statistics, local health resources, housing, food supply, transportation, and
many other such factors represented throughout the CHA. Through the assessment, this
document seeks to identify subpopulations that face significant health challenges in Pima
County, and how these disparities can be mitigated.

7
Geography and Environment of Pima County

Pima County is located in the southern part of Arizona and north of the Sonora, Mexico
border. Pima is one of fifteen current counties and one of four original counties in the state of
Arizona. The county expands roughly 9,200 square miles and the elevation ranges from
approximately 1,200 feet to 9,185 feet, the peak of Mount Lemmon (Pima County, 2016a).
Within Pima County, there is the Coronado National Forest, Catalina State Park, Organ Pipe
Cactus National Monument, Ironwood National Monument, Buenos Aires National Wildlife
Refuge and Saguaro National Park (Pima County, 2016a). Also, there are two Native tribe
reservations: the Tohono O’odham Nation and the Pascua Yaqui Nation.
Figure 1. Map of Pima County.

Image retrieved from:
https://pimamaps.pima.gov/Html5Viewer/index.html?configBase=https://pimamaps.pima.gov/G
eocortex/Essentials/REST/sites/mainsite/viewers/mainmap/virtualdirectory/Resources/Config/De
fault
The environment of Pima County includes a number of mountain ranges including Puerto
Blanco Mountains, Sonoyta Mountains, Sikort Chuapo Mountains, Santa Rosa Mountains,
8
Comobart Mountains, Coyote Mountains, Alvarez Mountains, Tortolita Mountains, Tucson
Mountains, Santa Rita Mountains, and Santa Catalina Mountains (Pima County, 2016a). Pima
County determines air quality by using the Environmental Protection Agency’s (EPA) National
Ambient Air Quality Standards, which uses two standards, Primary Standard, which provides
public health protections, and Secondary Standard, which provides public welfare protections
(EPA, 2017). The current air quality usually ranges in the “good” condition meaning it meets
both of the standards. (Pima County, 2018a). Pima County has mainly a desert environment that
affects its climates with average high summer temperatures of 100 degrees Fahrenheit and
average low summer temperatures of 72 degrees Fahrenheit and average high winter
temperatures of 73 degrees Fahrenheit and average low winter temperatures of 50 degrees
Fahrenheit. Annually, Pima County gets around 12 inches of rain (U.S Climate Data, 2017).
The residents of Pima County face numerous issues in regards to the threats posed by the
environment and geography. The primary concern that has become the forefront of many
campaigns is the issue of water quality and safety. Since the early 1940s, the chemical
Trichlorethylene (TCE), has been continually dumped into groundwater supplies of the south
side of Tucson by the company, Hughes Aircraft, as well as the city of Tucson. This industrial
solvent caused a multitude of health issues seen within the residents of south Tucson, such issues
include: cancer, lupus, central nervous disorders, and birth defects (Davis, 2017). In 1981,
lawsuits were brought forward by south Tucson’s residents claiming that TCE can be linked to
the health issues that have arisen since the contamination began. However, it was not until 1987
that the city of Tucson worked to clean the contaminated wells and provide residents with clean
drinking water (Trichlorethylene, 2014). Through continued inaction and negligence, the
residents of south Tucson are extremely hesitant to drink the water provided to them from the
9
city of Tucson. Unfortunately, the health issues that arose from the chemical, TCE, affected
certain populations within the city of Tucson. In 2016, the poverty rate of south Tucson was
48.9%, with a population of 5,627 (South, 2016), indicating that many individuals who were
primarily lower socioeconomic status in south Tucson were disproportionately affected by the
contaminated water compared to their wealthier counterparts.
Figure 2. TCE Contamination.

Image retrieved from: http://coep.pharmacy.arizona.edu/tce/tce_plume_large.html
Another issue that affects a different population within Pima County surrounds the
problem of air quality. Southern Arizona faces numerous dust storms throughout the year, and
with that comes unexpected health consequences that primarily affect those who have breathing
problems as well as the elderly. Such health problems include asthma attacks, cause or aggravate
bronchitis and other lung diseases, as well as impacting the body’s ability to withstand infections
(Dust, n.d.). In 2016, the number of inpatient discharges for asthma in Pima County was 10,481
with 3,558 being male and 7,283 being female. The demographics included 6,971 White Non-
Hispanic, 2,549 Hispanic or Latino, 628 Black or African-American, 484 American Indian or
10
Alaska Native, 121 Asian or Pacific Islander, and 86 Refused (Arizona Department of Health
Services, 2017). Also noted in the 2016 report was the third leading cause of death in the elderly
(65+) being chronic lower respiratory diseases, which can be greatly impacted by the air quality.
The number of deaths in the elderly due to chronic lower respiratory diseases for Pima County
was 493 in 2016. (Pima County, 2018a). The demographics for the total number of cases for
chronic lower respiratory diseases in the year 2016 include 3,432 for White non-Hispanic, 211
for Hispanic or Latino, 87 for Black or African-American, 38 for American Indian or Alaska
Native, and 20 for Asian or Pacific Islander (Pima County, 2016a).
Extreme heat is also another concern that many residents face during the summer months.
Pima County’s average temperature for the month of July is 104 degrees Fahrenheit, with many
of those days reaching temperatures in the 105-110 degree Fahrenheit range (Pima County,
2018s). Through continued exposure to extreme heat and the body’s limited ability to retain
homeostasis, many residents of Pima County face dehydration, heat strokes, and even death.
From 2006-2016, Pima County accounted for 40% of deaths in the state of Arizona due to
exposure to natural heat (Sagna et al., 2018). A group that is substantially impacted by the
extreme heat is undocumented immigrants. In 2016, 26% of the deaths of undocumented
immigrant remains identified by the Pima County medical examiner were caused by exposure to
extreme heat combined with dehydration (Pima County Office, 2017). Also, to be noted is that
with this extreme heat and overexposure to the sun and UV rays comes the potential health
concern of skin cancer. It was found that, in 2015, Pima County’s incidence rate for melanoma
of the skin was 25.8 cases per 100,000 individuals, the highest rate out of any county in the state
(State Cancer Profiles, 2015).

11
Invasive species of vegetation that are causing a substantial impact in the environment in
Pima County include brome, buffelgrass, Lehmann’s lovegrass, Boer’s lovegrass, and Johnson
grass. These various types of grasses have led to extreme fire hazards, the crowding out of
natural plants, and changing the current biome of the Sonoran Desert (Buffelgrass, n.d.). These
types of grasses can burn at over 1000 degrees and almost three times hotter than the natural
vegetation that burns in the Sonoran Desert, thus resulting in the destruction of the natural flora
in Pima County (Buffelgrass, n.d.). Different weeds that are also causing problems within Pima
County include various varieties of mustard and Malta starthistle and Centaurea melitensis
(Invasive, n.d.). Because of the various threats posed by these vegetation species, Pima County
has enlisted the help of volunteers and organizations to combat the constantly growing problem
of proliferating non-native grasses and weeds. Despite unanimous consensus that not only the
native vegetation but homes and communities may be threatened, these grasses and weeds
continue to prove financially difficult as well as time-consuming to deal with. Until a financially
feasible and time-friendly solution can be found, the problem with the vegetation in Pima County
will continue.
The health risks that affect any population or group of individuals related to the county’s
geography and population primarily surround the individuals who may be disproportionately
affected by their surroundings because of a lack of resources to meet required needs. Such
groups include the elderly, homeless, and lower socioeconomic status individuals, children,
immigrants, and minorities. These populations are affected by their environment and geography
due to the lack of access to much needed resources that stems from inadequate health care
systems in place, negligent education in regards to all aspects of an individual, and a lack of
12
services that can work to limit the illnesses, diseases, and complications that affect at-risk
populations.
However, Pima County is working diligently to place resources within reach for at-risk
populations. To address overexposure to heat in Pima County, for example, many organizations
such as the Salvation Army, Frontera, Pima County Libraries and others provide resources to the
homeless in regards to ‘cooling off’ during the summer months. Other resources that are being
applied to combat the mentioned asthma and other breathing problems include the University of
Arizona partnership with the Tucson Unified School District to implement an asthma-based
program that works to educate children about asthma (Kelly, 2018). A Pima County initiative
that aims to address the heat-related deaths is through educating communities on how to stay safe
during the extreme heat. Pima County officials have released tips and information regarding the
signs and symptoms of heat-related illnesses as well as how to prepare and care for your body
during outside activities (Long, 2018). Resources that focus on enabling each and every single
individual to reach their full potential regardless of the environment and geography that
surrounds a county will be required to limit health care costs while allowing individuals to
participate fully in the community.
Demographic Information
Out of the 6,728,577 residents of Arizona, 1,003,338 reside in Pima County (US Census,
2017). The greater part of Pima’s population (78.1%) consists of those who are 18 years or older,
followed by those who are 65 years or older (17.8%) and children under 5 years old (5.9%).
Females make up 50.8% of the population in Pima County whereas males make up 49.2%. These
sex demographics are similar to those of the state of Arizona where females make up 50.3% and
males make up 49.7% of the total population.

13
The majority of residents in Pima County are White (95.9%), followed by Black (3.5%),
American Indian or Alaskan Native (3.2%), Asian (2.7%), and Native Hawaiian or Pacific
Islander (0.1%). A total of 36.1% of Pima County residents identify as Hispanic or Latino
ethnicity (any race). White individuals make up the majority of each age cohort, followed closely
behind Hispanics. The age group 0-4 shows very similar levels of both White and Hispanic
individuals (Pima County, 2016a).
Figure 3. Pima County Demographics

Image retrieved from: https://statisticalatlas.com/county/Arizona/Pima-County/Race-and-
Ethnicity#figure/relative-ethno-racial-composition-by-age
Table 1. Pima County Population Demographics.

Pima County Arizona
Population (2016 estimate) 1,003,338 6,728,577

% Male 49.2 49.7
% Female 50.8 50.3
% under 5 years old 5.9 6.5
% 18 years or older 78.1 75.9
% 65 years or older 17.8 15.9
% of race White 95.9 96.7
% of race Black 3.5 4.3
14
% race American Indian or 3.2 4.4

Alaskan Native
% race Asian 2.7 3.1
% Native Hawaiian or Pacific 0.1 0.2
Islander
% Hispanic or Latino 36.1 30.5
ethnicity (any race)
(Pima County Population Demographics, 2016)
Socioeconomic Stratification
Socioeconomic stratification is when a society categorizes people based on factors such
as income, wealth, race, education, and power. The system could be thought of as a ranking or
hierarchy. For example, in the United States it is apparent that the government and society in
general takes status into consideration when determining power and wealth (Lumen, 2018).
Socioeconomic status on the other hand is a combination of a person's work experience and
social position compared to others income, education, and occupation. In regards to
socioeconomic stratification and socioeconomic status, it is important to fully understand the
term poverty and all of its aspects. Poverty is the condition of not meeting the basic needs to get
by on a day to day basis. There are two different forms of poverty, one being absolute poverty
meaning that the individual does not have enough resources to maintain adequate physical
health. The second classification of poverty is relative poverty, which refers to when people do
not enjoy a level of living according to the government. In addition to the proposed poverty line,
Pima County is now ranked to be number two in poverty. A study conducted by the Bureau of
Economic Analysis concluded that the average Arizonan earns far less compared to numerous
states. The average annual income in Pima County in particular was calculated to be $33,259
even with multiple assistance such as the Recovery Act and other programs providing aide with
tax relief and support on multiple levels; Americans were barely kept out of poverty.
15
Figure 4. Poverty Statistics of Pima County.

Image retrieved from: https://tucson.com/news/local/arizona-is-now-no-in-
poverty/article_551a7372-415a-5dc5-a27d-ab19a1171e81.html
In terms of how poverty is measured and reported, the United States determine the
official poverty is measured by comparing approximately 100,000 addresses in the course of
three months (February, March, and April). The estimates are collected through the Current
Population Survey Annual Social and Economic Supplement (CPS ASEC). Poverty in
comparison to the official poverty measure has a similar process. The main difference is the
United States compares a person's income to the set poverty threshold and all those who earn less
are then considered poor. The same process takes effect when creating the family's income
(University of Wisconsin-Madison, 2018). The individual median household income in Pima
County was calculated to $47,560 and the individual income was then calculated to about half at
a total of $26,204.
16
Figure 5. Poverty Rate by Age (2016).

Image retrieved from: https://mapazdashboard.arizona.edu/health-social-well-being/poverty-rate
Figure 6. Poverty Rate by Race & Ethnicity (2016).

Image retrieved from:https://mapazdashboard.arizona.edu/health-social-well-being/poverty-rate
17
Figure 7. Poverty Rate Comparisons between Tucson, Arizona, and the U.S. (2016).
Image retrieved from: https://mapazdashboard.arizona.edu/health-social-well-being/poverty-rate
When comparing the multiple graphs, it is crucial to take into consideration the
relationship of educational attainment level to the individual and family income, race/ ethnicity,
family household and sex. Throughout Pima County, the average male salary is $59,876 in
comparison to female, the female average salary is $45,805. In 2016, it was calculated that a
male earned 1.31% more than a female regardless of their occupation. In the graph below, it
shows the five most common occupations and a comparison of the wages earned by a male or
female as a full-time employee.
Figure 8. Pima County Employment Statistics.

Image retrieved from: https://datausa.io/profile/geo/pima-county-az/
18
Similar to the female average salary, the household income is less than the average
median annual income. The United States is slightly over $55,000 while Pima County is
averaged at an approximate of $47,560.
Figure 9. Median Household Income.

In addition to gender differences, race and ethnicity have become an important factor in
determining wages. Asians earn the highest wages in Pima County (averaging $61,346),
followed by Caucasian earning $48,799. In addition, Figure X (shown below) is constructed of
nine different colors each representing a race; light blue is American Indian, turquoise is Asian,
orange represents White, light orange is African-American, purple is Pacific Islander, dark blue
is two or more races, navy blue is unknown, yellow represents American Indian, and finally red
is Alaskan Native. For four of the common occupations, every race/ethnicity is within a close
proximity of the average salary. It is in the miscellaneous managers section in which Asians
exceed the average salary by triple the average amount.

19
Figure 10. Pima County Occupations.

Health Statistics
Pima County has a total population of 1,022,769 people (U.S. Census Bureau, 2016).
Pima County has a diverse population that experiences a variety of health outcomes. These
health outcomes are influenced by several factors, including race, gender, ethnicity and age. The
incidence of communicable diseases is depicted in Figure 11. It is apparent that influenza is the
most prominent infectious disease among the residents of Pima County and that valley fever
follows as a close second. This figure depicts the morbidity among communicable diseases in
Pima County, it is obvious that a majority of these communicable diseases could be avoided and
prevented.
20
Figure 11. Percent of Reported Cases of Communicable Diseases

Infectious Disease Epidemiology. (2013)
The most common causes of morbidity in Pima County are included the figure below.
Table 2 shows the behaviors and preventative actions that influence morbidity in Pima County
and Arizona as a whole. For example, Pima County as a whole has a higher binge drinking
average than the rest of Arizona (Healthy Pima, 2018).
Table 2. Leading Causes of Morbidity in Pima County.

Cause of Morbidity Pima County Arizona
Binge Drinking 17.5% 13.4%
Smoking 16.4% 16.3%
Overweight/Obese 59.5% 61.9%
Colon Cancer Screening 15.0% 15.0%
Pap Test History 78.7% 73.3%
Mammogram 75.5% 69.5%
Diabetic Monitoring 81% 79%
Physical Inactivity 30% 21%
(Healthy Pima, 2018)
The leading cases of noncommunicable diseases in Pima County are obesity, diabetes,
asthma, and cancer, each of these diseases affect all demographics independently (Healthy Pima,
2018). Diabetes has the highest rates among American Indian/Alaska Native individuals; this
group’s average morbidity rate from diabetes in the population in 2015 was 18.4%. The
21
Black/African-American group followed with 13.1% of the population being burdened by
diabetes. 11.2% of Hispanics and 9.5% of Whites were affected by diabetes in Pima County. The
group with the lowest morbidity due to diabetes was the Asian/Pacific Islander group at 4.0%.
Diabetes specifically affects the following age groups: ages 65+ (20.1%), 55-65 (17.7%), and 45-
54 (12%). The younger groups, 35-44 (5.2%), 25-34 (2.4%), and 18-24 (1.4%), are generally not
as burdened with diabetes as are the older groups (Sagna et al., 2017). Men, on average, have
greater morbidity rates of diabetes (10.9%) when compared to females (9.7%) (Sagna et al.,
2017).
Cancer is also a leading morbidity in Arizona; this disease takes many lives and affects
all ethnicities, genders and groups differently. The table below demonstrates the incidence of
cancer among all ethnicities, it is apparent that non-white Hispanics are the most affected by
cancer in Pima County, followed by Blacks, White Hispanics, American Indians, and Asian &
Pacific Islander. The cancer statistics for Pima County indicate that men (381.5 cases of cancer
per 100,000 men) have higher rates of cancer than women (342.9 cases of cancer per 100,000
women) (Humble, 2010). Pima County’s most prevalent cancer is breast cancer, shortly followed
by lung/bronchial cancer (Synergy: Lifestyle Medicine, 2018).
Table 3. Cancer Incidence Rates in Pima County by Race.

Race Incidence Rate per 100,000 persons
White Non-Hispanic 408.0
White Hispanic 271.2
Black 316.9
American Indian 256.5
Asian & Pacific Islander 234.5
All Races 379.78
(ADHS, 2018)
There are different mortality rates for people living in Pima County of different age
groups, sex, and racial/ethnic groups. According to the Arizona Department of Health Services
22
(AZDHS), The leading cause of death in infants is related to low birth weight, and the leading
cause of death in children (age 1-14 years) is congenital brain malfunction (AZDHS, 2018). The
most deaths in adolescents (15-19 years) are caused by motor vehicle accidents, while the main
cause of death in young adults (20-44 years) is “assault by other and unspecified firearm
discharge”. The main cause of death in both mid age (45-64) and aged (85+) is chronic ischemic
heart disease (AZDHS, 2018). Lastly, the main cause of death in the elderly (65-84) is also
chronic ischemic heart disease (Infectious Disease Epidemiology 2013).
Men and women in Pima County have different mortality rates and statistics. Deaths for
both genders in Pima County in 2017 reached 9,527 (Kemp et al., 2018). Men made up 52.7% of
these deaths, and women made up 47.3% of these total deaths (Kemp et al., 2018). Major
cardiovascular diseases were the leading cause of death in both males and females in Pima
County, with the second leading cause of death in men and women being malignant neoplasms
(Kemp et al., 2018).
Cardiovascular disease also was the leading cause of death in all racial and ethnic groups
in Arizona, with African-Americans having a higher death rate from this disease, at 266.8 deaths
per 100,000 cases. Malignant neoplasm was the second leading cause of death in all racial and
ethnic groups (Sagna et al., 2017).
As far as mortality goes for all racial and ethnic groups in Arizona, American Indians
have the highest rates of mortality and Asians have the lowest rates. In a count of per 100,000
individuals, 0.97% of American Indians died, followed by African-Americans at 0.83%, then
white non-Hispanics at 0.7%, then Hispanics at 0.6%, and lastly Asians at 0.41% (Sagna et al.,
2017).
23
Figure 12. Total Mortality Rates from All Causes

Image retrieved from: https://pub.azdhs.gov/health-stats
Within Arizona, people have perceptions and ideas of health status within genders,
racial/ethnic groups, and age groups. In Arizona, 81% of the population reported having good
health status, and 80% of Pima County residents reported good to excellent health (Bass et al.,
2014).
24
Figure 13. Health Reports for Arizona, by County.

Image retrieved from: https://azdhs.gov/preparedness/public-health-statistics/behavioral-risk-
factor-surveillance/index.php
A slightly higher rate of men than women reported good to excellent health, at 81.8%, as
opposed to women at 80.2% (Bass et al., 2014). The rate of people who reported good to
excellent health varied among age groups, at 91.3% for those 18-24, 85.5% for those 25-35,
84.4% for those 35-44, 77.7% for those 45-54, 73.6 for those 55-64, and finally 76% for those
65+ (Bass et al., 2014). Within racial and ethnic groups, Asian/Pacific islanders reported good
health at the highest rate at 91.4%, followed by white non-Hispanics at 83.7%, African-
Americans at 78.5%, Hispanics at 75.1%, and American Indians at 73.4% (Bass et al., 2014).
Local Health Resources
Residents of Pima County rely on multiple resources for their health service needs. With
the county’s population exceeding 1 million people, certain services need to be offered to take
25
action in providing healthcare for individuals across the area. A few governmental agencies that
provide health services are Pima County Health Department and Pima County Department of
Environmental Quality (PDEQ).
The Pima County Health Department is dedicated to helping residents of the county
maintain and achieve the highest level of wellness. This department offers a wide spectrum of
services. Their areas of services include advisories and alerts, preventative health, clinics and
maps, consumer health and food safety, behavioral health, education and outreach, resources for
professionals, sexual health, and personal records (Pima County, 2018j). Specific health services
from these categories include policies and procedures, immunizations, food recalls, prescription
medicine disposal, communicable disease reporting, treatment for HIV and sexually transmitted
diseases, and birth/death certificates. Environmental health is just as important as physical and
overall health. The PDEQ serves to protect the long-term benefits of the residents of Pima
County. This department is responsible for identifying and responding to environmental issues.
Their main areas of services include services in water, air, and waste and recycling. Specific
services include air quality monitoring, sewage collection systems, and the waste program
(Environmental Quality, 2018).
Community-based organizations that offer health services include Casa de los Niños and
United Way of Tucson and Southern Arizona. Casa de los Niños is a community-based
organization that was founded to protect children from child abuse and neglect. Specific services
include behavioral and mental health treatment, immediate crisis medication, and child abuse
prevention programs. Their main health service focus is on behavioral health, which includes
individual, family, and group therapy and psychiatric services (Urizar-Faught, 2018). The United
Way of Tucson and Southern Arizona (UWTSA) focuses on four main services for a healthy
26
community. The ELDER Alliance strives to ensure that adults stay healthy and active and
independent in the community. The End of Life Care Partnership is committed to ensuring
quality of life at every stage through education, support, sound policy and choices. UWTSA also
provides Affordable Care Act navigation services to those who need them so every Southern
Arizonan can have access to quality, affordable health insurance. UWTSA also works with
parent educators, childcare centers, and homes throughout the community to implement healthy
nutrition to decrease obesity among young children (Gray-Emmer, n.d.).
Faith-based organizations in Pima County include the Tucson Interfaith HIV/AIDS
Network or TIHAN, which is a non-profit organization that allows individuals and faith
communities to come together to reduce stigma and sustain hope for those living with
HIV/AIDS. This foundation has a program called “Living Well with HIV” that provides a
variety of classes, presentations, and discussions that support individuals with HIV in becoming
more active participants in their own physical, emotional, and spiritual health and wellbeing. Poz
Cafe is also a monthly lunch service for people living with HIV. It is a great opportunity for
people to get out of the house, take a break, meet other positive people, and enjoy great food.
TIHAN also provides a monthly care package filled with toiletries such as toilet paper, paper
towels, shampoo, soap, toothpaste/toothbrushes, deodorant, and feminine hygiene products.
Individuals with HIV/AIDS are eligible for one Care Package a month (TIHAN, 2017). Teen
Challenge Arizona or TCAZ is a Christian Faith-based solution on the drug epidemic. TCAZ
strives to help people become mentally sound, emotionally balanced, socially adjusted,
physically well and spiritually alive (TCAZ, 2018). Outreach services include church
presentations, school drug-prevention presentations, and health fairs and community
involvement.
27
Pima County has many great resources for the general population. They also provide
great resources for special populations that are in need of specific resources. The Pima County
provides special resources for the disability population like DIRECT disability resource center,
Pima Council on Aging (PCOA), Southern Arizona AIDS Foundation (SAAF), Southwest Fair
Housing Council (SWFHC). DIRECT is a center that promotes independent living with variety
of housing options that are equipped with assisting agents for people who are disabled. PCOA
provides aging services like advocacy programs and information to the elderly population to
improve the aging experience for people. SAAF is an organization that provides a range of
housing services like programs, meetings, and skill-building workshops to help prevent the
spread of HIV/AIDS. SWFHC was designed to create equal access for housing and housing
services by removing forms that have relations to illegal discrimination or discouraging practices
that deny access to housing for certain people.
Cultural Factors
Pima County is an extremely diverse community that is home to people of all ethnicities,
races, and cultures. Of the 1,022,769 people in the community 51.8% identify as White, 37.3%
as Hispanic or Latino, 4.1% as African-American, 4.3% as American Indian, and 3.3% as Asian.
For more than 200 centuries, American Indians have maintained Tucson as their home. In 2000,
Tucson became the 8th largest city in terms of how many American Indians lived there. In 1990
the metro area became the 23rd largest place where Hispanics reside (Tucson Update – Ethnicity,
2015). A majority of Pima County’s residents, regardless of their race or ethnicity, are living in
Health Professional Shortage Areas (Healthy People, 2016). There is a higher percentage of
Hispanics that reside in Pima county than any other county in Arizona that speak a language
other than English at home. The most prevalent diseases among all the ethnicities throughout the
28
county include cardiovascular disease, hypertension, diabetes (especially in the American Indian
community), obesity, and HIV/AIDS. Communities of low socioeconomic status and ethnic
minority communities are more likely to experience a shortage in food in the physical
environments around them. With that being said Latinos and African-Americans are more likely
to live in food deserts which makes them eat foods that aren’t good for them causing them to
become overweight and their health to decline (Pima County, 2018j). Another issue that
communities with health disparities suffer with is the little access they have to outdoor or
recreational facilities to get physical activity, which is another cause for minorities in Pima
County to be overweight. Neighborhoods that are known to have a low socioeconomic status,
ethnic segregation, undesirable commercial establishments, and poverty are known to suffer
from a social disorder that can be associated with negative outcomes (Target Area Report, 2012).
There are many cultural factors that impact each cultural environment of one’s health
status. Socio-economic status of an individual happens to be one of the main influences on health
in a specific cultural population (Hernandez, et al., 2006). Debating on one’s socioeconomic
status, whether it is poverty or wealth, it defines how an individual’s lifestyle affects specific
health situations. In Pima County, it is recorded to have more than 18% of the population claim
to be living below the poverty line (Pima County, 2018j) Socioeconomic status is based on many
varieties like race/ethnicity, gender, immigration status, etc. (Hernandez, et al., 2006). The
leading group living on or below the poverty line is females aged 18 to 24, followed by men
aged 18 to 24 (Pima County, 2016j). Pima County’s proximity to the Mexican border can
indirectly contribute to poor nutrition, heating and health insurance, which are risk factors that
lower health status in a socioeconomic figure (Hernandez, et al., 2006). There are many cultural
factors that impact each cultural environment of one’s health status. Socioeconomic status of an
29
individual happens to be one of the main health factors in a specific cultural population
(Hernandez, et al., 2006). Debating on one’s socioeconomic status, whether it is poverty or
wealth, it defines how an individual’s lifestyle affects specific health situations. Pima County is
recorded to have more than 18% of the population claim to be living below the poverty line
(Pima County, 2018j). Socioeconomic status is based on many varieties like race/ethnicity,
gender, immigration status, etc. (Hernandez, et al., 2006). The leading gender living on the
poverty line or below it is females from ages 18 to 24, and then men within the same age group
(Pima County, 2018j). Pima County’s proximity to the border can lead to poor nutrition, heating
and health insurance, which are risk factors that lower residents’ health status in a socioeconomic
figure (Hernandez, et al., 2006).
Figure 14. Poverty by Age and Gender in Pima County.

Image retrieved from: https://datausa.io/profile/geo/pima-county-az/.
30
The County’s Governmental Organization and Functions
Figure 15. Pima County Organizational Chart.

Image retrieved from: http://webcms.pima.gov/
Pima County is composed of diverse and growing bodies of governmental leadership in
the form of organizations, agencies, and individuals. Pima County is consistently governed by
the Board of Supervisors, followed by the County Administrators. According to Figure 15, The
realm of organization for these governing bodies fall within five categories: Administration,
Community and Economic Development, Justice and Law Enforcement, Health Services, and
Public Works. There are five members on the Pima County Board of Supervisors that are divided
by district; these supervisors are responsible for guiding public policy in their region. The locally
elected supervisors work with other districts to ensure safe communities, oversee municipal
services, review and enforce taxation, manage revenues, create and manage the county’s budget,
and, most generally, protect the public health of the entire county (Pima County, 2018e).
31
As seen in Figure 15, under the Board of Supervisors are the County Administrators.
County Administrators work to provide management, coordination, and communication of the
goals, information, and legislation set forth by the Board of Supervisors (Pima County,
2018g). The five district supervisors and the County Administrators collaborate to boost the
Community and Economic Developmental status of the county. In this sector, there are five
department divisions: Community Development and Neighborhood Conservation, Community
Services, Employment, Training, Attraction and Tourism, Pima County Public Library, and
Stadium District. These departments work together to improve the standard of living for low-
income and rural populations and promote the economic development of a community (Pima
County, 2018h). These community services are overseen by the Community Action Agency
Board, which includes 15 members from various county districts. There are 5 members from the
Pima County Board of Supervisors, 5 elected low-income representatives, and 5 representatives
from the private sectors. Together, these individuals serve to advise and empower community
service programs (Pima County, 2018f).
The promotion of a healthy and safe community is also the responsibility of the Board of
Supervisors within the Justice and Law Enforcement sector of Pima County. The Pima County
Sheriff’s Department is responsible for a plethora of services available to the communities of
Pima County. They uphold a number of duties, such as reports, neighborhood watch, orders of
protection, to promote and protect the safety of citizens (Pima County Sheriff’s Department,
2018). In addition to Pima County Sheriff’s Department, there is the Arizona Supreme Court of
Pima County; which works with the administrations and execution of justice under the law. The
Arizona Supreme Court of Pima County contributes to the timely, fair, and efficient manner of
the judicial system in the county and boosts the confidence of justice and safety for the people
32
(Arizona Supreme Court, 2018).
To keep everyone in Pima County healthy, the Pima County Health Department dedicates
their resources to promoting and maintaining optimal levels of health and wellness. Services
provided by this organization are: preventative health, education and outreach, sexual health,
personal records, behavioral health, consumer health and food safety, and volunteerism (Pima
County, 2018j). For the people of Pima County, the Health Department provides comprehensive
and professional networks for enhancing community health and wellness. Public Works, another
sector under the Board of Supervisors, allows employees to increase the quality of life for the
benefit of present and future citizens of Pima County. The Public Works department includes
several sub-departments that promote the safety of the community and environmental health
(Pima County, 2018q).
The sections of Public Works are: Development Services, Environmental Quality, Flood
Control, Natural Resources, Parks, and Recreation, Office of Sustainability and Conservation,
Real Property Services (Real Estate), Transportation, and Wastewater Reclamation (Pima
County, 2018q).
Within Pima County’s Organizational Chart, there are a few departments that consist of
maintaining the health and safety of the county/ or state. The organizations that provide health
and safety to the county/ or state are Health Services and Sheriffs that fall under Justice & Law
Enforcement. Within the Health services are the following:
• Attractions and Tourism: Helps in increasing economic stability through businesses such as
Old Tucson, Arizona-Sonora Desert Museum, Pima Air and Space Museum, etc. (Pima
County, 2018c).
• Behavioral Health: Provide better accessibility and availability for those that need behavioral
33
health services (Pima County, 2018d).
• Community and Economic Development: Has 5 departments that contribute in improving
standards of living in low-income and rural areas (Pima County, 2018e).
• Community Development and Neighborhood Conversion: Allows to have more livable and
viable county for residents to help improve their quality of life (Pima County, 2018f).
• Community Services, Employment and Training: Have programs that improve economic and
social sustainability of Pima County by:
o Developing skilled workers for quality jobs;
o Assisting employers to address workforce and recruitment needs; Mitigating the
impact of layoffs;
o Assisting households in financial crisis;
o Helping persons with barriers, such as homelessness and lack of literacy, to
transition into our economic talent pool (Pima County, 2018g).
• Health Department: Help residents in maintaining optimal level of wellness in Pima County
(Pima County, 2018j).
• Medical Examiner: Provide accurate, timely, compassionate and professional death
investigation services for the citizens (Pima County, 2018k).
• Office of Emergency Management: Establishes a comprehensive countywide, all-hazards
structure to provide for successful and well-organized coordination of Pima County
regional emergency management activities (Pima County, 2018l).
• Pima Animal Care Center: Rescue pets in need, protect the community and save lives (Pima
County, 2018m).
• Pima County Wireless Integrated Network (PCWIN): Allows for public services to reach out
34
and talk to each other by radio in real time on a single system, regardless of their
jurisdiction boundaries (Pima County, 2018n).
• Public Health Emergency Preparedness: This department engages in collaborative,
community-focused emergency health planning to address biological, chemical,
radiological, or natural disaster events that result in public health threats or emergencies
(Pima County, 2018).
The safety in the county is provided by the Pima County Sheriff Department. They offer
a multitude of services such as police reports, neighborhood watch, crime report maps, orders of
protection, sex offenders, and a list of State of Arizona Sex Offenders (Pima County, 2018p).
The Pima County Board of Supervisors is responsible for how the organizations influence
the decision-making regarding the county’s health and quality of life. The Board of Supervisors
duties are to establish policies and direction for all the departments that also includes Health
Services and Justice & Law Enforcement. The Board of Supervisors appoints these specific
departments to the County Administrators. The County Administrator has the responsibilities of
implementing board policy and creating an annual County Budget; which is to be submitted to
the Board of Supervisors for further consideration. Most of the organizations are influenced by
whether there is enough money in order to be provided into the county. In that regard, funding
has a significant on the county’s overall health and county residents’ quality of life.
Housing
There were 459,915 total housing units in the Pima County in the year of 2017 with
19.1% of individuals below poverty levels in Pima County (Data Access and Dissemination
Systems, 2010). Pima County provides housing programs to help low-income individuals and
those in need of special care. The Home Repair and Weatherization program is for low-income
35
housing in Pima County, which provides repair services to homes where the residents may not be
able to afford it (Home Repair Assistance, 2018). Pima County evaluates the needs and cost of
the home damage and pays to fix it depending on individuals’ income and housing status. Other
resources to help low-income housing with repair damage is the City of Tucson Housing and
Community Development Department (Home Repair Assistance, 2018). The resource for
disabled housing necessities in Pima County is the Community Home Repair Projects of Arizona
(CHRPA), a resource that provides wheelchair-access home additions. Direct Center for
Independence Inc, provides assistance in creating safer homes for the elderly to accommodate
their needs in Pima County (Home Repair Assistance, 2018). Habitat for Humanity Tucson and
Old Pueblo Community Services helps fund and creates rehabilitation homes for disabled
veterans in Southern Arizona (Home Repair Assistance, 2018).
In Pima County, the estimated median cost per month for occupied housing units was
$874 in 2016. The estimated median cost per month for owner occupied housing units was $924
in 2016. In Pima County, the estimated median cost per month for renter occupied housing units
was $831 in 2016 (Data Access and Dissemination, 2010).
Table 4. Yearly Cost of Housing in Pima County.

Year Estimated Estimated Estimated for renter
Median cost median cost occupied housing
per month for per month for units.
occupied owner
housing unit. occupied
housing unit.
2010 $880 $1,056 $737
2011 $906 $1,076 $769
2012 $906 $1,059 $782
2013 $896 $982 $798
2014 $889 $945 $813
2015 $874 $945 $816
2016 $874 $924 $831
(Data Access and Dissemination, 2010)
36
Figure 16. Monthly Cost of Housing in Pima County.

Image retrieved from: https://factfinder.census.gov/
According to the U.S. Department of Housing and Urban Development and U.S. Federal
Bureau of Investigation, “severe housing problems is the percentage of the households with at
least one or more of the following housing problems: lacks complete kitchen facilities, lacks
complete plumbing facilities, is severely overcrowded or severely cost burdened.” Poor housing
is defined by the presence of “infectious and chronic diseases, infestations, and poor childhood
development” (Affordable Housing Development, 2018). Many aspects contribute to the poor
conditions of housing, and Pima County provides resources to help those in need.
It is stated that in Pima County, 19% of the population has severe housing problems.
Violent Crimes have a damaging effect on the populations’ residence health. According to the
U.S Department of Housing and Urban Development, per 100,000 individuals, Pima County has
a 434 Violent Crime Rate. In Pima County, 19% of people stated that they get Inadequate Social
Support; which diminishes the physical and mental health of the county residents (Recovery
37
Tracker, 2018).
The housing available for the low-income populations has been changing dramatically in
the past years. In 2014, Pima County voted for $10,000,000 to be funded to the Pima County
Affordable Housing Bond Program, which is a non-profit organization that licensed builders can
apply to for bond funds for affordable housing developments. Their mission includes the
opportunity to increase the amount of affordable housing for low-and median-income families
(Affordable Housing Development, 2018.). There is also affordable housing for people with
disabilities. DIRECT (Disability Resource Center) is a program that helps and promotes
independent living for elders and offers affordable assistance for people with disabilities. Some
services that they provide are wheelchair accessibility ramps and bathroom safety features for the
tenants (Pima County, 2018r). Pima County also has workbooks available for foreclosure
prevention, emergency mortgage help, financial planning, and utility assistance. These
workbooks hold helpful tips and information necessary for low-income homeowners
(Foreclosure Prevention, 2018).
The TPCH (Tucson/Pima Coalition to End Homelessness) reported 1,762 homeless
people on January 26, 2016. When calculated, 211 were chronically homeless (experienced
homelessness more than 4 time in the past 3 years), 479 had mental illnesses, 460 were substance
abusers, 90 had HIV/AIDS, 333 were victims of domestic violence abuse, and 281 were
veterans. These people are also the highest users of emergency rooms and hospital services. Most
homeless people go to the emergency room due to hyponatremia, which occurs when lower
sodium levels (salt) are detected in the blood. Symptoms include fatigue nausea, headaches, and
disturbance of memory and/or concentration, this can also lead to severe dehydration (Hope of
Glory Ministries, 2016). Pima County is currently in a 10-year plan to end homelessness. The
38
plan is to create “permanent supportive housing” by building or buying a house for 20 or so
individuals with serious mental health illnesses, along with building or buying “transitional
housing” for families who need some time to re-establish themselves. To get the money to build
or buy these homes, Pima County plans on increasing funds from Arizona State Department of
Housing for Emergency and Utility Assistance by $250,000 a year (Homelessness, 2018).
Food Supply
In Pima County, there are many different ways that food is provided to all of the
population. There is a wide variety of options that residents of Pima County can choose from to
fulfill their nutritional needs. In 2007, data was provided to show people the distribution of food
resources throughout Pima County. A way people get food is at grocery stores, these stores give
people the choice of what ingredients and produce they want to eat. Grocery stores offer a wide
array of fresh and processed foods. Farmers’ markets are a way for residents to pick up fruits,
vegetables, cheeses, and baked goods from local farmers. There are 15 farmers’ markets in Pima
County. They are not distributed evenly, making them non-accessible to some of the population.
Convenience stores are comparable to mini-grocery stores that carry mostly processed food made
available for people who are on-the-go or cannot afford a traditional grocery store. Despite the
high amount of processed foods offered in convenience stores, there has been an increase in
fruits made available to consumers in convenience stores (The Packer, 2013). There are 278
convenience stores in Pima County. Restaurants are an alternative to at home cooking where
people can enjoy food made by chefs. There are 615 full-service restaurants in Pima County.
Another alternative for people to receive a meal quickly is through fast-food. This is the
unhealthiest option and often leads to people becoming malnourished. There are 594 fast-food
restaurants in Pima County. Food banks and food pantries offer a resource for those who cannot
39
afford food. There are 31 food banks and food pantries in Pima County (Food Pantries,
2018). These are all very diverse ways that Pima County provides food to its population.
Businesses such as grocery stores, convenience stores, restaurants, fast food restaurants, farmers’
markets, and food banks allow residents to have a variety of different options for food.
Community agencies work with community partners to provide people who face food
insecurity with food boxes and to make unpurchased produce available. Community
organizations have been utilizing gardens to educate residents on growing and preparing their
own food. By educating residents about gardens, the county attempts to ameliorate food security.
The Community Food Bank of Southern Arizona focuses on making it accessible for residents to
have access to food banks by offering an array of food pantry locations throughout Pima County
(Community Food Bank of Southern Arizona, 2018). Although Pima County manages to provide
food and resources to its residents, increasing the number of people who use these available
resources remains a challenge.
As of 2016, there are approximately 1,016,206 individuals living in Pima County in
Tucson, AZ (Data Access, 2016). Out of this total population, around 15% of people live in a
food desert, which can be defined as an area with no grocery stores or access to healthy foods
within one mile in which a majority of individuals live at a status 20% below the federal poverty
line (Data Access, 2016). Data shows that 43% of people living in food deserts identify as Latino
(Data Access, 2016). Geographically, these food deserts are primarily located in the downtown
area or South Tucson (García, 2014).
In Pima County, there are many individuals who do not have the opportunity to have
access to healthy foods which is detrimental to a healthy lifestyle. For these people, there are
many resources available to them so that they can gain access to healthy foods and fresh
40
produce. To begin, non-profit organizations as well as independently owned companies are
reaching out to individuals with inadequate food supply. Desert Survival Inc. is an organization
that provides over 70 species of edible fruit trees which make up the majority of the Mission
Garden fruit trees (Nabhan, 2018). Also, Civano Nursery provides food to neighboring
businesses that have no access to healthy food. Along with organizations, school gardens provide
a source of healthy food for people in Pima County that do not already have access. For example,
Manzo Elementary school garden offers over 35 seasonal crop species that provide people with
healthy fruits and vegetables (Nabhan, 2018). Additionally, Robert Naylor’s school garden
became a major source of food for children and refugees in that geographical area for less
fortunate individuals. Lastly, food banks are vital to providing food to those who cannot provide
it for themselves.
Education
According to the U.S. Census Bureau, Pima County’s overall educational attainment
among residents is relatively high: 87.7% of Pima County residents graduated from at least high
school with a high school diploma. This is a higher percentage of educational attainment in
comparison to the state of Arizona: 86.2% of all Arizonans have at least a high school diploma.
Additionally, 30.8% of Pima County residents received at least a bachelor’s degree, which is 2%
higher than the same statistic for the state of Arizona (U.S. Census, 2016). Overall, Pima County
has a higher percentage of education attainment when compared to Arizona’s average percentage
of educational attainment.
Segmenting these statistics further by race allows for an assessment of the influence of
race on educational attainment. According to the U.S. Census Bureau, Native Hawaiian and
41
other Pacific Islander have the highest percentage of individuals who graduated high school or
higher at 93.1%. Closely behind them are non-Hispanic Whites at 90.1% and following are
Blacks at 88% (U.S. Census, 2010). Only falling 2% behind Blacks are Asians at 86.6% and
Hispanics have the lowest percentage of individuals who graduated from high school at 73.3%.
Asians have the highest percentage of individuals that earned a Bachelor’s Degree or higher at
50.3% and American Indian or Alaska Native have the lowest percentage at 11.8%. Whites have
the next highest percentage at 33.2% and following them are Native Hawaiian and other Pacific
Islanders at 25.9%. The differences in percentages between race/ethnic groups can be attributed
to the resources and opportunities that each group is presented throughout their lifetime. When
dividing the educational attainment by sex, one can see that there isn’t a significant difference.
Most of the percent's differ by less that 1% and the biggest difference is seen between Asian
males and females obtaining a bachelor’s degree or higher. Table 5 demonstrates the percentages
of educational attainment separated by race, gender, and the level of education received.
Table 5. Educational Attainment in Pima County by Race, Gender, and Level of Education.
Race High Bachelor’s
school Degree or
graduate Higher
or higher
Total (%) Male (%) Female Total (%) Male (%) Female
(%) (%)
White 90.1% 90.3% 90% 33.2% 34.2% 32.2%
Black 88% 86.8% 89.5% 21.9% 21.3% 22.6%

American 76.3% 76.2% 76.3% 11.8% 11.9% 11.8%
Indian or
Alaska
Native
Asian 86.6% 88.5% 85.2% 50.3% 55.5% 46.5%
Native 93.1% 90.2% 96.4% 25.9% 27.8% 23.7%
Hawaiian
42
and Other
Pacific
Islander
Hispanic 73.7% 73.5 73.8 14.4 13.4 15.2
or Latino
(U.S. Census Bureau, 2010)
Dropout rates are important representations of schools’ success in maintaining student
retention from the first day of the academic year to the last (Arizona Department of Education,
2018). These dropout rates can influence educational reform to greater prioritize performance
measures. Pima County accounts for 12% of individuals who dropped out of school and has one
of the lowest dropout rates in Arizona (Arizona Department of Education, 2018). Santa Cruz
County has the highest dropout rate at 25% which is about twice as large as the percentage noted
within Pima County.
According to the Arizona Department of Education (2018), dropout rates in Pima County
are shown to be highest amongst American Indian or Alaskan Native at 9.3%. However, these
dropout rates continue to decrease with African-Americans following at 7% and Hispanic or
Latino closely behind at 6%. Following Hispanics or Latino with a 0.7% decrease are Native
Hawaiian or Pacific Islander at 5.3%. Whites have the lowest dropout rates of 4.4% in
comparison to all other races. This is a dramatic 5-point decrease from American Indian or
Alaskan Native. Along with ethnicity differences, males and females also tend to have different
dropout rates. Overall, females are shown to have a lower dropout rate of 4.8% than males with a
rate of 6.1% (Arizona Department of Education, 2018).
The Pima County graduation rate in comparison to the rest of the counties located in
Arizona is relatively low. Pima County’s graduation rate is 77.6% and is the third lowest county
in Arizona . Just below Pima County is Apache County at 74.2% and Pinal County at 71.7%. As
seen Pima County is not too far from the lowest county and is 20% away from Greenlee County
43
which has the highest graduation rate at 92.2%. Although Pima County is one of the lowest, it is
not too far from the Arizona State average graduation rate of 79.5% (High School Graduation,
2018).
According to the Arizona Department of Education (2017), the ethnicity presented with
the highest graduation rate is Asians at 87.5% and following them with 79% are Whites (Arizona
Department of Education, 2017). Hispanics graduation rates are at 71%, which is not far from
Whites. At a 4% decrease from Hispanics, African-Americans are seen to have a graduation rate
of 67.6%. The race shown with the lowest graduation rate in Pima County however, are Native
Hawaiian or Pacific Islander at 60%. The difference between the highest racial group, Asians,
and the lowest racial group, Native Hawaiian or Pacific Islander, comes at over a 20% decrease.
The overall percentage of females graduating from high school is 77.6% and males 70.3%
(Arizona Department of Education, 2017). This coincides with the high school dropout rates as
females had a lower rate than males. Therefore, it appears evident why females have a higher
graduation rate than males within the county.
Pima County offers a wide variety of educational resources targeted for specific
populations. Pima County offers educational resources with a focus in: dropout prevention,
English learners, education for the homeless, foster, gifted, migrant, and special learners. With
over 160,000 students enrolled in one of the 17 Pima County school districts, there is a resource
for every intellectual (Pima County School Superintendent, 2014).
The Zip Code Project is a resource concerning youth who are not attending school or
employed. With a focus on ages 16-24, the Zip Code Project targets disengaged youth. This
project offers student resources, opportunities, referrals, and grant funding in hopes of reducing
dropouts and improving quality of life. Within the Ajo community, 65% are unemployed and
44
55% are not enrolled in school. These high statistics make Ajo one of the four zip codes selected
as a critical area of focus (Dickenson, 2016).
Figure 17. Zip Code Project Data.

Image retrieved from: http://www.azed.gov/
The Migrant Education Program (MEP) is a source for migrant students (ages 3-21) and
parents to better prepare academically. Home visits, summer school, interpreting for migrant
parents, home academic support for preschoolers, and parent meetings are provided. Options can
be combined depending on what the student adapts best to (Migrant Education, 2017).
45
Figure 18. Increasing Diversity in Arizona Charter Schools Over Time.

Image retrieved from: https://azcharters.org/
Arizona charter schools are high quality public schools accessible to Pima County
students. Charter schools offer a driven and dedicated support system to students to improve
academic achievements with high results. Pima County offers dozens of charter schools: Satori
Charter School, Math & Science Success Academy, BASIS Tucson Primary, Arizona College
Prep Academy, etc. Academic results depict how math passing rates have increased by 35% and
how there has been a 99% increase in the English Language Arts program over the past few
years. According to the 2015 National Assessment of Educational Progress, Arizona Charter
students have scored the greatest improvement, along with Massachusetts, among all 50 states.
Also, charter schools involve all different races. A total of 55% of all charter school students
identify with a racial/ethnic group different than white (Our Impact, 2015).
Pima Accommodation District provides an academic curriculum for juvenile court and
detention students. The Court Alternative Program of Education (CAPE) works with the Pima
County Juvenile Detention Center as well as the Pima County Adult Detention Center to teach
daily subjects: reading, literature, writing, math, science, social studies, and Spanish (Pima
County Annual Report, 2015). In 2015, five youths, who were detained, received a GED. Two
CAPE schools are located in Pima County: CAPE School and CAPE-Detention School. Not only
does CAPE serve as an educational resource for students, but it also serves to assist parents of
the juveniles. (Pima County School Superintendent, 2018).
Pima County offers several homeschool resources. Christian Home Educators of Tucson-
Southeast, Faith Home Educators, and Quest for Education and Arts are some of the many
homeschools’ within the area that involve hands-on work. Within the home-schools, early
education through high school honors education is covered while providing substantial
46
knowledge in: math, foreign languages, history, government etc. Furthermore, many homeschool
resources dictate an emphasis on religion. Biblical standards as well as social settings are
focused on throughout the process of properly educating the youth. Almost all homeschool
resource centers are offered online but some (listed above) have in-person addresses (Guest
Guidelines, 2018).
Within Pima County, one of the main concerns is the shortage of teachers available for
students. It’s shown that 24% of first year teachers and 20% of second year Arizona teachers
resigned from the profession in the years 2014 and 2015. In the years of 2016-2017, the average
salary for an Arizona teacher was around $47,218. However, the average U.S teacher salary was
$57,611; a noticeable $10,00 difference is seen between the two. Yet, the AZ Kids Can’t Wait
Plan of 2018 has big hopes with improving teachers’ salaries. This organization promotes
Proposition 301: Extend and Expand teacher salaries and Capital Funding. The campaign is still
in progress but the goal is to generate over $400 million to improve this concern (Arizona
Department of Education, 2018). Furthermore, children/families also struggle financially. The
Arizona Voucher Program pays partial or full tuition for private school children who can’t afford
to pay. This money is sourced from public schools and their additional money. The money is
saved from when a student was supposed to attend that school but never did (Afford Private
School, 2018).
Road repair is directly linked to educational concerns within Pima County. Road
concerns are an educational concern because it affects the students ability to get to and from
school. Pima County has come up with a 10-year Road Repair Plan in hopes of preserving and
reconstructing the “bad” roads. The Sun Tran, Link, Shuttle, and Van all contain different transit
fares. With cleaner and safer roads, students in Pima County, especially Tucson, can rely more
47
on the new and improved roads. The 10-year Road Plan is in the process of making money spent
worth its while (Pima County Road Repair Plan, 2018).
School Health and Nutrition Programs
The state of Arizona utilizes The National School Lunch Program and the School
Breakfast Program in order to provide a reduced or free breakfast or lunch. Students are eligible
based off parent’s income and size of their household (National School Lunch Programs, 2018).
The Tucson Unified School District utilizes this national program and they have also set up a
“Together Every Kid Eats” program. This program allows students to eat free through the
funding of donations.. The program also has an online portal for those looking to donate money
towards students school lunches. Donators can go to the Together Every Kid Eats webpage to
locate average prices of meals for students based on age division. Food services will ensure that
each eligible student will be given the proper nutritional service and will work with families to
help manage their meal account (School Meal Programs, 2018).
Table 6. Student Meal Prices for the 2017-2018 School Year.

Breakfast, PreK-5 $1.25 Lunch, PreK-5 Grade $2.30
Grade
Breakfast, 6-8 Grade $1.50 Lunch, 6-8 Grade $2.80
Students in K-8 Students in K-8
Schools Schools
Breakfast, Middle & $1.50 Lunch, Middle & $2.80
High Schools High Schools
Reduced Price $ .25 Reduced Price $ .40
Breakfast, K-12 Lunch, K-12
Milk, K-12 $ .30 Milk, K-12 $ .30
Second Student $1.75 Second Student $2.85
Meal/Unenrolled Meal/Unenrolled
Student Meal/Adult Student Meal/Adult
Meals, without milk Meals, without milk
Second Student $2.00 Second Student $3.10
Meal/Unenrolled Meal/Unenrolled
Student Meal/Adult Student Meal/Adult
Meals, with milk Meals, with milk
48
Note. Data for School Meal Programs in Tucson, Arizona is under the National School Lunch
program and Tucson Unified School District (School Meal Programs, 2018).
Pima County Food Alliance is a system that was developed in Pima County to allow low-
income families and children to receive fresh foods from local farmers. This system supports
economic development along with our local farmers. Pima County Food Alliance has created
projects such as School Gardening and the National Farm to School Network that allows schools
to implement programs that encompasses gardening and learning about sustainability as well as
growing their own food. These schools have the opportunity to create their own garden and the
outside community can participate as well. Students will grow their own produce and learn how
to make healthy lifestyle choices through nutrition and agriculture education (School Gardening,
2018).
Another program offered is “Summer Lunch Buddies - Helping Kids Eat Healthy,” which
networks with different organizations like Tucson Unified School District, the University of
Arizona, Food Banks, American Indian Tribes, and non-profit organizations that offer food
assistance to students within Arizona (AZ Health Zone, 2018). This program is a federally-
funded program that is offered during the summer breaks and provides children 18 years and
younger the opportunity to get free food. Proof of income or a filled out application is not
needed, using the available mapping tool on the website allows you access to finding the nearest
participation location.
The Community Food Bank of Southern Arizona partners with school programs. The
resources offered through the Nutrition Education program include Farm to Child, School
Pantries, and After School Meals & Snacks (Community Food Bank, 2017). For each program,
the goal for the Nutrition Education program is to educate students and their parents on the
importance of healthy eating. The Farm to Child program was created for low-income schools
49
within Tucson and there are currently 35 schools in Tucson that are a part of the Farm to Child.
The program’s focus is educating both students and their teachers about their having a healthy
diet and how a garden offers fresh foods. Of the 35 schools, 10 schools are certified in serving
the foods grown from the garden in the school cafeteria.
The second program that the Community Food Bank of Southern Arizona partners with
is, “School Pantries,” which offers food distributions to students and their families, as well as
educating students on Nutrition Education and recipes for healthy foods that they can take home
to share with their families. Aside from the 9 school pantries in Tucson, there are also 3 mobile
pantries and 2 family resource centers that are located throughout the Pima County.
The third program that the Community Food Bank of Southern Arizona partners with is
the “After School Meals & Snacks program.” There are a total of 14 locations including Parks
and Recreation centers, libraries, and other youth centers. This program establishes better access
to healthier foods, especially in “at-risk youth” in low-income areas in Tucson. The after school
meals and snacks program is offered for anyone 18 years old and younger; they are allowed to go
to any school location and sign in with the facility before getting their snacks and meals.
Table 7. After School Meal & Snack Programs: Meal Sites.
Locations Address Time

Frank and Edith Morton 3155 E. Grant Rd 5:30 pm - 6:30 pm
Clubhouse
Marty Birdman Recreation 2536 N. Castro 4:30 pm - 5:30 pm
Center
Roy Drachman Clubhouse 5901 S. Santa Clara 4:30 pm - 5:30 pm
Wednesdays 4 pm - 5 pm
Steve Daru Clubhouse 1375 N. El Rio Dr. 4:00 pm - 5:00pm
Pascua Yaqui Clubhouse 5010 W. Calle Torim 5:30 pm - 6:30 pm
Holmes-Tuttle Clubhouse 2585 E. 36th St. 6 pm - 7 pm
Jim & Vicki Click Clubhouse 1935 S. Columbus Blvd. 5 pm - 6 pm
Wednesdays 4:00pm
Freedom Recreation Center 5000 E. 29th St 4:30 pm - 5:30 pm
50
John Valenzuela Youth 1550 S. 6th Ave. 4:30 pm - 5:30 pm Mon-

Center South Tucson Thurs
Note. Data for Meal Sites offered through Community Food Bank of Southern Arizona,
(Community Food Bank, 2017).
Table 8. After School Meal & Snack Programs: Snack Sites.

Locations Address Times
El Rio Neighborhood Center 1390 W. Speedway Blvd. 4 pm
Wednesdays 3:30 pm
Marty Birdman Recreation 2536 N. Castro Ave. 3:30 pm
Center Thursdays 3 pm
Santa Rosa Neighborhood 1080 S. 10th Ave. 4 pm
Center Wednesdays 3:30 pm
Cherry Avenue Recreation 5085 S. Cherry Ave. 3 pm
Center Wednesdays 2:30 pm
Archer Center 1665 S. La Cholla Blvd. 3 pm
Trinity Place Apartments 6240 S. Campbell Ave. 3:40 pm
Refugee Focus 55 N. 6th Ave., Suite 101 Tuesday - Thursday 3:30 pm
Eckstrom-Columbus Library 4350 E. 22nd St. Tuesdays & Wednesdays
3:30 pm only
Santa Rosa Library 1075 S. 10th Ave. Tuesdays & Thursdays 3:15
pm
Martha Cooper Library 1377 N. Catalina Ave. Tuesdays 4 pm
Wednesdays 3 pm
Thursdays 3 pm
Mission Library 3770 S. Mission Rd. Tuesdays 4 pm
Wednesdays 3 pm
Southwest Library 6855 S. Mark Rd. Wednesdays 3:30 pm
Quincie-Douglas Library 1585 E. 36th St. Wednesdays 3:30 pm
Valencia Library 202 W. Valencia Rd. Mondays 3 pm
Tuesdays 3 pm
Wednesdays 1:30-2:00 pm.
3pm
Thursdays 3pm
Woods Memorial Library 3455 N. First Ave. Tuesdays 3:30 pm
Note. Data for Snack Sites offered through Community Food Bank of Southern
Arizona,(Community Food Bank, 2017).
Overall, the Community Food Bank of Southern Arizona partners with these programs to
provide all children with better access to healthy foods by educating students within the Tucson
community on the importance of living a healthier lifestyle by making better food choices (for
the students and their families who may not be able to afford these nutritious foods that children
51
need), and reducing the risk of health-related diseases (diabetes, obesity, etc.) within Pima
County.
The AZDHS has created programs and policies community and school wide that can allow
children to maintain healthy lifestyle choices as well. Empower Schools is a policy that ensures
schools are maintaining a healthy environment for children. Health within schools stems beyond
making sure children are receiving the proper nutrition. Health within schools also means ensuring
that school counselors, social workers, nurses, and food service/directors are located in all schools.
School systems can seek advice from the School Health Advisory Councils on how to implement
school health programs and policies (ADHS, 2018)
Social Welfare Programs
Social welfare programs are a key provider for families and individuals in need in the
Southern Arizona community. For example, Tucson Electric and Power (TEP), a community
agency, offers a multitude of programs for low-income individuals to help them reduce the amount
of electricity they use within their home. With their program ‘Help with Emergency Energy Relief
Operation’ (HEERO), customers have the ability to anonymously donate to those who need
assistance paying their bills when in an emergency situation (TEP, 2016). Every year,
approximately 8,200 customers add between $1 or $5 to their monthly bill in order to help
contribute to around 600 low-income households in Tucson (TEP, 2016). The program overall has
proven to be extremely successful, generating approximately $150,000 every year. Along with the
HEERO program, TEP offers the ‘Home Energy Assistance Fund’ (HEAF), which utilizes
unclaimed utility deposits in order to help customers repair or replace their heating and cooling
units. Annually, $2 million in HEAF funds has gone towards low-income families in Arizona in
order to help contribute to their utility deposits (TEP, 2016). Another program within TEP that is
52
connected to the US government is the ‘Low-Income Home Energy Assistance Program’. This
program supports families in paying their heating and cooling bills and accumulates approximately
4 billion to 5.2 billion dollars annually. Overall, through the use of these community as well as
governmental agencies, TEP is able to help low-income families afford power within their homes.
For individuals who need both utility as well as renters assistance, Tucson Urban League
helps those who are low-income or in a crisis situation within Pima County. The overall goal
behind this program is one that is community-based, focusing on limiting the amount of
homelessness within the county as a whole. The utility assistance within the program not only
focuses on gas and electric bills, but water and phone bills as well. Overall, the program’s mission
statement identifies with the fact that “every American has lives in a safe, decent, affordable and
energy efficient housing on fair terms”(Community Support Organization, 2016).
The Pima County community offers multiple social welfare programs that target specific
populations in financial need. Southern Arizona has a large population of Hispanic families who
fall under the category of low-income households. A program that is found in multiple states but
holds a large presence in Arizona is Chicanos por la Causa (CPLC). This program provides housing
for single and multiple family homes that are at a more affordable cost for lower income families.
CPLC has provided multiple housing homes to 3,471 residents and a single family home to 35
families (Chicanos Por La Causa, 2018). Housing counseling is offered as well as a resource to aid
families in financial struggle surrounding their living situation. They offer housing assistance
which helps families when in conflict with landlords, or with any pending foreclosures that they
have on their property. Along with assistance, families and individuals can receive counseling at
CPLC. The counselors help families create a financial plan and help prepare them for
homeownership. Last year alone Chicanos por la Causa “helped 333 families avoid foreclosure or
53
eviction” (Chicanos Por La Causa, 2018). They also serve “3,057 clients across all housing
counseling services” (Chicanos Por La Causa, 2018). Another social welfare program that focuses
on a target population is the Southern Arizona Aids Foundation (SAAF, 2018). They focus on
providing resources and support to the LGBTQ community who struggle financially. For residents
who already have a place to live but struggle to meet their rent can receive short term emergency
assistance from SAAF with their financial assistance that will help residents pay their bills and
avoid eviction. The Southern Arizona Aids Foundation supports over 100 families and individuals
through their direct housing and financial payment assistance (SAAF, 2018).
Southern Arizona offers multiple religiously based programs that provide financial
assistance to local community members. Interfaith Community Services (ICS) is a program
focused on bringing diverse faiths from the community together to help support those in need.
They were founded originally at the St. Andrew’s Presbyterian Church. ICS offers emergency
financial aid to all residents of the Pima County community, especially those who are struggling
with a financial crisis, whether that be long or short term. The program offers short term financial
assistance to help pay rent and utility bills that families may not be able to pay at the moment.
Financial aid counselors are also available to help individuals take a step by step approach to
address their troubles. Families and individuals are given the opportunity to work directly with the
counselor to create a plan of action and identify the problems that are instigating their financial
struggles. ICS states that, “this personal counseling makes a difference in helping struggling
individuals and families help themselves” (Emergency Financial Aid, 2018).
Catholic Community Services of Southern Arizona is another program that offers safe
housing, counseling, and adoption amongst other programs to better the community as a whole.
This program focuses on a variety of individuals from children to families to senior citizens.
54
Overall this programs mission is to “touch lives every day in great and small ways” and help those
live with “independence and dignity”. Within CCS, specifically, is a program called Foster Family
Care which is where they recruit and assess families to welcome foster children into their homes.
This program is a great addition to the community and enables families to provide for children in
need with a good and fitting home life. Similarly, CCS has another program related to Domestic
Violence which is dedicated to emergency shelter. This emergency shelter serves to “provide a
welcoming and safe environment for those needing support to leave a harmful situation”. However,
this program is open to men and women who have experienced not only domestic violence, but
sexual assault, elder abuse, and even trafficking. Not only does this program provide resources on
its own, but it pairs with House of Hope and Nuestra Casa in order to provide transitional living
for those who need it. An essential program that falls under Catholic Community Services is their
‘basic services’ which provides food, clothing, and housewares to individuals and families. CCS
pairs with Pio Decimo’s food pantry and Clothing Closet in order to accomplish their goals.
Overall, CCS has contributed a lot to the community of Southern Arizona (Catholic Community
Services, 2014).
Transportation
The primary means of transportation within Pima County include driving, biking,
walking, and public transit (DADS, 2010a). While there are multiple means of transportation in
Pima County, driving is the most commonly used mode of transportation within this community.
According to the American Community Survey from 2012-2016, 86.5% of the population within
Pima County use their own private form of transportation (car, truck, van, motorcycle). Biking
accounts for 1.8%, while walking accounts for 2.3% of transportation throughout Pima County.
55
Lastly, 2.8% of the population in Pima County uses some form of public transportation as a way
to get around (DADS, 2010a).
Figure 19. Common methods of Transportation in Pima County.

Image retrieved from: https://datausa.io/profile/geo/01000US/#mode_transport
This chart compares the primary modes of transportation within Pima County (orange) to
the overall percentages of these transportation methods within the United States (grey). As is the
case in Pima County, driving is the most commonly used method of transportation throughout the
U.S. as well.
In Pima County, a high proportion of residents have access to reliable methods of
transportation in one way or another. For those who do not own private vehicles, the other
methods of transportation (biking, walking, carpooling, public transit) are just as reliable within
the community. In Pima County, 9.9% of the population carpools daily. Carpooling statistics
differentiated by sex show that 10.6% of the female population carpools while 9.4% of the male
population carpools in Pima County (DADS, 2010b).
Biking is another reliable method of transportation available to the residents of Pima
County. Programs such as The Loop and Bike Buddy exist to help residents who use bikes to
56
commute throughout the community. These programs encourage biking as a beneficial and
healthy source of transportation within Pima County in hopes to promote the use of this cost-
effective transportation method. The Loop is a primary bike route offered as a systematic means
to transport around Pima County. This system connects over 120 miles of paved pathways from
Rillito, Santa Cruz and Pantano River Parks to the Julian Wash and Harrison Road Greenways
(Chuck, 2018).
Public transit is an additional method of transportation throughout Pima County. The rates
for public transit, although not nearly as high as the rates for driving and carpooling, are greater
than those of biking and walking. Forms of public transit offered throughout Pima County include
the Sun Tran, SunLink, Sun Shuttle, and Sun Van (Sun Van, 2018). Table 9 depicts the fares of
public transit in Pima County that became effective on the 1st of January of 2018. Fares fluctuate
based on whether or not individuals have a SunGO Card and ID. Options to purchase these cards
are available on their website (Sun Van, 2018). Despite the variety of options offered through Pima
County’s transportation services, there are many challenges facing the transportation systems in
Pima County (The Road to Recovery, 2018).
Table 9. New Fares on Sun Tran, Sun Link and Sun Shuttle.
Note. Data for Pima County Public Transportation Cost. (Sun Van, 2018).
57
The Pima County Transportation Department is tasked with the maintenance, design,
construction, and operations of all unincorporated Pima County. This includes about 2,200 miles
of roadways along with street lights, street signs, traffic signals, bridges, and drainage systems
(The Road to Recovery, 2018). Due to a lack of funding, the Pima County Health Department
has been unable to properly manage and maintain the roads and infrastructure in Pima County.
Subsequently, nearly 60% of the county’s roads are in poor or failing condition (The Road to
Recovery, 2018). It would cost the Pima County Health department 250 million to repair the
roadways with an additional 30 million a year, for 10 years, in order to prevent the problem from
getting worse (The Road to Recovery, 2018). In order to meet these costs, Pima County would
need to pass a countywide half-cent sales tax for the repair and maintenance on county roads.
Currently, Pima County is the only county in Arizona that does not impose a countywide sales
tax, but enforcing one would generate enough funding for the Pima County Transportation
Department to properly maintain the roads and infrastructure for the county (The Road to
Recovery, 2018).
Transportation can be related to health problems in relation to quality of the environment
and air pollution. When it comes to the environment, the resident’s welfare, safety, and quality of
life is considered within the community’s population (Pima County, 2018s). Air pollution is
becoming an increasingly important issue, especially within Pima County. As of August 3, 2018,
the Pima Clean Air Program issued a high pollution advisory due to the elevation of ground-level
ozone air pollution (PDEQ, 2018). This is directly related to health problems because people
within the population could begin to experience shortness of breath or breathing discomfort,
coughing, wheezing, and throat irritation. The quality of air pollution could determine how long
people should be outside and what time of the day is safe to be outside (Pima County, 2018a).
58
The only problem with this is that people are often not able to control when they are outdoors or
not. By limiting the amount of driving in motor vehicles, Pima County may be able to improve
its air quality. A way that Pima County limits the health problems related to transportation is by
encouraging residents to take a “Drive-Less Pledge.” According to the PDEQ’s Clean Air
Program, "skipping a trip in your motorized vehicle or taking a “no-drive” day each week can
reduce air pollution by more than 1,100 pounds a year, which will help clean the air for
everyone” (Drive-Less, 2018).
Since individuals within a community can control what method of transportation they
take, they are also able to control the quality of air within their community. Other methods of
transportation, like biking, carpooling, and public transportation are better than driving in order
to improve the overall quality of the environment and the health problems within Pima County.
The highest cost expenditures come from driving a car or motorized vehicle compared to other
methods of transportation. This is due to the amount of money spent on gas, car maintenance,
parking, registration, motor vehicle taxes, etc. Other forms of transportation such as shuttles,
buses, and trams are cheaper than driving because it is a public form of transportation. Though
the cost of time would be greater than driving, public transportation or bike use provides a more
economically and environmentally conscious alternative. Riding a bike does not diminish the
overall quality of air and the costs of biking is far favored over the cost of transportation via
motorized vehicle. Although the costs of driving are the most expensive in terms of
transportation throughout Pima County, the cost of time is minimal compared to other methods
of transportation.
59
Occupational Data
The employment rate in the Arizona has increased because of the increase in the state
construction industry. The unemployment rate as of August 2018 in Pima county was 4.8%,
which shows a downward trend compared to other counties in Arizona. However there is rise in
the construction of residential buildings which will increase the employment levels.
Unemployment has a significant impact on health outcomes in a community and the high
unemployment in Pima County depicts the state of public health in the county.
Pima County has a workforce of 50.81% women and 49.19% men, based on the
population of the county. The population of the workforce in Pima County is made up of 436,074
people which is the population above 16 years of age. However, 4.6% of this population are
unemployed, according to unemployment data. Only 11.0% of the entire population in Pima
County is covered with health insurance among people 65 years or older. Regarding labor force
participation by race, the mixed color ethnic groups have a labor participation rate of 65%. The
Hispanic ethnic group follows with a labor force participation of 64%, the 2+ races group
follows with 63% labor force participation, the African-American group follows with 62%, and
the White non-Hispanics have the lowest labor participation of 53%. Regarding education, the
workforce with a bachelor’s degree or higher has the highest labor force participation of 78%
and those with below high school education have the lowest labor force participation at 60%
(Pima County, Arizona Population, 2018).
Categories of employment in Pima County are diverse, and healthcare and social
assistance have the highest number of the workforce standing at 15.1% as of 2016. The
employment categories in Pima Counties include; healthcare and social assistance (15.1%), retail
trade (12.3%), education services (9.8%), accommodation and food service (8.4%),
60
administration, support, waste management services (7%), professional, scientific, technology
(6.8%), construction (6.5%), manufacturing (6.2%), public administration (5.8%) among others
(Pima County, 2018e). These data show that health care and social assistance have the largest
workforce in Pima County, accounting for 40.3% of the total employment which can translate to
better public health services and outcomes in the county. Females make up 76.59% of the health
care industry and the men make up 23.41%. In the retail industry, the females make up 49.13%
of it while the men make up 50.87%. The education sector consist of 61.42% of females and
38.58% of men. In the administrative sector the men constitute of 62.66% and the females form
37.34%. Females make up 48.35% in the professional industry and the men form 51.65%. The
manufacturing industry constitute of 29.15% of the females and 70.85% of the men. Other
industries in the county host 55.76% of the females and 44.24% of the men. From this data, it is
seen that the working class interestingly consists of more women than men in Pima County.
Whites constitute 66% of the employed, Hispanic constitute 64.1%, the blacks consist of 60.6%,
the Asians make up 60% while the mixed race consist of 58% and other races consist of 59.9%
of the employed.
Pima County has many large businesses. The current largest employer is the University of
Arizona. Between faculty, staff, and student workers, the university employs over 10,800 people.
Raytheon Missile Systems is the second largest employer in Pima County, with roughly 10,300
employees. Raytheon Missile Systems produce many missile systems for the U.S and our allied
forces, and their headquarter is located here in Tucson. The Davis-Monthan Air Force Base is
home to 9,100 employees. Other large employers are the State of Arizona with over 8,800
employees, Wal-Mart Stores Inc. employing 7,450 people, Tucson Unified School district with
7,688 workers, and U.S. Border Patrol with 6,500 employees (ARG Publications, 2018).
61
The health risks associated with working in Pima County depends upon the job that is being
performed. A desk assistant at the University of Arizona has a lower health risk than someone
working a forklift for Wal-Mart, or someone putting together missiles and chemicals at Raytheon
Missile Systems. The health risks depend on the line of work and hazards associated with it.
However, these companies have policies in place to do their best to protect their workers. For
workers at the University of Arizona, they are at an increased risk of catching infectious diseases,
such as a cold or flu due to being around so many different people. Employees also face work-
place stress and legal considerations to accommodate everyone, which can be stressful on a person
(Morgan, 2017). Those employed with the U.S. Border Patrol are at an increased health risk of
violence, car chases, guns, and drugs. They are exposed to harsh temperatures of the Arizona desert
and may suffer from sunburn, skin cancer, and heat stroke (SafeGuard, 2018). Due to the nature
of the desert landscape, they also may encounter more breathing challenges due to the dirt. Their
encounters with dangerous and violent situations, such as seeing people die while trying to cross
over illegally or holding their dead infant, may cause them to have psychological troubles later on
such as PTSD (Soular, 2017).
Other Community Factors Impacting Health
Beyond the transportation and occupation aspects of the community health, a variety of
miscellaneous community factors have also significantly impacted the health of Pima County.
Specifically, such community factors have helped to increase the health awareness and health
literacy of the Pima County population. For examples, Pima County Employee Wellness offers a
variety of “quality programs and activities to encourage and support healthy, active lifestyles”
(Pima County, 2018b). These programs emphasize the importance of education, awareness, self-
care and behavioral changes to make meaningful strides towards improved health. The programs
62
that are offered with Pima County Employee Wellness are split into six different sections: Current
Programs and Activities, On-site Programs & Activities, Gym Subsidies & Discounts, Wellness
Challenges, Health Management Support Programs, and Resources & Events. These benefits,
which are made accessible to Pima County employees year-round, are designed to improve
participants’ quality of life (Pima County, 2018).
Current Programs and Activities include Flu Shots, Mobile Onsite Mammography and Fit
& Lean Team Challenge. Flu shots are offered this year from September-October and “El Rio
has partnered with Pima County to offer free on-site flu shots for all Pima County employees,
spouses, domestic partners and any dependents 18 years or older” (Pima County, 2018b). There
are also over 20 locations available for convenience and if anyone isn’t under the Pima County
medical plan, fees can be covered by using other insurance carriers. The Mobile Onsite
Mammography is a program available during the months of February and August and is
beneficial to help detect any abnormalities in women’s breasts. The Fit & Lean Team Challenge
is a 9-week summer program that encourages employees to “rejuvenate their motivation to
practice healthy behaviors to support their weight loss and maintenance goals” (Pima County,
2018b). The challenge consists of tracking workouts throughout the week, having weekly
challenges and participating in weigh-in/outs. These activities add up to points for prizes and
there are also grand prizes awarded to the top three winning teams/ individuals.
On-site Programs & Activities are “available for all employees to attend, are held at
various worksites and are typically available during the lunch break” (Pima County, 2018g).
Some activities include fitness classes like Zumba, health coaching, mindful meditation, weight
watchers, walking activities and wellness workshops that focus on living healthy through fitness,
nutrition and stress management. The on-site programs and activities are managed by “Employee
63
Wellness, volunteers and the Wellness Council of Arizona,” and depending on the program
selected there is selected fees that apply (Pima County, 2018).
Gym Subsidies & Discounts allows Pima County employees and any family member that
lives in the same household to receive subsidized “membership rates at local fitness facilities”
(Pima County, 2018b). Additional amenities such as personal training or onsite child care would
require the payment of extra service fees at participating facilities such as LA fitness or the
YMCA. Another program that welcomes all employees to participate is Wellness Challenges.
Eight unique challenges are designed to get employees to participate in healthy lifestyles and no
matter where one works or what challenge is chosen, all materials needed to complete the
challenge are provided. These challenges can also be completed whenever is most convenient to
the employee because there are no designated classes to attend.
The next set of wellness programs provided are Health Management Support Programs.
This program teaches Pima County employees how one “can prevent health-related medical
conditions and/or manage your current health condition” (Pima County, 2018b). This program
provides particular immediate benefit given the high prevalence for diabetes, young pregnancies
and tobacco use in the Pima County population. Under this program, there are services provided
to raise awareness and focus on prevention. For example, Pima County has partnered up with
Aetna’s Beginning Right Maternity Program to help mothers achieve a healthier pregnancy and
baby. The diabetes prevention group is a support group that helps people “who are prediabetic or
diabetic eat healthier, increase their physical activity, and lose weight” (Pima County, 2018b).
Finally, tobacco cessation support is offered under this program to help individuals quit tobacco
by attending counseling to increase their rates of abstinence.

64
Other initiatives have also promoted health and wellness within Pima County. The
University of Arizona’s College of Medicine (Tucson campus) held a Health & Wellness Fair for
all Pima County/City of Tucson employees in order to shed light on the number of resources
Pima County offers its employees. In addition to the opportunities that Pima County presents its
employees, commercial and non-profit vendors were also present at the Health & Wellness Fair
in order to promote opportunities for employees to better their own health and wellness through
“information, screenings, demonstrations, and more…” (University of Arizona Department of
Medicine, 2016). This event actively promoted public health awareness on a broad scale by
introducing the population to tangible opportunities to better their personal health.
The University of Arizona Eller Business School established a Social Media Monitoring
and Surveillance for Vector Borne Disease program that allowed for the spread of awareness of
public health issues related to vector borne diseases. This system works to track social media
trends and screen key public health topics popular among the online community, to “elicit public
feedback and reporting” on topics relevant to public health, and to measure the effectiveness
(through reach and impact) of social media campaigns promoting positive public health
practices, especially in relation to vector-borne diseases such as Zika Virus, West Nile Virus,
Dengue Fever, and the Chikungunya Virus (Social Media Monitoring, 2018). The Pima County
Health Department also encouraged the awareness of vector-borne (specifically mosquito-borne)
illnesses in the community through community-level programs such as “Fight the Bite! Day and
Night,” which was a 2016 program that shed light on the importance of adopting a preventative
approach to mosquito-borne diseases (the use of repellant, long-sleeve clothing, etc.) (The
University of Arizona, 2017).

65
Apart from the previously categorized factors impacting community health in Pima
County, these community factors also greatly influence the health of the county. Through health
education and awareness programs, these other community factors not only educate the public on
relevant public health issues in the community, but also encourage the upholding of public health
principles and individual positive health practices.

66
Summary
Part 1
As of 2017, Pima County has a population of 1,003,338 individuals. Out of this
population, around 95.9% is White, 3.5% is Black, 3.2% is American Indian or Alaskan Native,
2.7% is Asian, and 0.1% is Native Hawaiian or Pacific Islander. Furthermore, 36.1% of all Pima
County residents identify as being Hispanic or Latino (US Census, 2017). However, with the
race classification and statistics, there are socioeconomic factors that are also shown in Pima
County. As an overall county with an average income of $33,259, Pima is ranked as the 2nd most
poverty-stricken county in Arizona. Asians are shown to have the highest average income of
$65,469, followed by Caucasians earning $54,461, and the lowest income race is African-
Americans with a median income of $32,584. As an extension of their low-income status,
African-Americans also have the highest poverty rate at 25.8% (Pima County, 2016a). The large
gaps in socioeconomic status also translate to disparities in health quality and health status.
Socioeconomic status, location, race distribution, and population size all have direct
effects on health status, health needs, and quality of life. The three most prominent causes of
death in Pima County are heart disease, cancer, and diabetes. In Arizona as a whole,
cardiovascular disease remains a leading cause of death. In 2010, Pima County had an average
CVD mortality rate of 191.8 deaths per 100,000 residents, compared to the 188.6 deaths per
100,000 residents of Arizona. Out of the 15 counties, Pima ranked 10th in terms of number of
deaths. Cancer is also a large cause of death in Pima County. When looking at cancers, in terms
of race, non-white Hispanics and Blacks have shown to have the highest rates of cancer, an
incident rate of 408.0 deaths/100,000 persons and 316.9 deaths / 100,000 persons respectively.
When looking at each race individually, each group is affected by specific health
problems and health needs that may not be relevant to other races. Generally, Asians tend to be
67
affected by the fewest health problems. They have the lowest morbidity from diabetes, cases of
cancer, and cardiovascular disease. On the other hand, Blacks/African-Americans and
Hispanic/Latinos have very high percentages of mortality from diseases. Blacks and Hispanics
have diabetes mortality rates of 13.1% and 11.2%, respectively. Hispanics and Blacks are also
shown to have the highest rates of cancer, per 100,000 cases (AZDHS, 2018). By extension, we
can say that Hispanics, Blacks, and American Indians generally experience a lower quality of life
as compared to White and Asian populations.
Not only do the different races demonstrate vastly different areas of the spectrum, they
also show how socioeconomic status impacts health status and health needs. Groups that tend to
have higher incomes are able to access healthier foods, afford hospital visits, pay for better
insurance, and other superior health needs. However, there is a group that is often misunderstood
and underrepresented: American Indians. American Indians have been a part of US history for a
very long time; however, their health concerns and proper health judgement have often been
biased due to public opinion. It should be a primary public health focus to give American Indians
a holistic assessment of their health needs and health status, as well as give them fair treatment
when these health issues are identified.

68
Part 2
American Indians comprise 3.2% of the population of Pima County (Pima County
Population Demographics, 2016). Though this is a relatively small proportion of the population
of the entire Pima County, the subpopulation is affected by significant health challenges and
burdens. When comparing the total mortality from all causes for multiple racial/ethnic groups in
Pima County, the mortality of American Indians was found to be the highest (0.97%) in
comparison to all other racial/ethnic groups (Population Health and Vital Statistics, 2018). In a
comparison of health reports from multiple racial groups, American Indians reported “good
health” in the lowest numbers (Bass et al., 2014). American Indians also suffer from the lowest
level of educational attainment; they have demonstrated consistently elevated high school
dropout rates, and only 11.8% of Pima County American Indians hold at least a Bachelor’s
degree. The number and extent of these health disparities among the American Indian population
puts the group at an aggregate health risk that is incommensurate with the size and proportion of
the population in comparison to the total population of Pima County.
The American Indian population in Pima County suffers disproportionately from type 2
diabetes when compared to other subgroups of the population. In particular, 18.1% of Pima
County’s American Indian population was documented as suffering from morbidity due to
diabetes in 2015. This health disparity in Pima County’s American Indian population is seen
among all American Indian groups, but is especially pronounced in members of the Tohono
O’odham Nation, which is geographically localized almost entirely in Pima County. According
to the AZDHS’s Tohono O’odham Nation Statistical Profile for 2017, “unspecified diabetes
mellitus” is the leading cause of death among Tohono O’odham individuals between the ages of
65 and 84, classifying type 2 diabetes as a major health issue plaguing the Tohono O’odham
69
people (Tohono O’odham Nation Primary Care Area, 2017). The incidence and effects of type 2
diabetes among members of the Tohono O’odham Nation can be attributed to food insecurity
that American Indians have faced since the colonial beginnings of American history. The actions
and unfair treatment of American Indians by White European colonists not only drove them off
their land, but also placed them in areas where they suffered from a lack of access to health
resources.
Since a major risk factor for type 2 diabetes is poor diet quality, food insecurity is a key
determinant of diabetes status. Food insecurity is also an issue of particular significance to the
Tohono O’odham Nation. According to the Department of Planning & Economic Development
of the Tohono O’odham Nation Tribe (DPED), households on the Tohono O’odham Nation are
35% more likely to receive SNAP benefits when compared to other households in Pima County
(DPED, 2010). Further, the unavailability and inconvenience of access to traditional, more
healthful American Indian foods have exacerbated food insecurity in the Tohono O’odham
population.
For improved health and quality of life, we believe that the Tohono O’odham people
need active public health awareness and education initiatives that promote positive health
behaviors, especially in diet quality. These could include the use of Community Health Workers
(CHWs) who would work with the population to educate them on the health risks and
consequences associated with type 2 diabetes, and then build positive health and eating habits
through workshops and intervention programs in which individuals would learn how to access
and prepare healthier foods.

70
References
ADHS (2018). Arizona Cancer Registry. Retrieved September 30, 2018, from:
https://www.azdhs.gov/preparedness/public-health-statistics/cancer-registry/index.php
Affordable Housing Development. (2018). Retrieved October 10, 2018, from
https://webcms.pima.gov/cms/one.aspx?portalId=169&pageId=24388
Air. (2018). Retrieved October 4, 2018, from
http://webcms.pima.gov/government/environmental_quality/air/
ARG Publications. (2018). Top 25 Tucson Employers and Businesses. Retrieved October 1,
2018, from http://www.phoenixrelocationguide.com/Top-25-Tucson-Employers-and-
Businesses/
Arizona Charter Schools Association, 2015, Increasing Diversity in Arizona Charter Schools
Over Time, Image retrieved October, 9, 2018, from: https://azcharters.org/
Arizona Department of Education. Data-Cohort 2017 Four Year Grad Rate Data. (2017).
Retrieved October 3, 2018 from https://www.azed.gov/accountability-research/data/
Arizona Department of Education. Data-Dropout Rates 2018. (2018). Retrieved October 9, 2018
from https://www.azed.gov/accountability-research/data/
Arizona Superior Court in Pima County. (2018). Retrieved October 10, 2018, from
https://www.sc.pima.gov/default.aspx
Asthma In Arizona. (n.d.). Retrieved October 10, 2018, from
https://www.azasthma.org/asthma-in-arizona/
AZDHS | Vital Records. (2018). Retrieved October 5, 2018 from
https://azdhs.gov/licensing/vital-records/index.php
71
AZDHS | Nutrition and Physical Activity and Obesity Program (NUPAO). (2018). Retrieved
September 30, 2018, from https://www.azdhs.gov/prevention/nutrition-physical-
activity/nutrition-physical-activity-obesity/index.php#empower-schools
AZ Health Zone Summer Lunch Buddies: Helping Kids Eat Healthy (2018). Retrieved October
10, 2018, from https://www.azhealthzone.org/summerfood
Bass, J., Bailey R., & Gieszl S. (2014). Arizona Behavioral Risk Factor Surveillance Survey
2014. Retrieved October 2, 2018, from https://azdhs.gov/preparedness/public-health-
statistics/ behavioral-risk-factor-surveillance/index.php
Buffelgrass and Other Grassy Desert Invaders. (2018). Retrieved October 11, 2018, from
http://webcms.pima.gov/cms/one.aspx?portalId=169&pageId=61835
Catholic Community Services of Southern Arizona | Social Services. (2014). Retrieved October
6, 2018, from https://www.ccs-soaz.org/
CHET-SE Dress Code, Conduct, & Guest Guidelines. (2018). Retrieved September 27, 2018,
from https://www.homeschool-life.com/121/custom/64076
Chicanos Por La Causa. (2018). Retrieved October 5, 2018, from
https://cplc.org/housing/housing.php
Centers for Disease Control and Prevention. (2015). Community Health Assessments and Health
Improvement Plans. Retrieved October 2, 2018, from
https://www.cdc.gov/stltpublichealth/cha/plan.html
Community Food Bank of Southern Arizona. (2018). Retrieved October 10, 2018, from
https://www.communityfoodbank.org/Locations/Tucson
72
Community Food Bank of Southern Arizona. (2018) Meal Sites offered through Community
Food Bank of Southern Arizona. Image retrieved October 7, 2018, from:
https://www.communityfoodbank.org/
Community Support Organization Tucson | Financial Empowerment Center Tucson. (2016).
Retrieved from https://tucsonurbanleague.org/
Data Access and Dissemination Systems (DADS). (2010). United States Census
Bureau. Retrieved October 1, 2018, from
https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF
Data Access and Dissemination Systems (DADS). (2010a). Pima County, American Factfinder.
Retrieved October 10, 2018 from
https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml?src=bkmk
Data Access and Dissemination Systems (DADS). (2010b). Pima County, Financial
Characteristics. Retrieved from
Data Access and Dissemination Systems (DADS). (2016). Your Geography Selections.
Retrieved October 10, 2018, from
https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_
16_1YR_B01003&prodType=table
Davis, T. (2017). South-side Tucsonans mobilize for another water-pollution struggle.
Retrieved September 30, 2018, from https://tucson.com/news/local/south-side-tucsonans-
mobilize-for-another-water-pollution-struggle/article_25aafd92-3a5a-5550-bbd6-
9fc0d02cd0dd.html
73
Department of Planning & Economic Development Tohono O’odham Nation Tribe. (2010).
Demographic Analysis of the Tohono O’odham Nation. Retrieved October 25, 2018,
from file:///T:/Temp/Downloads/tohono_oodham_nation_0.pdf
Dickenson, C. (2016). Zip Code Project Data. Arizona Department of education. Retrieved
September 30, 2018, from
http://www.azed.gov/zipcode/files/2016/12/zipcodeproject_toolkit_final-v2.pdf
Drive-Less Pledge. (2018). Retrieved October 4, 2018, from
https://webcms.pima.gov/cms/one.aspx?portalId=169&pageId=192695
Dust Storms - Pinal County. (n.d.). Retrieved September 30, 2018, from
http://www.pinalcountyaz.gov/AirQuality/Dust/Pages/DustStorms.aspx
Emergency Financial Aid. (2018). Retrieved October 3, 2018, from
https://www.icstucson.org/emergency-financial-aid
Environmental Protection Agency. (2017). Reviewing National Ambient Air Quality Standards
(NAAQS): Scientific and Technical Information. EPA. Retrieved October 4, 2018 from:
https://www.epa.gov/naaqs
Fazzino, David V. (2008) Traditional Food Security: Tohono O’odham Traditional Foods in
Transition. University of Florida. Retrieved October 25, 2018 from
http://etd.fcla.edu/UF/UFE0021669/fazzino_d.pdf
Fischer, H. (2017). As employment rises across Arizona, Pima County trends
downward. Capitol Media Services. Retrieved September 30, 2018, from
https://tucson.com/business/as-employment-rises-across-arizona-pima-county-trends-
downward/article_16952953-992b-5b3b-9837-81b79652ed43.html.
Food Pantries. (2018). Retrieved October 10, 2018, from

74
https://www.foodpantries.org/ci/az-tucson
Foreclosure Prevention. (2018). Retrieved October 10, 2018, from
https://webcms.pima.gov/community/help_now/foreclosure_prevention/
García, F. (2014). State of the County’s Health. Pima County Health Department. Retrieved
October 10, 2018, from
https://webcms.pima.gov/UserFiles/Servers/Server_6/File/Health/Health%20Data,%20St
atistics%20and%20Reports/StateCountyHealth2014.pdf
G.P. Nabhan., J. Mabry., D. Johnson., C. Ferrales. (2018). State of Tucson’s Food System.
Retrieved October 10, 2018, from
https://foodstudies.arizona.edu/sites/default/files/publications/TucsonFoodSystems2017_l
ow.pdf
Gray-Emmer, J. (n.d.). Healthy Communities. Retrieved October 8, 2018 from:
https://www.unitedwaytucson.org/healthy_communities
Healthy People, (2016.).40 Years of Increasing Access to Health Services through Mobile Health
in Tucson, AZ. Retrieved October 24, 2018, from
https://www.healthypeople.gov/2020/healthy-people-in-action/story/40-years-of-
increasing-access-to-health-services-through-mobile
Healthy Pima. (2018). Community Wellbeing. Retrieved October 1, 2018, from
https://www.healthypima.com/
Helping our Community. (2013). Retrieved October 10, 2018,
from https://www.cdoassemblyofgod.com/helping-our-community/
Hernandez, Blazer, Hernandez, Lyla M, Blazer, Dan G., & Institute of Medicine . Committee on
Assessing Interactions, Among Social, Behavioral, Genetic Factors in Health. (2006).

75
Genes, behavior, and the social environment moving beyond the nature/nurture debate.
Washington, DC: National Academies Press.
High School Graduation Rates. (2018). Retrieved September 25, 2018, from
https://mapazdashboard.arizona.edu/education/high-school-graduation-rates
Homelessness. (2018). Retrieved October 10, 2018, from
https://webcms.pima.gov/community/help_now/homelessness
Home Page. (2018). Retrieved October 10, 2018, from http://thegardenkitchen.org/
Home Repair Assistance. (2018.). Retrieved October 10, 2018, from
https://webcms.pima.gov/community/housing/home_repair_assistance/
Hope of Glory Ministries. (2016). Retrieved October 10, 2018, from
http://www.tucsonhope.org/homeless-facts/
Housing Services. (n.d.). Retrieved October 4, 2018, from https://saaf.org/care-services/housing-
services/
Howard Fischer Capitol Media Services. (2010). Arizona is now No. 2 in poverty. Retrieved
October 5, 2018, from https://tucson.com/news/local/arizona-is-now-no-in-
poverty/article_551a7372-415a-5dc5-a27d-ab19a1171e81.html
How is poverty measured? (2018). Retrieved September 30, 2018 from
https://www.irp.wisc.edu/resources/how-is-poverty-measured/
Humble, W. (2010). Pima County Cancer Report 2001-2010. Retrieved October 22, 2018, from
http://webcms.pima.gov/UserFiles/Servers/Server_6/File/Health/Health Data, Statistics
and Reports/Pima Cancer Data 2001-10 - FINAL - 8-1-14.pdf
Infectious Disease Epidemiology. (2013). Retrieved October 10, 2018 from:

76
https://www.azdhs.gov/documents/preparedness/epidemiology-disease-control/disease-
data-statistics-reports/annual-reports-archive/infectious-disease-epidemiology-report-
2008-2013.pdf
Invasive Species E.I.S. Issue Paper: Sonoran Desert Conservation Plan. (n.d.). Retrieved
https://webcms.pima.gov/UserFiles/Servers/Server_6/File/Government/Office%20of%20
Sustainability%20and%20Conservation/Conservation%20Sciece/The%20Sonoran%20De
sert%20Conservation%20Plan/Accomplishments/Timeline%20reports/Invasive%20Speci
es%20Issue%20Paper.pdf
Kelly, G. (2018). UA Leads Asthma Program With Tucson Unified School District
and American Lung Association. Retrieved October 10, 2018, from
https://uanews.arizona.edu/story/ua-leads-asthma-program-with-tucson-unified-school-
district-and-american-lung-association
Kemp, M.S., Gupta, S., Torres, C. (2018). Advances Vital Statistics by County of Residence
Arizona, 2017. Retrieved October 10, 2018, from https://pub.azdhs.gov/health-
stats/report/avs/index.php
Links & FAQs. (2018). Retrieved October 7, 2018, from http://www.schools.pima.gov/links-faqs
Long, B. (2018). Pima County releases tips on how to "Beat the Heat". Retrieved
October 10, 2018, from https://www.kgun9.com/news/local-news/pima-county-releases-
tips-on-how-to-beat-the-heat
Lumen Learning. (n.d.). Introduction to Sociology. Retrieved from
https://courses.lumenlearning.com/sociology/chapter/what-is-social-stratification/
Make a real change in someone's life. (2017). Retrieved October 10, 2018, from
77
https://www.communityfoodbank.org/
McShane, M. Q., & National Research. (2018). How to Tell If You Can Afford Private
School. Retrieved September 30, 2018, from https://www.edchoice.org/blog/how-to-tell-
if-you-can-afford-private-school/
Migrant Education / Migrant Education Homepage. (2017). Retrieved October 10, 2018, from
https://www.maranausd.org/migrant
Morgan, L. A. (2017). The Hazards of Being a Teacher. Retrieved from
https://work.chron.com/hazards-being-teacher-9309.html
National School Lunch Program. (2018). Retrieved October 7, 2018, from
http://www.azed.gov/hns/nslp/
Nutrition Education Community Food Bank of Southern Arizona (2017). Retrieved October 1,
2018 from https://www.communityfoodbank.org/Our-Work/Programs/Nutrition
Our Impact. (2015.). Retrieved October 4, 2018, from https://azcharters.org/our-impact/
PDEQ issues another High Pollution Advisory. (2018). Retrieved October 4, 2018, from
http://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=440964
Pima Accommodation. (2018). Retrieved October 7, 2018, from
http://www.schools.pima.gov/pima-accommodation
Pima County. (2016a). DATA USA. Retrieved September 25, 2018, from
https://datausa.io/profile/geo/pima-county-az/
Pima County. (2016b). Mosquitoes. Retrieved September 30, 2018, from
https://webcms.pima.gov/health/preventive_health/disease_control/mosquitoes
Pima County. (2016c). Transportation. Retrieved October 1, 2018, from
https://datausa.io/profile/geo/pima-county-az/#category_transportation
78
Pima County. (2018a). Air Quality. Retrieved October 5, 2018 from:
http://webcms.pima.gov/government/environmental_quality/air/air_monitoring/
Pima County. (2018b). Employee Wellness Programs. Retrieved September 30, 2018, from
https://webcms.pima.gov/government/human_resources/employee_wellness_programs/
Pima County. (2018c). Attractions & Tourism. Retrieved October 10, 2018, from
http://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=18639
Pima County. (2018d). Behavioral Health. Retrieved October 10, 2018, from
http://webcms.pima.gov/government/behavioral_health/
Pima County. (2018e). Community and Economic Development. Retrieved October 10, 2018,
from http://webcms.pima.gov/government/community_and_economic_development/
Pima County. (2018f). Community Development and Neighborhood Conservation. Retrieved
http://webcms.pima.gov/government/community_development_neighborhood_conservati
on/
Pima County. (2018g). Community Services, Employment and Training. Retrieved October 10,
2018, from
http://webcms.pima.gov/government/community_services_employment_and_training/
Pima County. (2018h). County Administrator. Retrieved October 10, 2018,
from https://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=551
Pima County. (2018i). Food Environment Statistics. Retrieved October 10,
2018, from http://www.city-data.com/food/food-Pima-Arizona.html
Pima County. (2018j). Health Department. Retrieved October 10, 2018,
from http://webcms.pima.gov/government/health_department/
79
Pima County. (2018k). Medical Examiner. Retrieved October 10, 2018,
from http://webcms.pima.gov/government/medical_examiner/
Pima County. (2018l). Office of Emergency Management. Retrieved October 10, 2018,
from http://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=18529
Pima County. (2018m). Pima Animal Care Center. Retrieved October 10, 2018,
from http://webcms.pima.gov/government/pima_animal_care_center/
Pima County. (2018n). Pima County Wireless Integrated Network (PCWIN). Retrieved October
10, 2018, from http://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=82043
Pima County. (2018o). Public Health Emergency Preparedness. Retrieved October 10, 2018,
from http://webcms.pima.gov/government/public_health_emergency_preparedness
Pima County. (2018p). Law Enforcement Agencies and Links. Retrieved October 10, 2018,
from http://webcms.pima.gov/government/law_enforcement/
Pima County. (2018q). Public Works. Retrieved October 10, 2018,
from https://webcms.pima.gov/government/public_works
Pima County. (2018r). Special Needs. Retrieved October 10, 2018,
from https://webcms.pima.gov/community/housing/special_needs/
Pima County. (2018s). Environmental Quality. Retrieved October 10, 2018, from
http://webcms.pima.gov/government/environmental_quality/
Pima County, Arizona Population 2018. (2018). World Population Review. Retrieved October
1, 2018, from http://worldpopulationreview.com/us-counties/az/pima-county-population/.
Pima County AZ Education Data. (2017). Retrieved September 28, 2018, from
http://www.towncharts.com/Arizona/Education/Pima-County-AZ-Education-data.html
Pima County Sheriff's Department. (2018). Retrieved October 10, 2018, from
80
https://www.pimasheriff.org/
Pima County Office of the Medical Examiner Annual Report 2016. (2017). Retrieved
https://webcms.pima.gov/UserFiles/Servers/Server_6/File/Government/Medical
Examiner/Resources/Annual-Report-2016.pdf
Pima County, This Land Is Your Land, 40 Years of Voters Conservation Support. (n.d-a).
Retrieved from:
http://webcms.pima.gov/UserFiles/Servers/Server_6/File/Government/Natural%20Resour
ces%20Parks%20and%20Recreation/Natural%20Resources/FINAL%20This%20Land%
20is%20your%20Land.pdf
Pima County Transportation. (2015). The Roads to Recovery [Brochure]. Retrieved
October 1, 2018 from
http://webcms.pima.gov/UserFiles/Servers/Server_6/File/Government/Transportationr
nsportation%20Funds/RevisedMarch2015-1613-TransportationFUndingBasicsbrochu.
df
Population Health and Vital Statistics: Arizona Health Status and Vital Statistics 2016 Annual
Report for the Elderly Mortality. (2018). Retrieved October 11, 2018, from
https://pub.azdhs.gov/health-stats/report/ahs/ahs2016/index.php?pg=state
Population Health and Vital Statistics: Hospital Inpatient Discharges & Emergency Room Visits
Statistics for Asthma. (2018). Retrieved October 11, 2018, from
https://pub.azdhs.gov/health-stats/hip/index.php?pg=asthma
Population Health and Vital Statistics: Vital Statistics Trends in Arizona. (2018). Retrieved
81
October 11, 2018, from https://pub.azdhs.gov/health-
stats/menu/info/trend/index.php?pg=deaths
Poverty Rate. (2017). Retrieved October 3, 2018
from https://mapazdashboard.arizona.edu/health-social-well-being/poverty-rate
Recovery Tracker. (2018). Retrieved October 10, 2018 from
https://projects.propublica.org/recovery/locale/arizona/pima/dept/8600
SAAF. (2018). Retrieved September 28, 2018 from https://saaf.org/
SafeGuard. (2018). The Dangers of Being a Border Patrol Agent. Retrieved from
https://www.safeguardclothing.com/articles/dangers-that-come-with-being-a-border-p
trol-agent/
Sagna, M., Gupta, S., & Torres, C. (2018). Mortality and Morbidity From Exposure to
Excessive Natural Heat in Arizona, 2006-2016. Retrieved October 10, 2018, from
https://pub.azdhs.gov/health-stats/report/heat/heat-2016.pdf
School Gardening. (2018). Retrieved October 1, 2018, from
http://www.pimafoodalliance.org/resources/school-gardening/
School Meal Programs, Student Meal Prices for the 2017-2018 School Year. Image retrieved
October 10, 2018, from: http://www.tusd1.org/Departments/Food-Services/School-Meal-
Programs
School Meal Programs. (2018). Retrieved September 30, 2018, from
http://www.tusd1.org/Departments/Food-Services/School-Meal-Programs
Some convenience stores fill up on fruit, vegetables. (2018). Retrieved October 10, 2018, from
https://www.thepacker.com/article/some-convenience-stores-fill-fruit-vegetables
Soular, D. A. (2017). Border agents, and the risks at the edge of the line. Retrieved from
82
https://www.usatoday.com/border-wall/story/us-border-patrol-control-
mexico/633139001/
South Tucson, AZ. (2016). Retrieved September 30, 2018, from
https://datausa.io/profile/geo/south-tucson-az/z
State Cancer Profiles. (2015). Retrieved September 30, 2018, from
https://statecancerprofiles.cancer.gov/incidencerates/index.php?stateFIPS=04&cancer=05
3&race=00&sex=0&age=001&type=incd&sortVariableName=rate&sortOrder=desc#resu
lts
Sun Van. (2018). Retrieved October 1, 2018, from
http://www.sunvan.com/files/17_Dec_8_2018TransitFares.pdf
Synergy: Lifestyle Medicine (2018). Arizona Cancer Statistics by County, Age, Race and More.
Retrieved October 3, 2018, from:
https://www.synergylifestylemedicine.com/blog/arizona-cancer-statistics-county-age-
race-gender/
Target Area Report. (2012). Retrieved October 25, 2018, from
https://azprc.arizona.edu/sites/default/files/Pima County CPPW Target Area Final
Report.pdf
TCAZ. (2018). Retrieved September 30, 2018, from https://tcaz.org/about-us/
TIHAN. (2017.). Retrieved October 3, 2018, from https://tihan.org/services/
The Chuck Huckelberry Loop. (2018). Retrieved October 1, 2018, from
http://webcms.pima.gov/cms/one.aspx?portalId=169&pageId=35827
83
The Pima County School Superintendent's Office Promotes Educational Excellence Through
LEADERSHIP, SERVICE, & COLLABORATION. (2018). Retrieved September 30,
2018, from http://www.schools.pima.gov/
The University of Arizona. (2017). Fight the Bite! Day and Night Campaign – Prevention of
West Nile Virus and other mosquito-transmitted illnesses. Retrieved October 25, 2018,
from https://uaatwork.arizona.edu/node/35846
Tohono O’odham Nation Primary Care Area Statistical Profile – 2017. (2017). Retrieved
October 25, 2018, from https://azdhs.gov/documents/prevention/health-systems-
development/data-reports-maps/primary-care/pima/82.pdf
Trichlorethylene (TCE) Pollution in Tucson Water. (2014). Retrieved September
30, 2018, from https://www.library.pima.gov/blogs/post/trichlorethylene-tce-pollution-in-
tucson-water/
Tucson Electric Power. (2016) Retrieved October 3, 2018, from https://www.tep.com/
Tucson Update - Ethnicity. (2015). Retrieved September 28, 2018, from
https://www.tucsonaz.gov/hcd/tucson-update-ethnicity
Tucson South Primary Care Area (PCA) Statistical Profile. (2018). Retrieved October 10, 2018,
from https://azdhs.gov/documents/prevention/health-systems-development/data-reports-
maps/primary-care/pima/111.pdf
University of Arizona Department of Medicine. (2016). 2016 Health & Wellness Fair for Pima
County/City of Tucson Employees. Retrieved October 2, 2018, from
http://deptmedicine.arizona.edu/event/2016/2016-health-wellness-fair-pima-countycity-
tucson-employees
University of Arizona Eller INSITE. (2018). Social Media Monitoring and Surveillance for
84
Vector-Borne Diseases. Retrieved October 1, 2018, from
https://insiteua.org/research/social-media-vector-borne-diseases
Urizar-Faught, C. (2018). Behavioral Health Services. Retrieved October 5, 2018, from
https://www.casadelosninos.org/programs-resources/behavioral-health-treatment-
programs/behavioral-health-services/
U.S. Bureau. (2010). Your Geography Selections. Retrieved October 4, 2018, from
https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_
16_5YR
U.S. Census Bureau QuickFacts: Pima County, Arizona. (n.d.). Retrieved September 29, 2018,
from https://www.census.gov/quickfacts/fact/table/pimacountyarizona/PST045217
U.S Census Bureau, 2012-2016 American Community Survey 5-Year Estimates.
Retrieved October 7, 2018, from:
U.S Census, 2010, Educational Attainment in Pima County by Race. Image retrieved September
30, 2018, from: https://www.census.gov/programs-surveys/decennial-
census/decade.2010.html
What Is Poverty? Definition and Measurement. (n.d.). Retrieved September 30, 2018,
from https://poverty.ucdavis.edu/what-poverty-definition-and-measurement
10-year Pima County Road Repair Plan. (2018). Retrieved September 28, 2018,
from http://webcms.pima.gov/cms/One.aspx?portalId=169&pageId=345232
85

Cha

Diunggah oleh

Informasi Dokumen

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

Cha

Diunggah oleh

Hak Cipta:

Format Tersedia

Community Health Assessment for Pima County

Health Education Council B

October 25, 2018

Contributors to the Community Health Assessment

List of Tables ..................................................................................................................................4

List of Figures .................................................................................................................................5

Geography and Environment of Pima County ...........................................................................7

Socioeconomic Stratification .......................................................................................................14

Health Statistics ............................................................................................................................19

Local Health Resources ...............................................................................................................24

Cultural Factors ...........................................................................................................................27

The County’s Governmental Organization/Function...............................................................30

Food Supply ..................................................................................................................................38

School Health and Nutrition Programs .....................................................................................47

Social Welfare Programs .............................................................................................................51

Occupational Data .......................................................................................................................59

Other Community Factors Impacting Health ...........................................................................61

Table 1. Pima County Population Demographics. .........................................................................13

Figure 1. Map of Pima County. .......................................................................................................7

Figure 2. TCE Contamination ..........................................................................................................9

Figure 3. Pima County Demographics ...........................................................................................13

Figure 4. Poverty Statistics ............................................................................................................15

Figure 5. Poverty Rate by Age (2016).. .........................................................................................16

Figure 6. Poverty Rate by Race & Ethnicity (2016). .....................................................................16

Figure 8. Pima County Employment Statistics ..............................................................................17

Figure 9. Median Household Income. ...........................................................................................18

Figure 10. Pima County Occupations. ...........................................................................................19

Figure 11. Percent of Reported Cases of Communicable Diseases. ..............................................20

Figure 12. Total Mortality Rates from All Causes. .......................................................................23

Figure 13. Health Reports for Arizona, by County.. ......................................................................24

Figure 14. Poverty by Age and Gender in Pima County. ..............................................................29

Figure 15. Pima County Organizational Chart. .............................................................................30

Figure 16. Monthly Cost of Housing in Pima County. ..................................................................36

Figure 17. Zip Code Project Data. .................................................................................................44

Figure 19. Common Methods of Transportation in Pima County .................................................55

A Community Health Assessment (often known as a community health needs assessment

status of Pima County, these including: geography, demographic information, socioeconomic

County, and how these disparities can be mitigated.

Geography and Environment of Pima County

Figure 1. Map of Pima County.

Comobart Mountains, Coyote Mountains, Alvarez Mountains, Tortolita Mountains, Tucson

temperatures of 73 degrees Fahrenheit and average low winter temperatures of 50 degrees

contaminated water compared to their wealthier counterparts.

Figure 2. TCE Contamination.

Native, and 20 for Asian or Pacific Islander (Pima County, 2016a).

extreme heat is undocumented immigrants. In 2016, 26% of the deaths of undocumented

(State Cancer Profiles, 2015).

participate fully in the community.

males make up 49.7% of the total population.

individuals (Pima County, 2016a).

Figure 3. Pima County Demographics

Table 1. Pima County Population Demographics.

Population (2016 estimate) 1,003,338 6,728,577

% race American Indian or 3.2 4.4

Socioeconomic stratification is when a society categorizes people based on factors such

social position compared to others income, education, and occupation. In regards to

socioeconomic stratification and socioeconomic status, it is important to fully understand the

Figure 4. Poverty Statistics of Pima County.

official poverty is measured by comparing approximately 100,000 addresses in the course of

(University of Wisconsin-Madison, 2018). The individual median household income in Pima

Figure 5. Poverty Rate by Age (2016).

Figure 6. Poverty Rate by Race & Ethnicity (2016).

female as a full-time employee.