Santa Clara County residents are improving their health in some areas and losing ground in others. A recent report on public health in the county reveals that low-income and minority communities have higher instances of disease, and are more likely to engage in unhealthy behavior and have poor diets.
The Health Profile Report, released July 20 by the county health department, showed drops in teen and adult smoking, teen birth rates and unsafe sex practices. The immunization rate among kindergarteners increased, the report found.
"It's good to see trends move in the right direction," said Dr. Marty Fenstersheib, a public health officer for the county.
He pointed to active community coalitions, better health education and tight school policies on immunization for strides made in public health countywide.
Fenstersheib said that, on average, 21 percent of Americans are smokers, while only 10 percent of Santa Clara County residents smoke.
According to the report, the county will continue to combat smoking with a $7 million federal grant for tobacco prevention. Fenstersheib said the county plans to spend that grant on efforts to reduce secondhand smoke by promoting smoke-free colleges and developing multilingual and multicultural anti-tobacco campaigns.
But while Fenstersheib found much encouraging news in the report, "we still have a way to go," he said.
According to the report, the number of uninsured has increased, obesity and diabetes are up among adults, and the number of overweight and obese teens remains at 25 percent.
The doctor said obesity is a major concern, not only for local health officials, but nationwide, particularly as it leads to other health problems.
"Diabetes and obesity go hand in hand," Fenstersheib said. "We have seen, over the last few decades, a gradual increase, year after year, in the diabetes and obesity rates in this county, this state and this country."
The "fattening of America," as he put it, is being caused by a confluence of events. Children are eating more fast food, as parents have less time to cook. Those same children get less physical activity and they spend more time indoors, playing video games and watching TV.
Fenstersheib said poorer communities often experience higher instances of obesity because there are fewer parks, or parks are unsafe and parents prefer that children stay indoors; schools in lower income areas are often forced to cut back on physical education; and that poor people often live in "food deserts" where unhealthy foods are cheaper and easier to access than fresh produce and other healthy choices.
In illustrating the gravity of the obesity epidemic, Fenstersheib noted that there are two kinds of diabetes -- one that is genetic and one that is caused by an individual's behavior. The latter of the two used to be referred to as "adult onset diabetes," because it usually was not seen until adulthood, after decades of poor eating habits. However, this type of diabetes is now being referred to as "type 2 diabetes," since children are commonly developing the disease.
Furthermore, the report finds disparities that show certain populations are more at risk for poor health and disease.
Among the report's findings:
-Low-income residents who make less than $20,000 a year are nearly 20 percent more likely to be overweight or obese than those who make $70,000 a year or more.
-Low-income residents are nearly 10 percent more likely to be smokers than those who make $75,000 a year or more.
-Hispanic and black residents are uninsured at a higher rate than the overall community.
-Hispanic and black residents suffer higher rates of AIDS infection than the overall community.
-Suicide rates are higher among whites than Asians and Hispanics.
Fenstersheib said the report will help the county work toward understanding these disparities, so that it can work to overcome them. In a upcoming study, he said, the county will attempt to define the multifaceted sources of failing health in Santa Clara County, such as income, education, and access to resources.
Figuring out the root of these issues and working to halt them is something everyone in the county should be concerned about, Fenstersheib said -- even those who are healthy.
The burden unhealthy people place on the local hospitals and other local services "costs everybody, because services for other things have to be diverted," Fenstersheib said.
Additionally, when people who should be contributing to society are taken from the workforce due to disease, "that costs your entire community," Fenstersheib said. "You want to have a community that stays healthy and productive."