icanatwork

Charting the Course VI 2010

Published February 2011

Community Health Improvement Partners

Catalyst for Coalition

Community Benefit Challenge

Senate Bill 697 (1994)

Formation of CHIP

CHIP Vision and Mission

Vision

The leading countywide health partnership advancing the wellbeing of all San Diegans

Mission

Improving the health of all San Diegans through needs assessment advocacy education and programs best accomplished collectively

CHIP Values

As a public-private collaborative dedicated to community health improvement CHIP values

COLLABORATION Where we can make a difference

RESPECT Recognition of each memberrsquos perspective

NEUTRALITY A safe place to collaborate

INNOVATION A forum for critical thought

EFFICIENCY Wise use of resources

CREDIBILITY A reliable source

2-1-1 San Diego

American Lung Association

Council of Community Clinics

County of San Diego HHSA San Diego

Hospice and The Institute for Palliative Medicine

Kaiser Permanente

Project Concern International

Rady Childrenrsquos Hospital amp Health Center

San Diego County Medical Society

San Diego State University College of Health amp Human Services

Scripps Health

Sharp Health Plan

UCSD Health System

UCSD School of Medicine

Vista Hill Foundation

2011 CHIP Executive Partners

Thank you to our sponsors

Premier Sponsorsbull SB697 Hospitals of San Diego County

bull Kaiser Permanente

bull Rady Childrenrsquos Hospital

bull Scripps Health

bull Sharp HealthCare

bull Sharp Health Plan

Supporting Sponsorsbull The San Diego Foundation

bull Alliance Health Care Foundation

Contributing Sponsorsbull Mental Health Systems

CHIP San Diego County Health Needs Assessment

Charting the Course I 1995 (February 1996)

Charting the Course II 1998 (April 1999)

Charting the Course III 2001 (March 2002)

Charting the Course IV 2004 (March 2005)

Charting the Course V 2007 (January 2008)

Charting the Course VI 2010 (February 2011)

Uses Charting the Course VI-- A Community Health Needs Assessment

Fulfilling the requirements of SB 697

Not-For-Profit Hospitals --- Community benefit plans(ldquoBaucus Health Care Plan Would Impose New Requirements on Tax-Exempt Hospitalsrdquo)

Provide a community resource

Monitor changes and trends

Basis for development amp evaluation of interventions

Foundation for policy and advocacy

Needs Assessment Process

August 2009 Process Begins

Process of Development

amp Model Selection

March Community

Kick-Off

April-May Prioritization

Aug-Sept Regional Meetings

Jan-March 2011

Publication

2010 Issue Categories

Overarching Issues (4 Issues)

Access to health services

Health communications and health information technology

Public health infrastructure

Social determinants of health

Health-Related Behaviors

(6 Issues)

Keeping immunizations current

Smoking cessation

Improving nutrition

Increasing physical activity

Achieving healthy weight status

Maintaining Oral health

Preventing violence and injury

Health Outcomes (7 Issues)

Cancer

Diabetes

Heart disease and stroke

Infectious diseases

Maternal infant and child health

Mental health

Respiratory diseases

Who RespondedResponses by Geographic Region Served

Region CountPercent of

total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718

2010 Priority Health Issues



A combination of nutrition weight status physical

activity and fitness

Injury and violence

Mental health and mental disorders

Community Forums

Develop a regionally focused understanding of health needs and

Develop a list of some of the root causes of

Obesity

Violence amp Injury

Poor Mental Health

Engage the community

32 million residents

49 minorities

Growing older adult population

4200 square miles

San Diego County

bull 4200 square miles

bull Urban to remote

bull Geographically diverse

Access to Health

Services

General Health Status Insurance

Coverage amp Medical Home

Only 56 of adults were in excellent or very good health

85 of adults were currently insured

87 of adults had a usual place to go when sick or needing health advice

83 of adults visited a doctor during the past year

Source County of San Diego Health and Human Services Agency Public Health Services Community Health Statistics Unit Community

Profiles Accessed online at wwwsdhealthstatisticscom 72610

Economic Recession Impact on Coverage Type of Coverage amp Utilization

Changes in health insurance coverage 23 of adults were uninsured in 2009

Changes in healthcare utilization gt half of uninsured adults had no regular source of care

Higher ER utilization 12 increase from 2006-2009

Higher primary care clinic utilization

Competing demands for family budget

Impact on Hospitals Increases in Med-Cal uninsured bad debtcharity care

Putting Off Care Because of CostPercent who say in the past 12 months they or another family member in their household has done each because of the cost

Impact to the Business Community

Health status is impacted by access amp utilization of healthcare for workforce and families

Recessions impact employers and in turn impact employees Benefits reduction

Increased insurance premiums

Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health

Poor smokers face a greater risk of getting lung cancer and

heart disease than rich smokers

CEOs face more stress and are therefore at greater risk of heart disease than middle

managers or other workers

Political decisions (laws and social policies) have a greater impact on population health

than individual behaviors (diet smoking and exercise)

Health Equity

On average in the US how many more supermarkets are there in predominantly white neighborhoods compared to predominantly Black amp Latino neighborhoods

A about the sameB 15 times as manyC 2 times as manyD 4 times as manyE 6 times as many

Social Determinants of Health

The social determinants of health are the circumstances in which people are born grow up live work and age as well as the systems put in place to deal with illness These circumstances are in turn shaped by a wider set of forces economics social policies and politics (WHO)

Is Inequality Making Us Sick

Social Determinants of

Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias

Community Acceptance

Cultural Factors

Mass Media Influence

Politics

Living Conditions

Geography


bull There are many factors that impact health beyond the employer and employee

bull Healthier communities = healthier workforcebull What can the business community do to assure a

healthier community

bull Do your employees feel empowered

bull Social connectedness

bull Personal or collective efficacy

bull Discussion

Obesity ampWeight Status

San Diego County Rate 73

(BMI ge30 or ~ 30 lbs overweight for 5rsquo 4rdquo person)

Obesity Trends Among US AdultsBRFSS 1985

Source Behavioral Risk Factor Surveillance System CDC

No Data lt10 10ndash14 15ndash19


























































No Data lt10 10ndash14 15ndash19 gt20




















No Data lt10 10ndash14 15ndash19 20ndash24 25ndash29 ge30











































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Adult BehaviorsSan Diego County 2007

55 of adults were obese or overweight

bull Low fruit and vegetable consumption 47 of adults eat 5+ servings

High fast food consumption 75 of adults eat fast food 3+ times per week

Low physical activity 13 of adults get no physical activity

Characteristics of Obese AdultsSan Diego County 2007

bull Lower Education Less than BSBA degree (264) BSBA+ (138)

Working age 25-64 yrs (241)

Poor to good health lt very good (326) gt very good (132)

Disabled Disabled (287) not disabled (191)

Taking Medication for Mental Disorders Medication for emotionalmental health (647)

CHIS 2007

Overweight - 2009San Diego County Children and Adolescents by Grade

369

349

320

195

234

293

15

20

25

30

35

40

Grade 5 Grade 7 Grade 9

Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females

California Department of Education Physical Fitness Report 2009

Children amp Adolescent BehaviorsSan Diego County 2007

Low fruit and vegetable consumption 23 adolescents eat 5+ servings

50 children eat 5+ servings

Low physical activity 73 of children get recommended vigorous PA

67 of adolescents get recommended vigorous PA

High TV Viewing amp Gaming 15 of children 3+ hours on weekdays

25 of adolescents 3+ hours on weekdays

Community Regional Forum InputSummary of Identified Root Causes Obesity

Nutrition Limited access to affordable

fresh healthful foods

Fast foods are easily accessible less expensive and marketed heavily

Other Language barriers

Physical Activity Limited access to safe

affordable space for physical activity

Societal norms do not support physical activity

Societyrsquos encouragement of sedentary activities

Fear of crime and safety issues related to being physically active in neighborhoods and parks


A healthy workforce is more than the employee Wellness doesnrsquot stop when people clock out

Families

Communities

How can we encourage healthier families amp communities

Discussion

Injury and

Violence

Injury and Violence

bull Injury and Violence includes both unintentional and intentional injuriesndashUnintentional injuries are predictable and preventable

through environmental and behavioral changes

bull Motor Vehicle Crashes

bull Falls

ndash Intentional injuries are preventable through increased awareness and behavioral changesbull Homicide and assault

bull Suicide and self-inflicted

Unintentional Injury PyramidSan Diego County 2008

932persons

died as a result of an unintentional injury

during 2008

20850 patients

Admitted to hospital as a result of an unintentional

injury during 2008

149900 patients

Discharged from hospital emergency departments as a result of an

unintentional injury during 2008

patients

Physiciansrsquo office or clinic visits as a result of unintentional injury

125

100

74

19

0

2

4

6

8

10

12

14

Poisoning Overdose dagger

Motor Vehicle Falls Pedestrian

Rate

per 1

00

00

0

Underlying Cause of Deathdagger Due to all intents including suicide and homicide Due to motor vehicle accidents

Injury DeathsSan Diego County 2007

Deaths Due to Motor VehiclesSan Diego County 2007

100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate

Male Female White African American

Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007

Community Regional Forum InputSummary of Identified Root Causes Unintentional Injury

Unintentional Injury

Limited access to and knowledge and awareness of prevention

Unsafe home environments

High-risk activities among youth

Cultural bias against services for seniors and Latinos

Low literacy levels

Intentional Injury DeathsSan Diego County 2000-2008

Aggravated AssaultSan Diego County 2000-2009

Community Regional Forum InputSummary of Identified Root Causes Injury amp Violence

Violence

Gang activity

Easy access to and use of illicit drugs and alcohol


Language and cultural issues related to laws and trust in government programs

Military culture conflicts with civilian code of conduct

Cultural norms do not support reporting problems

Distrust of neighbors community leaders and fear of retaliation

Low literacy levels


bull Where does injury and violence prevention fit intoworksite wellnessbull Encouragement of physical activity rarr use of appropriate

safety equipment

bull Worksite safety

bull Stress management

bull Discussion

Mental Health

Emotional Well-being Access amp Utilization of Mental Health Services

8 of adults had psychological distress in the past year

13 of adults saw any healthcare provider for emotional-mental andor alcohol-drug issues in past year

16 of adults felt they needed help for emotional-mental andor alcoholdrug issues in the past year

Of those who felt they needed help 65 received treatment

10 of adults have taken prescriptions meds (2+weeks)

22 of adolescents were at risk for depression

Source County of San Diego Health and Human Services Agency Public Health Services Community Health Statistics Unit

Community Profiles Accessed online at wwwsdhealthstatisticscom 72610 Center for Epidemiologic Studies Depression Scale

(CES-D8)

ED Discharges with Principal Diagnosis of Mental DisorderSan Diego County 2008

8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)

Serious Mental IllnessSan Diego County 2007

Prevalence countywide 50

Highest among youth (74)

Prevalence households earning lt200 FPL 82

Highest among adults 25-60 (102)

The number of MHS clients is increasing CMHS clients increased 4 since 2005

AMHS clients increased 8 since 2006

Cost of Serious Mental Illness$318 Billion a Year

Suicide DeathsSan Diego County 2000-2008

(CoSDCHS 2010)

Suicide by AgeSan Diego County 2008

113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)

Factors that Impact Suicide

Gender Male suicide rate is more than three times higher than females Men between the ages of 35-44 have the highest number of suicides

Age Adults between the ages of 25 and 54 have the highest number of suicides Older adults (65+) have highest suicide rate (203)

RaceEthnicity Suicide rate is highest among Whites (167) followed by Blacks (73) AsianOther (55) and Hispanic (37)

Geographic Area Suicide rate is highest in East (125) and Central (121) regions of the County

Suicide Method Firearms are the leading method of completed suicide (410)

Toxicology Of those tested 564 of men and 675 of women tested positive for alcohol andor drugs at the time of their death

Source Suicide in San Diego County 2000-2007 data report

Community Regional Forum InputSummary of Identified Root Causes Mental Illness

Society

Stigma associated with mental illness

Cultural beliefs related to mental illness

Socioeconomic cultural and language barriers to care

System

Provider systems intimidate consumers

Limited number of culturally competent psychiatrists and nurses

Primary care physicians unwilling to accept referrals or do screening assessment and brief interventions

Limited knowledge on how to navigate the mental health treatment system


bull Well-being = Physical Health + Mental Healthbull Physical manifestations of mental illnesses

bull Decreased productivity

bull Lower job satisfaction

bull What responsibility do you have to your employeesrsquo mental healthbull Stress management

bull EAP options

bull Stigma

bull Discussion

Next Steps

Are our wellness programs meeting the needs of the population

bull Survey of regional wellness efforts

bull Creation of regional ldquoWellness Indexrdquo

bull Create a ldquoBusiness Guide to Community Healthrdquo

wwwsdchiporg

Contact Information

Holly SalazarDirector of Strategic OutcomesCommunity Health Improvement Partnershsalazarsdchiporg858-609-7966

Catalyst for Coalition

Community Benefit Challenge

Senate Bill 697 (1994)

Formation of CHIP


Vision


Mission


CHIP Values








2-1-1 San Diego





Kaiser Permanente





Scripps Health

Sharp Health Plan

UCSD Health System








bull Scripps Health























amp Model Selection

March Community

Kick-Off



Jan-March 2011

Publication








(6 Issues)


Smoking cessation

Improving nutrition






Cancer

Diabetes


Infectious diseases


Mental health




total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718






Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information



Vision


Mission


CHIP Values








2-1-1 San Diego





Kaiser Permanente





Scripps Health

Sharp Health Plan

UCSD Health System








bull Scripps Health























amp Model Selection

March Community

Kick-Off



Jan-March 2011

Publication








(6 Issues)


Smoking cessation

Improving nutrition






Cancer

Diabetes


Infectious diseases


Mental health




total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718






Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


CHIP Values








2-1-1 San Diego





Kaiser Permanente





Scripps Health

Sharp Health Plan

UCSD Health System








bull Scripps Health























amp Model Selection

March Community

Kick-Off



Jan-March 2011

Publication








(6 Issues)


Smoking cessation

Improving nutrition






Cancer

Diabetes


Infectious diseases


Mental health




total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718






Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


2-1-1 San Diego





Kaiser Permanente





Scripps Health

Sharp Health Plan

UCSD Health System








bull Scripps Health























amp Model Selection

March Community

Kick-Off



Jan-March 2011

Publication








(6 Issues)


Smoking cessation

Improving nutrition






Cancer

Diabetes


Infectious diseases


Mental health




total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718






Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information






bull Scripps Health























amp Model Selection

March Community

Kick-Off



Jan-March 2011

Publication








(6 Issues)


Smoking cessation

Improving nutrition






Cancer

Diabetes


Infectious diseases


Mental health




total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718






Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information



















amp Model Selection

March Community

Kick-Off



Jan-March 2011

Publication








(6 Issues)


Smoking cessation

Improving nutrition






Cancer

Diabetes


Infectious diseases


Mental health




total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718






Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information









(6 Issues)


Smoking cessation

Improving nutrition






Cancer

Diabetes


Infectious diseases


Mental health




total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718






Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information




total respondents

North Coastal

48 676

North Inland 46 648

North Central

49 690

Central 57 803

East 48 678

South 51 718






Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information







Injury and violence


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


Community Forums



Obesity

Violence amp Injury

Poor Mental Health



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information



49 minorities


4200 square miles

San Diego County




Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


Access to Health

Services





















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information






















Reduced hourssalary

Increased workload

Other observations

3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS

Social Determinants

of Health







Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information








Health Equity







Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information






Health

Economic Factors

Social Inclusion

Education

Racial Ethnic Bias


Cultural Factors


Politics

Living Conditions

Geography




healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information





healthier community




bull Discussion































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information
































































































































3-FOUR-50

Three Behaviors

Four Chronic

Diseases

50 of ALL

DEATHS












CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information













CHIS 2007


369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information



369

349

320

195

234

293

15

20

25

30

35

40


Pe

rce

nt

BM

I a

bo

ve

he

alt

h f

itn

es

s z

on

e

Grade

Males Females





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information





















Families

Communities


Discussion

Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


Injury and

Violence

Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


Injury and Violence




bull Falls




932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information



932persons


during 2008

20850 patients


injury during 2008

149900 patients



patients


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


125

100

74

19

0

2

4

6

8

10

12

14



Rate

per 1

00

00

0




100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information



100

139

60

106113 115

162

101

164

0

2

4

6

8

10

12

14

16

18

Overall Rate


Latino Ages 15-24

Ages 25-64

Ages 65 plusA

ge-a

dju

ste

d

sp

ecif

ic r

ate

per 1

00

00

0

20

07

CoSD 2007







Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information








Low literacy levels




Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information





Violence

Gang activity







Low literacy levels



safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information




safety equipment



bull Discussion

Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


Mental Health










(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information











(CES-D8)


8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information



8095 84747717

10063

12184

6082

982510362

11342

5714

0

200

400

600

800

1000

1200

1400

Overall Rate


Latino Ages 15-24

Ages 25-44

Ages 45-64

Ages 65 plus

Age

-ad

just

eds

pec

ific

rat

e p

er

10

00

00

200

7

(CoSDCHS 2010)










(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information











(CoSDCHS 2010)


113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information



113

60

104

160

191

224

127153

255

0

5

10

15

20

25

30

Overall Rate

15-24 25-34 35-44 45-54 55-64 65-74 75-84 85 plus

Ag

e-s

pecif

ic r

ate

per

10

00

00

(CoSDEPI 2010)










Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information











Society




System










bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information







bull EAP options

bull Stigma

bull Discussion

Next Steps





wwwsdchiporg

Contact Information


Next Steps





wwwsdchiporg

Contact Information


wwwsdchiporg

Contact Information


Contact Information


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