Professional Documents
Culture Documents
Doris Buezo
Alexa Reyes
HSCI 617
Dr. Becerra
30 October 2017
Table of Contents
Methods...4
Indicators.4
Demographic...4
Social...5
Physical...7
Healthcare8
Behavior.10
Recommendations.12
References.13
3
Introduction
Imperial County is located in Southern California near the Mexican border east of San
Diego County. According to U.S. Census Bureau American Community Survey or 2011-2015
Imperial County has 178,206 residents compared 38,421,464 residents in California. Imperial
County is composed of 14 cities which include Brawley, Calexico, Calipatria, etc. This county
was established in California in 1907 and it is the ninth largest California County encompassing
Methods
Data information on Imperial County was obtained from the following website:
general information from the user. On the link Community Health Needs Assessment which
was under the Maps and Data tab, the central tab Run an Indicator Report was selected. Then
the state California and Imperial County was selected as the intended cohort. This lead to
Imperial Counties Health Indicators Report which included social & economic factors, physical
Demographics
Indicators chosen for Imperial County demographics were females (sex), and age (25-
34). For the purpose of this study women between the ages of 25-34 were the main focus due to
life changing experiences they phase during this time. We wanted to analyze how life choices,
education, and employment play a role in womens health outcomes and quality of life. It is
believed that these years are critical for women largely because some are graduating from
college during this time, are looking for employment or changing careers/jobs. Having that said
we wanted to look at Imperial County women population in order to better understand their
health outcomes, life style, life expectancy, quality of life etc. based on career choices.
According to CHNA database it was found that Imperial County has a total of 178,206 residents
of which 87,039 of them are females. Of these women, 50.3% are White, 20.1% are Black,
46.7% are Native American/Alaskan Native, 48.5% are Asian, 34.5% are Native
Hawaiian/Pacific Islander, 46.3% are of some other race, and 54.8% are multiple races as shown
on Figure 2. In the age category 24,762 individuals in Imperial County within the ages 25-34 of
For our Social Indicators Population with Bachelors Degree or Higher and
Unemployment were evaluated. It is expected that individuals with higher education of at least a
Bachelor's degree have less financial burdens and higher quality of life which includes physical,
mental and social aspects of life. A study done by Tavakoli-Fard states that there is a close
association between work ability and health-related quality of life (HRQoL). In other words,
educated women with a higher education have better health outcomes compared to those that
dont have a higher education. According to CHNA data 15,102 Imperial County residents have
a Bachelors degree or higher over the age of 25. This means that 14.08 percent of all residents
have at least a bachelors compared to 31.43 percent for the State of California and 29.77 percent
in the U.S as shown in Figure 3. This goes to show that the number of individuals living in
Imperial County without at least a bachelors degree outweigh those that do have a career.
Unfortunately CHNA did not have data on the number of women that have a bachelor's degree or
higher and only provided the total amount of residents that have a bachelors degree or higher. I
would say this is a limitation largely because it does not allow us to fully analyze how many
6
women in this county have at least a four year degree or higher as well as have a better
When looking at unemployment it was found that 27.3 percent of Imperial County
residents are unemployed. This means that out of 77,398 individuals in the labor force 21,160 are
unemployed in this county alone. Comparing that with the State of California which is 5.8
percent (Unemployed) and the nation at 5.2 percent, Imperial County clearly has a high
unemployment rate as shown in figure 4. This could possibly mean that Imperial County has a
high poverty rate, lower education, lower health outcomes, lower health care, and possibly low
life expectancy. Interestingly a study done by Singh et al. that looked at unemployment and life
expectancy found that there is a close association between the two. The author further stated
cardiovascular diseases, liver cirrhosis, suicide, and mental health problems in a number
of countries (Singh & Siahpush, 2016). Having that said one can conclude that Imperial
7
County Imperial population may have a lower health outcomes due to their high
unemployment rate. Unfortunately, the CHNA database was not able to show how many
women in Imperial County are unemployed. Singhs study however, allows us to better
understand how unemployment can drastically affect women's life quality and life
expectancy.
Physical
The indicator chosen for the physical determinant is assisted housing. Within Imperial
County there are 56,067 total housing units as of 2010 and 3,156 total Housing and Urban
Development (HUD)- assisted housing units. The rate per 10,000 housing units is 562.9. This
figure demonstrates a significantly higher rate when compared to California and the United
States, 352.4 and 375.41, respectively. Housing is an important physical indicator because a safe
home in a safe location ensures adequate for health for an individual or family. Fenelon et al.
(2016) describes how housing assistance is correlated with improved health outcomes, including
8
psychological well-being. The high rate within Imperial County demonstrates how displacement
is a greater physical and even mental threat to people within this county as compared to the
nation. Physical indicators, such as how many people are in use of assisted housing units,
provide insight to understanding socioeconomic status and ways for public health intervention.
Healthcare
Lack of prenatal care is the healthcare indicator chosen for this community health needs
assessment. It is through access to the healthcare system that individuals may participate in
preventative care such as prenatal care. Without private or public health care coverage, many
individuals are put at risk for increased death, cancer, and chronic diseases (Bittoni et al., 2015).
Total births within Imperial County is 12,619 and mothers starting prenatal care in the first
semester accounts for 6,542 mother. Mothers with late or no prenatal care is 4,886 and prenatal
care not reported within the county consists of 1,191 cases. The total percentage of mothers with
9
late or no prenatal care is 38,72%. Compared to California (18.1%) and the United States
(17.3%), it is evident that Imperial County severely lacks in preventative measures such as
prenatal care for birth defects and malnutrition among infants and mothers.
This is an important indicator relevant to females especially within the ages of 25-34
because this is the age group when most women become pregnant. Analyzing these
demographics and females access to prenatal care can help determine the reasons for lack of
use. Finding ways in which education can be raised can be a potential public health intervention
to decrease the lack of prenatal care rate. With educational resources, women will learn the value
of prenatal care, and with it, help combat many health issues that may arise when the infant is
born.
Behavior
10
Physical inactivity is the behavioral indicator chosen with the greatest threat to public
health within Imperial County. The total population (age 20+) within Imperial County is
121,163 and the population with no leisure time for physical activity accounts for 25,323
individuals. This means that 20.8% of the population is with no leisure time for physical activity.
Compared to California (17.3%) and the United States (21.8%) , Imperial County has more
individuals with less time for physical activity compared to the state level but less compared to
This indicator is a critical measure of how behavioral determinants can impact long-term
health outcomes. For example, a study by Johnson and Johnson (2015) evaluated childhood
obesity rates compared to rural and urban areas and found that children from rural areas are more
likely to be obese. The population size for Imperial County encompasses only 178,206 residents,
indicating that it is a rural area. Therefore, it can be inferred that obesity rates would be higher
among these rural children compared to larger counties within the state. This is due to inadequate
If physical inactivity is separated by gender, females lack more in physical activity than
males within Imperial County. Compared to the national and state level, females are also noted
to be with higher rates for physical inactivity. This demonstrates the need for public health
intervention to focus on females education regarding physical activity and the health benefits
Recommendations
This community health needs assessment for Imperial County demonstrates many
opportunities for public health intervention and support. Based on the indicators provided some
of the most concerning issues for Imperial County are lack of education, unemployment rates,
use of assisted housing, and access to preventative health. As mentioned within the social
indicators report, the unemployment rate within Imperial County is nearly five times greater
when compared to the state and national levels. Educational level with bachelors degree or
higher is less than half the rate when compared to state and national levels. Access to prenatal
care and no leisure time for physical activity is also significantly substandard when compared to
state and national levels. In order to help improve health outcomes and ensure access to
healthcare services within this county, public health professionals must work to influence policy
makers and key informants. Through this, realistic public health policies that support community
implementing policies that support behavioral health. By developing health education programs
that support physical activity and educate females on the benefits of prenatal care into
motherhood, many chronic diseases and comorbidities can be prevented. Policies that improve
economic job opportunities are imperative for this county in order to increase access to health
care services and adequate housing. It is through economic development that poverty and
unemployment rates can decrease, and subsequently increase education attainment. Policies that
ensure access to social and educational resources will help alleviate Imperial Countys needs
References
Bittoni et al. (2015), Lack of private health insurance is associated with higher mortality from
cancer and other chronic disease, poor diet quality, and inflammatory biomarkers in the
Fenelon et al. (2017). Housing Assistance Programs and Adult health in the United States.
Johnson and Johnson. (2015). Urban-Rural Differences in Childhood and Adolescent Obesity in
the United States: A Systematic Review and Meta-Analysis. Childhood Obesity. 11(3).
223-241.
Singh GK, Siahpush M. Inequalities in US Life Expectancy by Area Unemployment Level, 19902010
https://www.hindawi.com/journals/scientifica/2016/8290435/
Tavakoli-Fard N, Mortazavi S-A, Kuhpayehzadeh J, Nojomi M. Quality of life, work ability and other
important indicators of womens occupational health. Int J Occup Med Environ Health.
2016;29(1):7784.