Running head: HEALTH OUTCOMES IN SAN BERNARDINO COUNTY 1

Rochelle Granados

October 11, 2017

Health Science 610

Professor Hernandez

Health Outcomes
HEALTH OUTCOMES IN SAN BERNARDINO COUNTY 2

Background

After analyzing the demographics of San Bernardino County this paper will

identify the health status and health data compared to the State of California health data

in 2009. The population’s health status will determine the health outcomes associated

with the population’s demographics. Analyzing this information will give a better

understanding of the communities before implementing preventative health programs.

The information is provided by the San Bernardino County Department of Public Health.

Mortality Rates

San Bernardino is significantly has a higher death rate 778.1 per 100,000 than

the overall state level of 654.9 per 100,000. Nationally based on 2011, the top leading

causes of death are heart disease, cancer, chronic lower respiratory diseases, stroke,

and accidents according to the Center of Disease Control and Prevention. The highest

death rates in San Bernardino County are due to all cancer at 170 per 100,000

population in 2009-2011 compared to the state’s 156.4 per 100,000. The next top

cause of death is caused by coronary heart disease 164.8 per 100,000 populations

compared to the state being 122.4 per 100,000 populations. This data can be attributed

to the high rates of poverty levels and proves that low-income communities experience

diseases however, their employment status and if they qualify for health care can lead

to not receive consistent treatment. Another leading disease in the county and the state

is diabetes as shown in the table 1. Lung Cancer accounts to 40.3 per 100,000 deaths

in the county. The population’s health behavior such as smoking can be a predicament

to lung cancer and heart disease. Reasons individuals choose to smoke vary however
HEALTH OUTCOMES IN SAN BERNARDINO COUNTY 3

by analyzing the demographics of the county it can implicate that they are not given the

same opportunities than in other places in California.

Death Rate per 100,000 2009-2011

Homicides 5.2
6

Diabetes 20.2
33.9

Stroke 38.1
43.7

Coronary Heart Disease 122.4

164.8

Lung Cancer 36.5

40.3

All Cancer Deaths 156.4

170

0 20 40 60 80 100 120 140 160 180

California San Bernardino County

Stress over finances can play a huge factor on the health choices an individual makes.

For example, they may have lean towards the idea packaged food is inexpensive

however; it’s a diet with processed foods, high sodium, and high sugar intake. These

foods are attributing factors to chronic disease.

Death rates differ among ethnicity for example African Americans appear to have

the highest overall death rates in San Bernardino County 823.4 per 100,000

individuals. As shown in the table below, they have a higher rate of all cancer deaths,

heart disease and circulatory system, diabetes, and homicides. According to

census.gov the Black or African American alone 29.2% are under the poverty level

being the highest population compared to other ethnic groups. Homicide rates among

African Americans are significantly higher at 14.7 per 100,000 than any other race. This

is drastically alarming and demonstrates that this population is vulnerable to unsafe

neighborhoods and higher risk of obesity. Homicide rates are even greater among low-
HEALTH OUTCOMES IN SAN BERNARDINO COUNTY 4

income communities; unfortunately they contribute to the safety, walkability, and obesity

of children and adults. Other social determinant that may contribute to the high rates of

heart disease is lack of exercise however, low-income communities do not have

accessibility to lit up parks and tend to have fewer sidewalks. Safety is a huge factor

that relates to how active a community may be. Parents may not let their children be

outside to play or go to the park’s playgrounds, they are limited to meet the necessary

exercise to have a healthy lifestyle. This means more sedentary time in front of a

television and/or computer becoming more prevalent to become overweight and obese

when they are adults.

Analysis of poverty impact

Poverty levels are alarming in the San Bernardino County since poverty is a

detrimental factor that can affect the population’s health. California has a 16.6% of

individuals living in poverty and 19.3% in San Bernardino County. Poverty can affect the

cities eventually affecting individuals. For example, first it initiates with the issue that

there are not enough grocery stores available in the community and the Retail Food

Environment Index measures this. It is presented in the county data that for every

produce store there are 5.72 fast food and convenience stores compared to the state

ratio being 4.18. The San Bernardino County has the worst Retail Food Environment

Index than any other County in the State. This generates a problem because there are

more chances for people to choose to eat fast food. An individual’s built environment

impacts their health and the lifestyle that they pursue.

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Morbidity rates

Cardiovascular disease is common from an unhealthy diet, smoking, obesity,

stress, genetics, and/or high blood pressure. African Americans have a significantly

higher hospitalization rate for heart disease 160.1 per 10,000 individuals than any other

ethnicity in San Bernardino County Education attainment well correlates with an

individual’s health and socioeconomic status as stated in the County website. According

to the demographics the black race has a low rate of individuals that receives a

bachelor’s degree or higher only 20.4% and that could be contributed to their ongoing

high rates of heart disease. Next highest ethnicity is white or other race with 121.2 per

10,000. Latino is 86.4 per 10,000 and Asian and Pacific Islander 52.4 per 10,000. The

lowest rate is Native Americans 33.9 per 10,000.

Data shows that African Americans have a greater rate of a stroke, 39.7 per

10,000 compared to the next highest rate being white or other race 28.7 per 10,000 in

2009. Latinos are not close behind with 26.1 per 10,000, while Asian or Pacific Islander

remains at the lowest with 15.4 per 10,000. The statistics have a similar pattern as

hospitalization rates according to coronary heart disease.

Mortality and Morbidity Data over Demographic Data

The demographics of San Bernardino County reflect the health outcomes of the

population. There is relationship between the heart disease and poverty level, the

greater the amount of people with heart disease the higher their poverty level is. There

is slightly more Latinos that are obese with 34.8% 18 years and older in 2009 and

34.1% African Americans. Taking in consideration that half the populations in San

Bernardino County are Latinos it reflects the health of the County overall. These two
HEALTH OUTCOMES IN SAN BERNARDINO COUNTY 6

ethnic groups have higher rates of heart disease and lower levels of education.

Education and poverty level can relate to a chronic illness according to National Poverty

Center. The cultural food is a major risk factor among the Latino population because

they are high in trans saturated fat known to cause heart disease. As part of there

celebrations is to bring the family together by sharing food and barbecuing. Finally the

White ethnic group has a rate of 29.2% of adults in San Bernardino County 7% higher

than in the overall state. As shown in the chart below, San Bernardino has higher rates

of obesity than in the State of California.

Obesity Rates 18 Years and Older

40.0%
35.0%
Percentage of Adults

30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
African
Latino White
American
San Bernardino County 24.1% 34.80% 29.20%
California 27.60% 29.90% 21.10%

Introspection

I have learned that the mortality and morbidity are much higher in the county than

in the state level. The demographics of the county can impact the overall health of the

communities. The built environment and how accessible they are to fast foods and fresh

produce grocery stores make a detrimental affect on the preventative chronic illnesses.

Unfortunately there are more fast food options that directly attribute to the top diseases
HEALTH OUTCOMES IN SAN BERNARDINO COUNTY 7

in the San Bernardino County population. I found interesting that African Americans had

higher rates of stroke, heart disease, and close to being the highest on being obese.

There definitely is a pattern that is linked by many social determinants of health and

socioeconomic status.

Conclusion

San Bernardino County’s morbidity and mortality rates are not equitable since

they are far more than the state levels. Low income and food insecure communities are

more likely to have poor nutrition and be obese, leading to preventable chronic

diseases. This population is more vulnerable than the state levels due to the lower rates

of education, poverty level, and median income. When there is less access to healthy

options people are more inclined to purchase fast food or packaged processed food.

These foods are not healthy and increase the chances of obesity, chronic illnesses, and

diabetes. In addition reflecting on the high rates of poverty demonstrates that they need

more preventative education programs; with these resources they can reach Healthy

2020 objectives. The demographics are a reflection of the county’s statistics therefore it

is necessary to implement more resources to decrease the mortality and morbidity rates

among San Bernardino County.

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Reference

Our Community Vital Signs. (2013). Retrieved October 12, 2017,

from http://communityvitalsigns.org/Portals/41/OurCommunityVitalSigns2013FinalRepo
rt.pdf

Reports & Health Data. (n.d.). Retrieved October 16, 2017, from
http://wp.sbcounty.gov/dph/health-data-maps/