This report covered a wide variety of health topics that help illustrate the health status of the California border counties, San Diego and Imperial Counties. It is important to understand the unique challenges faced by these communities in combating obesity, diabetes, mental health issues, TB, STIs, HIV/AIDS and vaccine-preventable diseases.
The population of the California border counties continues to grow. In terms of race/ethnicity, in Imperial County Latinos make up the majority of the population, whereas in San Diego County, they are the largest majority. The Latino population in the California border region is less likely to have graduated from college and is more likely than the White population to live at or below 200% of the Federal Poverty Level. Furthermore, the percent of Imperial County residents living below 200% of the Federal Poverty Level rose from 61% in 2015 to 65% for 2016-2017.
Chronic diseases are important indicators of the health of communities. This report includes data on obesity, diabetes and mental health. As of 2017, 23% of adults in San Diego County and 39% of adults in Imperial County were obese. Whereas both San Diego County and the State of California as a whole met the Healthy People 2020 target for obesity, Imperial County did not meet this target and has one of the highest rates of obesity in the entire state. This finding highlights the importance of health promotion programs and the creation of policies that help create a healthy environment promoting improved health at the California border region.
Similarly, diabetes is a significant and growing challenge in the region. In 2016-2017, 9% of adults in San Diego County and 18% of adults in Imperial County were reported to be diagnosed with diabetes. In the realm of mental health issues, regarding suicide, Latinos have had significantly lower rates of suicide than Whites in the California border region.
Infectious diseases, such as TB, STIs, HIV/AIDS and vaccine-preventable diseases, continue to be a significant challenge in the California border region. In California and border counties, the rate of TB was higher among Latinos than Whites. A large proportion of TB cases in California and the border counties are of Mexican origin. Overall, the rate of tuberculosis remained constant in the State of California at 5 per 100,000 since 2016; however, the percent of cases contributed by the border counties increased from 12.6% in 2016 to 14% for 2017-2018. The border region and Southern California at large experience a higher incidence of M. bovis cases than the statewide incidence. CDPH is committed to preventing and controlling TB in California. Continued collaboration with international health partners, especially those in Mexico, as well as public health interventions aimed at reducing TB are essential in effectively controlling TB in California.
The California border counties had 28,242 total individuals living with HIV infection in 2016 and 2017 combined. In addition, the California border counties reported 981 new cases of HIV during the same period. Most of the population living with HIV and the individuals newly diagnosed with HIV in the border region are male. The higher rates for individuals living with HIV and new cases are in the African-American population.
STIs in California increased during recent years. The California border region had an increase in gonorrhea, syphilis and congenital syphilis. Most of the STIs cases in the California border region were among men, and a comparison by race indicated that the highest rates were among African-Americans. In 2015, the rate of gonorrhea was 139 per 100,000 in California whereas the rate for 2016-2017 was reported as 177 per 100,000; this represents a 27% increase in rate. This trend was also observed for the border counties, with a 118% increase in rate for Imperial County and a 46% increase in rate for San Diego County. The rates of congenital syphilis in California also rose by 82%, with a rate of 28 per 100,000 live births in 2015 and 51 per 100,000 in 2016-2017. During 2016-2017, San Diego County had 20 cases of congenital syphilis, and Imperial County had three cases. This disease is preventable with access to prenatal care and timely treatment.
During the period of 2016-2017, there were three cases of measles in San Diego County and no cases in Imperial County. For pertussis, there were 1,558 cases in San Diego County and four cases in Imperial County. The rate of pertussis cases for San Diego in this period was more than three times higher than that in California statewide.
Differences in health outcomes highlight the key health needs of the region and can aid in identifying necessary resources and services for the California border residents. The CDPH, OBBH develops this report to inform and educate the California Legislature on the health needs of the California border region. This information is important to enable a more focused approach to address the needs of the region.
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