General Health
San Francisco County currently ranks 8th out of the 58 California counties in overall health.1 San Francisco residents have a lower rate of premature death than the state of California; in fact San Francisco is in the 80th percentile for that measure.2
Lung Health
In San Francisco, 12.2 % of the population are current smokers vs. 11.9 % statewide.3 The highest rates of smoking are among the 45-64 year age group and among men.4 Unfortunately, among San Francisco teenagers, 18.3% are reported to be e-cigarette users, which is higher than 9.1% of teens statewide.5
Overall, lung disease (including lung cancer, COPD, influenza, and pneumonia) accounts for more deaths than any other health condition except all cancers combined.6
Lung Cancer
San Francisco is ranked 21st among other California counties in terms of lung cancer mortality with an age-adjusted death rate of 30.3/100,000 population.7 This is below the national objective of 45.5/100,000 and the same as California overall (30.6/100,000),8 which is good news. Incidence of lung cancer is higher among men, with a rate of 59.4 cases/100,000, than it is among women, with a rate of 39.1 cases/100,000.9 Incidence also varies by race and ethnicity. The highest rates of lung cancer are among Blacks (83.7/100,000), and the lowest among Hispanics (27.6/100,000).10
Chronic Obstructive Pulmonary Disease (COPD)
San Francisco is ranked fourth in the state for COPD death rates at 18.9/100,000, which is lower than the statewide death rate of 33.3/100,000.11 Among age groups, whereas COPD is the 7th leading cause of death countywide,20 it ranks 4th among those aged 65-84.12
Asthma
The percentage of San Franciscans who have ever been diagnosed with asthma is 21.3%, which is higher than the state of California as a whole at 15.0%.13 Among children and teens aged 1-17, the percentage jumps to 14.2%, which is lower than the statewide rate of 16.7 %.14 However, there are discrepancies varying by neighborhood. The neighborhood with the highest age-adjusted emergency room rate due to asthma is Bayview-Hunters Point with a 93.0 ER visits/10,000 population.15 This is followed by the Tenderloin/Hayes Valley/ North of Market neighborhood at 82.5, South of Market at 73.9, and Western Addition/Japantown/Pacific Heights at 42.5.16 The neighborhood with the lowest age-adjusted ER rate is the Marina/Cow Hollow with a rate of 20.1/10,000.17 The county-wide rate is 44.0/10,000.18
Tuberculosis
San Francisco ranks second in California with 12.5 tuberculosis cases/100,000 compared to 5.6 cases/100,000 statewide between 2013-2015.19 This is also four times higher than the nationwide rate of 2.9/100,000.20 The highest rates of tuberculosis in San Francisco can be found among Asian populations.21 Additionally, 84% of cases are from foreign-born populations, which is slightly higher than the 66% of cases statewide.22
Influenza and Pneumonia
The death rate due to influenza and pneumonia is 11.6 deaths/100,000 people, which ranks 18th in California.23 Trends indicate that since 2006, death rates have been decreasing.24 San Francisco also had a hospitalization rate due to vaccine-preventable influenza and pneumonia in adults 65+ of 5.7 /10,000 people25 between 2013-2015. This is a significant decrease from a rate of 7.9/10,000 between 2003-2005.26 Part of the reason for this decline can likely be attributed to the high vaccination rate among San Franciscans 65 and older. 76.4% of adults in this age group reported receiving the influenza vaccine in the last 12 months.27 Hospitalization rates are highest in the neighborhoods of Marina/Cow Hollow (1,1/10,000), South of Market (3.9/10,000), and Tenderloin/Hayes Valley/North of Market (4.3/10,000).28
Bibliography
1. Robert Wood Johnson Foundation. (2018). San Francisco. Retrieved September 2018 from County Health Rankings and Roadmaps: http://www.countyhealthrankings.org/app/california/2018/rankings/san-francisco/county/outcomes/overall/snapshot
2. Robert Wood Johnson Foundation. (2018). San Francisco. Retrieved September 2018 from County Health Rankings and Roadmaps: http://www.countyhealthrankings.org/app/california/2018/rankings/san-francisco/county/outcomes/overall/snapshot
3. UCLA Center for Health Policy Research. (2018). California Health Interview Survey (CHIS). Retrieved September 2018 from http://ask.chis.ucla.edu/
4. Healthy Communities Institute. (2018). San Francisco Health Improvement Partnership. Retrieved September 2018 from SFHIP: http://www.sfhip.org/indicators/index/view?indicatorId=8&localeId=275
5. UCLA Center for Health Policy Research. (2018). California Health Interview Survey (CHIS). Retrieved September 2018 from http://ask.chis.ucla.edu/
6. California Department of Public Health. (2018). County Health Status Profiles 2018. Retrieved September 2018 from https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/CHSP-SANFRANCISCO.pdf
7. California Department of Public Health. (2018). County Health Status Profiles 2017. Retrieved September 2018 from https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/OHIRProfiles2017.pdf
8. Ibid.
9. Healthy Communities Institute. (2018). San Francisco Health Improvement Partnership. Retrieved from SFHIP: http://www.sfhip.org/index.php?module=indicators&controller=index&action=view&indicatorId=303&localeId=275
10. Ibid.
11. California Department of Public Health. (2018). County Health Status Profiles 2017. Retrieved September 2018 from https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/OHIRProfiles2017.pdf
12. California Department of Public Health. (2018). County Health Status Profiles 2018. Retrieved September 2018 from https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/CHSP-SANFRANCISCO.pdf
13. Healthy Communities Institute. (2018). San Francisco Health Improvement Partnership. Retrieved from SFHIP: http://www.sfhip.org/indicators/index/view?indicatorId=360&localeId=275
14. UCLA Center for Health Policy Research. (2018). California Health Interview Survey (2016). Retrieved from http://ask.chis.ucla.edu/
15. Healthy Communities Institute. (2018). San Francisco Health Improvement Partnership. Retrieved from SFHIP: www.sfhip.org
16. Ibid.
17. Ibid.
18. Ibid.
19. California Department of Public Health. (2018). County Health Status Profiles 2017. Retrieved September 2018 from https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/OHIRProfiles2017.pdf
20. Centers for Disease Control and Prevention. (2018). Trend in Tuberculosis, 2016. Retrieved December September 2018 from https://www.cdc.gov/tb/publications/factsheets/statistics/tbtrends.htm
21. Centers for Disease Control and Prevention. (2018). WONDER Database: Online Tuberculosis Information System. Retrieved December September 2018 from http://wonder.cdc.gov
22. Ibid.
23. California Department of Public Health. (2018). County Health Status Profiles 2017. Retrieved September 2018 from https://www.cdph.ca.gov/Programs/CHSI/CDPH%20Document%20Library/OHIRProfiles2017.pdf
24. Healthy Communities Institute. (2018). San Francisco Health Improvement Partnership. Retrieved from SFHIP: www.sfhip.org
25. Ibid.
26. Ibid.
27. Ibid.
28. Ibid.