FIREARM-RELATED DEATHS, 2010-2012 T he crude death rate from firearm-related injuries for California was 7.9 deaths per 100,000 population, a risk of dying from firearm-related injuries equivalent to approximately one death for every 12,655.5 persons. This rate was based on the 2010 through 2012 three-year average number of deaths equaling 2,968.7 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 15.5 in Shasta County to 4.3 in Santa Clara County, a factor of 3.6 to 1. The age-adjusted death rate from firearm-related injuries for California during the 2010 through 2012 three-year period was 7.7 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 14.1 in San Joaquin County to 4.3 in Santa Clara County. Fourteen counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective IVP-30 of no more than 9.2 age-adjusted deaths due to firearm-related injuries per 100,000 population. An additional eleven counties with unreliable age-adjusted death rates and one county with no deaths due to firearm-related injuries met the objective. The California average age-adjusted death rate from firearm-related injuries for the 2007-2009 period was 8.4. California Department of Public Health 37 County Health Status Profiles 2014 TABLE 18 FIREARM-RELATED DEATHS RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 x COUNTY OF RESIDENCE 20 21 22 23 24 25 26 ALPINE YOLO SANTA CLARA SAN MATEO ORANGE KINGS IMPERIAL MARIN SAN BENITO VENTURA SAN FRANCISCO SAN DIEGO SANTA BARBARA SONOMA RIVERSIDE NAPA MONO LASSEN LOS ANGELES CALIFORNIA GLENN SANTA CRUZ SIERRA PLACER YUBA SAN LUIS OBISPO SAN BERNARDINO 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 FRESNO SACRAMENTO STANISLAUS ALAMEDA CONTRA COSTA MERCED MONTEREY SUTTER EL DORADO BUTTE MADERA TULARE KERN HUMBOLDT NEVADA SOLANO TEHAMA PLUMAS TUOLUMNE INYO COLUSA SHASTA SAN JOAQUIN LAKE MENDOCINO AMADOR CALAVERAS SISKIYOU MARIPOSA DEL NORTE TRINITY MODOC * Note: Sources: x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 1,118 0.0 202,630 7.3 3.6 * 1,806,881 78.0 4.3 727,980 34.0 4.7 3,047,120 151.3 5.0 151,655 7.3 4.8 * 177,229 8.7 4.9 * 254,359 16.7 6.6 * 55,950 2.7 4.8 * 830,215 47.3 5.7 813,123 50.7 6.2 3,125,321 192.3 6.2 425,756 26.0 6.1 486,778 35.3 7.3 2,220,502 153.0 6.9 137,634 10.0 7.3 * 14,305 1.0 7.0 * 34,668 2.7 7.7 * 9,860,836 750.7 7.6 37,570,307 2,968.7 7.9 28,255 2.3 8.3 * 265,569 22.0 8.3 3,146 0.3 10.6 * 356,367 30.3 8.5 72,620 5.7 7.8 * 270,119 27.7 10.2 2,053,348 182.0 8.9 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: IVP-30 939,278 87.7 9.3 1,430,884 136.0 9.5 518,141 50.3 9.7 1,526,220 157.3 10.3 1,061,375 106.7 10.0 259,289 27.0 10.4 419,998 45.7 10.9 94,764 10.0 10.6 * 180,663 20.7 11.4 220,521 26.7 12.1 152,008 16.7 11.0 * 447,665 49.0 10.9 848,839 92.3 10.9 135,218 17.3 12.8 * 98,593 14.0 14.2 * 414,337 49.3 11.9 63,514 8.7 13.6 * 19,953 2.7 13.4 * 55,041 7.0 12.7 * 18,687 3.0 16.1 * 21,502 2.7 12.4 * 178,089 27.7 15.5 692,862 97.7 14.1 64,419 11.7 18.1 * 88,071 12.7 14.4 * 37,288 8.7 23.2 * 45,143 9.0 19.9 * 44,875 8.7 19.3 * 17,977 3.3 18.5 * 28,498 5.7 19.9 * 13,546 4.3 32.0 * 9,565 3.3 34.8 * AGE-ADJUSTED DEATH RATE 3.6 * 4.3 4.7 4.8 4.9 * 5.2 * 5.3 * 5.4 * 5.6 5.9 6.0 6.0 6.7 7.0 7.0 * 7.1 * 7.2 * 7.4 7.7 7.8 * 8.1 8.2 * 8.2 8.3 * 8.4 9.1 9.2 9.3 9.4 9.6 10.1 10.3 10.5 10.5 10.7 * 10.7 11.0 11.2 * 11.2 11.4 11.6 * 12.0 * 12.0 12.1 * 12.3 * 12.6 * 12.9 * 12.9 * 13.9 14.1 14.5 * 14.7 * 15.7 * 16.7 * 16.8 * 18.4 * 19.4 * 26.8 * 30.5 * 95% CONFIDENCE LIMITS LOWER 1.5 3.4 3.3 4.0 2.0 2.3 3.1 1.0 4.1 4.4 5.1 3.9 4.7 5.8 3.4 0.2 1.3 6.8 7.5 1.2 5.1 0.0 5.5 2.9 5.6 7.7 UPPER 7.3 5.3 6.6 5.6 10.0 9.9 8.6 16.8 7.4 7.7 6.8 8.8 9.3 8.1 12.9 39.6 22.2 7.9 8.0 25.7 12.2 106.6 11.6 18.5 12.2 10.4 7.4 7.8 7.1 8.5 8.3 6.9 7.7 5.1 6.6 7.2 6.5 8.3 9.2 6.8 6.6 8.9 5.4 2.2 5.0 2.7 2.3 9.2 11.5 7.4 7.8 7.1 7.7 7.5 4.2 6.9 7.8 7.0 11.4 11.0 12.7 11.7 12.3 15.2 14.1 19.6 16.4 16.1 17.9 14.8 14.0 18.4 20.2 15.9 23.2 38.1 25.9 37.6 40.0 20.1 17.2 25.6 25.3 30.2 31.8 32.2 51.3 43.1 66.3 84.8 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 38 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA AGE-ADJUSTED DEATH RATES x HOMICIDE (THREE-YEAR AVERAGES) 2007-2009 5.9 9.6 1.7 * 4.7 * 3.5 * 6.3 * 10.3 6.8 * 3.4 * 7.7 3.5 * 4.8 * 3.9 * 4.8 * 8.0 4.5 * 6.8 * 3.0 * 7.9 6.4 * 2.4 * 0.9 * 6.6 * 8.1 9.1 1.5 * 1.3 * 2.6 1.7 * 4.2 * 5.0 6.5 5.6 * 7.0 3.2 7.2 7.8 2.5 * 3.0 2.2 * 2.8 2.3 * 3.8 * 5.2 * 8.8 2.5 * 5.8 4.1 * 6.5 * 1.8 * 8.8 2.4 * 3.3 2.0 * 4.9 * 2010-2012 5.2 8.5 4.0 * 4.5 * 1.0 * 6.7 * 7.3 9.3 * 2.9 * 7.9 1.2 * 3.9 * 2.4 * 1.9 * 8.3 6.0 * 6.8 * 4.7 * 6.0 5.8 * 1.2 * 3.1 * 5.8 * 7.4 * 14.2 * 9.5 1.2 * 3.1 * 2.2 2.0 * 2.9 * 4.2 6.0 4.7 * 6.0 2.9 6.1 12.0 1.8 * 3.2 2.6 * 2.8 4.5 * 3.7 * 5.1 * 8.9 2.4 * 6.9 5.6 * 4.0 * 14.3 * 7.7 2.0 * 2.5 1.7 * 5.0 * AGE-ADJUSTED DEATH RATES FIREARM-RELATED DEATHS (THREE-YEAR AVERAGES) 2007-2009 8.4 11.1 50.8 * 11.9 * 11.0 11.4 * 13.0 * 13.4 6.2 * 10.3 * 9.6 9.7 * 13.4 * 6.2 * 14.9 * 11.7 6.3 * 13.9 * 9.7 * 9.2 8.4 * 4.5 * 12.5 * 17.1 * 8.7 15.7 * 2.6 * 10.5 4.9 * 13.2 * 4.8 6.3 11.4 * 8.3 9.1 8.1 * 10.0 6.5 7.0 10.2 7.4 5.7 4.3 * 4.3 6.1 * 12.6 11.7 * 23.9 * 11.6 7.0 9.1 8.2 * 11.8 * 30.8 * 12.4 7.4 * 6.5 5.3 * 9.6 * 2010-2012 7.7 10.1 15.7 * 11.0 16.7 * 12.9 * 10.3 19.4 * 10.7 9.3 7.8 * 11.6 * 5.2 * 12.9 * 11.4 4.9 * 14.5 * 7.2 * 7.4 11.2 * 5.3 * 18.4 * 14.7 * 10.5 30.5 * 7.1 * 10.5 7.0 * 12.0 * 4.8 8.2 12.3 * 7.0 9.4 5.4 * 9.1 6.0 5.9 14.1 8.4 4.7 6.0 4.3 8.1 13.9 8.2 * 16.8 * 12.0 6.7 9.6 10.7 * 12.1 * 26.8 * 11.2 12.6 * 5.6 3.6 * 8.3 * AGE-ADJUSTED DEATH RATES DRUG-INDUCED DEATHS (THREE-YEAR AVERAGES) 2007-2009 11.1 10.9 21.2 * 31.4 19.7 * 4.3 * 10.2 16.5 * 18.5 12.6 22.9 * 35.4 9.8 * 10.0 * 17.0 8.7 * 32.2 23.8 * 7.7 7.8 * 13.0 13.5 * 20.5 * 10.7 36.2 * 8.9 9.4 * 14.3 * 10.3 13.8 25.0 * 11.5 17.3 6.6 * 11.0 12.1 21.7 17.1 12.3 7.5 12.8 7.0 12.0 32.1 16.9 * 10.2 12.9 16.2 13.9 * 14.7 * 28.1 * 7.6 23.2 * 10.5 8.3 * 6.0 * 2010-2012 10.8 8.8 25.4 * 37.1 29.1 * 4.4 * 10.6 9.1 * 19.3 10.4 18.2 * 37.2 11.5 * 9.2 * 19.1 8.8 * 42.6 20.7 * 6.7 16.0 11.3 17.6 * 14.4 * 14.0 28.2 * 11.6 * 10.8 11.3 * 15.1 * 10.0 7.5 34.0 * 12.4 14.3 9.6 * 9.2 12.6 18.1 18.4 14.9 7.3 11.5 7.5 18.8 28.2 41.1 * 25.2 * 11.6 12.7 16.6 15.6 * 16.0 * 16.1 * 8.2 28.0 * 12.8 10.6 6.4 * ottee * Rates and percentages are deemed unreliable based on fewer than 20 data elements. ottee - Rates and percentages are not calculated for zero events. Note: Age-adjusted death rates are per 100,000 population and exclude multiple causes of death. California Department of Public Health 78 County Health Status Profiles 2014 xv? COU NTY HEALTH STA PROFILES DEPAARTNIEN .01: PUBLIC HEALTH END NCE LOCASL HEALTH OFFICERS NATIONM HEALTH WEEK APRIL .7-13, 2014 . . . I . COUNTY HEALTH STATUS PROFILES 2014 California Department of Public Health Center for Health Statistics and Informatics Este Geraghty, MD, MPH, MS, Deputy Director California Department of Public Health Center for Health Statistics and Informatics Tony Agurto, MPA, Assistant Deputy Director California Department of Public Health Public Health Policy and Research Branch Scott Christman, MPDS, Chief California Department of Public Health Assessment and Policy Section Norman Lim, Chief California Department of Public Health Data Analysis Reporting Unit Elaine Bilot, MS, MA, Chief In collaboration with California Conference of Local Health Officers Muntu Davis, MD, MPH, President EDMUND G. BROWN JR. GOVERNORS State of California** Diana S. Dooley Secretary California Health and Human Services Agency Ron Chapman, MD, MPH Director & State Health Officer I California Department of Public Health ACKNOWLEDGMENTS John Rudzinskas, MBA Research Program Specialist I, with the California Department of Public Health (CDPH), Public Health Policy and Research Branch, Assessment and Policy Section, Data Analysis Reporting Unit prepared this report. Alicia Van Hoy, MA Research Program Specialist I, with the CDPH, Public Health Policy and Research Branch, Assessment and Policy Section, Data Analysis Reporting Unit independently peer reviewed the tables and thematic maps. Scott Fujimoto, MD, MPH with the CDPH, Public Health Policy and Research Branch, was an advisor and evaluator of the data analysis. Bill Schooling, with the Department of Finance provided the 2012 race/ethnic population estimates by county with age and sex detail. Michael Curtis, PhD and Carina Saraiva, MPH with the CDPH, Maternal, Child and Adolescent Health Program provided direction in accessing the most current breastfeeding information. Denise Gilson with the CDPH, Sexually Transmitted Disease Control Branch provided chlamydia and gonorrhea case incidence data. Linda Johnson with the CDPH, Tuberculosis Control Branch provided tuberculosis case incidence data. Valorie Eckert, MPH with the CDPH, Office of AIDS provided AIDS case incidence data. Jan Christensen with the CDPH, Public Health Policy and Research Branch, Health Information and Research Section, Data Quality Management Unit matched the birth and infant death records from the Birth and Death Statistical Master Files to create the Birth Cohort-Perinatal Outcome Files of linked births and deaths. Daniel Cox with the CDPH, Information Technology Services Division, Application Development and Support Branch, Health and Administrative Support Section prepared the Web page and data links for the Internet version of the report and county summary tables. Center for Health Statistics and Informatics staff, who collected, coded, and edited birth and death certificates, the basis of the Birth and the Death Statistical Master Files. Cover photography by John Rudzinskas. Mount Shasta. ii State of Ca ifornia?Health and Human Services Agency California Department of Public Health RON CHAPMAN, MD, MPH EDMUND G. BROWN JR. Director State Health Of?cer Governor Dear Colleague: We are pleased to present California?s County Health Status Profiles 2014 (Profiles). This report contains selected health status indicators recommended by the U.S. Department of Health and Human Services for monitoring state and local progress toward achieving the goals set forth in Healthy People 2020 (HP 2020). The HP 2020 National Objectives challenge public health professionals to increase the span of high quality healthy lives, achieve health equity, and encourage quality of life healthy behaviors for all. This annual report includes data years 2006-2012. Please note this is the complete version of Profiles. The Birth Cohort Infant Mortality Tables are included, and reflect the incorporation of the 2011 Birth? Cohort?Perinatal Outcome File data. The health status indicators are based on significant and readily available data to help guide the course of health promotion and preventive services. This report is updated each year and amended according to priorities developed by CDPH and the California Conference of Local Health Officers. This report is an important tool to evaluate the health of Californians. rviuiitu Davis, MD, MPH Director State Health Officer President California Department of Public Health California Conference of Local Health Officers Director's Of?ce, MS 0500 - P.O. Box Sacramento, CA 95899-7377 (916) 558-1700 (916) 558-1762 FAX Internet Address: TABLE OF CONTENTS INTRODUCTION ..................................................................................................... 1-2 TABLES WITH HIGHLIGHTS ................................................................................. 3-82 TABLES 1 – 19 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 – 23 20 21 22F 22M 23 24A – 24E 24A 24B 24C 24D 24E HEALTH STATUS INDICATORS MORTALITY INDICATORS PER 100,000 POPULATION All Causes of Death ............................................................................................ All Cancer Deaths ............................................................................................... Colorectal Cancer ............................................................................................... Lung Cancer ........................................................................................................ Female Breast Cancer ........................................................................................ Prostate Cancer .................................................................................................. Diabetes .............................................................................................................. Alzheimer’s Disease ............................................................................................ Coronary Heart Disease ...................................................................................... Cerebrovascular Disease (Stroke) ...................................................................... Influenza/Pneumonia .......................................................................................... Chronic Lower Respiratory Disease ................................................................... Chronic Liver Disease and Cirrhosis ................................................................... Accidents (Unintentional Injuries) ....................................................................... Motor Vehicle Traffic Crashes ............................................................................. Suicide................................................................................................................. Homicide………………. ....................................................................................... Firearm-Related Deaths ...................................................................................... Drug-Induced Deaths .......................................................................................... 3-4 5-6 7-8 9-10 11-12 13-14 15-16 17-18 19-20 21-22 23-24 25-26 27-28 29-30 31-32 33-34 35-36 37-38 39-40 MORBIDITY INDICATORS PER 100,000 POPULATION Acquired Immunodeficiency Syndrome (AIDS)................................................... Chlamydia ........................................................................................................... Gonorrhea Females 15 To 44 Years Old ............................................................ Gonorrhea Males 15 To 44 Years Old ................................................................ Tuberculosis ........................................................................................................ 41-42 43-44 45-46 47-48 49-50 BIRTH COHORT INFANT MORTALITY UNDER ONE YEAR OF AGE PER 1,000 LIVE BIRTHS Infant Mortality, All Race/Ethnic Groups ............................................................. Asian/Pacific Islander Infant Mortality ................................................................. Black Infant Mortality ........................................................................................... Hispanic Infant Mortality ...................................................................................... White Infant Mortality .......................................................................................... iv 51-52 53-54 55-56 57-58 59-60 TABLE OF CONTENTS (continued) TABLES 25 – 27B 25 26 27A 27B HEALTH STATUS INDICATORS NATALITY INDICATORS PER 100 LIVE BIRTHS OR 1,000 POPULATION Low Birthweight Infants ....................................................................................... Births to Adolescent Mothers, 15-19 Years Old Per 1,000 Live Births ............... Prenatal Care Begun During the First Trimester ................................................ Adequate/Adequate Plus Prenatal Care ............................................................. 61-62 63-64 65-66 67-68 BREASTFEEDING INITIATION RATES PER 100 LIVE BIRTHS 28 Breastfeeding Initiation During Early Postpartum ................................................ 69-70 2011 CENSUS POPULATION HEALTH INDICATOR 29 30 Persons Under 18 In Poverty .............................................................................. 71-72 CURRENT AND PRIOR THREE-YEAR AVERAGE RATES AND PERCENTAGES BY COUNTY A Comparison of Three-Year Average Rates And Percentages Among Selected Health Status Indicators ....................................................................... 73-82 TECHNICAL NOTES................................................................................................................... 83-93 APPENDIX A California’s Health Status Profile 2014 ........................................................................................... 94 BIBLIOGRAPHY ........................................................................................................................... 95-96 v CALIFORNIA COUNTIES 2011 STATEWIDE POPULATION: 37,570,307 Del Norte Siskiyou Modoc 9 Humb.-Md} Trinity Shasta Lassen Population Under 300,000 300,000 to 900,000 - Over 900,000 San Francisco San Mateo Santa Cruz Mariposa Monterey Santa Barbara Imperial State of California, Department of Finance, Report P-3: State and County Population Projections by RacefEthnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. INTRODUCTION County Health Status Profiles 2014 (Profiles 2014) has been published annually for the State of California since 1993. This report presents public health data that can be directly compared with clearly established benchmarks, such as national standards, and populations of similar composition. Appendix A (page 94) provides a summary table of California’s rates for selected health status indicators, target rates established for Healthy People 2020 (HP 2020) National Objectives and the previous period rates. In keeping with the goal of using national standards, causes of death were coded using the International Classification of Diseases, Tenth Revision (ICD-10) and age-adjusted rates were calculated using the 2000 Standard Population weights to facilitate meaningful comparison of vital statistics data rates over time and between groups. For additional information on the HP 2020 recommendations, visit the Centers for Disease Control and Prevention. Profiles 2014 contains vital statistics and morbidity tables that show the population, number of events, crude rates, and age-adjusted death rates (when appropriate) or percentages by county of residence (except where noted). In these tables, counties are ranked by rates or percentages based on the methodology described in the Technical Notes section (pages 83 to 93). Data limitations and qualifications are provided in the Technical Notes to assist the reader with interpretation and comparison of these data among the counties. For those who want to learn more about the challenges associated with analysis of vital events involving small numbers, small area analysis, and age-adjusted death rates, references to relevant statistical publications are located in the bibliography. The tables identify the upper and lower 95 percent confidence limits, which provide a means to assess the degree of stability for the estimated rates and percentages. Confidence intervals based on 100 or more events are calculated utilizing a normal approximation. In cases where there are fewer than 100 events, the gamma distribution is applied to prevent producing a negative lower limit confidence interval. For additional information on the gamma distribution, please see National Vital Statistics Report, Volume 57, No. 14, April 17, 2009. Vital statistics rates and percentages are subject to random variation, which is inversely related to the number of events (e.g., deaths) used to calculate the rates and percentages. Rates calculated from fewer than 20eventsare considered unreliable and are indicated with an asterisk (*). Dashes (-) indicate that percentages and confidence limits are not calculated due to zero events. Thematic maps of California’s 58 counties provide added visual comparison of rates or percentages from each table (excluding Table 30) along with the customary health status indicator highlights. The race/ethnicity population figures by county with age and sex detail were provided by the Demographic Research Unit, California Department of Finance, and were utilized as denominators for the rate calculations. The current period, (2010-2012), used the 2011 (mid-year) population figures from the State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. Rates developed for the previous period, (2007-2009), used the 2008 (mid-year) population figures from the State of California, Department of Finance, Race/Hispanics Population with Age and California Department of Public Health 1 County Health Status Profiles 2014 Gender Detail, 2000–2010. Sacramento, California, September 2012 estimates. The following California Department of Public Health (CDPH) offices provided data for this report: Vital Records, Communicable Disease Control, Genetic Disease Screening Program, Maternal, Child and Adolescent Health Program, and the Office of AIDS. The estimates of persons under age 18 in poverty for 2011 were obtained from the U.S. Census Bureau. To access electronic copies of this report, visit the CDPH, Center for Health Statistics and Informatics, Public Health Policy and Research Branch site. If you have questions about this report, or desire additional state or county health status data and statistics please write, phone, or e-mail: California Department of Public Health Center for Health Statistics and Informatics Public Health Policy and Research Branch MS 5101 P.O. Box 997410 Sacramento, CA 95899-7410 Telephone (916) 552-8095 Fax (916) 650-6889 Email DAReports@cdph.ca.gov Profiles for the years 1999 through 2013 are available on the CDPH website. Paper copies of the 1993 through 2006 reports may be purchased for $10 by contacting the Public Health Policy and Research Branch at the above address or phone number. California Department of Public Health 2 County Health Status Profiles 2014 DEATHS DUE TO ALL CAUSES, 2010-2012 T he crude death rate from all causes for California was 634.0 deaths per 100,000 population, a risk of dying equivalent to approximately one death for every 157.7 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 238,203.3 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 1,261.0 in Lake County to 326.2 in Mono County, a factor of 3.9 to 1. The age-adjusted death rate from all causes for California during the 2010 through 2012 three-year period was 641.5 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 951.4 in Lake County to 467.0 in Mono County. A Healthy People 2020 National Objective for deaths due to all causes has not been established. The California average age-adjusted death rate for the 2007-2009 period was 677.4. California Department of Public Health 3 County Health Status Profiles 2014 TABLE 1 DEATHS DUE TO ALL CAUSES RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x COUNTY OF RESIDENCE MONO MARIN SANTA CLARA SAN MATEO SAN BENITO SAN FRANCISCO ORANGE MONTEREY VENTURA SANTA BARBARA ALAMEDA LOS ANGELES SANTA CRUZ IMPERIAL CONTRA COSTA SAN DIEGO PLACER EL DORADO CALIFORNIA NEVADA SONOMA NAPA SAN LUIS OBISPO MARIPOSA YOLO RIVERSIDE INYO SOLANO CALAVERAS KINGS COLUSA TUOLUMNE MERCED MENDOCINO MADERA SACRAMENTO GLENN FRESNO AMADOR SAN BERNARDINO SUTTER LASSEN SAN JOAQUIN TULARE STANISLAUS PLUMAS BUTTE TRINITY KERN HUMBOLDT SISKIYOU TEHAMA MODOC SHASTA YUBA SIERRA DEL NORTE LAKE ALPINE x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: 14,305 46.7 326.2 254,359 1,864.3 733.0 1,806,881 9,164.0 507.2 727,980 4,616.0 634.1 55,950 278.0 496.9 813,123 5,598.3 688.5 3,047,120 17,741.3 582.2 419,998 2,333.7 555.6 830,215 5,031.7 606.1 425,756 2,885.0 677.6 1,526,220 9,147.7 599.4 9,860,836 57,735.3 585.5 265,569 1,653.7 622.7 177,229 964.3 544.1 1,061,375 7,067.0 665.8 3,125,321 19,727.3 631.2 356,367 2,760.3 774.6 180,663 1,349.3 746.9 37,570,307 238,203.3 634.0 98,593 959.3 973.0 486,778 3,864.7 793.9 137,634 1,167.3 848.1 270,119 2,260.3 836.8 17,977 171.3 953.1 202,630 1,176.0 580.4 2,220,502 14,449.3 650.7 18,687 201.7 1079.2 414,337 2,872.7 693.3 45,143 466.3 1033.0 151,655 784.7 517.4 21,502 149.7 696.1 55,041 607.3 1103.4 259,289 1,519.3 586.0 88,071 809.0 918.6 152,008 1,018.3 669.9 1,430,884 10,307.0 720.3 28,255 223.0 789.2 939,278 6,133.0 652.9 37,288 432.3 1159.4 2,053,348 12,187.0 593.5 94,764 745.3 786.5 34,668 233.7 674.0 692,862 4,829.3 697.0 447,665 2,831.0 632.4 518,141 3,727.7 719.4 19,953 226.0 1132.7 220,521 2,211.0 1002.6 13,546 151.3 1117.2 848,839 5,336.3 628.7 135,218 1,228.0 908.2 44,875 533.7 1189.2 63,514 623.3 981.4 9,565 113.3 1184.9 178,089 2,015.0 1131.5 72,620 536.7 739.0 3,146 38.7 1229.1 28,498 277.0 972.0 64,419 812.3 1261.0 1,118 10.0 894.5 * AGE-ADJUSTED DEATH RATE NONE 467.0 522.7 526.9 542.4 572.1 578.4 580.1 584.1 593.2 601.3 606.8 611.4 614.7 616.1 619.4 627.2 634.4 636.6 641.5 641.6 650.2 650.4 651.4 651.8 662.4 672.8 701.6 705.7 716.6 720.7 722.1 722.5 722.9 724.4 728.5 730.9 732.0 734.6 737.1 755.5 761.2 764.2 766.1 773.7 777.6 782.6 790.2 795.0 806.4 818.5 818.6 820.6 847.5 860.4 871.7 884.1 890.0 951.4 1135.7 * 95% CONFIDENCE LIMITS LOWER 342.7 498.2 516.0 526.5 503.7 563.0 571.5 560.1 576.6 579.0 594.2 606.4 584.2 576.9 604.7 618.4 610.5 601.8 638.9 598.8 629.2 612.2 623.8 548.5 623.9 661.8 601.7 679.5 647.2 668.8 605.0 662.4 686.2 672.9 683.3 716.6 634.9 716.0 664.5 741.8 706.3 663.5 744.2 744.8 752.4 674.0 756.2 659.7 784.3 771.6 745.6 755.1 685.2 821.9 796.5 627.7 783.8 883.8 544.6 UPPER 621.6 547.1 537.8 558.3 640.6 593.8 588.7 608.1 609.8 623.7 619.5 616.5 645.3 655.2 634.1 636.1 658.3 671.5 644.1 684.4 671.3 688.7 678.9 755.2 700.9 683.9 801.5 731.9 785.9 772.6 839.3 782.6 759.7 776.0 773.6 745.2 829.0 753.3 809.7 769.2 816.1 864.8 787.9 802.5 802.8 891.2 824.2 930.4 828.5 865.3 891.5 886.1 1009.7 898.9 947.0 1210.2 996.2 1019.0 2088.5 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 4 County Health Status Profiles 2014 DEATHS DUE TO ALL CANCERS, 2010-2012 T he crude death rate from all cancers for California was 150.7 deaths per 100,000 population, a risk of dying from all cancers equivalent to approximately one death for every 663.5 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 56,622.3 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 297.7 in Amador County to 104.4 in Kings County, a factor of 2.9 to 1. The age-adjusted death rate from all cancers for California during the 2010 through 2012 three-year period was 153.3 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 195.9 in Lake County to 128.8 in Lassen County. Thirty-four counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective C-1 of no more than 160.6 age-adjusted deaths due to all cancers per 100,000 population. An additional two counties with unreliable rates met the objective. The California average age-adjusted death rate from all cancers for the 2007-2009 period was 161.0. California Department of Public Health 5 County Health Status Profiles 2014 TABLE 2 DEATHS DUE TO ALL CANCERS RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 x COUNTY OF RESIDENCE 27 28 29 30 31 32 33 34 35 36 MONO SIERRA LASSEN INYO IMPERIAL SANTA CLARA PLUMAS MARIPOSA VENTURA SANTA BARBARA SAN MATEO KINGS SANTA CRUZ MARIN ORANGE MONTEREY MADERA EL DORADO SAN FRANCISCO ALAMEDA LOS ANGELES FRESNO SAN BENITO SAN LUIS OBISPO CONTRA COSTA PLACER CALIFORNIA TULARE NEVADA YOLO TUOLUMNE RIVERSIDE KERN SAN DIEGO GLENN MODOC SUTTER 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 MERCED CALAVERAS SONOMA STANISLAUS MENDOCINO NAPA SAN BERNARDINO SAN JOAQUIN SACRAMENTO COLUSA SOLANO HUMBOLDT TRINITY BUTTE AMADOR YUBA SHASTA SISKIYOU TEHAMA DEL NORTE LAKE ALPINE x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 14,305 7.7 53.6 * 3,146 4.3 137.7 * 34,668 39.7 114.4 18,687 39.0 208.7 177,229 214.7 121.1 1,806,881 2,360.7 130.6 19,953 41.7 208.8 17,977 40.0 222.5 830,215 1,190.0 143.3 425,756 649.0 152.4 727,980 1,192.0 163.7 151,655 158.3 104.4 265,569 387.7 146.0 254,359 505.0 198.5 3,047,120 4,406.0 144.6 419,998 566.0 134.8 152,008 213.3 140.3 180,663 332.0 183.8 813,123 1,394.0 171.4 1,526,220 2,237.7 146.6 9,860,836 13,990.0 141.9 939,278 1,227.3 130.7 55,950 73.3 131.1 270,119 516.7 191.3 1,061,375 1,746.3 164.5 356,367 673.7 189.0 37,570,307 56,622.3 150.7 447,665 560.0 125.1 98,593 238.0 241.4 202,630 273.3 134.9 55,041 138.3 251.3 2,220,502 3,383.0 152.4 848,839 1,059.0 124.8 3,125,321 4,872.7 155.9 28,255 49.0 173.4 9,565 23.7 247.4 94,764 158.7 167.4 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: C-1 259,289 340.0 131.1 45,143 117.0 259.2 486,778 942.7 193.7 518,141 783.7 151.2 88,071 192.3 218.4 137,634 285.3 207.3 2,053,348 2,763.0 134.6 692,862 1,067.0 154.0 1,430,884 2,403.7 168.0 21,502 36.3 169.0 414,337 735.7 177.6 135,218 269.7 199.4 13,546 37.3 275.6 220,521 501.3 227.3 37,288 111.0 297.7 72,620 116.0 159.7 178,089 438.3 246.1 44,875 130.0 289.7 63,514 149.7 235.6 28,498 61.7 216.4 64,419 177.0 274.8 1,118 2.0 178.9 * AGE-ADJUSTED DEATH RATE 58.9 * 81.3 * 128.8 132.9 135.8 136.5 138.8 138.9 141.4 141.8 142.9 143.6 144.3 144.3 144.8 146.2 148.6 148.7 148.9 149.3 149.3 149.6 150.0 150.2 153.2 153.3 153.3 153.5 154.9 155.4 156.5 157.0 157.0 158.7 159.4 159.7 160.6 160.6 161.1 161.7 162.2 163.1 164.4 166.3 167.0 169.9 171.8 175.1 175.6 176.2 178.8 180.8 181.0 182.6 182.7 188.1 188.4 188.5 195.9 343.4 * 95% CONFIDENCE LIMITS LOWER 24.9 23.7 91.9 94.5 117.5 131.0 99.9 99.2 133.2 130.8 134.7 120.6 129.4 131.4 140.5 134.0 128.4 132.3 140.9 143.0 146.8 141.1 117.6 137.0 145.9 141.6 152.0 140.7 134.5 136.6 129.7 151.7 147.4 154.1 117.9 102.0 135.5 143.8 130.9 151.6 151.5 140.4 146.7 160.6 159.5 164.8 122.9 162.6 154.6 126.1 164.6 146.4 148.7 165.2 154.6 157.9 144.4 166.3 41.6 UPPER 117.6 201.2 175.6 181.7 154.1 142.1 187.8 189.2 149.5 152.9 151.1 166.5 159.1 157.2 149.2 158.4 168.7 165.1 156.8 155.6 151.8 158.1 188.4 163.4 160.5 165.0 154.6 166.4 175.3 174.1 183.3 162.3 166.7 163.2 210.8 238.2 185.6 178.4 192.6 172.8 174.6 188.4 186.0 173.4 180.2 178.8 242.1 188.5 197.7 246.2 197.0 215.6 216.5 200.1 221.6 218.9 241.9 225.5 1240.4 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 6 County Health Status Profiles 2014 DEATHS DUE TO COLORECTAL CANCER, 2010-2012 T he crude death rate from colorectal cancer for California was 14.1 deaths per 100,000 population, a risk of dying from colorectal cancer equivalent to approximately one death for every 7,093.7 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 5,296.3 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 23.2 in Shasta County to 9.9 in Monterey County, a factor of 2.3 to 1. The age-adjusted death rate from colorectal cancer for California during the 2010 through 2012 three-year period was 14.2 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 18.0 in Merced County to 10.6 in Monterey County. Twenty-two counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective C-5 of no more than 14.5 age-adjusted deaths due to colorectal cancer per 100,000 population. An additional fifteen counties with unreliable rates and one county with no colorectal cancer deaths met the objective. The California average age-adjusted death rate from colorectal cancer for the 2007-2009 period was 15.1. California Department of Public Health 7 County Health Status Profiles 2014 TABLE 3 DEATHS DUE TO COLORECTAL CANCER RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 x COUNTY OF RESIDENCE 37 38 SIERRA MARIPOSA COLUSA MONO TRINITY MONTEREY MARIN KINGS LASSEN SUTTER NEVADA SAN BENITO PLACER SANTA CLARA ORANGE AMADOR PLUMAS GLENN SANTA CRUZ YOLO SAN MATEO VENTURA SAN LUIS OBISPO SANTA BARBARA NAPA TULARE SISKIYOU CALAVERAS FRESNO ALAMEDA MADERA IMPERIAL KERN EL DORADO BUTTE SONOMA CALIFORNIA SAN DIEGO LOS ANGELES 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 INYO CONTRA COSTA SAN JOAQUIN HUMBOLDT YUBA SOLANO SAN FRANCISCO MENDOCINO SACRAMENTO RIVERSIDE DEL NORTE TUOLUMNE LAKE SHASTA STANISLAUS SAN BERNARDINO MERCED TEHAMA ALPINE MODOC * Note: Sources: x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 3,146 0.0 17,977 1.7 9.3 * 21,502 1.3 6.2 * 14,305 0.7 4.7 * 13,546 2.0 14.8 * 419,998 41.7 9.9 254,359 39.7 15.6 151,655 12.0 7.9 * 34,668 3.3 9.6 * 94,764 11.3 12.0 * 98,593 17.0 17.2 * 55,950 5.3 9.5 * 356,367 52.0 14.6 1,806,881 218.7 12.1 3,047,120 383.7 12.6 37,288 7.7 20.6 * 19,953 3.7 18.4 * 28,255 3.7 13.0 * 265,569 33.3 12.6 202,630 22.7 11.2 727,980 109.7 15.1 830,215 112.0 13.5 270,119 45.3 16.8 425,756 60.7 14.2 137,634 22.3 16.2 447,665 48.0 10.7 44,875 9.0 20.1 * 45,143 9.3 20.7 * 939,278 111.0 11.8 1,526,220 209.3 13.7 152,008 19.7 12.9 * 177,229 21.7 12.2 848,839 92.3 10.9 180,663 29.3 16.2 220,521 40.0 18.1 486,778 82.0 16.8 37,570,307 5,296.3 14.1 3,125,321 447.3 14.3 9,860,836 1,362.7 13.8 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: C-5 18,687 4.0 21.4 * 1,061,375 169.7 16.0 692,862 95.0 13.7 135,218 22.3 16.5 72,620 9.7 13.3 * 414,337 64.7 15.6 813,123 146.7 18.0 88,071 17.7 20.1 * 1,430,884 223.3 15.6 2,220,502 346.7 15.6 28,498 5.3 18.7 * 55,041 13.7 24.8 * 64,419 14.7 22.8 * 178,089 41.3 23.2 518,141 82.7 16.0 2,053,348 289.7 14.1 259,289 37.3 14.4 63,514 14.7 23.1 * 1,118 0.3 29.8 * 9,565 4.0 41.8 * AGE-ADJUSTED DEATH RATE 4.9 * 5.7 * 6.2 * 10.1 * 10.6 10.8 11.0 * 11.2 * 11.5 * 11.5 * 11.6 * 11.9 12.4 12.4 12.4 * 12.4 * 12.4 * 12.5 12.7 12.8 13.0 13.0 13.2 13.2 13.3 13.4 * 13.5 * 13.5 13.7 13.7 * 13.7 13.8 13.8 13.9 13.9 14.2 14.4 14.4 14.5 14.7 * 14.8 15.0 15.1 15.3 * 15.4 15.5 15.6 * 16.1 16.2 16.2 * 16.3 * 16.7 * 17.4 17.4 17.8 18.0 18.5 * 26.3 * 26.7 * 95% CONFIDENCE LIMITS LOWER 0.4 0.3 0.0 1.2 7.6 7.7 5.7 2.6 5.8 6.7 3.9 8.9 10.7 11.1 5.2 3.1 3.1 8.6 8.0 10.4 10.5 9.5 10.1 8.3 9.8 6.1 6.3 10.9 11.8 8.3 8.6 11.1 9.2 9.9 11.0 13.8 13.0 13.6 4.0 12.5 12.1 9.5 7.2 11.9 13.0 9.2 13.9 14.5 5.5 8.8 9.3 12.5 13.9 15.7 12.7 10.3 0.0 7.3 UPPER 19.6 26.5 46.4 36.5 14.4 14.7 19.2 31.1 20.4 18.4 26.4 15.6 14.0 13.6 24.7 33.0 33.1 17.5 19.2 15.3 15.4 17.4 16.9 19.9 17.6 25.4 25.3 16.0 15.6 21.2 20.9 16.9 19.7 18.9 17.2 14.6 15.7 15.2 37.7 17.0 18.4 22.8 28.5 19.7 18.0 24.8 18.2 17.9 36.9 27.5 27.8 23.6 21.6 19.9 24.7 30.8 344.3 68.3 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 8 County Health Status Profiles 2014 DEATHS DUE TO LUNG CANCER, 2010-2012 T he crude death rate from lung cancer for California was 33.7 deaths per 100,000 population, a risk of dying from lung cancer equivalent to approximately one death for every 2,963.4 persons. This rate was based on the 2010 through 2012 three-year average number of deaths equaling 12,678.0 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 86.7 in Amador County to 23.3 in Kings County, a factor of 3.7 to 1. The age-adjusted death rate from lung cancer for California during the 2010 through 2012 three-year period was 34.8 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 61.9 in Del Norte County to 26.3 in Santa Cruz County. Thirty-eight counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective C-2 of no more than 45.5 age-adjusted deaths due to lung cancer per 100,000 population. An additional ten counties with unreliable rates met the objective. The California average age-adjusted death rate from lung cancer for the 2007-2009 period was 38.8. California Department of Public Health 9 County Health Status Profiles 2014 TABLE 4 DEATHS DUE TO LUNG CANCER RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 x COUNTY OF RESIDENCE 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 MONO SIERRA SANTA CRUZ SANTA CLARA IMPERIAL VENTURA SANTA BARBARA MODOC PLUMAS LOS ANGELES SAN MATEO SAN BENITO YOLO EL DORADO MARIN ORANGE ALAMEDA ALPINE KINGS PLACER SAN LUIS OBISPO MONTEREY NEVADA LASSEN SAN FRANCISCO CALIFORNIA TUOLUMNE FRESNO GLENN SAN DIEGO CONTRA COSTA CALAVERAS NAPA RIVERSIDE MADERA SAN BERNARDINO SONOMA MERCED TULARE INYO STANISLAUS KERN MENDOCINO HUMBOLDT SHASTA SACRAMENTO MARIPOSA SOLANO BUTTE 49 50 51 52 53 54 55 56 57 58 SAN JOAQUIN SUTTER TRINITY YUBA AMADOR SISKIYOU TEHAMA COLUSA LAKE DEL NORTE x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 14,305 1.0 7.0 * 3,146 1.0 31.8 * 265,569 67.3 25.4 1,806,881 476.7 26.4 177,229 44.3 25.0 830,215 239.0 28.8 425,756 132.0 31.0 9,565 4.7 48.8 * 19,953 10.0 50.1 * 9,860,836 2,889.3 29.3 727,980 259.7 35.7 55,950 16.0 28.6 * 202,630 56.0 27.6 180,663 74.3 41.1 254,359 112.3 44.2 3,047,120 976.3 32.0 1,526,220 484.3 31.7 1,118 0.7 59.6 * 151,655 35.3 23.3 356,367 146.0 41.0 270,119 114.3 42.3 419,998 128.0 30.5 98,593 53.7 54.4 34,668 10.0 28.8 * 813,123 321.3 39.5 37,570,307 12,678.0 33.7 55,041 32.3 58.7 939,278 283.7 30.2 28,255 11.3 40.1 * 3,125,321 1,084.3 34.7 1,061,375 404.7 38.1 45,143 29.0 64.2 137,634 63.3 46.0 2,220,502 808.0 36.4 152,008 54.7 36.0 2,053,348 625.3 30.5 486,778 223.0 45.8 259,289 82.7 31.9 447,665 144.7 32.3 18,687 11.7 62.4 * 518,141 191.7 37.0 848,839 269.7 31.8 88,071 49.7 56.4 135,218 64.7 47.8 178,089 105.7 59.3 1,430,884 600.7 42.0 17,977 13.0 72.3 * 414,337 184.0 44.4 220,521 123.3 55.9 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: C-2 692,862 280.3 40.5 94,764 46.7 49.2 13,546 10.7 78.7 * 72,620 31.0 42.7 37,288 32.3 86.7 44,875 37.0 82.5 63,514 42.3 66.7 21,502 11.3 52.7 * 64,419 51.7 80.2 28,498 20.0 70.2 AGE-ADJUSTED DEATH RATE 6.9 * 17.9 * 26.3 28.1 28.2 28.8 29.2 29.4 * 31.0 * 31.4 31.4 31.5 * 32.1 32.4 32.5 32.7 32.9 33.1 * 33.1 33.1 33.5 33.8 34.0 34.1 * 34.7 34.8 34.9 35.3 35.3 * 36.1 36.3 37.1 37.4 37.6 38.5 38.8 38.9 39.5 40.1 40.2 * 40.3 40.6 42.2 42.8 43.3 43.6 44.0 * 44.1 45.1 45.5 45.7 47.1 50.2 * 50.4 51.0 51.4 53.0 54.7 * 55.1 61.9 95% CONFIDENCE LIMITS LOWER 0.2 0.5 20.4 25.5 20.5 25.1 24.2 9.1 14.9 30.2 27.6 18.0 24.3 25.5 26.4 30.6 29.9 0.2 23.1 27.7 27.2 27.9 25.5 16.3 30.9 34.2 23.9 31.1 17.8 33.9 32.7 24.8 28.7 35.0 29.0 35.7 33.7 31.4 33.5 20.5 34.5 35.6 31.3 33.0 34.9 40.0 23.4 37.6 37.0 UPPER 38.5 99.6 33.4 30.6 37.8 32.5 34.3 70.5 57.1 32.6 35.3 51.1 41.7 40.7 38.7 34.8 35.9 247.1 46.0 38.5 39.7 39.8 44.4 62.7 38.5 35.5 49.2 39.5 62.7 38.3 39.9 53.2 47.8 40.2 50.1 41.9 44.2 49.0 46.7 70.7 46.0 45.5 55.7 54.6 51.6 47.1 75.3 50.6 53.2 40.3 34.5 24.7 34.2 35.0 36.2 38.2 27.7 41.1 37.8 51.1 62.6 90.5 71.5 71.9 70.9 71.5 97.1 72.4 95.6 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 10 County Health Status Profiles 2014 DEATHS DUE TO FEMALE BREAST CANCER, 2010-2012 T he crude death rate from female breast cancer for California was 22.8 deaths per 100,000 female population, a risk of dying from breast cancer equivalent to approximately one death for every 4,380.3 females. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 4,311.7 and a female population count of 18,886,503 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 34.2 in Shasta County to 17.5 in Tulare County, a factor of 2.0 to 1. The age-adjusted death rate from female breast cancer for California during the 2010 through 2012 three-year period was 20.9 deaths per 100,000 female population. Reliable age-adjusted death rates ranged from 26.0 in Placer County to 17.7 in Santa Barbara County and San Francisco County. Twelve counties with reliable age-adjusted death rates met the Healthy People 2020 National Objective C-3 of no more than 20.6 age-adjusted deaths due to female breast cancer per 100,000 female population. An additional seventeen counties with unreliable rates and one county with no female breast cancer deaths met the objective. The statewide age-adjusted death rate for female breast cancer did not meet the national objective. The California average age-adjusted death rate for female breast cancer for the 2007-2009 period was 22.1. California Department of Public Health 11 County Health Status Profiles 2014 TABLE 5 DEATHS DUE TO FEMALE BREAST CANCER RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER x COUNTY OF RESIDENCE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 ALPINE MONO TRINITY SIERRA PLUMAS MARIPOSA LASSEN MADERA TUOLUMNE YOLO NEVADA SUTTER TEHAMA INYO SANTA BARBARA SAN FRANCISCO SANTA CLARA EL DORADO STANISLAUS FRESNO MARIN TULARE NAPA ORANGE SAN BENITO SAN MATEO GLENN KERN MONTEREY MENDOCINO 31 32 33 IMPERIAL MERCED RIVERSIDE CALIFORNIA ALAMEDA KINGS YUBA DEL NORTE LOS ANGELES SAN JOAQUIN VENTURA SAN DIEGO SACRAMENTO SAN LUIS OBISPO CONTRA COSTA LAKE BUTTE HUMBOLDT SHASTA SOLANO SAN BERNARDINO CALAVERAS SANTA CRUZ SONOMA PLACER COLUSA MODOC SISKIYOU AMADOR 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: x 2011 FEMALE POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 542 0.0 6,727 0.3 5.0 * 6,567 0.7 10.2 * 1,545 0.3 21.6 * 9,971 1.7 16.7 * 8,857 1.7 18.8 * 12,412 2.0 16.1 * 78,298 11.7 14.9 * 26,053 7.7 29.4 * 103,964 15.3 14.7 * 49,919 14.0 28.0 * 47,702 9.0 18.9 * 31,876 7.3 23.0 * 9,209 3.0 32.6 * 211,998 43.7 20.6 400,862 87.3 21.8 900,393 173.7 19.3 90,377 22.3 24.7 261,663 49.3 18.9 469,537 86.0 18.3 129,509 37.3 28.8 223,201 39.0 17.5 68,884 18.0 26.1 * 1,540,252 336.0 21.8 28,140 5.7 20.1 * 369,857 92.0 24.9 13,980 3.3 23.8 * 411,019 75.0 18.2 204,221 44.0 21.5 43,896 13.0 29.6 * HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: C-3 86,144 17.0 19.7 * 128,603 24.0 18.7 1,115,181 242.3 21.7 18,886,503 4,311.7 22.8 777,759 178.3 22.9 65,741 11.7 17.7 * 35,980 7.7 21.3 * 12,649 3.7 29.0 * 4,996,079 1,142.3 22.9 347,612 76.3 22.0 417,811 102.3 24.5 1,556,284 365.7 23.5 729,256 174.0 23.9 132,094 38.7 29.3 543,509 142.7 26.2 32,020 10.7 33.3 * 111,398 33.0 29.6 67,112 19.7 29.3 * 90,541 31.0 34.2 207,225 54.7 26.4 1,032,116 224.3 21.7 22,546 9.0 39.9 * 133,099 36.3 27.3 247,141 79.7 32.2 182,487 62.0 34.0 10,451 2.7 25.5 * 4,770 1.7 34.9 * 22,439 10.7 47.5 * 17,024 9.3 54.8 * AGE-ADJUSTED DEATH RATE 3.1 * 5.7 * 8.3 * 8.8 * 10.0 * 10.4 * 14.9 * 15.7 * 15.8 * 16.8 * 16.9 * 17.2 * 17.4 * 17.7 17.7 17.8 18.3 18.6 19.0 19.2 19.2 19.4 * 19.5 19.5 * 19.6 20.2 * 20.2 20.3 20.6 * 20.6 20.7 * 20.7 20.8 20.9 21.0 21.0 * 21.1 * 21.3 * 21.4 21.5 21.5 21.6 22.0 22.1 22.2 22.9 * 23.0 23.1 * 23.3 23.4 23.6 23.6 * 24.1 24.8 26.0 26.2 * 27.2 * 28.0 * 32.2 * 95% CONFIDENCE LIMITS LOWER 0.0 0.0 0.0 0.8 0.9 1.3 7.6 6.6 8.9 9.2 7.7 7.1 3.6 12.8 14.2 15.1 11.5 13.8 15.2 13.6 13.7 11.5 17.4 6.9 15.8 4.6 15.9 14.7 11.0 12.0 13.3 18.2 20.3 17.8 10.7 8.9 5.4 20.1 17.0 17.3 19.4 18.7 15.7 18.5 11.3 15.8 14.0 15.8 17.6 20.4 10.8 16.9 19.6 19.9 4.7 2.4 13.8 15.0 UPPER 41.0 42.2 108.9 35.5 40.1 37.5 26.2 31.4 25.8 28.3 32.0 34.8 50.7 23.8 21.8 20.5 27.7 24.6 23.5 26.5 26.3 30.7 21.6 43.3 24.0 56.1 25.4 27.2 35.3 33.1 30.9 23.5 21.5 24.1 36.9 42.1 56.7 22.6 26.9 25.8 23.8 25.4 30.3 25.9 41.4 32.3 35.7 33.0 30.5 26.7 44.9 33.3 30.8 33.3 81.3 109.1 50.5 60.4 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 12 County Health Status Profiles 2014 DEATHS DUE TO PROSTATE CANCER, 2010-2012 T he crude death rate from male prostate cancer for California was 16.2 deaths per 100,000 male population, a risk of dying from prostate cancer equivalent to approximately one death for every 6,167.7 males. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 3,029.3 and a male population count of 18,683,804 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 28.1 in Butte County to 12.6 in Fresno County, a factor of 2.2 to 1. The age-adjusted death rate from male prostate cancer for California during the 2010 through 2012 three-year period was 20.5 deaths per 100,000 male population. Reliable age-adjusted death rates ranged from 24.6 in Butte County to 16.2 in San Francisco County. Fifteen counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective C-7 of no more than 21.2 age-adjusted deaths due to prostate cancer per 100,000 male population. An additional sixteen counties with unreliable rates and one county with no prostate cancer deaths met the objective. The California average age-adjusted death rate from male prostate cancer for the 2007-2009 period was 22.7. California Department of Public Health 13 County Health Status Profiles 2014 TABLE 6 DEATHS DUE TO PROSTATE CANCER RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 x COUNTY OF RESIDENCE 29 30 31 32 ALPINE LASSEN PLUMAS MONO GLENN MODOC TUOLUMNE MARIPOSA MENDOCINO MADERA SAN FRANCISCO MARIN EL DORADO SANTA CLARA MERCED FRESNO PLACER TRINITY SONOMA ORANGE SAN MATEO VENTURA COLUSA STANISLAUS YOLO SANTA CRUZ LOS ANGELES ALAMEDA CALIFORNIA SACRAMENTO MONTEREY CALAVERAS IMPERIAL 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 CONTRA COSTA KINGS SUTTER RIVERSIDE SAN LUIS OBISPO NAPA SAN JOAQUIN TULARE SAN DIEGO SANTA BARBARA KERN DEL NORTE SHASTA AMADOR HUMBOLDT TEHAMA SOLANO SAN BERNARDINO BUTTE SISKIYOU INYO LAKE NEVADA YUBA SAN BENITO SIERRA * Note: Sources: x 2011 MALE POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 576 0.0 22,256 0.7 3.0 * 9,982 1.0 10.0 * 7,578 0.7 8.8 * 14,275 1.3 9.3 * 4,795 0.7 13.9 * 28,988 6.0 20.7 * 9,120 1.7 18.3 * 44,175 7.7 17.4 * 73,710 9.7 13.1 * 412,261 63.7 15.4 124,850 23.3 18.7 90,286 14.7 16.2 * 906,488 118.0 13.0 130,686 14.3 11.0 * 469,741 59.3 12.6 173,880 34.0 19.6 6,979 2.0 28.7 * 239,637 44.3 18.5 1,506,868 228.3 15.2 358,123 64.7 18.1 412,404 65.3 15.8 11,051 1.7 15.1 * 256,478 37.3 14.6 98,666 13.3 13.5 * 132,470 22.3 16.9 4,864,757 744.3 15.3 748,461 119.3 15.9 18,683,804 3,029.3 16.2 701,628 113.0 16.1 215,777 32.0 14.8 22,597 6.7 29.5 * 91,085 14.0 15.4 * HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: C-7 517,866 97.3 18.8 85,914 8.0 9.3 * 47,062 8.3 17.7 * 1,105,321 200.3 18.1 138,025 32.7 23.7 68,750 16.3 23.8 * 345,250 54.3 15.7 224,464 31.3 14.0 1,569,037 285.3 18.2 213,758 44.3 20.7 437,820 56.3 12.9 15,849 3.0 18.9 * 87,548 23.7 27.0 20,264 6.3 31.3 * 68,106 14.7 21.5 * 31,638 8.3 26.3 * 207,112 37.3 18.0 1,021,232 149.0 14.6 109,123 30.7 28.1 22,436 8.0 35.7 * 9,478 3.3 35.2 * 32,399 10.3 31.9 * 48,674 19.3 39.7 * 36,640 7.3 20.0 * 27,810 7.0 25.2 * 1,601 1.0 62.5 * AGE-ADJUSTED DEATH RATE 4.1 * 7.6 * 9.7 * 9.9 * 11.3 * 14.5 * 15.0 * 15.2 * 16.0 * 16.2 16.3 17.0 * 17.1 17.7 * 18.2 18.8 19.0 * 19.1 19.1 19.2 19.4 19.5 * 19.6 19.8 * 20.2 20.3 20.3 20.5 20.7 21.0 21.1 * 21.2 * 21.2 21.3 21.3 * 21.9 * 22.0 22.0 22.1 * 22.3 22.3 22.4 22.6 22.8 23.3 * 23.4 23.6 * 23.7 * 23.7 * 23.8 24.5 24.6 24.8 * 26.5 * 27.1 * 28.1 * 28.7 * 39.0 * 40.4 * 95% CONFIDENCE LIMITS LOWER 0.0 0.2 0.0 0.6 0.1 5.3 1.3 6.4 7.6 12.5 10.3 9.5 14.0 9.8 13.8 13.0 2.3 13.9 16.6 14.8 15.0 1.7 13.8 10.6 12.7 18.9 16.6 19.8 16.9 14.4 8.3 11.6 17.2 9.2 9.6 18.9 15.1 12.7 16.7 15.2 19.8 16.5 17.3 4.8 14.9 9.0 13.1 10.4 16.8 20.5 16.6 10.7 6.1 13.2 17.0 11.8 15.7 1.0 UPPER 30.8 42.3 72.4 45.8 84.7 31.6 60.3 30.4 29.8 20.7 24.3 28.3 20.3 29.6 23.4 26.3 68.5 25.5 21.6 24.5 24.7 78.3 27.0 33.6 30.5 21.8 24.1 21.3 24.6 29.6 44.2 35.5 25.9 42.0 42.6 25.1 31.0 35.7 29.0 31.6 25.0 30.4 29.6 68.1 34.9 50.5 39.2 46.1 32.8 28.6 34.9 48.9 73.8 49.4 43.7 58.1 80.4 225.2 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 14 County Health Status Profiles 2014 DEATHS DUE TO DIABETES, 2010-2012 T he crude death rate from diabetes for California was 20.0 deaths per 100,000 population, a risk of dying from diabetes equivalent to approximately one death for every 4,996.7 persons. This rate was based on a 2010 through 2012 threeyear average number of deaths equaling 7,519.0 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 29.6 in Humboldt County to 12.6 in Marin County, a factor of 2.4 to 1. The age-adjusted death rate from diabetes for California during the 2010 through 2012 three-year period was 20.4 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 34.2 in San Bernardino County to 8.9 in Marin County. The Healthy People 2020 National Objective D-3 for diabetes mortality is based on both underlying and contributing causes of death. This report does not utilize multiple causes of death data. Therefore, California’s progress in meeting this objective will not be addressed in this report. The California average age-adjusted death rate from diabetes for the 2007-2009 period was 21.2. California Department of Public Health 15 County Health Status Profiles 2014 TABLE 7 DEATHS DUE TO DIABETES RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x COUNTY OF RESIDENCE AMADOR MONO MARIN MODOC NEVADA COLUSA TRINITY SAN MATEO SAN FRANCISCO PLUMAS EL DORADO MARIPOSA TUOLUMNE PLACER NAPA SAN LUIS OBISPO SANTA CRUZ ORANGE INYO DEL NORTE CALAVERAS SIERRA VENTURA MADERA SANTA BARBARA SONOMA SHASTA CONTRA COSTA MONTEREY MENDOCINO BUTTE SAN BENITO LASSEN LAKE RIVERSIDE SUTTER SAN DIEGO TEHAMA CALIFORNIA SISKIYOU ALAMEDA ALPINE STANISLAUS SACRAMENTO YOLO SANTA CLARA LOS ANGELES TULARE YUBA SOLANO HUMBOLDT MERCED IMPERIAL SAN JOAQUIN KINGS FRESNO GLENN KERN SAN BERNARDINO x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE AGE-ADJUSTED DEATH RATE HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: D3 NOT APPLICABLE 37,288 4.0 10.7 * 6.4 * 14,305 0.7 4.7 * 7.9 * 254,359 32.0 12.6 8.9 9,565 1.7 17.4 * 10.2 * 98,593 14.7 14.9 * 10.2 * 21,502 2.3 10.9 * 10.5 * 13,546 2.3 17.2 * 10.8 * 727,980 100.0 13.7 11.9 813,123 113.3 13.9 11.9 19,953 3.7 18.4 * 12.3 * 180,663 25.7 14.2 12.5 17,977 2.3 13.0 * 12.5 * 55,041 11.3 20.6 * 12.8 * 356,367 58.0 16.3 13.2 137,634 23.7 17.2 13.4 270,119 46.3 17.2 13.9 265,569 37.7 14.2 14.0 3,047,120 456.3 15.0 14.9 18,687 4.7 25.0 * 15.3 * 28,498 4.7 16.4 * 15.4 * 45,143 11.7 25.8 * 15.4 * 3,146 0.7 21.2 * 15.4 * 830,215 132.3 15.9 15.8 152,008 22.0 14.5 16.0 425,756 76.7 18.0 16.4 486,778 95.3 19.6 16.7 178,089 39.0 21.9 16.7 1,061,375 192.0 18.1 16.7 419,998 66.3 15.8 16.9 88,071 18.0 20.4 * 17.0 * 220,521 47.3 21.5 17.3 55,950 8.7 15.5 * 18.1 * 34,668 5.7 16.3 * 18.3 * 64,419 15.7 24.3 * 18.5 * 2,220,502 411.3 18.5 19.1 94,764 19.3 20.4 * 19.3 * 3,125,321 604.0 19.3 19.5 63,514 16.0 25.2 * 19.9 * 37,570,307 7,519.0 20.0 20.4 44,875 13.0 29.0 * 20.5 * 1,526,220 310.7 20.4 20.7 1,118 0.3 29.8 * 20.9 * 518,141 99.0 19.1 21.0 1,430,884 295.3 20.6 21.1 202,630 38.3 18.9 22.1 1,806,881 379.3 21.0 22.2 9,860,836 2,096.3 21.3 22.5 447,665 82.3 18.4 22.6 72,620 14.0 19.3 * 22.6 * 414,337 98.3 23.7 24.1 135,218 40.0 29.6 26.4 259,289 55.3 21.3 27.2 177,229 43.7 24.6 28.2 692,862 178.3 25.7 28.4 151,655 31.7 20.9 28.6 939,278 235.3 25.1 28.8 28,255 9.0 31.9 * 29.3 * 848,839 216.3 25.5 33.0 2,053,348 555.0 27.0 34.2 95% CONFIDENCE LIMITS LOWER 1.7 0.0 6.1 0.9 5.7 1.6 1.6 9.5 9.7 3.1 8.1 1.9 6.5 10.1 8.6 10.2 9.9 13.5 4.7 4.7 7.9 0.1 13.0 10.0 12.9 13.5 11.9 14.3 13.1 10.1 12.7 8.1 6.5 10.5 17.3 11.7 18.0 11.3 19.9 10.9 18.4 0.0 17.1 18.7 15.6 19.9 21.6 18.0 12.4 19.6 18.9 20.5 20.5 24.1 19.5 25.1 13.4 28.5 31.3 UPPER 16.4 59.1 12.6 40.9 17.0 34.9 35.7 14.2 14.2 32.8 18.4 41.6 22.8 17.1 20.0 18.5 19.2 16.3 36.8 36.9 27.1 115.1 18.5 24.2 20.5 20.4 22.8 19.1 21.6 26.8 23.0 34.8 40.6 30.2 21.0 30.1 21.1 32.2 20.9 35.0 23.1 273.4 25.6 23.5 30.3 24.4 23.5 28.0 37.9 29.3 36.0 35.4 37.9 32.6 40.5 32.5 55.6 37.5 37.1 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 16 County Health Status Profiles 2014 DEATHS DUE TO ALZHEIMER’S DISEASE, 2010-2012 T he crude death rate from Alzheimer’s disease for California was 30.2 deaths per 100,000 population, a risk of dying from Alzheimer’s disease equivalent to approximately one death for every 3,315.6 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 11,331.3 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 61.8 in Butte County to 11.7 in Imperial County, a factor of 5.3 to 1. The age-adjusted death rate from Alzheimer’s disease for California during the 2010 through 2012 three-year period was 30.5 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 48.5 in Solano County to 14.1 in Imperial County. A Healthy People National Objective for deaths due to Alzheimer’s disease has not been established. The California average age-adjusted death rate from Alzheimer’s disease for the 2007-2009 period was 28.1. California Department of Public Health 17 County Health Status Profiles 2014 TABLE 8 DEATHS DUE TO ALZHEIMER'S DISEASE RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: x COUNTY OF RESIDENCE ALPINE INYO MODOC SAN BENITO LASSEN IMPERIAL SIERRA CALAVERAS MONO PLUMAS TUOLUMNE MENDOCINO MONTEREY GLENN SAN LUIS OBISPO YUBA TULARE SAN FRANCISCO DEL NORTE SISKIYOU MERCED LOS ANGELES SUTTER SACRAMENTO ALAMEDA MARIPOSA SAN BERNARDINO HUMBOLDT VENTURA COLUSA SAN MATEO AMADOR RIVERSIDE NAPA CALIFORNIA TRINITY SANTA BARBARA CONTRA COSTA EL DORADO LAKE TEHAMA NEVADA FRESNO PLACER KERN ORANGE SANTA CRUZ MARIN SAN DIEGO MADERA SANTA CLARA SONOMA STANISLAUS KINGS YOLO SAN JOAQUIN SHASTA BUTTE SOLANO x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: 1,118 0.0 18,687 1.0 5.4 * 9,565 1.3 13.9 * 55,950 5.3 9.5 * 34,668 3.7 10.6 * 177,229 20.7 11.7 3,146 0.7 21.2 * 45,143 9.7 21.4 * 14,305 1.0 7.0 * 19,953 4.3 21.7 * 55,041 15.3 27.9 * 88,071 19.7 22.3 * 419,998 75.7 18.0 28,255 6.3 22.4 * 270,119 80.7 29.9 72,620 12.3 17.0 * 447,665 80.0 17.9 813,123 252.7 31.1 28,498 7.0 24.6 * 44,875 17.0 37.9 * 259,289 47.3 18.3 9,860,836 2,355.7 23.9 94,764 24.7 26.0 1,430,884 370.7 25.9 1,526,220 401.3 26.3 17,977 7.3 40.8 * 2,053,348 399.7 19.5 135,218 43.3 32.0 830,215 245.0 29.5 21,502 6.0 27.9 * 727,980 272.3 37.4 37,288 19.3 51.8 * 2,220,502 642.3 28.9 137,634 60.7 44.1 37,570,307 11,331.3 30.2 13,546 5.7 41.8 * 425,756 164.7 38.7 1,061,375 361.0 34.0 180,663 63.0 34.9 64,419 26.7 41.4 63,514 24.3 38.3 98,593 53.7 54.4 939,278 281.0 29.9 356,367 156.7 44.0 848,839 199.3 23.5 3,047,120 1,097.3 36.0 265,569 94.7 35.6 254,359 139.3 54.8 3,125,321 1,193.0 38.2 152,008 49.7 32.7 1,806,881 678.3 37.5 486,778 254.0 52.2 518,141 185.0 35.7 151,655 36.0 23.7 202,630 74.3 36.7 692,862 257.0 37.1 178,089 104.3 58.6 220,521 136.3 61.8 414,337 186.0 44.9 AGE-ADJUSTED DEATH RATE NONE 3.2 * 10.1 * 11.5 * 13.4 * 14.1 14.8 * 15.1 * 15.3 * 16.1 * 17.2 * 17.4 * 18.6 21.1 * 21.6 23.0 * 23.4 23.7 23.8 * 24.0 * 24.4 25.1 25.5 26.3 26.7 28.1 * 28.5 28.7 28.8 29.5 * 30.2 30.3 * 30.5 30.5 30.5 30.8 * 30.8 31.3 31.4 31.5 31.9 32.8 33.9 34.8 34.8 35.7 36.0 36.4 36.6 38.5 39.1 39.5 39.6 40.3 41.1 41.8 42.2 42.8 48.5 95% CONFIDENCE LIMITS LOWER 0.1 0.6 3.9 3.4 8.7 0.1 7.1 0.4 4.7 9.7 10.6 14.7 8.0 17.1 12.0 18.6 20.8 9.6 14.0 18.0 24.1 16.4 23.6 24.1 11.6 25.7 20.8 25.1 10.8 26.6 18.3 28.1 23.3 30.0 10.9 26.1 28.0 24.1 20.7 20.5 24.6 29.9 29.3 30.0 33.5 29.1 30.3 34.5 28.6 36.1 34.5 33.8 28.2 32.3 36.6 34.0 35.5 41.5 UPPER 17.8 46.4 26.1 35.6 21.6 110.5 28.0 85.3 39.8 28.1 27.0 23.3 45.0 26.8 39.9 29.2 26.7 49.0 38.5 32.5 26.1 37.7 29.0 29.4 57.0 31.3 38.7 32.4 64.3 33.8 47.1 32.9 39.3 31.1 68.4 35.6 34.6 40.2 45.9 47.3 42.8 37.9 40.2 39.7 37.8 44.1 42.5 38.7 50.8 42.1 44.4 45.3 55.8 51.6 47.0 50.3 50.1 55.5 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 18 County Health Status Profiles 2014 DEATHS DUE TO CORONARY HEART DISEASE, 2010-2012 T he crude death rate from coronary heart disease for California was 105.0 deaths per 100,000 population, a risk of dying from coronary heart disease equivalent to approximately one death for every 952.2 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 39,457.0 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 183.7 in Lake County to 54.2 in San Benito County, a factor of 3.4 to 1. The age-adjusted death rate from coronary heart disease for California during the 2010 through 2012 three-year period was 106.2 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 161.3 in Yuba County to 62.6 in San Benito County. Twenty-nine counties with reliable age-adjusted death rates met the Healthy People 2020 National Objective HDS-2 of no more than 100.8 age-adjusted deaths due to coronary heart disease per 100,000 population. An additional two counties with unreliable rates met the objective. The statewide age-adjusted death rate for coronary heart disease did not meet the national objective. The California average age-adjusted death rate from coronary heart disease for the 2007-2009 period was 122.9. California Department of Public Health 19 County Health Status Profiles 2014 TABLE 9 DEATHS DUE TO CORONARY HEART DISEASE RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER x COUNTY OF RESIDENCE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ALPINE SAN BENITO MONO MARIN SAN FRANCISCO YOLO SANTA CLARA SAN MATEO CONTRA COSTA MONTEREY LASSEN ALAMEDA SOLANO SAN LUIS OBISPO SANTA CRUZ NAPA EL DORADO VENTURA INYO NEVADA SONOMA TUOLUMNE SAN DIEGO SANTA BARBARA TEHAMA PLACER ORANGE SISKIYOU COLUSA CALAVERAS PLUMAS 32 33 34 35 36 37 AMADOR HUMBOLDT DEL NORTE BUTTE MENDOCINO TRINITY CALIFORNIA IMPERIAL MARIPOSA SIERRA SACRAMENTO GLENN KINGS FRESNO SHASTA SUTTER SAN JOAQUIN MERCED LOS ANGELES RIVERSIDE SAN BERNARDINO LAKE MADERA KERN TULARE MODOC STANISLAUS YUBA 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 1,118 0.7 55,950 30.3 14,305 4.7 254,359 238.0 813,123 700.3 202,630 127.7 1,806,881 1,278.0 727,980 659.7 1,061,375 900.3 419,998 318.7 34,668 24.0 1,526,220 1,220.3 414,337 331.3 270,119 296.3 265,569 223.0 137,634 163.3 180,663 188.3 830,215 770.3 18,687 27.7 98,593 149.0 486,778 580.0 55,041 85.0 3,125,321 3,028.3 425,756 481.7 63,514 76.7 356,367 437.3 3,047,120 3,050.3 44,875 67.7 21,502 20.7 45,143 68.7 19,953 30.7 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: 37,288 63.7 135,218 156.0 28,498 33.3 220,521 306.7 88,071 122.0 13,546 23.0 37,570,307 39,457.0 177,229 163.0 17,977 30.0 3,146 5.7 1,430,884 1,542.7 28,255 34.3 151,655 113.0 939,278 949.3 178,089 283.7 94,764 115.0 692,862 737.7 259,289 244.7 9,860,836 11,803.0 2,220,502 2,678.0 2,053,348 1,979.3 64,419 118.3 152,008 186.3 848,839 859.7 447,665 485.3 9,565 19.7 518,141 729.0 72,620 95.7 59.6 * 54.2 32.6 * 93.6 86.1 63.0 70.7 90.6 84.8 75.9 69.2 80.0 80.0 109.7 84.0 118.7 104.2 92.8 148.1 151.1 119.2 154.4 96.9 113.1 120.7 122.7 100.1 150.8 96.1 152.1 153.7 HDS-2 170.7 115.4 117.0 139.1 138.5 169.8 105.0 92.0 166.9 180.1 * 107.8 121.5 74.5 101.1 159.3 121.4 106.5 94.4 119.7 120.6 96.4 183.7 122.6 101.3 108.4 205.6 * 140.7 131.7 AGE-ADJUSTED DEATH RATE 24.3 * 62.6 64.0 * 64.2 69.9 72.8 73.6 76.3 77.9 79.7 80.2 80.8 81.2 82.8 83.9 87.6 88.2 89.8 91.0 93.7 94.9 96.0 96.1 96.8 98.4 98.7 99.2 99.2 99.3 100.6 100.6 100.8 102.5 103.8 105.2 105.3 105.5 105.6 106.2 106.8 107.7 109.0 * 110.0 111.0 111.3 114.8 116.9 117.3 117.9 119.3 124.9 125.0 130.1 134.8 135.8 136.4 137.3 141.0 * 153.3 161.3 95% CONFIDENCE LIMITS LOWER 0.1 42.3 19.7 55.9 64.7 60.0 69.5 70.4 72.7 70.9 51.4 76.2 72.3 73.2 72.6 73.8 75.4 83.4 60.3 78.2 86.9 76.7 92.6 88.0 77.6 89.4 95.6 77.0 61.2 78.2 68.2 78.9 87.2 72.6 93.3 86.3 66.9 105.1 90.3 72.7 38.6 104.5 77.0 90.4 107.5 103.1 95.8 109.3 104.2 122.6 120.2 124.3 110.0 116.1 127.2 125.0 85.7 142.0 130.6 UPPER 181.7 89.2 153.5 72.5 75.1 85.6 77.6 82.2 83.0 88.6 119.4 85.4 90.0 92.4 95.2 101.3 101.0 96.2 131.8 109.2 102.8 118.7 99.6 105.6 123.1 108.0 102.7 125.8 152.3 127.4 143.1 131.0 120.4 147.5 117.4 124.8 158.5 107.2 123.3 153.8 242.3 115.6 154.9 132.2 122.2 130.6 138.8 126.5 134.3 127.2 129.7 135.9 159.6 155.5 145.7 149.6 218.5 164.5 197.1 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 20 County Health Status Profiles 2014 DEATHS DUE TO CEREBROVASCULAR DISEASE (STROKE), 2010-2012 T he crude death rate from cerebrovascular disease (stroke) for California was 35.9 deaths per 100,000 population, a risk of dying from cerebrovascular disease equivalent to approximately one death for every 2,787.2 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 13,479.7 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 78.2 in San Luis Obispo County to 25.2 in Santa Clara County, a factor of 3.1 to 1. The age-adjusted death rate from cerebrovascular disease for California during the 2010 through 2012 three-year period was 36.6 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 56.7 in San Luis Obispo County to 25.1 in El Dorado County. Ten counties with reliable age-adjusted death rates met the Healthy People 2020 National Objective HDS-3 of no more than 33.8 age-adjusted deaths due to cerebrovascular disease per 100,000 population. An additional six counties with unreliable rates met the objective. The statewide age-adjusted death rate for cerebrovascular disease did not meet the national objective. The California average age-adjusted death rate from cerebrovascular disease for the 2007-2009 period was 40.2. California Department of Public Health 21 County Health Status Profiles 2014 TABLE 10 DEATHS DUE TO CEREBROVASCULAR DISEASE (STROKE) RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER x COUNTY OF RESIDENCE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ALPINE TRINITY EL DORADO MONO LASSEN SANTA CLARA MARIN GLENN PLUMAS SAN MATEO CALAVERAS SAN DIEGO SANTA CRUZ AMADOR PLACER MENDOCINO 17 18 19 20 21 22 23 24 ORANGE SAN FRANCISCO VENTURA LOS ANGELES IMPERIAL TUOLUMNE NEVADA SANTA BARBARA CALIFORNIA SOLANO RIVERSIDE KINGS SONOMA ALAMEDA NAPA MONTEREY INYO CONTRA COSTA YOLO SACRAMENTO SAN BERNARDINO KERN SAN BENITO STANISLAUS MADERA SUTTER MARIPOSA BUTTE FRESNO SAN JOAQUIN SISKIYOU DEL NORTE MERCED SIERRA COLUSA SHASTA LAKE TULARE MODOC TEHAMA YUBA HUMBOLDT SAN LUIS OBISPO 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 1,118 0.3 29.8 * 13,546 4.3 32.0 * 180,663 52.0 28.8 14,305 2.0 14.0 * 34,668 7.0 20.2 * 1,806,881 455.0 25.2 254,359 101.7 40.0 28,255 9.3 33.0 * 19,953 8.3 41.8 * 727,980 270.3 37.1 45,143 21.3 47.3 3,125,321 1,023.7 32.8 265,569 85.3 32.1 37,288 20.7 55.4 356,367 148.0 41.5 88,071 38.3 43.5 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: HDS-3 3,047,120 1,055.0 34.6 813,123 343.0 42.2 830,215 297.7 35.9 9,860,836 3,300.0 33.5 177,229 53.7 30.3 55,041 31.3 56.9 98,593 56.7 57.5 425,756 181.0 42.5 37,570,307 13,479.7 35.9 414,337 146.7 35.4 2,220,502 791.0 35.6 151,655 39.0 25.7 486,778 232.0 47.7 1,526,220 564.7 37.0 137,634 72.3 52.6 419,998 153.7 36.6 18,687 12.0 64.2 * 1,061,375 443.7 41.8 202,630 71.3 35.2 1,430,884 563.7 39.4 2,053,348 616.0 30.0 848,839 252.7 29.8 55,950 20.0 35.7 518,141 200.7 38.7 152,008 58.3 38.4 94,764 43.3 45.7 17,977 11.3 63.0 * 220,521 132.7 60.2 939,278 364.0 38.8 692,862 275.7 39.8 44,875 30.3 67.6 28,498 13.7 48.0 * 259,289 92.0 35.5 3,146 2.0 63.6 * 21,502 9.0 41.9 * 178,089 113.7 63.8 64,419 42.0 65.2 447,665 173.7 38.8 9,565 7.0 73.2 * 63,514 40.0 63.0 72,620 29.7 40.9 135,218 84.7 62.6 270,119 211.3 78.2 AGE-ADJUSTED DEATH RATE 12.2 * 21.2 * 25.1 25.5 * 25.5 * 26.5 27.5 29.8 * 29.8 * 31.4 32.2 32.5 32.7 33.1 33.4 33.5 33.8 34.7 34.7 35.2 35.4 35.5 35.7 36.3 36.4 36.6 37.0 37.1 37.6 37.8 38.0 38.0 38.3 38.6 * 38.8 40.1 40.3 40.4 40.6 41.4 42.8 43.4 43.7 44.2 * 44.4 44.7 44.8 45.1 45.6 * 45.6 45.6 * 45.7 * 47.0 48.0 48.8 52.0 * 52.0 52.9 55.7 56.7 95% CONFIDENCE LIMITS LOWER 0.0 6.2 18.8 3.1 10.3 24.0 22.1 13.8 13.1 27.6 20.0 30.5 26.1 20.4 28.0 23.7 32.6 31.0 31.2 34.1 26.6 24.3 27.4 31.0 36.0 31.0 34.5 26.8 32.8 34.8 29.8 32.2 19.9 35.1 31.3 37.0 37.2 35.5 25.3 36.9 33.0 31.7 22.3 36.7 40.0 39.4 30.5 24.7 36.7 5.5 20.9 38.2 34.6 41.5 20.9 37.2 35.6 44.5 48.9 UPPER 159.0 52.3 33.0 92.0 52.5 28.9 33.0 55.9 57.9 35.2 49.0 34.5 40.4 50.7 38.8 45.9 36.8 38.4 39.3 36.6 46.4 50.6 47.0 41.8 37.3 43.1 39.7 51.5 42.8 41.2 47.9 44.4 67.4 42.5 50.5 43.7 43.7 45.7 63.9 48.8 56.1 58.8 78.4 52.1 49.3 50.1 64.2 76.9 55.9 164.7 86.8 55.7 64.9 56.1 107.2 70.9 75.6 68.9 64.4 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 22 County Health Status Profiles 2014 DEATHS DUE TO INFLUENZA/PNEUMONIA, 2010-2012 T he crude death rate from influenza/pneumonia for California was 15.8 deaths per 100,000 population, a risk of dying from influenza/pneumonia equivalent to approximately one death for every 6,316.1 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 5,948.3 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 24.3 in Nevada County to 9.1 in San Bernardino County, a factor of 2.7 to 1. The age-adjusted death rate from influenza/pneumonia for California during the 2010 through 2012 three-year period was 16.1 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 23.9 in Tulare County to 8.2 in Sonoma County. A Healthy People 2020 National Objective for deaths due to influenza/pneumonia has not been established. The California average age-adjusted death rate from influenza/pneumonia for the 2007-2009 period was 19.1. California Department of Public Health 23 County Health Status Profiles 2014 TABLE 11 DEATHS DUE TO INFLUENZA/PNEUMONIA RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: x COUNTY OF RESIDENCE ALPINE MONO SONOMA INYO TRINITY SAN LUIS OBISPO SAN DIEGO VENTURA CONTRA COSTA SHASTA IMPERIAL MONTEREY HUMBOLDT RIVERSIDE PLUMAS SANTA BARBARA COLUSA MARIN SAN BERNARDINO MENDOCINO MODOC TEHAMA SISKIYOU EL DORADO SANTA CRUZ SANTA CLARA ALAMEDA PLACER MARIPOSA CALAVERAS NEVADA TUOLUMNE SAN FRANCISCO LASSEN GLENN SUTTER BUTTE NAPA DEL NORTE MERCED MADERA CALIFORNIA SAN BENITO SAN JOAQUIN ORANGE SAN MATEO KINGS STANISLAUS KERN SOLANO SACRAMENTO YOLO LAKE YUBA FRESNO LOS ANGELES AMADOR TULARE SIERRA x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: 1,118 0.0 14,305 0.7 4.7 * 486,778 53.3 11.0 18,687 2.3 12.5 * 13,546 2.0 14.8 * 270,119 33.3 12.3 3,125,321 301.7 9.7 830,215 84.3 10.2 1,061,375 124.3 11.7 178,089 26.7 15.0 177,229 17.0 9.6 * 419,998 45.0 10.7 135,218 18.3 13.6 * 2,220,502 247.7 11.2 19,953 3.7 18.4 * 425,756 61.3 14.4 21,502 2.7 12.4 * 254,359 46.0 18.1 2,053,348 186.0 9.1 88,071 14.0 15.9 * 9,565 1.7 17.4 * 63,514 9.7 15.2 * 44,875 8.0 17.8 * 180,663 27.3 15.1 265,569 35.7 13.4 1,806,881 231.3 12.8 1,526,220 209.0 13.7 356,367 62.0 17.4 17,977 4.0 22.3 * 45,143 10.0 22.2 * 98,593 24.0 24.3 55,041 12.3 22.4 * 813,123 147.7 18.2 34,668 4.3 12.5 * 28,255 4.3 15.3 * 94,764 15.0 15.8 * 220,521 45.7 20.7 137,634 30.3 22.0 28,498 4.7 16.4 * 259,289 31.7 12.2 152,008 21.3 14.0 37,570,307 5,948.3 15.8 55,950 7.7 13.7 * 692,862 105.3 15.2 3,047,120 527.3 17.3 727,980 157.7 21.7 151,655 18.0 11.9 * 518,141 86.7 16.7 848,839 119.0 14.0 414,337 76.3 18.4 1,430,884 270.0 18.9 202,630 35.7 17.6 64,419 17.7 27.4 * 72,620 12.7 17.4 * 939,278 180.0 19.2 9,860,836 2,024.0 20.5 37,288 14.3 38.4 * 447,665 84.7 18.9 3,146 1.0 31.8 * AGE-ADJUSTED DEATH RATE NONE 5.8 * 8.2 8.3 * 8.5 * 9.1 9.4 9.9 10.9 11.1 11.2 * 11.3 11.6 * 11.7 11.7 * 11.9 11.9 * 12.0 12.0 12.2 * 12.2 * 12.3 * 12.4 * 12.7 13.2 13.3 14.0 14.0 14.2 * 14.4 * 14.5 14.5 * 14.6 14.7 * 15.0 * 15.1 * 15.1 15.2 15.3 * 15.6 15.9 16.1 16.2 * 17.0 17.3 17.5 17.7 * 18.3 18.9 19.0 19.1 20.5 20.7 * 21.4 * 21.5 21.8 23.5 * 23.9 24.2 * 95% CONFIDENCE LIMITS LOWER 0.0 6.2 1.3 1.0 6.2 8.3 7.9 9.0 7.3 6.5 8.3 6.9 10.2 3.0 9.1 2.1 8.8 10.3 6.6 1.1 5.8 5.3 8.4 9.2 11.6 12.0 10.7 3.9 6.9 9.3 7.6 12.2 4.3 4.4 8.4 11.1 10.3 4.7 10.6 9.9 15.7 6.9 13.7 15.8 14.8 10.5 14.7 15.4 15.0 16.8 14.3 12.2 11.3 18.4 20.8 13.0 19.1 0.6 UPPER 43.5 10.8 27.6 30.6 12.7 10.5 12.2 12.9 16.2 17.9 15.2 18.3 13.1 31.3 15.3 36.9 16.0 13.8 20.4 49.0 22.9 24.4 18.5 18.3 15.1 15.9 17.9 36.5 26.6 21.5 25.1 16.9 36.5 37.2 24.9 20.2 21.6 36.7 22.0 24.3 16.5 32.4 20.2 18.8 20.3 28.0 22.6 22.3 23.8 21.4 28.4 32.9 36.8 24.7 22.8 39.2 29.6 134.7 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 24 County Health Status Profiles 2014 DEATHS DUE TO CHRONIC LOWER RESPIRATORY DISEASE, 2010-2012 T he crude death rate from chronic lower respiratory disease deaths for California was 34.7 deaths per 100,000 population, a risk of dying from chronic lower respiratory disease equivalent to approximately one death for every 2,878.9 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 13,050.3 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 97.5 in Shasta County to 16.7 in Imperial County, a factor of 5.8 to 1. The age-adjusted death rate from chronic lower respiratory disease deaths for California during the 2010 through 2012 three-year period was 36.2 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 74.0 in Tehama County to 19.6 in Imperial County. A Healthy People 2020 National Objective for deaths due to chronic lower respiratory disease has not been established. The California average age-adjusted death rate from chronic lower respiratory disease for the 2007-2009 period was 38.7. California Department of Public Health 25 County Health Status Profiles 2014 TABLE 12 DEATHS DUE TO CHRONIC LOWER RESPIRATORY DISEASE RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: x COUNTY OF RESIDENCE ALPINE MONO IMPERIAL SAN FRANCISCO MARIN SANTA CLARA LASSEN SANTA BARBARA SAN MATEO SANTA CRUZ ALAMEDA MONTEREY SAN BENITO LOS ANGELES TRINITY ORANGE VENTURA MARIPOSA NAPA CONTRA COSTA SAN DIEGO FRESNO CALIFORNIA PLACER SAN LUIS OBISPO SONOMA EL DORADO TUOLUMNE SACRAMENTO KINGS SOLANO NEVADA MADERA MERCED SAN JOAQUIN CALAVERAS RIVERSIDE AMADOR TULARE INYO MENDOCINO PLUMAS STANISLAUS SUTTER SIERRA YOLO DEL NORTE COLUSA GLENN SAN BERNARDINO HUMBOLDT SISKIYOU BUTTE KERN MODOC YUBA LAKE SHASTA TEHAMA x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: 1,118 0.0 14,305 0.7 4.7 * 177,229 29.7 16.7 813,123 204.3 25.1 254,359 78.0 30.7 1,806,881 413.3 22.9 34,668 7.0 20.2 * 425,756 124.0 29.1 727,980 215.0 29.5 265,569 74.3 28.0 1,526,220 418.0 27.4 419,998 115.7 27.5 55,950 14.0 25.0 * 9,860,836 2,845.7 28.9 13,546 7.0 51.7 * 3,047,120 930.0 30.5 830,215 270.0 32.5 17,977 10.3 57.5 * 137,634 59.7 43.4 1,061,375 382.0 36.0 3,125,321 1,045.7 33.5 939,278 284.0 30.2 37,570,307 13,050.3 34.7 356,367 163.7 45.9 270,119 128.3 47.5 486,778 228.0 46.8 180,663 87.3 48.3 55,041 37.0 67.2 1,430,884 586.3 41.0 151,655 44.0 29.0 414,337 171.0 41.3 98,593 67.7 68.6 152,008 59.3 39.0 259,289 88.7 34.2 692,862 273.3 39.4 45,143 30.7 67.9 2,220,502 976.3 44.0 37,288 29.7 79.6 447,665 169.7 37.9 18,687 14.3 76.7 * 88,071 55.7 63.2 19,953 15.7 78.5 * 518,141 239.0 46.1 94,764 50.7 53.5 3,146 2.3 74.2 * 202,630 91.7 45.2 28,498 17.0 59.7 * 21,502 11.0 51.2 * 28,255 17.0 60.2 * 2,053,348 845.7 41.2 135,218 84.7 62.6 44,875 39.7 88.4 220,521 164.7 74.7 848,839 390.3 46.0 9,565 9.0 94.1 * 72,620 40.0 55.1 64,419 60.7 94.2 178,089 173.7 97.5 63,514 58.3 91.8 AGE-ADJUSTED DEATH RATE NONE 7.9 * 19.6 21.2 22.0 24.5 25.6 * 25.6 25.8 28.6 28.9 29.9 30.5 * 31.1 31.4 * 31.4 32.5 33.0 * 33.6 34.1 34.3 35.7 36.2 37.3 37.3 39.4 41.3 41.5 42.9 43.2 43.3 43.4 43.8 44.3 45.1 45.6 46.1 47.8 47.9 48.5 * 50.0 51.0 * 51.7 52.0 52.1 * 52.3 54.7 * 55.0 * 56.0 * 56.1 56.7 58.2 58.4 62.3 65.4 * 66.6 69.3 70.8 74.0 95% CONFIDENCE LIMITS LOWER 0.0 13.2 18.3 17.4 22.1 10.3 21.0 22.3 22.5 26.0 24.4 16.7 30.0 12.6 29.3 28.6 16.1 25.6 30.6 32.2 31.5 35.6 31.5 30.8 34.1 33.1 29.3 39.4 31.4 36.7 33.7 33.4 35.6 39.7 30.9 43.2 32.2 40.6 26.7 37.7 29.0 45.1 38.7 7.9 42.2 31.9 27.5 32.6 52.3 45.3 41.5 49.4 56.1 29.9 47.6 53.0 60.2 56.3 UPPER 59.2 28.1 24.2 27.5 26.9 52.7 30.2 29.3 35.9 31.7 35.4 51.2 32.3 64.6 33.4 36.4 60.1 43.3 37.5 36.4 39.9 36.8 43.0 43.9 44.6 50.9 57.3 46.4 58.0 49.9 55.1 56.4 54.5 50.5 64.8 49.0 68.3 55.1 80.8 65.0 83.3 58.3 68.4 172.9 64.2 87.6 98.5 89.7 60.0 70.2 79.3 67.5 68.6 124.1 90.7 89.1 81.4 95.6 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 26 County Health Status Profiles 2014 DEATHS DUE TO CHRONIC LIVER DISEASE AND CIRRHOSIS, 2010-2012 T he crude death rate from chronic liver disease and cirrhosis for California was 11.9 deaths per 100,000 population, a risk of dying from chronic liver disease and cirrhosis equivalent to approximately one death for every 8,390.5 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 4,477.7 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 31.6 in Lake County to 9.4 in San Francisco County, a factor of 3.3 to 1. The age-adjusted death rate from chronic liver disease and cirrhosis for California during the 2010 through 2012 three-year period was 11.5 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 23.2 in Lake County to 7.1 in Marin County. One county with a reliable age-adjusted death rate met the Healthy People 2020 National Objective SA-11 of no more than 8.2 age-adjusted deaths due to chronic liver disease and cirrhosis per 100,000 population. An additional three counties with unreliable rates and one county with no deaths due to chronic liver disease and cirrhosis met the objective. The statewide age-adjusted death rate for chronic liver disease and cirrhosis did not meet the national objective. The California average age-adjusted death rate from chronic liver disease and cirrhosis for the 2007-2009 period was 11.4. California Department of Public Health 27 County Health Status Profiles 2014 TABLE 13 DEATHS DUE TO CHRONIC LIVER DISEASE AND CIRRHOSIS RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: x COUNTY OF RESIDENCE ALPINE MONO PLUMAS MARIN GLENN SAN FRANCISCO LASSEN SAN MATEO SANTA CLARA ALAMEDA PLACER CONTRA COSTA ORANGE SAN BENITO MONTEREY VENTURA SAN DIEGO MODOC EL DORADO CALAVERAS NEVADA SACRAMENTO COLUSA CALIFORNIA SIERRA MARIPOSA RIVERSIDE SONOMA SUTTER SAN LUIS OBISPO SOLANO NAPA LOS ANGELES SANTA BARBARA KERN SANTA CRUZ SAN BERNARDINO YOLO AMADOR STANISLAUS MENDOCINO YUBA MERCED MADERA FRESNO IMPERIAL INYO SAN JOAQUIN BUTTE KINGS HUMBOLDT TULARE SHASTA TUOLUMNE DEL NORTE SISKIYOU TEHAMA LAKE TRINITY x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 1,118 0.0 14,305 0.7 4.7 * 19,953 2.0 10.0 * 254,359 25.7 10.1 28,255 2.7 9.4 * HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: SA-11 813,123 76.7 9.4 34,668 3.0 8.7 * 727,980 75.7 10.4 1,806,881 171.0 9.5 1,526,220 149.7 9.8 356,367 39.3 11.0 1,061,375 109.7 10.3 3,047,120 305.7 10.0 55,950 6.0 10.7 * 419,998 41.7 9.9 830,215 91.3 11.0 3,125,321 332.3 10.6 9,565 1.7 17.4 * 180,663 26.3 14.6 45,143 8.0 17.7 * 98,593 14.3 14.5 * 1,430,884 162.0 11.3 21,502 2.7 12.4 * 37,570,307 4,477.7 11.9 3,146 0.7 21.2 * 17,977 3.3 18.5 * 2,220,502 262.7 11.8 486,778 70.3 14.4 94,764 11.7 12.3 * 270,119 41.0 15.2 414,337 55.0 13.3 137,634 18.7 13.6 * 9,860,836 1,232.0 12.5 425,756 53.0 12.4 848,839 97.7 11.5 265,569 38.3 14.4 2,053,348 244.0 11.9 202,630 25.7 12.7 37,288 7.7 20.6 * 518,141 68.3 13.2 88,071 13.7 15.5 * 72,620 9.7 13.3 * 259,289 33.0 12.7 152,008 22.0 14.5 939,278 131.0 13.9 177,229 25.3 14.3 18,687 4.3 23.2 * 692,862 106.3 15.3 220,521 38.7 17.5 151,655 20.3 13.4 135,218 24.7 18.2 447,665 63.7 14.2 178,089 38.0 21.3 55,041 13.0 23.6 * 28,498 6.3 22.2 * 44,875 11.3 25.3 * 63,514 14.3 22.6 * 64,419 20.3 31.6 13,546 3.7 27.1 * AGE-ADJUSTED DEATH RATE 3.0 * 5.7 * 7.1 7.7 * 8.2 8.3 8.8 * 9.0 9.1 9.1 9.2 9.2 9.4 10.0 * 10.2 10.3 10.3 10.4 * 10.4 10.5 * 10.5 * 10.9 11.0 * 11.5 11.6 * 11.7 * 11.8 11.9 11.9 * 12.1 12.2 12.3 * 12.4 12.5 12.7 12.7 13.1 13.2 13.3 * 13.5 13.9 * 13.9 * 14.5 14.9 15.1 15.3 15.6 * 15.7 15.8 16.0 16.3 16.4 16.4 16.6 * 17.5 * 17.5 * 19.5 * 23.2 23.2 * 95% CONFIDENCE LIMITS LOWER 0.0 0.7 4.6 1.4 UPPER 6.5 1.8 7.1 7.7 7.6 6.5 7.5 8.4 3.7 7.3 8.3 9.2 0.9 6.8 4.5 5.8 9.2 2.0 11.1 0.1 2.7 10.4 9.3 6.1 8.7 9.2 7.4 11.7 9.4 10.3 9.0 11.4 8.6 5.6 10.5 7.5 6.6 10.0 9.3 12.5 9.9 4.6 12.7 11.2 9.8 10.5 12.6 11.6 8.8 6.6 8.8 10.7 14.2 5.9 22.1 20.6 10.4 23.9 10.4 25.6 11.3 10.5 10.6 12.5 11.0 10.5 21.7 13.8 12.6 11.5 41.7 15.2 20.7 17.5 12.6 34.0 11.8 86.9 32.5 13.2 15.1 21.0 16.5 15.9 19.3 13.1 16.3 15.5 17.4 14.7 19.4 26.5 17.1 23.5 25.9 20.3 22.6 17.7 22.5 38.7 18.8 21.7 24.6 24.1 20.9 22.6 28.4 37.2 31.1 32.5 35.7 61.8 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 28 County Health Status Profiles 2014 DEATHS DUE TO ACCIDENTS (UNINTENTIONAL INJURIES), 2010-2012 T he crude death rate from accidents (unintentional injuries) for California was 27.7 deaths per 100,000 population, a risk of dying from accidents equivalent to approximately one death for every 3,613.5 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 10,397.3 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 101.9 in Lake County to 19.7 in Los Angeles County, a factor of 5.2 to 1. The age-adjusted death rate from accidents for California during the 2010 through 2012 three-year period was 27.3 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 88.6 in Lake County to 19.5 in Los Angeles County. Twenty-five counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective IVP-11 of no more than 36.0 age-adjusted deaths due to accidents per 100,000 population. An additional three counties with unreliable rates met the objective. The California average age-adjusted death rate from accidents for the 2007-2009 period was 29.9. California Department of Public Health 29 County Health Status Profiles 2014 TABLE 14 DEATHS DUE TO ACCIDENTS (UNINTENTIONAL INJURIES) RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 x COUNTY OF RESIDENCE 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 LOS ANGELES ORANGE ALAMEDA SAN MATEO SANTA CLARA SAN BERNARDINO CONTRA COSTA SANTA BARBARA SONOMA MARIN MONO CALIFORNIA SOLANO VENTURA PLACER NAPA SAN DIEGO IMPERIAL MONTEREY YOLO RIVERSIDE SAN FRANCISCO SACRAMENTO SAN BENITO SANTA CRUZ TULARE SAN LUIS OBISPO INYO FRESNO 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 KINGS STANISLAUS COLUSA EL DORADO NEVADA SIERRA KERN SAN JOAQUIN MADERA SUTTER LASSEN CALAVERAS MERCED MARIPOSA GLENN MENDOCINO AMADOR PLUMAS DEL NORTE TUOLUMNE YUBA SHASTA TRINITY BUTTE TEHAMA SISKIYOU HUMBOLDT MODOC LAKE ALPINE x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 9,860,836 1,940.7 19.7 3,047,120 651.7 21.4 1,526,220 333.3 21.8 727,980 169.7 23.3 1,806,881 415.3 23.0 2,053,348 476.7 23.2 1,061,375 278.3 26.2 425,756 116.0 27.2 486,778 139.3 28.6 254,359 83.3 32.8 14,305 3.3 23.3 * 37,570,307 10,397.3 27.7 414,337 115.0 27.8 830,215 237.0 28.5 356,367 108.0 30.3 137,634 46.7 33.9 3,125,321 976.3 31.2 177,229 51.7 29.2 419,998 127.7 30.4 202,630 58.3 28.8 2,220,502 683.3 30.8 813,123 294.3 36.2 1,430,884 453.7 31.7 55,950 17.3 31.0 * 265,569 89.3 33.6 447,665 139.3 31.1 270,119 104.0 38.5 18,687 7.7 41.0 * 939,278 317.7 33.8 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: IVP-11 151,655 50.7 33.4 518,141 195.0 37.6 21,502 8.3 38.8 * 180,663 76.0 42.1 98,593 45.7 46.3 3,146 1.0 31.8 * 848,839 328.7 38.7 692,862 281.7 40.7 152,008 62.3 41.0 94,764 40.0 42.2 34,668 16.0 46.2 * 45,143 22.0 48.7 259,289 102.3 39.5 17,977 10.7 59.3 * 28,255 14.3 50.7 * 88,071 49.0 55.6 37,288 22.3 59.9 19,953 12.0 60.1 * 28,498 17.7 62.0 * 55,041 35.7 64.8 72,620 41.0 56.5 178,089 115.7 64.9 13,546 9.3 68.9 * 220,521 154.7 70.1 63,514 43.0 67.7 44,875 34.7 77.3 135,218 98.3 72.7 9,565 8.0 83.6 * 64,419 65.7 101.9 1,118 0.7 59.6 * AGE-ADJUSTED DEATH RATE 19.5 20.9 20.9 21.1 22.9 24.8 25.1 26.0 26.2 27.2 27.3 * 27.3 27.6 28.2 28.4 29.6 30.4 30.6 30.9 30.9 31.3 31.5 31.6 32.1 * 32.6 33.7 34.1 35.2 * 36.0 36.0 37.5 38.1 38.1 * 38.4 40.1 41.1 * 41.5 41.8 41.9 42.2 42.4 * 43.7 43.8 45.0 * 49.9 * 51.2 51.7 54.9 * 56.7 * 58.6 58.9 60.3 63.7 * 66.2 66.4 67.6 70.0 74.7 * 88.6 92.8 * 95% CONFIDENCE LIMITS LOWER 18.7 19.3 18.7 17.9 20.7 22.5 22.1 21.2 21.8 21.6 6.3 26.7 22.5 24.5 22.9 21.7 28.4 22.8 25.4 23.5 29.0 27.8 28.7 18.8 26.2 28.0 27.3 14.8 31.9 27.9 32.7 16.8 30.3 29.3 1.0 37.0 36.8 32.2 30.1 24.2 27.4 35.2 22.2 27.5 37.8 32.5 28.4 33.4 41.0 42.2 48.8 29.6 55.3 48.1 47.0 56.8 32.3 68.5 0.5 UPPER 20.4 22.5 23.2 24.3 25.1 27.1 28.1 30.9 30.7 33.7 76.0 27.8 32.8 31.8 33.9 39.4 32.3 40.3 36.3 40.0 33.7 35.1 34.6 51.1 40.1 39.4 40.9 70.2 40.0 49.3 43.5 74.1 48.1 53.6 229.0 46.1 46.7 53.7 57.4 68.8 66.2 52.4 81.2 83.2 67.6 78.1 95.9 90.0 81.2 79.8 71.8 119.5 77.2 89.5 94.2 85.3 147.2 112.8 693.1 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 30 County Health Status Profiles 2014 DEATHS DUE TO MOTOR VEHICLE TRAFFIC CRASHES, 2010-2012 T he crude death rate from motor vehicle traffic crashes for California was 7.4 deaths per 100,000 population, a risk of dying from motor vehicle traffic crashes equivalent to approximately one death for every 13,433.8 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 2,796.7 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 17.7 in Humboldt County to 2.7 in San Francisco County, a factor of 6.5 to 1. The age-adjusted death rate from motor vehicle traffic crashes for California during the 2010 through 2012 three-year period was 7.3 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 17.6 in Humboldt County to 2.6 in San Francisco County. Twenty-two counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective IVP-13.1 of no more than 12.4 age-adjusted deaths due to motor vehicle traffic crashes per 100,000 population. An additional twelve counties with unreliable rates and one county with no deaths due to motor vehicle traffic crashes met the objective. The California average age-adjusted death rate from motor vehicle traffic crashes for the 2007-2009 period was 9.5. California Department of Public Health 31 County Health Status Profiles 2014 TABLE 15 DEATHS DUE TO MOTOR VEHICLE TRAFFIC CRASHES RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 x COUNTY OF RESIDENCE 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 SIERRA SAN FRANCISCO MARIN ALAMEDA SAN MATEO ORANGE SANTA CRUZ SANTA CLARA SONOMA CONTRA COSTA INYO LOS ANGELES SAN DIEGO SANTA BARBARA VENTURA SOLANO CALIFORNIA PLACER SAN LUIS OBISPO SACRAMENTO MONTEREY EL DORADO NAPA YOLO IMPERIAL RIVERSIDE YUBA SAN BERNARDINO PLUMAS SAN JOAQUIN SAN BENITO STANISLAUS LASSEN FRESNO GLENN KERN 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 SHASTA NEVADA TULARE BUTTE MONO MERCED KINGS AMADOR SUTTER TUOLUMNE MADERA MENDOCINO HUMBOLDT MARIPOSA SISKIYOU TEHAMA COLUSA CALAVERAS TRINITY DEL NORTE LAKE MODOC ALPINE * Note: Sources: x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 3,146 0.0 813,123 22.3 2.7 254,359 7.7 3.0 * 1,526,220 67.7 4.4 727,980 32.3 4.4 3,047,120 143.3 4.7 265,569 13.3 5.0 * 1,806,881 92.7 5.1 486,778 26.3 5.4 1,061,375 58.3 5.5 18,687 1.7 8.9 * 9,860,836 621.7 6.3 3,125,321 202.7 6.5 425,756 30.0 7.0 830,215 57.0 6.9 414,337 31.0 7.5 37,570,307 2,796.7 7.4 356,367 26.7 7.5 270,119 22.7 8.4 1,430,884 117.7 8.2 419,998 34.0 8.1 180,663 15.0 8.3 * 137,634 11.7 8.5 * 202,630 17.3 8.6 * 177,229 15.7 8.8 * 2,220,502 209.7 9.4 72,620 6.7 9.2 * 2,053,348 198.7 9.7 19,953 2.3 11.7 * 692,862 73.0 10.5 55,950 6.0 10.7 * 518,141 61.7 11.9 34,668 4.7 13.5 * 939,278 112.7 12.0 28,255 3.3 11.8 * 848,839 103.3 12.2 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: IVP-13.1 178,089 24.7 13.9 98,593 14.0 14.2 * 447,665 59.7 13.3 220,521 32.0 14.5 14,305 1.3 9.3 * 259,289 34.3 13.2 151,655 21.0 13.8 37,288 5.7 15.2 * 94,764 14.0 14.8 * 55,041 9.3 17.0 * 152,008 24.7 16.2 88,071 15.0 17.0 * 135,218 24.0 17.7 17,977 3.3 18.5 * 44,875 10.0 22.3 * 63,514 12.0 18.9 * 21,502 4.0 18.6 * 45,143 8.0 17.7 * 13,546 2.7 19.7 * 28,498 7.0 24.6 * 64,419 16.0 24.8 * 9,565 3.0 31.4 * 1,118 0.3 29.8 * AGE-ADJUSTED DEATH RATE 2.6 3.0 * 4.3 4.4 4.6 4.8 * 5.1 5.2 5.5 6.2 * 6.2 6.3 6.7 6.8 7.2 7.3 7.6 7.7 8.2 8.3 8.4 * 8.4 * 8.5 * 9.1 * 9.5 9.5 * 9.8 10.5 * 10.7 10.9 * 12.0 12.1 * 12.2 12.4 * 12.4 12.4 13.4 13.4 * 13.4 13.7 13.8 * 14.0 14.1 14.3 * 14.7 * 15.1 * 16.4 16.5 * 17.6 18.1 * 19.6 * 19.7 * 19.8 * 20.1 * 22.2 * 23.0 * 24.2 * 26.3 * 42.9 * 95% CONFIDENCE LIMITS LOWER 1.6 1.3 3.4 3.0 3.8 2.6 4.1 3.4 4.2 0.5 5.7 5.4 4.5 5.1 4.9 7.0 5.0 4.9 6.7 5.7 4.7 4.3 5.0 5.2 8.2 3.7 8.4 1.6 8.4 4.0 9.2 3.7 9.9 2.8 10.0 8.6 7.3 10.2 9.4 0.8 9.7 8.7 5.0 8.1 7.0 10.6 9.2 11.2 4.2 9.4 10.2 5.4 8.7 4.0 9.2 13.8 5.4 0.0 UPPER 3.9 6.0 5.5 6.1 5.3 8.2 6.2 7.6 7.1 24.7 6.7 7.2 9.6 8.7 10.2 7.6 11.1 11.6 9.7 11.5 13.9 14.8 13.6 14.9 10.8 19.9 11.2 34.8 13.4 23.7 15.4 29.0 14.5 34.4 14.9 19.8 22.5 17.3 19.4 63.7 19.5 21.5 31.7 24.7 28.4 24.3 27.2 26.1 50.3 36.0 34.4 50.8 39.5 68.9 47.4 39.3 77.0 561.2 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 32 County Health Status Profiles 2014 DEATHS DUE TO SUICIDE, 2010-2012 T he crude death rate from suicide for California was 10.3 deaths per 100,000 population, a risk of dying from suicide equivalent to approximately one death for every 9,663.1 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 3,888.0 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 24.9 in Humboldt County to 7.8 in Los Angeles County, a factor of 3.2 to 1. The age-adjusted death rate from suicide for California during the 2010 through 2012 three-year period was 10.1 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 23.4 in Humboldt County to 7.7 in Los Angeles County. Eight counties with reliable age-adjusted rates and California as a whole met the Healthy People 2020 National Objective MHMD-1 of no more than 10.2 age-adjusted deaths due to suicide per 100,000 population. An additional six counties with unreliable rates and one county with no deaths due to suicide met the objective. The California average age-adjusted death rate from suicide for the 2007-2009 period was 10.0. California Department of Public Health 33 County Health Status Profiles 2014 TABLE 16 DEATHS DUE TO SUICIDE RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER x COUNTY OF RESIDENCE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 ALPINE GLENN IMPERIAL LOS ANGELES KINGS SANTA CLARA FRESNO SAN MATEO ALAMEDA SAN BENITO YOLO MONO MONTEREY ORANGE SAN FRANCISCO CALIFORNIA 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 RIVERSIDE SANTA BARBARA VENTURA TULARE SAN BERNARDINO STANISLAUS CONTRA COSTA SAN JOAQUIN KERN LASSEN SAN DIEGO SUTTER MERCED SOLANO SACRAMENTO NAPA SONOMA MARIN PLACER SANTA CRUZ COLUSA YUBA SAN LUIS OBISPO BUTTE MADERA INYO PLUMAS TUOLUMNE NEVADA MENDOCINO TEHAMA EL DORADO MODOC SISKIYOU SHASTA DEL NORTE HUMBOLDT LAKE SIERRA MARIPOSA AMADOR CALAVERAS TRINITY * Note: Sources: x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 1,118 0.0 28,255 2.0 7.1 * 177,229 12.3 7.0 * 9,860,836 773.3 7.8 151,655 11.7 7.7 * 1,806,881 151.0 8.4 939,278 76.0 8.1 727,980 68.0 9.3 1,526,220 136.0 8.9 55,950 4.7 8.3 * 202,630 17.7 8.7 * 14,305 1.3 9.3 * 419,998 37.7 9.0 3,047,120 294.3 9.7 813,123 88.3 10.9 37,570,307 3,888.0 10.3 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MHMD-1 2,220,502 226.7 10.2 425,756 44.7 10.5 830,215 90.3 10.9 447,665 43.0 9.6 2,053,348 209.0 10.2 518,141 54.0 10.4 1,061,375 118.7 11.2 692,862 71.7 10.3 848,839 92.0 10.8 34,668 4.7 13.5 * 3,125,321 381.0 12.2 94,764 11.3 12.0 * 259,289 28.7 11.1 414,337 52.3 12.6 1,430,884 182.7 12.8 137,634 18.7 13.6 * 486,778 69.0 14.2 254,359 39.7 15.6 356,367 49.0 13.7 265,569 36.3 13.7 21,502 2.7 12.4 * 72,620 10.3 14.2 * 270,119 51.7 19.1 220,521 40.3 18.3 152,008 25.3 16.7 18,687 3.7 19.6 * 19,953 4.0 20.0 * 55,041 11.3 20.6 * 98,593 21.0 21.3 88,071 18.3 20.8 * 63,514 13.0 20.5 * 180,663 38.7 21.4 9,565 2.3 24.4 * 44,875 10.0 22.3 * 178,089 43.3 24.3 28,498 6.7 23.4 * 135,218 33.7 24.9 64,419 18.3 28.5 * 3,146 0.7 21.2 * 17,977 5.0 27.8 * 37,288 12.0 32.2 * 45,143 14.0 31.0 * 13,546 4.0 29.5 * AGE-ADJUSTED DEATH RATE 7.1 * 7.2 * 7.7 7.9 * 8.1 8.4 8.5 8.6 8.9 * 8.9 * 9.1 * 9.1 9.4 9.8 10.1 10.2 10.3 10.4 10.5 10.6 10.6 10.7 10.8 10.9 11.6 11.8 * 11.8 12.2 * 12.2 12.3 12.6 12.7 * 12.8 12.9 13.0 13.4 13.5 * 14.1 * 16.9 17.3 17.4 17.8 * 18.4 * 18.6 * 19.0 19.2 * 19.2 * 19.7 21.4 * 22.2 * 22.6 23.3 * 23.4 24.6 * 25.1 * 25.7 * 26.9 * 28.3 * 28.4 * 95% CONFIDENCE LIMITS LOWER 0.9 3.7 7.2 4.0 6.8 6.6 6.6 7.1 2.7 5.3 0.5 6.4 8.3 7.9 9.8 9.0 7.6 8.5 7.7 9.1 8.0 8.8 8.5 9.4 3.6 10.6 6.1 8.2 9.2 10.7 7.6 9.9 9.2 9.6 9.4 2.4 6.8 12.6 12.4 11.3 4.5 5.0 9.4 11.8 11.4 10.2 14.0 3.2 10.6 16.4 9.1 16.2 14.6 0.1 8.4 13.9 15.4 7.7 UPPER 25.5 12.5 8.3 13.8 9.4 10.5 10.8 10.1 21.2 14.1 41.8 12.5 10.5 12.1 10.5 11.7 14.0 12.9 14.2 12.0 13.9 12.7 13.7 14.3 28.3 13.0 21.6 17.6 16.2 14.4 20.0 16.2 17.7 17.1 18.5 41.7 25.6 22.1 23.6 25.7 47.2 47.2 33.0 29.1 30.2 32.9 26.9 71.0 40.7 30.4 48.8 32.7 38.7 187.5 60.0 47.0 47.4 72.6 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 34 County Health Status Profiles 2014 DEATHS DUE TO HOMICIDE, 2010-2012 T he crude death rate from homicide for California was 5.3 deaths per 100,000 population, a risk of dying from homicide equivalent to approximately one death for every 18,965.3 persons. This rate was based on a 2010 through 2012 threeyear average number of deaths equaling 1,981.0 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 11.9 in San Joaquin County to 2.3 in Orange County, a factor of 5.2 to 1. The age-adjusted death rate from homicide for California during the 2010 through 2012 three-year period was 5.2 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 12.0 in San Joaquin County to 2.2 in Orange County. Six counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective IVP-29 of no more than 5.5 age-adjusted deaths due to homicide per 100,000 population. An additional twenty-six counties with unreliable rates and three counties with no homicide deaths met the objective. The California average age-adjusted death rate from homicide for the 2007-2009 period was 5.9. California Department of Public Health 35 County Health Status Profiles 2014 TABLE 17 DEATHS DUE TO HOMICIDE RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER x COUNTY OF RESIDENCE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 MONO SIERRA ALPINE CALAVERAS GLENN MARIN NAPA YOLO SAN LUIS OBISPO INYO TUOLUMNE PLACER ORANGE SONOMA IMPERIAL VENTURA SANTA BARBARA SANTA CLARA EL DORADO PLUMAS SAN DIEGO NEVADA MARIPOSA SAN MATEO SHASTA HUMBOLDT AMADOR TEHAMA RIVERSIDE BUTTE SANTA CRUZ LASSEN SAN BENITO YUBA SISKIYOU CALIFORNIA 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 SUTTER MENDOCINO MADERA SAN BERNARDINO LOS ANGELES SACRAMENTO KINGS SAN FRANCISCO COLUSA LAKE STANISLAUS CONTRA COSTA MERCED TULARE FRESNO KERN ALAMEDA SOLANO DEL NORTE MONTEREY SAN JOAQUIN MODOC TRINITY * Note: Sources: x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 14,305 0.0 3,146 0.0 1,118 0.0 45,143 0.7 1.5 * 28,255 0.3 1.2 * 254,359 2.7 1.0 * 137,634 1.7 1.2 * 202,630 3.7 1.8 * 270,119 5.7 2.1 * 18,687 0.7 3.6 * 55,041 0.7 1.2 * 356,367 6.7 1.9 * 3,047,120 70.0 2.3 486,778 11.0 2.3 * 177,229 4.3 2.4 * 830,215 20.3 2.4 425,756 11.0 2.6 * 1,806,881 50.7 2.8 180,663 4.7 2.6 * 19,953 0.3 1.7 * 3,125,321 95.0 3.0 98,593 2.7 2.7 * 17,977 0.3 1.9 * 727,980 21.7 3.0 178,089 6.3 3.6 * 135,218 5.0 3.7 * 37,288 1.3 3.6 * 63,514 2.0 3.1 * 2,220,502 92.3 4.2 220,521 10.0 4.5 * 265,569 12.0 4.5 * 34,668 1.7 4.8 * 55,950 2.3 4.2 * 72,620 3.0 4.1 * 44,875 2.0 4.5 * 37,570,307 1,981.0 5.3 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: IVP-29 94,764 5.3 5.6 * 88,071 4.7 5.3 * 152,008 8.7 5.7 * 2,053,348 124.3 6.1 9,860,836 619.3 6.3 1,430,884 87.7 6.1 151,655 9.0 5.9 * 813,123 53.0 6.5 21,502 1.3 6.2 * 64,419 4.0 6.2 * 518,141 36.0 6.9 1,061,375 74.0 7.0 259,289 19.7 7.6 * 447,665 36.0 8.0 939,278 74.7 7.9 848,839 71.0 8.4 1,526,220 133.0 8.7 414,337 36.0 8.7 28,498 2.7 9.4 * 419,998 42.3 10.1 692,862 82.7 11.9 9,565 1.3 13.9 * 13,546 1.7 12.3 * AGE-ADJUSTED DEATH RATE 1.0 * 1.2 * 1.2 * 1.2 * 1.7 * 1.8 * 1.9 * 2.0 * 2.0 * 2.2 2.4 * 2.4 * 2.5 2.6 * 2.8 2.9 * 2.9 * 2.9 3.1 * 3.1 * 3.2 3.7 * 3.9 * 4.0 * 4.0 * 4.2 4.5 * 4.5 * 4.7 * 4.7 * 5.0 * 5.1 * 5.2 5.5 5.6 * 5.8 * 5.8 * 6.0 6.0 6.0 6.0 * 6.1 6.7 * 6.8 * 6.9 7.3 7.4 * 7.7 7.9 8.3 8.5 8.9 9.3 * 9.5 12.0 14.2 * 14.3 * 95% CONFIDENCE LIMITS LOWER 0.0 0.0 0.2 0.1 0.4 0.6 0.0 0.0 0.8 1.8 1.2 0.7 1.5 1.3 2.1 0.9 0.0 2.3 0.6 0.0 2.0 1.4 1.3 0.2 0.5 3.4 2.1 2.3 0.4 0.7 1.0 0.6 4.9 UPPER 1.9 1.8 2.6 4.9 5.5 4.8 2.8 4.5 0.4 1.8 4.8 5.8 4.5 5.4 6.2 6.5 7.1 6.2 1.7 6.8 9.5 0.8 1.3 7.2 15.2 3.6 4.7 4.6 4.1 14.2 14.7 4.2 2.8 4.2 6.0 3.9 4.6 3.7 6.9 37.9 3.6 9.7 40.8 4.9 8.0 9.0 18.4 14.4 5.1 8.2 7.8 18.9 15.6 14.6 18.5 5.4 12.8 13.8 11.1 7.0 6.5 7.4 11.5 7.9 30.8 17.3 9.5 9.2 11.5 10.7 9.9 10.5 10.0 12.3 28.7 12.8 14.9 65.6 57.4 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 36 County Health Status Profiles 2014 DRUG-INDUCED DEATHS, 2010-2012 T he crude death rate from drug-induced deaths for California was 11.2 deaths per 100,000 population, a risk of dying from drug-induced deaths equivalent to approximately one death for every 8,937.4 persons. This rate was based on a 2010 through 2012 three-year average number of deaths equaling 4,203.7 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude rate ranged from 48.1 in Lake County to 6.9 in Los Angeles County, a factor of 6.9 to 1. The age-adjusted death rate from drug-induced deaths for California during the 2010 through 2012 three-year period was 10.8 deaths per 100,000 population. Reliable age-adjusted death rates ranged from 42.6 in Lake County to 6.7 in Los Angeles County. Thirteen counties with reliable age-adjusted death rates and California as a whole met the Healthy People 2020 National Objective SA-12 of no more than 11.3 age-adjusted drug-induced deaths per 100,000 population. An additional seven counties with unreliable age-adjusted death rates and one county with no drug-induced deaths met the objective. The California average age-adjusted death rate from drug-induced deaths for the 2007-2009 period was 11.1. California Department of Public Health 39 County Health Status Profiles 2014 TABLE 19 DRUG-INDUCED DEATHS RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 x COUNTY OF RESIDENCE 20 21 ALPINE COLUSA YUBA LOS ANGELES SAN MATEO SANTA CLARA PLACER TULARE KINGS ALAMEDA DEL NORTE SAN BERNARDINO INYO SAN BENITO ORANGE FRESNO CONTRA COSTA YOLO MONTEREY CALIFORNIA MARIN NAPA 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 SANTA BARBARA IMPERIAL SOLANO MONO RIVERSIDE SAN DIEGO SONOMA VENTURA MERCED SACRAMENTO MENDOCINO SAN LUIS OBISPO NEVADA SUTTER TEHAMA MADERA TRINITY STANISLAUS MARIPOSA SAN FRANCISCO GLENN SAN JOAQUIN SANTA CRUZ KERN EL DORADO LASSEN SISKIYOU AMADOR TUOLUMNE MODOC SHASTA CALAVERAS PLUMAS BUTTE HUMBOLDT SIERRA LAKE * Note: Sources: x 2011 POPULATION 2010-2012 DEATHS (AVERAGE) x CRUDE DEATH RATE 1,118 0.0 21,502 1.0 4.7 * 72,620 5.0 6.9 * 9,860,836 684.3 6.9 727,980 58.3 8.0 1,806,881 142.7 7.9 356,367 28.3 8.0 447,665 32.7 7.3 151,655 13.3 8.8 * 1,526,220 146.3 9.6 28,498 2.7 9.4 * 2,053,348 188.3 9.2 18,687 1.7 8.9 * 55,950 5.7 10.1 * 3,047,120 316.7 10.4 939,278 92.0 9.8 1,061,375 119.3 11.2 202,630 20.0 9.9 419,998 45.0 10.7 37,570,307 4,203.7 11.2 254,359 32.3 12.7 137,634 18.3 13.3 * HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: SA-12 425,756 48.0 11.3 177,229 19.3 10.9 * 414,337 49.0 11.8 14,305 1.7 11.7 * 2,220,502 272.0 12.2 3,125,321 410.0 13.1 486,778 66.7 13.7 830,215 107.3 12.9 259,289 33.0 12.7 1,430,884 209.7 14.7 88,071 14.0 15.9 * 270,119 40.7 15.1 98,593 16.0 16.2 * 94,764 14.3 15.1 * 63,514 9.7 15.2 * 152,008 23.7 15.6 13,546 2.3 17.2 * 518,141 86.0 16.6 17,977 4.7 26.0 * 813,123 169.3 20.8 28,255 4.7 16.5 * 692,862 125.7 18.1 265,569 50.3 19.0 848,839 155.3 18.3 180,663 36.3 20.1 34,668 8.3 24.0 * 44,875 10.0 22.3 * 37,288 10.7 28.6 * 55,041 14.0 25.4 * 9,565 2.3 24.4 * 178,089 50.3 28.3 45,143 12.7 28.1 * 19,953 6.7 33.4 * 220,521 80.7 36.6 135,218 52.3 38.7 3,146 1.0 31.8 * 64,419 31.0 48.1 AGE-ADJUSTED DEATH RATE 4.4 * 6.4 * 6.7 7.3 7.5 7.5 8.2 8.8 * 8.8 9.1 * 9.2 9.2 * 9.6 * 10.0 10.4 10.6 10.6 10.8 10.8 11.3 11.3 * 11.3 11.5 11.5 * 11.6 11.6 * 12.4 12.6 12.7 12.8 14.0 14.3 14.4 * 14.9 15.1 * 15.6 * 16.0 * 16.0 16.1 * 16.6 17.6 * 18.1 18.2 * 18.4 18.8 19.1 19.3 20.7 * 25.2 * 25.4 * 28.0 * 28.2 * 28.2 29.1 * 34.0 * 37.1 37.2 41.1 * 42.6 95% CONFIDENCE LIMITS LOWER 0.1 2.1 6.2 5.6 6.3 5.0 5.7 4.7 7.4 1.6 7.9 0.8 3.4 8.9 8.4 8.6 6.5 7.8 10.5 7.7 6.8 8.5 7.0 8.6 1.0 10.9 11.4 9.8 10.3 9.6 12.3 7.9 10.7 8.6 8.6 7.6 10.2 2.4 13.3 5.4 15.4 5.6 15.2 14.0 16.0 13.5 9.1 12.1 12.5 15.3 4.3 21.0 15.3 13.3 29.4 27.8 1.0 28.9 UPPER 24.2 15.0 7.2 9.5 8.7 10.8 11.6 15.0 10.3 28.3 10.5 36.9 21.3 11.1 12.8 12.5 16.4 14.4 11.1 15.9 17.8 15.3 18.0 15.3 46.7 13.9 13.8 16.1 15.2 19.7 16.2 24.1 20.2 24.5 26.0 29.7 23.9 53.5 20.5 42.3 20.9 43.6 21.7 24.8 22.1 26.6 40.2 46.3 45.9 47.0 93.7 37.2 50.0 71.4 46.1 48.7 229.0 60.4 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, 2010-2012 Death Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 40 County Health Status Profiles 2014 REPORTED INCIDENCE OF AIDS AMONG POPULATION AGES 13 YEARS AND OLDER, 2010-2012 T he crude case rate of reported AIDS cases for Californians, aged 13 years and older, was 8.6 cases per 100,000 of corresponding age population, or approximately one reported AIDS case for every 11,631.8 population, aged 13 years and older. This rate was based on a 2010 through 2012 three-year average reported number of cases of persons aged 13 years and older equaling 2,668.3 and a corresponding age population count of 31,037,119 as of July 1, 2011. Among counties with reliable rates, the crude case rate ranged from 35.1 in San Francisco County to 4.1 in San Mateo County, a factor of 8.4 to 1. Thirteen counties with reliable crude case rates and California as a whole met the Healthy People 2020 National Objective HIV-4 of no more than 12.4 AIDS cases per 100,000 population, aged 13 years and older. An additional thirty-seven counties with unreliable rates and six counties with no new AIDS cases met the objective. The California crude case rate of reported AIDS cases, aged 13 years and older, for the 2007-2009 period was 11.9. California Department of Public Health 41 County Health Status Profiles 2014 TABLE 20 REPORTED INCIDENCE OF AIDS AMONG POPULATION AGES 13 YEARS AND OVER RANKED BY THREE-YEAR AVERAGE CRUDE CASE RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: x COUNTY OF RESIDENCE x 2011 POPULATION AGED 13 AND OVER 2010-2012 CASES (AVERAGE) PLUMAS 17,534 0.0 INYO 16,024 0.0 MONO 12,151 0.0 MODOC 8,136 0.0 SIERRA 2,806 0.0 ALPINE 939 0.0 TEHAMA 52,328 0.3 SAN BENITO 44,934 0.3 CALAVERAS 39,518 0.3 SHASTA 150,412 1.3 MENDOCINO 74,315 0.7 PLACER 296,906 3.7 BUTTE 187,785 2.3 SUTTER 76,331 1.0 DEL NORTE 24,275 0.3 HUMBOLDT 115,709 1.7 GLENN 22,694 0.3 NEVADA 86,147 1.3 EL DORADO 153,567 2.7 YOLO 170,861 3.0 COLUSA 16,973 0.3 AMADOR 33,281 0.7 YUBA 57,371 1.3 SAN LUIS OBISPO 234,643 5.7 LAKE 55,049 1.3 MADERA 121,252 3.3 SANTA BARBARA 356,017 10.0 VENTURA 683,561 19.3 SANTA CRUZ 226,166 6.7 STANISLAUS 414,779 13.3 LASSEN 30,492 1.0 TUOLUMNE 48,619 1.7 MERCED 202,038 7.0 KINGS 121,136 4.3 TULARE 343,324 13.7 MONTEREY 338,637 13.7 SAN MATEO 610,486 25.3 MARIN 216,692 9.7 NAPA 115,842 5.7 SONOMA 412,118 21.3 SISKIYOU 38,426 2.0 SOLANO 344,506 19.0 TRINITY 11,923 0.7 SAN JOAQUIN 551,313 31.0 ORANGE 2,536,793 148.7 SAN BERNARDINO 1,642,434 101.0 RIVERSIDE 1,789,973 112.7 MARIPOSA 15,880 1.0 IMPERIAL 140,958 9.3 CONTRA COSTA 879,963 58.7 SACRAMENTO 1,172,524 78.7 KERN 666,363 47.7 SANTA CLARA 1,489,687 115.3 FRESNO 740,575 63.0 CALIFORNIA 31,037,119 2,668.3 SAN DIEGO 2,607,957 261.0 ALAMEDA 1,278,476 136.0 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: HIV-4 LOS ANGELES 8,206,444 1,041.7 SAN FRANCISCO 731,077 256.3 x 95% CONFIDENCE LIMITS CRUDE CASE RATE LOWER UPPER 0.6 * 0.7 * 0.8 * 0.9 * 0.9 * 1.2 * 1.2 * 1.3 * 1.4 * 1.4 * 1.5 * 1.5 * 1.7 * 1.8 * 2.0 * 2.0 * 2.3 * 2.4 * 2.4 * 2.7 * 2.8 * 2.8 * 2.9 * 3.2 * 3.3 * 3.4 * 3.5 * 3.6 * 4.0 * 4.0 * 4.1 4.5 * 4.9 * 5.2 5.2 * 5.5 * 5.6 * 5.6 5.9 6.1 6.3 6.3 * 6.6 * 6.7 6.7 7.2 7.7 8.5 8.6 10.0 10.6 12.4 12.7 35.1 0.0 0.0 0.0 0.0 0.0 0.3 0.2 0.0 0.0 0.1 0.0 0.1 0.3 0.4 0.0 0.0 0.1 0.9 0.1 0.6 1.3 1.7 1.2 1.7 0.1 0.3 1.4 1.0 2.2 2.2 2.7 2.1 1.7 3.2 0.6 3.3 0.0 3.8 4.9 5.0 5.1 0.2 3.1 5.1 5.3 5.3 6.3 6.5 8.3 8.8 8.8 8.3 9.7 11.0 4.1 6.7 3.3 4.1 7.3 18.0 5.8 19.2 7.1 5.4 5.1 25.7 15.0 10.7 5.4 11.2 7.6 5.2 4.4 6.2 5.5 18.3 13.8 7.1 8.9 6.7 6.8 6.1 8.3 10.9 7.9 18.8 8.6 41.8 8.0 6.8 7.3 7.5 35.1 12.4 8.6 8.4 9.5 9.2 10.9 8.9 11.2 12.4 11.9 30.8 13.5 39.4 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, Office of AIDS, HIV/AIDS Surveillance Section, data as of 12/27/2013. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 42 County Health Status Profiles 2014 REPORTED INCIDENCE OF CHLAMYDIA, 2010-2012 T he crude case rate of reported chlamydia cases for California was 434.5 cases per 100,000 population or approximately one reported chlamydia case for every 230.2 persons. This rate was based on a 2010 through 2012 three-year average reported number of cases equaling 163,240.0 and population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude case rate ranged from 665.1 in Kern County to 142.1 in El Dorado County, a factor of 4.7 to 1. Prevalence data are not available in all California counties to evaluate the Healthy People 2020 National Objective STD-1, as the Health People objective is restricted to females who are 15 to 24 years old and identified at a family planning clinic, and males and females under 24 years old who participate in a national job-training program. The California crude case rate of reported chlamydia cases for the 2007-2009 period was 397.8. California Department of Public Health 43 County Health Status Profiles 2014 TABLE 21 REPORTED INCIDENCE OF CHLAMYDIA RANKED BY THREE-YEAR AVERAGE CRUDE CASE RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x COUNTY OF RESIDENCE x 2011 POPULATION 2010-2012 CASES (AVERAGE) x 95% CONFIDENCE LIMITS CRUDE CASE RATE LOWER UPPER HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: STD-1 NOT APPLICABLE MODOC 9,565 5.3 55.8 * SIERRA 3,146 2.3 74.2 * ALPINE 1,118 1.0 89.4 * MARIPOSA 17,977 18.0 100.1 * TRINITY 13,546 14.3 105.8 * EL DORADO 180,663 256.7 142.1 COLUSA 21,502 30.7 142.6 CALAVERAS 45,143 66.0 146.2 NEVADA 98,593 154.7 156.9 DEL NORTE 28,498 46.7 163.8 AMADOR 37,288 64.7 173.4 SISKIYOU 44,875 79.3 176.8 LASSEN 34,668 64.0 184.6 TUOLUMNE 55,041 104.7 190.2 MONO 14,305 27.3 191.1 PLACER 356,367 701.0 196.7 MARIN 254,359 542.7 213.3 NAPA 137,634 309.3 224.8 INYO 18,687 44.3 237.2 GLENN 28,255 68.3 241.8 SUTTER 94,764 232.7 245.5 PLUMAS 19,953 51.3 257.3 SAN MATEO 727,980 1,909.3 262.3 LAKE 64,419 173.7 269.6 ORANGE 3,047,120 8,240.0 270.4 HUMBOLDT 135,218 380.0 281.0 SONOMA 486,778 1,370.7 281.6 YUBA 72,620 209.0 287.8 TEHAMA 63,514 184.0 289.7 SAN LUIS OBISPO 270,119 785.7 290.9 SHASTA 178,089 527.7 296.3 SANTA CRUZ 265,569 790.3 297.6 VENTURA 830,215 2,475.3 298.2 YOLO 202,630 604.3 298.2 SANTA CLARA 1,806,881 5,579.7 308.8 MENDOCINO 88,071 293.0 332.7 SAN BENITO 55,950 202.7 362.2 KINGS 151,655 552.3 364.2 IMPERIAL 177,229 659.3 372.0 MONTEREY 419,998 1,573.3 374.6 RIVERSIDE 2,220,502 8,328.7 375.1 STANISLAUS 518,141 1,947.0 375.8 CONTRA COSTA 1,061,375 4,046.7 381.3 BUTTE 220,521 845.7 383.5 SANTA BARBARA 425,756 1,644.3 386.2 MERCED 259,289 1,049.3 404.7 TULARE 447,665 1,813.0 405.0 CALIFORNIA 37,570,307 163,240.0 434.5 ALAMEDA 1,526,220 6,730.0 441.0 MADERA 152,008 683.0 449.3 SOLANO 414,337 1,872.7 452.0 SAN DIEGO 3,125,321 15,762.7 504.4 LOS ANGELES 9,860,836 49,907.7 506.1 SAN BERNARDINO 2,053,348 10,423.0 507.6 SAN JOAQUIN 692,862 3,688.7 532.4 SAN FRANCISCO 813,123 4,750.7 584.2 SACRAMENTO 1,430,884 8,625.0 602.8 FRESNO 939,278 6,081.0 647.4 KERN 848,839 5,645.3 665.1 18.9 11.3 2.3 59.3 58.3 124.7 96.7 113.1 132.2 120.2 133.8 140.0 142.2 153.7 126.3 182.1 195.4 199.7 172.6 187.9 214.0 191.8 250.5 229.5 264.6 252.8 266.7 248.8 247.8 270.5 271.0 276.9 286.4 274.5 300.7 294.6 312.4 333.8 343.6 356.1 367.0 359.1 369.5 357.6 367.5 380.2 386.3 432.4 430.4 415.6 431.5 496.5 501.7 497.9 515.2 567.6 590.1 631.1 647.7 126.9 246.3 498.4 158.2 176.5 159.5 202.8 186.0 181.6 218.0 221.2 220.2 235.7 226.6 277.4 211.3 231.3 249.8 318.1 306.4 277.1 338.0 274.0 309.7 276.3 309.3 296.5 326.8 331.6 311.2 321.6 318.3 309.9 322.0 316.9 370.8 412.1 394.6 400.4 393.1 383.1 392.5 393.0 409.3 404.9 429.2 423.6 436.6 451.5 483.0 472.4 512.2 510.6 517.4 549.6 600.9 615.5 663.7 682.4 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health, STD Control Branch (data reported through 08/19/2013). State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 44 County Health Status Profiles 2014 REPORTED INCIDENCE OF GONORRHEA AMONG FEMALES 15 TO 44 YEARS OLD, 2010-2012 T he crude case rate of reported gonorrhea cases among females, aged 15 to 44 years old, for California was 139.6 cases per 100,000 female population, aged 15 to 44 years old, or approximately one reported gonorrhea case for every 716.4 females in the corresponding age group. This rate was based on a 2010 through 2012 three-year average number of reported cases among females, aged 15 to 44, equaling 11,035.7 and a corresponding female population count of 7,905,972 as of July 1, 2011. Among counties with reliable rates, the crude case rate ranged from 330.5 in Sacramento County to 40.9 in San Luis Obispo County, a factor of 8.1 to 1. Twenty-nine counties with reliable crude case rates and California as a whole met the Healthy People 2020 National Objective STD-6.1 of no more than 251.9 new gonorrhea cases per 100,000 female population, aged 15 to 44 years old. An additional twenty-one counties with unreliable rates and five counties with no new gonorrhea cases met the objective. The California crude case rate of reported gonorrhea cases among females, aged 15 to 44 years old, for the 2007-2009 period was 144.6. California Department of Public Health 45 County Health Status Profiles 2014 TABLE 22F REPORTED INCIDENCE OF GONORRHEA AMONG FEMALES 15 TO 44 YEARS OLD RANKED BY THREE-YEAR AVERAGE CRUDE CASE RATE CALIFORNIA COUNTIES, 2010-2012 x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: COUNTY OF RESIDENCE x 2011 FEMALE POPULATION 15 TO 44 YRS OLD x 2010-2012 CASES (AVERAGE) COLUSA 4,096 0.0 PLUMAS 2,795 0.0 TRINITY 1,833 0.0 MODOC 1,405 0.0 ALPINE 146 0.0 LASSEN 4,412 0.3 INYO 2,923 0.3 MONO 2,789 0.3 MARIPOSA 2,522 0.3 DEL NORTE 4,224 0.7 EL DORADO 29,514 8.0 IMPERIAL 35,061 13.7 NEVADA 14,737 6.0 SAN LUIS OBISPO 50,524 20.7 SAN MATEO 143,262 62.0 SISKIYOU 6,560 3.0 NAPA 25,492 12.0 CALAVERAS 6,188 3.0 SONOMA 91,145 46.0 AMADOR 4,570 2.3 YOLO 50,355 26.0 ORANGE 642,422 347.7 KINGS 28,157 15.7 TULARE 92,934 52.7 SANTA CRUZ 55,890 32.0 PLACER 66,179 38.3 SANTA BARBARA 90,660 52.7 MARIN 41,252 24.7 TEHAMA 11,045 7.0 MONTEREY 85,451 55.7 SANTA CLARA 378,109 263.0 VENTURA 165,078 116.7 MERCED 55,180 39.0 BUTTE 43,922 32.7 GLENN 5,242 4.0 SUTTER 18,651 14.3 MENDOCINO 14,919 11.7 SIERRA 388 0.3 STANISLAUS 107,985 94.3 HUMBOLDT 26,923 23.7 SAN BENITO 11,485 10.3 SAN DIEGO 668,318 627.0 RIVERSIDE 460,715 432.7 YUBA 14,874 14.0 TUOLUMNE 7,507 7.3 SAN FRANCISCO 193,957 218.3 CALIFORNIA 7,905,972 11,035.7 SHASTA 31,163 45.3 LOS ANGELES 2,177,768 3,545.7 SAN BERNARDINO 445,096 761.7 MADERA 33,024 58.0 ALAMEDA 333,055 706.0 LAKE 10,178 23.7 CONTRA COSTA 207,726 483.3 SOLANO 81,029 192.0 SAN JOAQUIN 142,823 355.0 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: STD-6.1 KERN 171,920 493.0 FRESNO 198,597 634.3 SACRAMENTO 301,800 997.3 CRUDE CASE RATE 7.6 * 11.4 * 12.0 * 13.2 * 15.8 * 27.1 * 39.0 * 40.7 * 40.9 43.3 45.7 * 47.1 * 48.5 * 50.5 51.1 * 51.6 54.1 55.6 * 56.7 57.3 57.9 58.1 59.8 63.4 * 65.1 69.6 70.7 70.7 74.4 76.3 * 76.9 * 78.2 * 85.8 * 87.4 87.9 90.0 * 93.8 93.9 94.1 * 97.7 * 112.6 139.6 145.5 162.8 171.1 175.6 212.0 232.5 232.7 237.0 248.6 251.9 286.8 319.4 330.5 95% CONFIDENCE LIMITS LOWER 0.0 0.0 0.0 0.0 0.1 11.7 21.1 14.9 25.2 33.2 9.4 24.3 10.0 36.9 7.7 33.7 48.4 31.6 42.4 39.2 41.1 43.5 38.6 25.5 49.2 61.2 57.8 50.3 51.1 20.8 42.4 40.0 0.0 70.6 56.1 43.8 86.5 85.1 51.5 40.3 97.6 137.0 106.2 157.5 159.0 133.4 196.3 148.5 211.9 203.4 222.7 261.4 294.6 310.0 UPPER 98.8 149.1 156.3 172.8 117.9 53.4 65.8 88.6 62.7 55.5 133.6 82.2 141.7 67.3 169.6 75.7 59.8 90.8 74.2 80.8 79.4 76.1 88.5 130.6 84.7 78.0 83.5 96.6 104.6 195.4 128.2 137.6 1121.9 106.9 131.2 163.9 101.2 102.8 157.9 198.1 127.5 142.2 194.4 168.2 183.3 227.0 227.6 346.9 253.4 270.5 274.4 312.1 344.3 351.0 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, STD Control Branch, Data Request, August, 2013. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 46 County Health Status Profiles 2014 REPORTED INCIDENCE OF GONORRHEA AMONG MALES 15 TO 44 YEARS OLD, 2010-2012 T he crude case rate of reported gonorrhea cases among males, aged 15 to 44 years old, for California was 186.6 cases per 100,000 male population, aged 15 to 44 years old, or approximately one reported gonorrhea case for every 535.9 in the corresponding male population. This rate was based on a 2010 through 2012 three-year average number of reported cases equaling 15,390.3 and a corresponding male population count of 8,247,271 as of July 1, 2011. Among counties with reliable rates, the crude case rate ranged from 784.9 in San Francisco County to 46.7 in San Luis Obispo County, a factor of 16.8 to 1. Twenty-three counties with reliable crude case rates and California as a whole met the Healthy People 2020 National Objective STD-6.2 of no more than 194.8 new gonorrhea cases per 100,000 male population, aged 15 to 44 years old. An additional twenty-six counties with unreliable rates and two counties with no new gonorrhea cases met the objective. The California average crude case rate of reported gonorrhea cases among males, aged 15 to 44 years old, for the 2007-2009 period was 160.2. California Department of Public Health 47 County Health Status Profiles 2014 TABLE 22M REPORTED INCIDENCE OF GONORRHEA AMONG MALES 15 TO 44 YEARS OLD RANKED BY THREE-YEAR AVERAGE CRUDE CASE RATE CALIFORNIA COUNTIES, 2010-2012 x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: COUNTY OF RESIDENCE x 2011 MALE POPULATION 15 TO 44 YRS OLD x 2010-2012 CASES (AVERAGE) DEL NORTE 7,118 0.0 ALPINE 158 0.0 MONO 3,350 0.3 COLUSA 4,447 0.7 AMADOR 7,099 1.3 LASSEN 12,185 2.3 CALAVERAS 6,553 1.3 MODOC 1,540 0.3 EL DORADO 31,092 7.3 NEVADA 15,841 4.0 INYO 3,162 1.0 TRINITY 2,093 0.7 MENDOCINO 16,548 6.0 YUBA 15,316 5.7 NAPA 27,355 10.3 MARIPOSA 2,633 1.0 KINGS 42,738 17.0 IMPERIAL 41,242 16.7 TUOLUMNE 10,440 4.3 GLENN 5,561 2.3 PLUMAS 2,936 1.3 SAN LUIS OBISPO 59,919 28.0 SUTTER 19,462 9.7 BUTTE 46,934 24.7 SANTA BARBARA 99,021 54.0 PLACER 65,897 37.7 TULARE 97,510 56.0 SANTA CRUZ 58,428 36.3 MONTEREY 97,953 62.0 MERCED 58,471 37.3 SONOMA 96,493 61.7 SISKIYOU 7,143 4.7 HUMBOLDT 29,633 19.7 VENTURA 173,362 116.0 YOLO 48,881 33.0 TEHAMA 11,584 8.0 SAN BENITO 11,399 8.0 SIERRA 433 0.3 MADERA 30,584 24.0 STANISLAUS 110,265 88.0 MARIN 43,996 37.7 RIVERSIDE 471,217 409.3 SAN MATEO 148,207 137.3 ORANGE 658,082 637.3 SANTA CLARA 399,575 393.3 SHASTA 31,849 34.3 SAN BERNARDINO 454,387 636.7 LAKE 10,885 15.3 CONTRA COSTA 206,487 310.0 SOLANO 86,050 131.7 SAN DIEGO 725,700 1,322.7 CALIFORNIA 8,247,271 15,390.3 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: STD-6.2 SAN JOAQUIN 148,047 292.3 FRESNO 207,653 460.0 ALAMEDA 332,119 800.3 KERN 198,103 484.3 SACRAMENTO 304,979 809.7 LOS ANGELES 2,232,213 6,076.3 SAN FRANCISCO 204,944 1,608.7 CRUDE CASE RATE 10.0 * 15.0 * 18.8 * 19.1 * 20.3 * 21.6 * 23.6 * 25.3 * 31.6 * 31.9 * 36.3 * 37.0 * 37.8 * 38.0 * 39.8 * 40.4 * 41.5 * 42.0 * 45.4 * 46.7 49.7 * 52.6 54.5 57.2 57.4 62.2 63.3 63.8 63.9 65.3 * 66.4 * 66.9 67.5 69.1 * 70.2 * 77.1 * 78.5 79.8 85.6 86.9 92.7 96.8 98.4 107.8 140.1 140.9 * 150.1 153.0 182.3 186.6 194.8 197.5 221.5 241.0 244.5 265.5 272.2 784.9 95% CONFIDENCE LIMITS LOWER 0.0 0.1 1.0 2.9 1.1 0.0 9.7 6.9 0.8 0.2 13.3 13.1 18.4 1.0 23.2 23.4 12.1 6.4 2.5 31.1 23.5 33.9 41.0 40.4 43.4 43.6 48.5 45.0 49.0 20.2 40.3 54.7 46.5 29.8 30.3 0.0 50.3 64.0 60.5 78.5 77.2 89.3 88.7 74.8 129.2 79.4 133.4 126.9 172.4 183.7 174.8 201.3 224.3 222.7 247.2 265.4 746.6 UPPER 130.1 112.0 86.5 63.6 93.7 283.0 47.8 64.7 176.2 238.0 78.9 82.3 68.8 211.6 63.7 65.0 102.7 139.3 209.1 67.5 92.3 77.8 71.2 78.6 74.6 86.0 81.1 87.9 82.0 156.8 102.9 79.1 94.8 136.1 138.3 1007.5 116.8 98.3 117.7 95.3 108.2 104.4 108.2 150.4 151.0 231.1 166.8 179.1 192.1 189.6 220.1 241.8 257.7 266.3 283.8 279.1 823.3 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, STD Control Branch, Data Request, August, 2013. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 48 County Health Status Profiles 2014 REPORTED INCIDENCE OF TUBERCULOSIS, 2010-2012 T he crude case rate of reported tuberculosis cases for California was 6.1 cases per 100,000 population or approximately one reported tuberculosis case for every 16,480.4 persons. This rate was based on a 2010 through 2012 three-year average reported number of cases equaling 2,279.7 and a population count of 37,570,307 as of July 1, 2011. Among counties with reliable rates, the crude case rate ranged from 15.2 in Imperial County to 2.8 in San Bernardino County, a factor of 5.5 to 1. No county with a reliable crude case rate met the Healthy People 2020 National Objective IID-29 of no more than 1.0 new tuberculosis case per 100,000 population. Four counties with unreliable rates and ten counties with no new tuberculosis cases met the objective. The statewide tuberculosis crude case rate did not meet the national objective. The California crude case rate of reported tuberculosis cases for the 2007-2009 period was 7.1. California Department of Public Health 49 County Health Status Profiles 2014 TABLE 23 REPORTED INCIDENCE OF TUBERCULOSIS RANKED BY THREE-YEAR AVERAGE CRUDE CASE RATE CALIFORNIA COUNTIES, 2010-2012 RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Sources: x COUNTY OF RESIDENCE x 2011 POPULATION 2010-2012 CASES (AVERAGE) TUOLUMNE 55,041 0.0 SISKIYOU 44,875 0.0 DEL NORTE 28,498 0.0 PLUMAS 19,953 0.0 MARIPOSA 17,977 0.0 MONO 14,305 0.0 TRINITY 13,546 0.0 MODOC 9,565 0.0 SIERRA 3,146 0.0 ALPINE 1,118 0.0 TEHAMA 63,514 0.3 SHASTA 178,089 1.0 NEVADA 98,593 0.7 BUTTE 220,521 2.0 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: IID-29 EL DORADO 180,663 2.0 PLACER 356,367 5.0 CALAVERAS 45,143 0.7 MENDOCINO 88,071 1.3 SAN LUIS OBISPO 270,119 4.3 HUMBOLDT 135,218 2.3 INYO 18,687 0.3 AMADOR 37,288 0.7 YUBA 72,620 1.3 LASSEN 34,668 0.7 STANISLAUS 518,141 10.7 YOLO 202,630 4.7 SAN BENITO 55,950 1.3 SONOMA 486,778 12.0 LAKE 64,419 1.7 SAN BERNARDINO 2,053,348 57.0 RIVERSIDE 2,220,502 66.0 KINGS 151,655 5.0 SANTA CRUZ 265,569 9.0 NAPA 137,634 5.0 MERCED 259,289 10.3 VENTURA 830,215 34.3 TULARE 447,665 19.3 KERN 848,839 36.7 CONTRA COSTA 1,061,375 49.3 GLENN 28,255 1.3 SACRAMENTO 1,430,884 67.7 FRESNO 939,278 45.0 SUTTER 94,764 4.7 MARIN 254,359 12.7 MONTEREY 419,998 21.3 MADERA 152,008 8.3 SOLANO 414,337 23.7 SANTA BARBARA 425,756 25.0 CALIFORNIA 37,570,307 2,279.7 SAN JOAQUIN 692,862 44.7 ORANGE 3,047,120 208.3 LOS ANGELES 9,860,836 702.0 SAN DIEGO 3,125,321 239.7 COLUSA 21,502 1.7 SAN MATEO 727,980 57.3 ALAMEDA 1,526,220 154.0 SANTA CLARA 1,806,881 183.0 SAN FRANCISCO 813,123 107.3 IMPERIAL 177,229 27.0 x 95% CONFIDENCE LIMITS CRUDE CASE RATE LOWER UPPER 0.5 * 0.6 * 0.7 * 0.9 * 1.0 1.1 * 1.4 * 1.5 * 1.5 * 1.6 * 1.7 * 1.8 * 1.8 * 1.8 * 1.9 * 2.1 * 2.3 * 2.4 * 2.5 * 2.6 * 2.8 3.0 3.3 * 3.4 * 3.6 * 4.0 * 4.1 4.3 * 4.3 4.6 4.7 * 4.7 4.8 4.9 * 5.0 * 5.1 5.5 * 5.7 5.9 6.1 6.4 6.8 7.1 7.7 7.8 * 7.9 10.1 10.1 13.2 15.2 0.0 0.0 0.0 0.1 6.9 3.1 5.1 3.3 0.1 0.5 0.0 0.1 0.5 0.3 0.0 0.0 0.1 0.0 1.0 0.7 0.1 1.3 0.2 2.1 2.3 1.1 1.5 1.2 1.9 2.9 2.6 3.0 3.4 0.3 3.7 3.5 1.5 2.6 3.2 2.4 3.6 3.8 5.8 4.7 5.9 6.6 6.7 0.7 6.0 8.5 8.7 10.7 10.0 4.0 3.3 11.0 7.0 4.0 5.7 23.3 13.4 8.5 14.4 3.7 5.5 11.0 4.3 10.4 3.6 3.8 7.7 6.4 8.5 7.3 5.8 6.7 6.0 6.1 21.7 6.0 6.4 11.8 8.6 7.7 10.7 8.5 8.7 6.3 8.6 7.8 7.6 8.6 31.1 10.2 11.7 11.6 15.7 22.2 Rates are deemed unreliable based on fewer than 20 data elements. Rates, percentages, and confidence limits are not calculated for zero events. Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second by decreasing size of the population. California Department of Public Health, Tuberculosis Control Branch, Report on Tuberculosis in California, 2012. Richmond, CA, July 2013. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 50 County Health Status Profiles 2014 INFANT MORTALITY, ALL RACE/ETHNIC GROUPS, 2009-2011 T he California birth cohort infant death rate for all race/ethnic groups was 4.9 deaths per 1,000 live births, a risk of dying equivalent to approximately one infant death for every 205.3 births in the infant group. This rate was based on 2009 through 2011 three-year average numbers for all race/ethnic groups infant deaths equaling 2,499.3 and live births equaling 513,070. Among counties with reliable rates, the birth cohort infant death rate for all race/ethnic groups ranged from 7.0 in Fresno County to 2.9 in San Mateo County, a factor of 2.4 to 1. Nineteen counties with reliable infant death rates and California as a whole met the Healthy People 2020 National Objective MICH-1.3 of no more than 6.0 infant deaths per 1,000 birth cohort live births. An additional twenty-three counties with unreliable rates and three counties with no infant deaths met the objective. The California birth cohort infant death rate for all race/ethnic groups for the 2006-2008 period was 5.3. California Department of Public Health 51 County Health Status Profiles 2014 TABLE 24A INFANT MORTALITY, ALL RACE/ETHNIC GROUPS RANKED BY THREE-YEAR AVERAGE BIRTH COHORT INFANT DEATH RATE CALIFORNIA COUNTIES, 2009-2011 x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Source: COUNTY OF RESIDENCE THREE-YEAR AVERAGE LIVE BIRTHS INFANT DEATHS MARIPOSA 144.0 0.0 SIERRA 22.3 0.0 ALPINE 4.7 0.0 TUOLUMNE 447.3 1.0 AMADOR 279.0 0.7 SAN MATEO 9,232.0 26.3 TRINITY 116.0 0.3 SANTA CRUZ 3,241.0 9.7 MARIN 2,417.7 7.3 YOLO 2,417.3 7.3 SAN FRANCISCO 8,807.3 27.3 INYO 214.7 0.7 SANTA CLARA 24,265.0 80.7 EL DORADO 1,656.3 5.7 YUBA 1,250.3 5.0 ORANGE 38,928.7 156.3 PLACER 3,821.0 16.3 SAN DIEGO 44,487.3 195.3 VENTURA 11,053.3 49.3 MONO 148.7 0.7 ALAMEDA 19,545.7 87.7 IMPERIAL 3,098.0 14.0 SANTA BARBARA 5,888.7 26.7 MONTEREY 6,883.0 31.7 SUTTER 1,373.0 6.3 SONOMA 5,410.3 25.7 LOS ANGELES 134,447.7 656.3 BUTTE 2,428.7 12.0 CALIFORNIA 513,070.0 2,499.3 CONTRA COSTA 12,365.0 61.7 TULARE 8,162.7 41.0 RIVERSIDE 30,966.3 156.3 NAPA 1,583.3 8.0 MERCED 4,312.3 22.7 SAN LUIS OBISPO 2,661.0 14.0 LASSEN 315.7 1.7 STANISLAUS 7,828.7 41.7 SACRAMENTO 20,164.3 109.7 SOLANO 5,199.3 28.7 GLENN 416.7 2.3 NEVADA 771.3 4.3 HUMBOLDT 1,517.3 8.7 SAN BENITO 753.0 4.3 KINGS 2,572.0 15.3 COLUSA 333.7 2.0 SAN JOAQUIN 10,597.7 64.0 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-1.3 MADERA 2,409.0 14.7 KERN 14,512.3 89.3 SHASTA 2,076.3 13.0 SAN BERNARDINO 31,312.3 203.0 MENDOCINO 1,075.7 7.3 CALAVERAS 336.7 2.3 FRESNO 16,238.0 113.0 SISKIYOU 461.0 3.3 LAKE 722.0 5.3 DEL NORTE 347.3 2.7 PLUMAS 163.0 1.3 TEHAMA 770.0 6.3 MODOC 97.0 1.0 BIRTH COHORT INFANT DEATH RATE 2.2 * 2.4 * 2.9 2.9 * 3.0 * 3.0 * 3.0 * 3.1 3.1 * 3.3 3.4 * 4.0 * 4.0 4.3 * 4.4 4.5 4.5 * 4.5 4.5 * 4.5 4.6 4.6 * 4.7 4.9 4.9 * 4.9 5.0 5.0 5.0 5.1 * 5.3 5.3 * 5.3 * 5.3 5.4 5.5 5.6 * 5.6 * 5.7 * 5.8 * 6.0 * 6.0 * 6.0 6.0 6.1 * 6.2 6.3 * 6.5 6.8 * 6.9 * 7.0 7.2 * 7.4 * 7.7 * 8.2 * 8.2 * 10.3 * 95% CONFIDENCE LIMITS LOWER 0.1 0.0 1.9 0.0 1.4 1.3 1.3 2.1 0.0 2.6 1.2 1.3 3.4 2.5 3.8 3.3 0.0 3.6 2.5 3.0 3.1 1.7 3.1 4.5 2.6 4.7 3.8 3.6 4.3 2.2 3.3 2.9 0.5 3.8 4.4 3.7 0.8 1.6 2.6 1.7 3.4 0.7 4.7 3.4 4.9 3.3 5.6 2.8 1.1 5.7 1.7 2.5 1.4 0.5 3.1 0.3 UPPER 12.5 17.9 4.2 37.6 5.5 6.2 6.2 4.5 23.2 4.1 7.6 9.3 4.6 6.9 5.0 5.9 33.5 5.5 7.6 6.6 6.5 9.8 7.0 5.3 8.6 5.1 6.4 6.8 5.8 10.0 7.9 8.8 21.2 7.2 6.5 7.9 18.6 13.9 11.0 14.2 9.8 21.7 7.7 10.1 7.6 10.7 7.4 13.8 23.0 8.2 20.1 16.8 23.8 37.7 17.6 57.4 Rates, percentages, and confidence limits are not calculated for zero events. Rates are deemed unreliable based on fewer than 20 data elements. Counties were rank ordered first by increasing birth cohort death rate (calculated to 15 decimal places), second by decreasing total number of live births. California Department of Public Health: 2009-2011 Birth Cohort-Perinatal Outcome Files. California Department of Public Health 52 County Health Status Profiles 2014 ASIAN/PACIFIC ISLANDER INFANT MORTALITY, 2009-2011 T he California birth cohort infant death rate for Asian/Pacific Islanders was 3.9 deaths per 1,000 live births, a risk of dying equivalent to approximately one infant death for every 259.4 births in the infant group. This rate was based on 2009 through 2011 three-year average numbers for Asian/Pacific Islanders’ infant deaths equaling 247.0 and live births equaling 64,075.3. Among counties with reliable rates, the birth cohort infant death rate for Asian/Pacific Islanders ranged from 4.3 in San Diego County to 2.5 in Santa Clara County, a factor of 1.7 to 1. Five counties with reliable infant death rates for Asian/Pacific Islanders and California as a whole met the Healthy People 2020 National Objective MICH-1.3 of no more than 6.0 infant deaths per 1,000 birth cohort live births. An additional twenty-two counties with unreliable rates and twenty-six counties with no infant deaths met the objective. The California birth cohort infant death rate for Asian/Pacific Islanders for the 2006-2008 period was 4.5. California Department of Public Health 53 County Health Status Profiles 2014 TABLE 24B ASIAN/PACIFIC ISLANDER INFANT MORTALITY RANKED BY THREE-YEAR AVERAGE BIRTH COHORT INFANT DEATH RATE CALIFORNIA COUNTIES, 2009-2011 x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Source: COUNTY OF RESIDENCE THREE-YEAR AVERAGE LIVE BIRTHS INFANT DEATHS YUBA 114.3 0.0 SANTA CRUZ 91.3 0.0 KINGS 90.0 0.0 SAN LUIS OBISPO 77.7 0.0 HUMBOLDT 50.0 0.0 IMPERIAL 25.0 0.0 DEL NORTE 19.3 0.0 MENDOCINO 14.7 0.0 NEVADA 14.3 0.0 SAN BENITO 14.0 0.0 LASSEN 9.3 0.0 GLENN 9.0 0.0 SISKIYOU 8.3 0.0 TEHAMA 7.3 0.0 TUOLUMNE 7.0 0.0 COLUSA 4.7 0.0 AMADOR 3.3 0.0 CALAVERAS 3.3 0.0 MONO 3.3 0.0 INYO 3.0 0.0 MODOC 2.0 0.0 MARIPOSA 1.3 0.0 TRINITY 1.3 0.0 PLUMAS 0.7 0.0 SIERRA 0.3 0.0 ALPINE 0.0 0.0 SUTTER 203.3 0.3 BUTTE 174.7 0.3 MERCED 344.7 0.7 SAN FRANCISCO 2,640.3 6.3 SANTA CLARA 8,286.0 21.0 SAN MATEO 2,551.3 6.7 KERN 496.3 1.3 NAPA 112.7 0.3 SANTA BARBARA 208.7 0.7 RIVERSIDE 1,663.7 5.3 ORANGE 6,674.7 23.3 YOLO 281.7 1.0 MARIN 187.0 0.7 VENTURA 737.0 2.7 TULARE 257.0 1.0 ALAMEDA 5,482.3 21.3 CONTRA COSTA 1,944.7 7.7 CALIFORNIA 64,075.3 247.0 LOS ANGELES 15,958.7 64.3 SAN DIEGO 4,624.3 20.0 SHASTA 71.7 0.3 SAN BERNARDINO 1,762.0 8.7 FRESNO 1,715.0 9.3 SONOMA 240.3 1.3 SACRAMENTO 3,419.3 19.3 SOLANO 738.3 4.3 STANISLAUS 449.0 2.7 MONTEREY 277.3 1.7 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-1.3 SAN JOAQUIN 1,579.7 10.3 PLACER 300.0 2.3 EL DORADO 77.7 0.7 MADERA 34.0 0.3 LAKE 7.0 0.7 BIRTH COHORT INFANT DEATH RATE 1.6 * 1.9 * 1.9 * 2.4 * 2.5 2.6 * 2.7 * 3.0 * 3.2 * 3.2 * 3.5 3.6 * 3.6 * 3.6 * 3.9 * 3.9 3.9 * 3.9 4.0 4.3 4.7 * 4.9 * 5.4 * 5.5 * 5.7 * 5.9 * 5.9 * 6.0 * 6.0 6.5 * 7.8 * 8.6 * 9.8 * 95.2 * 95% CONFIDENCE LIMITS LOWER 0.0 0.0 0.0 0.9 1.6 1.0 0.1 0.0 0.0 1.1 2.2 0.1 0.0 0.7 0.1 2.4 1.7 3.4 3.1 2.6 0.0 2.2 2.5 0.3 3.4 1.7 1.1 0.5 3.2 1.2 0.0 0.0 0.5 UPPER 21.4 25.0 14.5 5.1 3.9 5.5 12.4 38.7 23.9 7.3 5.2 19.8 26.6 11.2 21.7 5.9 7.9 4.3 5.1 6.7 60.8 9.4 10.2 25.5 8.8 14.5 18.4 24.1 11.9 25.8 64.1 128.2 711.5 Rates, percentages, and confidence limits are not calculated for zero events. Rates are deemed unreliable based on fewer than 20 data elements. Counties were rank ordered first by increasing birth cohort death rate (calculated to 15 decimal places), second by decreasing total number of live births. California Department of Public Health: 2009-2011 Birth Cohort-Perinatal Outcome Files. California Department of Public Health 54 County Health Status Profiles 2014 BLACK INFANT MORTALITY, 2009-2011 T he California birth cohort infant death rate for Blacks was 10.1 deaths per 1,000 live births, a risk of dying equivalent to approximately one infant death for every 99.2 births in the infant group. This rate was based on 2009 through 2011 three-year average numbers of Black infant deaths equaling 280.3 and live births equaling 27,815.3. Among counties with reliable rates, the birth cohort infant death rate for Blacks ranged from 12.1 in San Bernardino County to 10.1 in Los Angeles County, a factor of 1.2 to 1. No county with a reliable infant death rate for Blacks met the Healthy People 2020 National Objective MICH-1.3 of no more than 6.0 infant deaths per 1,000 birth cohort live births. Two counties with unreliable infant death rates and thirty counties with no infant deaths met the objective. The statewide birth cohort Black infant death rate did not meet the national objective. The California birth cohort infant death rate for Blacks for the 2006-2008 period was 12.3. California Department of Public Health 55 County Health Status Profiles 2014 TABLE 24C BLACK INFANT MORTALITY RANKED BY THREE-YEAR AVERAGE BIRTH COHORT INFANT DEATH RATE CALIFORNIA COUNTIES, 2009-2011 x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Source: COUNTY OF RESIDENCE THREE-YEAR AVERAGE LIVE BIRTHS INFANT DEATHS MONTEREY 83.3 0.0 SANTA BARBARA 51.3 0.0 MADERA 33.7 0.0 IMPERIAL 23.7 0.0 SUTTER 23.3 0.0 SANTA CRUZ 15.7 0.0 NAPA 14.3 0.0 HUMBOLDT 11.0 0.0 EL DORADO 10.7 0.0 LAKE 9.3 0.0 MENDOCINO 5.0 0.0 SISKIYOU 3.7 0.0 TEHAMA 3.7 0.0 NEVADA 2.7 0.0 PLUMAS 2.0 0.0 SAN BENITO 1.7 0.0 COLUSA 1.3 0.0 GLENN 1.3 0.0 CALAVERAS 1.0 0.0 INYO 1.0 0.0 LASSEN 1.0 0.0 MARIPOSA 1.0 0.0 TUOLUMNE 1.0 0.0 AMADOR 0.3 0.0 DEL NORTE 0.3 0.0 MONO 0.3 0.0 ALPINE 0.0 0.0 MODOC 0.0 0.0 SIERRA 0.0 0.0 TRINITY 0.0 0.0 VENTURA 115.3 0.3 ORANGE 437.0 2.3 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-1.3 SANTA CLARA 495.3 3.0 SOLANO 679.3 4.7 YOLO 47.0 0.3 TULARE 90.7 0.7 ALAMEDA 2,241.3 17.3 SAN FRANCISCO 463.0 3.7 KERN 815.0 7.0 SAN DIEGO 1,954.0 17.0 CONTRA COSTA 1,104.7 9.7 SAN MATEO 138.7 1.3 PLACER 34.7 0.3 KINGS 103.3 1.0 LOS ANGELES 10,220.0 103.3 CALIFORNIA 27,815.3 280.3 SACRAMENTO 2,170.0 22.3 RIVERSIDE 1,611.7 17.7 SAN BERNARDINO 2,707.3 32.7 SAN JOAQUIN 755.0 10.0 SONOMA 68.0 1.0 MERCED 113.0 1.7 MARIN 44.7 0.7 FRESNO 844.7 15.7 STANISLAUS 163.0 3.7 YUBA 28.7 0.7 SAN LUIS OBISPO 13.3 0.3 SHASTA 21.3 0.7 BUTTE 31.7 1.3 BIRTH COHORT INFANT DEATH RATE 2.9 * 5.3 * 6.0 6.1 * 6.9 * 7.1 * 7.4 * 7.7 * 7.9 * 8.6 * 8.7 * 8.8 * 9.6 * 9.6 * 9.7 * 10.1 10.1 10.3 11.0 * 12.1 13.2 * 14.7 * 14.7 * 14.9 * 18.5 * 22.5 * 23.3 * 25.0 * 31.3 * 42.1 * 95% CONFIDENCE LIMITS LOWER 0.0 0.8 1.2 2.1 0.0 0.0 4.5 2.0 3.5 5.1 4.1 0.5 0.0 0.2 8.2 8.9 6.5 6.5 8.3 6.4 0.4 1.3 0.1 10.5 5.7 0.1 0.0 0.2 2.3 UPPER 37.8 17.7 17.7 16.5 92.7 54.9 12.3 21.1 17.7 13.9 16.3 44.3 125.7 53.9 12.1 11.3 15.5 17.4 17.0 24.4 81.9 59.2 111.5 30.3 59.9 173.7 326.9 233.5 193.9 Rates, percentages, and confidence limits are not calculated for zero events. Rates are deemed unreliable based on fewer than 20 data elements. Counties were rank ordered first by increasing birth cohort death rate (calculated to 15 decimal places), second by decreasing total number of live births. California Department of Public Health: 2009-2011 Birth Cohort-Perinatal Outcome Files. California Department of Public Health 56 County Health Status Profiles 2014 HISPANIC INFANT MORTALITY, 2009-2011 T he California birth cohort infant death rate for Hispanics was 4.7 deaths per 1,000 live births, a risk of dying equivalent to approximately one infant death for every 211.9 births in the infant group. This rate was based on 2009 through 2011 three-year average numbers of Hispanic infant deaths equaling 1,222.3 and live births equaling 259,013.3. Among counties with reliable rates, the birth cohort infant death rate for Hispanics ranged from 6.3 in Fresno County to 3.5 in Santa Clara County, a factor of 1.8 to 1. Fourteen counties with reliable infant death rates for Hispanics and California as a whole met the Healthy People 2020 National Objective MICH-1.3 of no more than 6.0 infant deaths per 1,000 birth cohort live births. An additional twenty-five counties with unreliable rates and nine counties with no infant deaths met the objective. The California birth cohort infant death rate for Hispanics for the 2006-2008 period was 5.2. California Department of Public Health 57 County Health Status Profiles 2014 TABLE 24D HISPANIC INFANT MORTALITY RANKED BY THREE-YEAR AVERAGE BIRTH COHORT INFANT DEATH RATE CALIFORNIA COUNTIES, 2009-2011 x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Source: COUNTY OF RESIDENCE THREE-YEAR AVERAGE LIVE BIRTHS INFANT DEATHS MONO 69.0 0.0 AMADOR 49.7 0.0 CALAVERAS 49.0 0.0 LASSEN 42.3 0.0 MARIPOSA 17.0 0.0 MODOC 11.7 0.0 TRINITY 10.0 0.0 SIERRA 2.3 0.0 ALPINE 0.3 0.0 GLENN 217.3 0.3 SAN MATEO 2,520.3 6.0 BUTTE 452.0 1.3 PLACER 702.0 2.3 SANTA CRUZ 1,849.0 6.3 SANTA CLARA 8,770.3 30.7 SANTA BARBARA 3,938.3 14.3 YOLO 999.7 3.7 SAN DIEGO 19,216.7 72.7 IMPERIAL 2,792.3 11.0 RIVERSIDE 18,257.0 78.0 ORANGE 19,205.0 83.3 YUBA 379.3 1.7 MONTEREY 5,143.0 22.7 ALAMEDA 5,848.0 26.3 SONOMA 2,281.0 10.3 LOS ANGELES 82,030.3 377.7 MERCED 2,777.7 13.0 CALIFORNIA 259,013.3 1,222.3 SAN JOAQUIN 5,276.7 25.3 INYO 69.3 0.3 NAPA 829.0 4.0 SACRAMENTO 5,678.3 27.7 DEL NORTE 67.7 0.3 CONTRA COSTA 4,330.0 21.7 SAN FRANCISCO 1,771.3 9.0 TULARE 5,908.7 30.3 VENTURA 6,648.7 34.7 SOLANO 1,712.3 9.0 SAN LUIS OBISPO 940.3 5.0 NEVADA 124.3 0.7 MADERA 1,767.0 9.7 COLUSA 243.0 1.3 SUTTER 539.3 3.0 MARIN 711.3 4.0 KINGS 1,521.0 8.7 EL DORADO 347.7 2.0 SAN BERNARDINO 18,290.7 109.0 KERN 8,708.3 52.0 MENDOCINO 388.0 2.3 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-1.3 STANISLAUS 4,206.3 26.0 FRESNO 9,709.7 61.0 SAN BENITO 545.0 3.7 HUMBOLDT 216.3 1.7 TEHAMA 266.7 2.3 LAKE 190.3 1.7 SHASTA 213.7 2.0 TUOLUMNE 64.3 0.7 SISKIYOU 79.3 1.0 PLUMAS 18.0 0.7 BIRTH COHORT INFANT DEATH RATE 1.5 * 2.4 * 2.9 * 3.3 * 3.4 * 3.5 3.6 * 3.7 * 3.8 3.9 * 4.3 4.3 4.4 * 4.4 4.5 4.5 * 4.6 4.7 * 4.7 4.8 4.8 * 4.8 * 4.9 4.9 * 5.0 5.1 * 5.1 5.2 5.3 * 5.3 * 5.4 * 5.5 * 5.5 * 5.6 * 5.6 * 5.7 * 5.8 * 6.0 6.0 6.0 * 6.0 6.2 6.3 6.7 * 7.7 * 8.8 * 8.8 * 9.4 * 10.4 * 12.6 * 37.0 * 95% CONFIDENCE LIMITS LOWER 0.0 0.9 0.2 0.5 1.3 2.4 2.0 0.9 3.0 2.0 3.4 3.5 0.4 2.8 3.0 2.2 4.1 2.5 4.5 3.1 0.0 1.3 3.2 0.0 3.1 2.3 3.5 3.6 2.4 1.7 0.0 2.6 0.3 1.1 1.5 2.6 0.7 4.8 4.5 0.9 4.0 4.8 1.7 0.7 1.3 0.8 1.1 0.1 0.3 0.2 UPPER 20.1 5.2 13.6 11.0 7.3 5.0 6.1 9.8 4.8 7.0 5.3 5.4 17.6 6.6 6.6 8.3 5.1 8.0 5.0 7.1 62.9 12.4 7.1 64.4 7.6 9.6 7.3 7.3 10.0 12.4 40.1 10.2 25.3 16.3 14.4 10.9 20.8 7.1 7.8 20.0 9.1 8.1 17.9 30.9 29.1 35.1 33.8 77.4 70.2 276.7 Rates, percentages, and confidence limits are not calculated for zero events. Rates are deemed unreliable based on fewer than 20 data elements. Counties were rank ordered first by increasing birth cohort death rate (calculated to 15 decimal places), second by decreasing total number of live births. California Department of Public Health: 2009-2011 Birth Cohort-Perinatal Outcome Files. California Department of Public Health 58 County Health Status Profiles 2014 WHITE INFANT MORTALITY, 2009-2011 T he California birth cohort infant death rate for Whites was 4.1 deaths per 1,000 live births, a risk of dying equivalent to approximately one infant death for every 246.8 births in the infant group. This rate was based on 2009 through 2011 three-year average numbers of White infant deaths equaling 570.3 and live births equaling 140,769.3. Among counties with reliable rates, the birth cohort infant death rate for Whites ranged from 6.6 in Kern County to 3.0 in Orange County, a factor of 2.2 to 1. Six counties with reliable infant death rates for Whites and California as a whole met the Healthy People 2020 National Objective MICH-1.3 of no more than 6.0 infant deaths per 1,000 birth cohort live births. An additional thirty-three counties with unreliable rates and three counties with no infant deaths met the objective. The California birth cohort infant death rate for Whites for the 2006-2008 period was 4.6. California Department of Public Health 59 County Health Status Profiles 2014 TABLE 24E WHITE INFANT MORTALITY RANKED BY THREE-YEAR AVERAGE BIRTH COHORT INFANT DEATH RATE CALIFORNIA COUNTIES, 2009-2011 x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 * Note: Source: COUNTY OF RESIDENCE THREE-YEAR AVERAGE LIVE BIRTHS INFANT DEATHS MARIPOSA 114.3 0.0 SIERRA 19.0 0.0 ALPINE 2.3 0.0 TUOLUMNE 349.3 0.3 SANTA CRUZ 1,186.3 1.7 MARIN 1,399.3 2.0 SAN FRANCISCO 3,588.7 6.0 YOLO 992.7 1.7 EL DORADO 1,156.7 2.3 SAN MATEO 2,714.0 7.0 ALAMEDA 4,717.3 13.0 VENTURA 3,349.0 10.0 ORANGE 11,497.0 34.7 SANTA CLARA 5,293.3 16.3 STANISLAUS 2,670.3 8.3 IMPERIAL 209.0 0.7 INYO 103.7 0.3 MONTEREY 1,228.3 4.0 HUMBOLDT 1,018.0 3.3 AMADOR 203.0 0.7 YUBA 673.3 2.3 SAN DIEGO 15,001.0 52.7 TRINITY 93.3 0.3 PLACER 2,605.3 9.7 LOS ANGELES 23,089.7 86.7 SAN BENITO 177.3 0.7 CONTRA COSTA 4,158.7 16.0 SACRAMENTO 7,798.0 31.7 SUTTER 567.7 2.3 CALIFORNIA 140,769.3 570.3 TULARE 1,748.3 7.3 SISKIYOU 317.7 1.3 SONOMA 2,554.7 11.0 SOLANO 1,662.3 7.3 LAKE 448.0 2.0 SHASTA 1,638.7 7.7 SAN LUIS OBISPO 1,524.7 7.7 PLUMAS 130.7 0.7 RIVERSIDE 8,288.7 44.0 BUTTE 1,606.0 8.7 LASSEN 240.3 1.3 SAN BERNARDINO 7,747.7 45.3 MERCED 1,000.0 6.0 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-1.3 NEVADA 591.0 3.7 FRESNO 3,369.3 21.0 NAPA 582.0 3.7 SAN JOAQUIN 2,566.7 16.3 KERN 4,122.0 27.0 TEHAMA 457.7 3.0 KINGS 749.7 5.0 MADERA 499.0 3.3 SANTA BARBARA 1,535.3 10.3 MENDOCINO 550.3 4.0 DEL NORTE 201.0 1.7 COLUSA 75.3 0.7 CALAVERAS 260.0 2.3 MONO 71.3 0.7 GLENN 177.7 1.7 MODOC 77.3 1.0 BIRTH COHORT INFANT DEATH RATE 1.0 * 1.4 * 1.4 * 1.7 * 1.7 * 2.0 * 2.6 * 2.8 * 3.0 * 3.0 3.1 * 3.1 * 3.2 * 3.2 * 3.3 * 3.3 * 3.3 * 3.5 * 3.5 3.6 * 3.7 * 3.8 3.8 * 3.8 * 4.1 4.1 * 4.1 4.2 * 4.2 * 4.3 * 4.4 * 4.5 * 4.7 * 5.0 * 5.1 * 5.3 5.4 * 5.5 * 5.9 6.0 * 6.0 6.2 * 6.2 6.3 * 6.4 * 6.6 6.6 * 6.7 * 6.7 * 6.7 * 7.3 * 8.3 * 8.8 * 9.0 * 9.3 * 9.4 * 12.9 * 95% CONFIDENCE LIMITS LOWER 0.0 0.1 0.2 0.6 0.1 0.3 1.0 1.5 1.4 2.1 1.8 1.4 0.0 0.0 0.9 0.8 0.0 0.5 2.6 0.0 1.8 3.0 0.0 2.2 2.8 0.6 3.7 1.7 0.2 2.1 1.8 0.5 2.0 2.1 0.0 3.9 2.4 0.3 4.3 2.2 1.6 3.9 1.6 3.7 4.3 1.4 2.2 1.5 3.3 2.0 0.7 0.0 1.4 0.0 0.8 0.3 UPPER 12.5 5.6 5.2 3.6 6.7 6.7 5.3 4.7 5.5 4.2 5.0 6.1 23.8 42.0 8.3 9.1 24.5 11.5 4.6 46.7 6.9 4.6 28.1 6.2 5.7 13.6 4.4 8.5 19.3 7.7 8.9 16.1 9.3 10.0 38.1 7.1 10.4 25.5 7.8 13.1 16.5 9.5 16.8 10.3 9.5 19.2 15.6 18.6 12.3 18.6 33.3 66.1 29.8 69.8 37.7 72.0 Rates, percentages, and confidence limits are not calculated for zero events. Rates are deemed unreliable based on fewer than 20 data elements. Counties were rank ordered first by increasing birth cohort death rate (calculated to 15 decimal places), second by decreasing total number of live births. California Department of Public Health: 2009-2011 Birth Cohort-Perinatal Outcome Files. California Department of Public Health 60 County Health Status Profiles 2014 LOW BIRTHWEIGHT INFANTS, 2010-2012 T he percentage of low birthweight infants for California was 6.8 per 100 live births, or about one for every 14.8 live births. The 6.8 percentage was based on a 2010 through 2012 three-year average number of low birthweight infants equaling 34,144.0 and live births of 505,237.3. Among counties with reliable percentages, the percent of low birthweight infants ranged from 7.7 in Fresno County to 4.4 in Tuolumne County, a factor of 1.7 to 1. Forty-seven counties with reliable percentages and California as a whole met the Healthy People 2020 National Objective MICH-8.1 of reducing the incidence of low birthweight infants to no more than 7.8 percent of total births. An additional nine counties with unreliable percentages met the objective. The California percentage of low birthweight infants for the 2007-2009 period was 6.8 per 100 live births. California Department of Public Health 61 County Health Status Profiles 2014 TABLE 25 LOW BIRTHWEIGHT INFANTS RANKED BY THREE-YEAR AVERAGE LOW BIRTHWEIGHT PERCENTAGE CALIFORNIA COUNTIES, 2010-2012 x x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x COUNTY OF RESIDENCE 2010-2012 LIVE BIRTHS (AVERAGE) LOW BIRTHWEIGHT LIVE BIRTHS NUMBER PERCENT DEL NORTE 337.0 14.7 CALAVERAS 339.7 15.0 TUOLUMNE 458.7 20.3 TRINITY 118.3 5.3 SIERRA 21.7 1.0 HUMBOLDT 1,503.0 78.7 SAN LUIS OBISPO 2,649.3 144.7 NEVADA 788.0 43.7 IMPERIAL 3,062.3 170.0 YUBA 1,239.3 69.0 MENDOCINO 1,091.0 61.3 SANTA CRUZ 3,168.7 178.3 YOLO 2,405.7 135.7 SONOMA 5,228.3 295.7 BUTTE 2,413.3 139.3 MONTEREY 6,743.0 389.3 MARIN 2,353.0 137.0 GLENN 397.7 23.3 SAN BENITO 735.7 43.3 SANTA BARBARA 5,735.3 338.3 PLACER 3,768.0 222.7 NAPA 1,509.0 89.7 SHASTA 2,089.0 124.7 SUTTER 1,314.7 79.0 STANISLAUS 7,709.0 473.0 TULARE 8,040.3 493.7 TEHAMA 753.3 46.3 MONO 146.0 9.0 COLUSA 318.0 19.7 VENTURA 10,814.3 676.7 EL DORADO 1,586.7 100.3 MODOC 94.0 6.0 LAKE 725.0 46.3 RIVERSIDE 30,528.0 1,957.3 KINGS 2,476.3 159.0 SAN DIEGO 44,283.0 2,865.3 ORANGE 38,174.3 2,471.0 PLUMAS 161.7 10.7 MADERA 2,364.3 157.0 SOLANO 5,088.7 341.3 MERCED 4,280.0 291.3 SAN MATEO 9,139.3 625.3 LASSEN 306.7 21.0 SANTA CLARA 23,963.0 1,641.3 CALIFORNIA 505,237.3 34,144.0 SACRAMENTO 19,885.0 1,362.3 CONTRA COSTA 12,155.7 839.7 KERN 14,416.7 1,007.0 SAN FRANCISCO 8,894.0 623.7 SAN JOAQUIN 10,348.0 727.3 MARIPOSA 146.0 10.3 LOS ANGELES 131,721.3 9,376.3 SAN BERNARDINO 30,876.3 2,221.3 SISKIYOU 469.0 34.3 AMADOR 275.3 20.3 ALAMEDA 19,284.0 1,429.3 FRESNO 16,130.3 1,242.0 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-8.1 INYO 208.0 17.7 ALPINE 6.0 0.7 4.4 * 4.4 * 4.4 4.5 * 4.6 * 5.2 5.5 5.5 5.6 5.6 5.6 5.6 5.6 5.7 5.8 5.8 5.8 5.9 5.9 5.9 5.9 5.9 6.0 6.0 6.1 6.1 6.2 6.2 * 6.2 * 6.3 6.3 6.4 * 6.4 6.4 6.4 6.5 6.5 6.6 * 6.6 6.7 6.8 6.8 6.8 6.8 6.8 6.9 6.9 7.0 7.0 7.0 7.1 * 7.1 7.2 7.3 7.4 7.4 7.7 7.8 8.5 * 11.1 * 95% CONFIDENCE LIMITS LOWER 2.4 2.5 2.7 1.5 0.1 4.1 4.6 4.0 4.7 4.3 4.3 4.8 4.7 5.0 4.8 5.2 4.8 3.7 4.3 5.3 5.1 4.8 4.9 4.8 5.6 5.6 4.5 2.8 3.8 5.8 5.1 2.3 4.7 6.1 5.4 6.2 6.2 3.3 5.6 6.0 6.0 6.3 4.2 6.5 6.7 6.5 6.4 6.6 6.5 6.5 3.4 7.0 6.9 5.1 4.5 7.0 7.3 5.0 0.1 UPPER 7.2 7.3 6.8 10.3 25.7 6.5 6.4 7.4 6.4 7.0 7.2 6.5 6.6 6.3 6.7 6.3 6.8 8.8 7.9 6.5 6.7 7.3 7.0 7.5 6.7 6.7 8.2 11.7 9.6 6.7 7.6 13.9 8.5 6.7 7.4 6.7 6.7 11.9 7.7 7.4 7.6 7.4 10.5 7.2 6.8 7.2 7.4 7.4 7.6 7.5 12.9 7.3 7.5 10.2 11.4 7.8 8.1 13.5 83.0 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing low birthweight percentage (calculated to 15 decimal places), second by decreasing size of the total number of live births. Source: California Department of Public Health: 2010-2012 Birth Statistical Master Files. California Department of Public Health 62 County Health Status Profiles 2014 BIRTHS TO ADOLESCENT MOTHERS, 15 TO 19 YEARS OLD, 2010-2012 T he age-specific birth rate to adolescents, aged 15 to 19 years old, in California was 28.3 per 1,000 female population, aged 15 to 19 years old, or approximately one birth for every 35.3 adolescent females in this age group. This rate was based on a 2010 through 2012 three-year average number of births by females, aged 15 to 19 years old, of 38,792.0 and a female population count, aged 15 to 19 years old, of 1,368,733 as of July 1, 2011. Among counties with reliable rates, the age-specific rate ranged from 53.5 in Tulare County to 9.9 in Marin County, a factor of 5.4 to 1. A Healthy People 2020 National Objective for births to adolescents, aged 15 to 19 years old, has not been established. The California age-specific birth rate to adolescents, aged 15 to 19 years old, for the 2007-2009 period was 37.8 per 1,000 female population in this age group. California Department of Public Health 63 County Health Status Profiles 2014 TABLE 26 BIRTHS TO ADOLESCENT MOTHERS, 15 TO 19 YEARS OLD RANKED BY THREE-YEAR AVERAGE AGE-SPECIFIC BIRTH RATE CALIFORNIA COUNTIES, 2010-2012 x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 COUNTY OF RESIDENCE 2011 FEMALE POPULATION 15-19 YRS OLD x 2010-2012 LIVE BIRTHS (AVERAGE) HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: SIERRA 79 0.7 MARIN 6,754 66.7 PLACER 12,742 148.3 SAN FRANCISCO 17,220 216.7 EL DORADO 6,303 80.7 NEVADA 3,021 44.7 SAN MATEO 21,251 322.3 YOLO 10,022 159.3 SAN LUIS OBISPO 10,328 164.7 TUOLUMNE 1,504 24.0 CONTRA COSTA 37,429 640.0 AMADOR 970 18.3 SANTA CLARA 56,308 1,064.7 SONOMA 16,168 307.3 CALAVERAS 1,380 26.3 MONO 412 8.0 ALAMEDA 47,617 926.0 ORANGE 110,171 2,257.3 NAPA 4,696 100.7 SAN BENITO 2,330 50.3 ALPINE 30 0.7 SANTA CRUZ 10,554 243.3 MARIPOSA 544 12.7 BUTTE 8,457 200.3 SOLANO 14,609 352.3 HUMBOLDT 4,449 107.3 PLUMAS 573 14.3 SAN DIEGO 106,916 2,809.7 VENTURA 31,279 840.0 CALIFORNIA 1,368,733 38,792.0 SACRAMENTO 51,094 1,452.0 RIVERSIDE 93,245 2,658.7 LOS ANGELES 360,060 10,396.3 SANTA BARBARA 18,767 552.7 SUTTER 3,450 101.7 MODOC 300 9.0 SHASTA 5,818 176.0 INYO 576 18.7 SAN JOAQUIN 28,284 949.3 COLUSA 821 28.0 LASSEN 914 31.3 SAN BERNARDINO 87,877 3,128.0 TEHAMA 2,289 81.7 STANISLAUS 20,578 735.3 SISKIYOU 1,236 45.7 MENDOCINO 2,602 97.3 LAKE 1,984 76.3 GLENN 1,063 41.0 TRINITY 396 15.3 YUBA 2,716 111.3 MERCED 11,971 495.0 MONTEREY 15,875 705.7 FRESNO 39,511 1,834.7 MADERA 5,779 286.0 IMPERIAL 7,376 372.0 KINGS 5,323 269.0 DEL NORTE 861 45.3 KERN 34,648 1,843.7 TULARE 19,204 1,027.3 95% CONFIDENCE LIMITS AGE-SPECIFIC BIRTH RATE NONE 8.4 * 9.9 11.6 12.6 12.8 14.8 15.2 15.9 15.9 16.0 17.1 18.9 * 18.9 19.0 19.1 19.4 * 19.4 20.5 21.4 21.6 22.2 * 23.1 23.3 * 23.7 24.1 24.1 25.0 * 26.3 26.9 28.3 28.4 28.5 28.9 29.4 29.5 30.0 * 30.3 32.4 * 33.6 34.1 34.3 35.6 35.7 35.7 36.9 37.4 38.5 38.6 38.7 * 41.0 41.4 44.5 46.4 49.5 50.4 50.5 52.6 53.2 53.5 LOWER 0.0 7.6 9.8 10.9 10.2 10.8 13.5 13.4 13.5 10.2 15.8 11.3 17.8 16.9 12.5 8.4 18.2 19.6 17.2 16.0 0.1 20.2 12.3 20.4 21.6 19.6 13.8 25.3 25.0 28.1 27.0 27.4 28.3 27.0 23.7 13.7 25.8 19.4 31.4 22.7 23.4 34.3 28.4 33.2 27.0 30.3 30.3 27.7 21.8 33.4 37.7 41.2 44.3 43.8 45.3 44.5 38.5 50.8 50.2 UPPER 62.8 12.5 13.5 14.3 15.9 19.8 16.8 18.4 18.4 23.7 18.4 29.7 20.0 21.1 27.9 38.3 20.7 21.3 25.6 28.5 165.7 26.0 40.1 27.0 26.6 28.7 41.7 27.3 28.7 28.6 29.9 29.6 29.4 31.9 35.2 56.9 34.7 50.8 35.7 49.3 48.6 36.8 44.3 38.3 49.3 45.6 48.1 52.3 63.6 48.6 45.0 47.7 48.6 55.2 55.6 56.6 70.4 55.6 56.8 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by increasing age-specific birth rate (calculated to 15 decimal places), second by decreasing size of the population. Sources: California Department of Public Health: 2010-2012 Birth Statistical Master Files. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 64 County Health Status Profiles 2014 PRENATAL CARE BEGUN DURING THE FIRST TRIMESTER OF PREGNANCY, 2010-2012 T he percentage of births to mothers with prenatal care begun during the first trimester of pregnancy for California was 83.6 per 100 live births. The 83.6 percentage was based on a 2010 through 2012 three-year average number of births to mothers with prenatal care begun during the first trimester of pregnancy equaling 413,217.0 and a live births total of 494,298.3. Among counties with reliable percentages, the percent of births to mothers with prenatal care begun during the first trimester of pregnancy ranged from 93.9 in Marin County to 55.7 in Imperial County, a factor of 1.7 to 1. Thirty counties with a reliable percentage and California as a whole met the Healthy People 2020 National Objective MICH-10.1 of achieving the percentage of mothers with prenatal care begun during the first trimester of pregnancy to at least 77.9 percent of total births. The California percentage of births to mothers with prenatal care begun during the first trimester of pregnancy for the 2007-2009 period was 82.7 per 100 live births. California Department of Public Health 65 County Health Status Profiles 2014 TABLE 27A PRENATAL CARE BEGUN DURING THE FIRST TRIMESTER OF PREGNANCY RANKED BY PERCENTAGE OF THREE-YEAR AVERAGE FIRST TRIMESTER CARE CALIFORNIA COUNTIES, 2010-2012 x x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x x COUNTY OF RESIDENCE 2010-2012 LIVE BIRTHS (AVERAGE) x FIRST TRIMESTER CARE TOTAL NUMBER PERCENT NUMBER MARIN 2,335.3 2,194.0 SAN MATEO 9,115.0 8,223.7 ORANGE 37,776.0 33,870.7 ALAMEDA 19,028.3 16,878.0 SAN FRANCISCO 8,838.3 7,822.7 FRESNO 15,221.7 13,438.0 AMADOR 274.3 238.7 LOS ANGELES 126,168.7 107,939.3 PLACER 3,751.7 3,198.3 SANTA CLARA 23,851.0 20,317.3 NAPA 1,492.7 1,269.7 SAN BENITO 731.3 621.3 RIVERSIDE 30,209.7 25,590.0 CONTRA COSTA 12,072.7 10,188.3 CALIFORNIA 494,298.3 413,217.0 SAN DIEGO 44,253.3 36,956.7 SONOMA 5,215.7 4,354.0 SAN BERNARDINO 30,433.0 25,296.3 YOLO 2,364.3 1,955.7 SANTA CRUZ 3,131.3 2,587.0 VENTURA 10,799.3 8,882.3 TUOLUMNE 455.0 372.7 SACRAMENTO 19,220.7 15,639.7 TULARE 7,933.3 6,389.7 SAN LUIS OBISPO 2,633.0 2,116.7 CALAVERAS 338.7 270.3 HUMBOLDT 1,479.7 1,180.3 INYO 205.0 162.3 DEL NORTE 335.0 263.3 EL DORADO 1,577.7 1,239.3 STANISLAUS 7,599.3 5,925.3 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-10.1 SOLANO 5,014.0 3,902.3 SISKIYOU 463.3 357.3 SAN JOAQUIN 10,203.3 7,858.0 MONO 143.0 109.0 KERN 13,727.0 10,418.3 PLUMAS 154.0 116.7 LASSEN 285.7 216.3 KINGS 2,443.7 1,843.3 NEVADA 779.3 584.7 SANTA BARBARA 5,710.7 4,280.3 MADERA 2,292.3 1,714.3 BUTTE 2,383.0 1,776.7 SIERRA 19.3 14.0 MONTEREY 6,563.7 4,744.0 COLUSA 316.0 227.7 MARIPOSA 138.7 99.7 MODOC 92.7 66.3 TEHAMA 750.3 527.0 YUBA 1,233.0 860.3 SUTTER 1,308.3 905.3 LAKE 715.7 489.3 SHASTA 2,062.3 1,408.7 MENDOCINO 1,077.3 729.0 GLENN 393.7 265.0 ALPINE 5.7 3.7 MERCED 4,154.0 2,630.3 TRINITY 116.3 65.3 IMPERIAL 2,911.0 1,622.3 93.9 90.2 89.7 88.7 88.5 88.3 87.0 85.6 85.3 85.2 85.1 85.0 84.7 84.4 83.6 83.5 83.5 83.1 82.7 82.6 82.2 81.9 81.4 80.5 80.4 79.8 79.8 79.2 78.6 78.6 78.0 77.9 77.8 77.1 77.0 76.2 75.9 75.8 75.7 75.4 75.0 75.0 74.8 74.6 72.4 * 72.3 72.0 71.9 71.6 70.2 69.8 69.2 68.4 68.3 67.7 67.3 64.7 * 63.3 56.2 55.7 95% CONFIDENCE LIMITS LOWER 90.0 88.3 88.7 87.4 86.5 86.8 76.0 85.0 82.3 84.0 80.4 78.3 83.7 82.8 83.3 82.7 81.0 82.1 79.0 79.4 80.5 73.6 80.1 78.6 77.0 70.3 75.2 67.0 69.1 74.2 76.0 75.4 69.1 75.3 61.9 74.4 62.0 65.6 72.0 68.9 72.7 71.2 71.1 39.6 70.2 62.7 58.5 55.4 64.2 65.1 64.7 62.3 64.7 62.8 59.2 16.3 60.9 43.4 53.0 UPPER 97.9 92.2 90.6 90.0 90.5 89.8 98.0 86.1 88.2 86.4 89.7 91.6 85.7 86.0 83.9 84.4 86.0 84.1 86.4 85.8 84.0 90.2 82.6 82.5 83.8 89.3 84.3 91.4 88.1 82.9 80.0 80.3 85.1 78.7 90.5 77.4 89.5 85.8 78.9 81.1 77.2 78.3 78.0 100.0 74.3 81.4 87.4 91.0 76.2 74.4 73.7 74.4 71.9 72.6 75.4 100.0 65.7 71.5 58.4 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by decreasing percentage of births to mothers with first trimester care (calculated to 15 decimal places), second by decreasing size of the total number of live births. Source: California Department of Public Health: 2010-2012 Birth Statistical Master Files. California Department of Public Health 66 County Health Status Profiles 2014 ‘ADEQUATE/ADEQUATE PLUS’ PRENATAL CARE (ADEQUACY OF PRENATAL CARE UTILIZATION INDEX), 2010-2012 T he percentage of births to mothers with ‘adequate/adequate plus’ prenatal care for California was 79.5 per 100 live births. The 79.5 percentage was based on a 2010 through 2012 three-year average number of births to mothers with ‘adequate/adequate plus’ prenatal care equaling 388,867.7 and a live births total of 489,055.3. Among counties with reliable percentages, the percent of births to mothers with ‘adequate/adequate plus’ prenatal care ranged from 89.6 in Fresno County to 58.1 in Imperial County, a factor of 1.5 to 1. Twenty-eight counties with reliable percentages and California as a whole met the Healthy People 2020 National Objective MICH-10.2 of increasing the proportion of pregnant women receiving early and adequate prenatal care to 77.6 percent of total births according to the Adequacy of Prenatal Care Utilization Index. Please see Technical Notes, Natality Section, for determination of ‘adequate/adequate plus’ definition and additional clarification. The California percentage of births to mothers with ‘adequate/adequate plus’ prenatal care for the 2007-2009 period was 79.0 per 100 live births. California Department of Public Health 67 County Health Status Profiles 2014 TABLE 27B 'ADEQUATE/ADEQUATE PLUS' PRENATAL CARE (ADEQUACY OF PRENATAL CARE UTILIZATION INDEX) RANKED BY PERCENTAGE OF THREE-YEAR 'ADEQUATE/ADEQUATE PLUS' PRENATAL CARE CALIFORNIA COUNTIES, 2010-2012 x x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x x COUNTY OF RESIDENCE 2010-2012 LIVE BIRTHS (AVERAGE) x ADEQUATE / ADEQUATE PLUS CARE 95% CONFIDENCE LIMITS TOTAL NUMBER NUMBER PERCENT LOWER UPPER FRESNO 14,665.0 13,139.3 ORANGE 37,457.7 33,247.3 SAN LUIS OBISPO 2,618.0 2,266.7 MARIN 2,331.0 2,011.0 AMADOR 273.7 233.3 SANTA CRUZ 3,076.0 2,593.7 SAN MATEO 9,109.0 7,670.0 PLACER 3,748.3 3,127.7 LOS ANGELES 124,414.0 102,491.3 VENTURA 10,791.7 8,879.3 DEL NORTE 333.7 272.3 MONO 142.7 116.3 RIVERSIDE 29,678.0 24,185.0 SANTA BARBARA 5,704.3 4,642.0 TUOLUMNE 453.7 368.0 CALAVERAS 337.3 272.7 SAN FRANCISCO 8,824.3 7,121.7 YOLO 2,360.7 1,895.7 SUTTER 1,307.3 1,044.3 CALIFORNIA 489,055.3 388,867.7 TULARE 7,884.3 6,244.0 COLUSA 315.3 249.3 ALAMEDA 18,890.3 14,905.7 INYO 205.0 161.7 YUBA 1,231.7 970.3 EL DORADO 1,576.0 1,241.3 SACRAMENTO 19,176.7 15,011.7 SAN BENITO 729.3 569.3 GLENN 388.3 302.7 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-10.2 BUTTE 2,361.3 1,831.0 HUMBOLDT 1,454.7 1,127.0 NAPA 1,482.7 1,146.7 SANTA CLARA 23,834.7 18,425.0 CONTRA COSTA 12,059.3 9,237.3 NEVADA 776.0 594.0 SISKIYOU 460.7 352.3 ALPINE 5.7 4.3 SAN BERNARDINO 30,334.0 23,151.0 MENDOCINO 1,067.0 812.0 TEHAMA 749.0 562.0 SONOMA 5,203.3 3,901.0 SAN DIEGO 44,244.7 32,714.3 SHASTA 2,007.0 1,471.0 KERN 13,086.3 9,533.3 KINGS 2,414.0 1,750.3 PLUMAS 151.7 109.0 SAN JOAQUIN 9,884.3 7,095.0 MONTEREY 6,523.3 4,681.0 SIERRA 19.3 13.7 STANISLAUS 7,346.7 5,151.0 MADERA 2,272.7 1,562.0 MARIPOSA 136.3 92.3 SOLANO 5,005.7 3,350.3 LAKE 704.3 466.7 LASSEN 282.7 183.3 MODOC 91.3 59.0 TRINITY 113.0 72.7 MERCED 4,081.0 2,512.7 IMPERIAL 2,879.3 1,672.7 89.6 88.8 86.6 86.3 85.3 84.3 84.2 83.4 82.4 82.3 81.6 81.5 81.5 81.4 81.1 80.8 80.7 80.3 79.9 79.5 79.2 79.1 78.9 78.9 78.8 78.8 78.3 78.1 77.9 77.6 77.5 77.5 77.3 77.3 76.6 76.5 76.5 76.5 * 76.3 76.1 75.0 75.0 73.9 73.3 72.8 72.5 71.9 71.8 71.8 70.7 * 70.1 68.7 67.7 66.9 66.3 64.9 64.6 64.3 61.6 58.1 88.1 87.8 83.0 82.5 74.3 81.1 82.3 80.5 81.9 80.6 71.9 66.7 80.5 79.0 72.8 71.2 78.8 76.7 75.0 79.3 77.2 69.3 77.6 66.7 73.8 74.4 77.0 71.6 69.2 91.1 89.7 90.1 90.0 96.2 87.6 86.1 86.4 82.9 84.0 91.3 96.4 82.5 83.7 89.4 90.4 82.6 83.9 84.7 79.8 81.2 88.9 80.2 91.0 83.7 83.1 79.5 84.5 86.7 74.0 73.0 72.9 76.2 75.0 70.4 68.5 22.3 75.3 70.9 68.8 72.6 73.1 69.5 71.4 69.1 58.4 70.1 69.7 38.3 68.2 65.3 54.6 64.7 60.2 55.5 49.2 50.4 59.2 55.3 81.1 82.0 81.8 78.4 78.2 82.7 84.5 100.0 77.3 81.3 81.2 77.3 74.7 77.0 74.3 75.9 85.4 73.5 73.8 100.0 72.0 72.1 83.0 69.2 72.3 74.2 83.3 80.9 64.0 60.9 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by decreasing percentage of births to mothers with 'adequate/adequate plus' prenatal care (calculated to 15 decimal places), second by decreasing size of the total number of live births. Source: California Department of Public Health: 2010-2012 Birth Statistical Master Files. California Department of Public Health 68 County Health Status Profiles 2014 BREASTFEEDING INITIATION DURING EARLY POSTPARTUM, 2010-2012 T he percentage of breastfed infants in California was 91.6 where the feeding method was known. This percentage was based on a 2010 through 2012 average of 399,368.7 breastfed infants and 435,939.3 births with a known feeding method. Among counties with reliable percentages, the percentages of breastfed infants ranged from 98.6 in Marin County to 80.4 in Kings County, a factor of 1.2 to 1. Fifty-five counties with reliable percentages and California as a whole met the Healthy People 2020 National Objective MICH-21.1 of increasing the proportion of breastfeeding mothers in the early postpartum period, usually 24 to 48 hours since birth, to an 81.9 percentage of total births. An additional county with an unreliable percentage met the objective. Commensurable data for breastfed infants in California for the 2007-2009 period are unavailable. California Department of Public Health 69 County Health Status Profiles 2014 TABLE 28 BREASTFEEDING INITIATION DURING EARLY POSTPARTUM RANKED BY THREE YEAR AVERAGE BREASTFEEDING INITIATION PERCENTAGE CALIFORNIA COUNTIES, 2010-2012 x x x RANK ORDER x COUNTY OF RESIDENCE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 2010-2012 BIRTHS (AVERAGE) WITH KNOWN FEEDING METHOD TOTAL NUMBER 95% CONFIDENCE LIMITS BREASTFED NUMBER MARIN 2,004.0 1,975.7 SANTA CRUZ 2,654.7 2,604.3 SONOMA 4,540.0 4,403.0 MONO 121.0 117.3 SAN MATEO 8,171.3 7,921.3 SIERRA 10.7 10.3 TRINITY 93.3 90.3 SAN LUIS OBISPO 2,338.0 2,260.7 NAPA 1,252.7 1,209.0 MONTEREY 5,658.7 5,461.0 NEVADA 659.0 635.7 ALAMEDA 16,400.3 15,796.0 SAN FRANCISCO 7,796.0 7,507.0 SANTA CLARA 20,731.0 19,935.3 INYO 184.3 176.7 SAN BENITO 592.7 567.3 EL DORADO 1,356.0 1,297.7 CONTRA COSTA 10,351.0 9,884.0 TUOLUMNE 403.3 384.7 SANTA BARBARA 4,975.3 4,737.0 MENDOCINO 945.3 899.7 YOLO 2,194.0 2,086.3 PLUMAS 108.7 103.3 PLACER 3,229.0 3,063.7 SAN DIEGO 34,525.3 32,750.0 VENTURA 9,398.3 8,911.7 HUMBOLDT 1,329.7 1,251.7 SHASTA 1,790.0 1,677.3 CALAVERAS 293.7 275.0 MARIPOSA 129.3 121.0 LASSEN 236.3 220.7 AMADOR 251.3 234.7 SOLANO 3,984.3 3,719.3 ORANGE 34,489.7 32,112.3 GLENN 363.0 336.3 CALIFORNIA 435,939.3 399,368.7 36 TEHAMA 703.7 643.3 37 RIVERSIDE 26,173.0 23,914.0 38 LAKE 603.0 549.3 39 SISKIYOU 328.3 299.0 40 LOS ANGELES 116,534.0 105,700.7 41 BUTTE 2,130.0 1,930.7 42 MADERA 2,092.0 1,895.7 43 SACRAMENTO 17,415.7 15,698.3 44 MODOC 33.3 30.0 45 DEL NORTE 303.0 271.3 46 IMPERIAL 2,688.3 2,402.0 47 MERCED 3,728.3 3,301.7 48 SUTTER 1,139.3 1,007.7 49 COLUSA 260.7 228.3 50 SAN JOAQUIN 8,494.0 7,387.7 51 SAN BERNARDINO 26,076.7 22,552.0 52 STANISLAUS 6,793.3 5,863.7 53 YUBA 1,063.3 909.3 54 KERN 12,434.7 10,579.7 55 TULARE 7,121.0 5,995.3 56 FRESNO 14,357.3 11,940.0 HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: MICH-21.1 57 KINGS 1,901.3 1,529.0 58 ALPINE 3.7 2.7 PERCENT 98.6 98.1 97.0 97.0 96.9 96.9 * 96.8 96.7 96.5 96.5 96.5 96.3 96.3 96.2 95.8 95.7 95.7 95.5 95.4 95.2 95.2 95.1 95.1 94.9 94.9 94.8 94.1 93.7 93.6 93.6 93.4 93.4 93.3 93.1 92.7 91.6 91.4 91.4 91.1 91.1 90.7 90.6 90.6 90.1 90.0 89.5 89.3 88.6 88.4 87.6 87.0 86.5 86.3 85.5 85.1 84.2 83.2 81.9 80.4 72.7 * LOWER UPPER 76.4 13.1 84.4 100.0 94.2 94.3 94.1 79.4 94.8 47.1 77.9 92.7 91.1 93.9 89.0 94.8 94.1 94.8 81.7 87.8 90.5 93.6 85.8 92.5 89.0 91.0 76.8 91.5 93.8 92.9 88.9 89.2 82.6 76.9 81.1 81.4 90.3 92.1 82.8 91.3 84.4 90.2 83.5 80.7 90.2 86.6 86.5 88.7 60.7 78.9 85.8 85.5 83.0 76.2 85.0 85.4 84.1 80.0 83.5 82.1 81.7 100.0 100.0 99.8 100.0 99.1 100.0 100.0 100.0 100.0 99.1 100.0 97.8 98.5 97.5 100.0 100.0 100.0 97.4 100.0 97.9 100.0 99.2 100.0 98.2 95.9 96.8 99.3 98.2 100.0 100.0 100.0 100.0 96.3 94.1 100.0 91.9 98.5 92.5 98.7 100.0 91.3 94.7 94.7 91.5 100.0 100.0 92.9 91.6 93.9 99.0 89.0 87.6 88.5 91.1 86.7 86.3 84.7 * Rates are deemed unreliable based on fewer than 20 data elements. Note: Counties were rank ordered first by decreasing breastfed percentage (calculated to 15 decimal places), second by decreasing number of births. Sources: California Department of Public Health, Center for Family Health, Genetic Disease Screening Program, Newborn Screening Data, 2010-2012. California Department of Public Health, Center for Family Health, Maternal, Child and Adolescent Health Program. California Department of Public Health 70 County Health Status Profiles 2014 PERSONS UNDER 18 IN POVERTY, 2011 C alifornians under 18 years of age living in poverty represent 22.6 percent of the population of persons under 18 years of age. This percentage is based on the U.S. Census Bureau, American Community Survey 2011 estimate of persons under 18 years of age, living in poverty, of 2,085,229 and a California Department of Finance corresponding population count of 9,214,425 as of July 1, 2011. All counties demonstrated reliable percentages for persons less than 18 years of age in poverty. The percentages ranged from 35.6 in Merced County to 9.8 in Placer County and San Mateo County, a factor of 3.6 to 1. A Healthy People 2020 National Objective for persons under 18 years of age in poverty has not been established. Californians under 18 years of age in poverty was 21.8 percent for 2010. California Department of Public Health 71 County Health Status Profiles 2014 TABLE 29 PERSONS UNDER 18 IN POVERTY RANKED BY PERCENTAGE OF CENSUS POPULATION UNDER 18 BELOW POVERTY CALIFORNIA COUNTIES, 2011 x x RANK ORDER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 x COUNTY OF RESIDENCE 2011 POPULATION UNDER 18 IN POVERTY NUMBER HEALTHY PEOPLE 2020 NATIONAL OBJECTIVE: SAN MATEO 160,750 15,751 PLACER 85,424 8,387 MARIN 51,983 5,618 SANTA CLARA 432,604 53,621 EL DORADO 40,109 5,309 CONTRA COSTA 258,003 37,692 SAN FRANCISCO 112,549 17,137 SONOMA 105,483 16,590 VENTURA 208,859 33,696 MONO 2,996 487 NAPA 31,219 5,150 ALAMEDA 341,530 56,573 SAN LUIS OBISPO 50,670 8,594 NEVADA 18,477 3,170 SAN BENITO 15,728 2,768 ORANGE 728,891 129,549 SANTA CRUZ 55,764 9,941 SOLANO 99,231 18,147 LASSEN 6,095 1,128 AMADOR 6,120 1,155 SAN DIEGO 723,802 137,647 SIERRA 508 99 COLUSA 6,264 1,229 CALAVERAS 8,594 1,701 YOLO 44,868 8,951 SANTA BARBARA 98,295 19,904 INYO 3,816 791 PLUMAS 3,503 753 CALIFORNIA 9,214,425 2,085,229 RIVERSIDE 615,707 141,314 TUOLUMNE 9,458 2,238 MONTEREY 111,651 27,097 SUTTER 25,548 6,248 MARIPOSA 3,136 767 SHASTA 39,287 9,651 SACRAMENTO 360,838 89,099 SAN JOAQUIN 199,369 49,527 HUMBOLDT 26,890 6,797 ALPINE 239 61 LOS ANGELES 2,357,593 606,778 SAN BERNARDINO 587,130 152,754 GLENN 7,776 2,050 YUBA 20,727 5,565 BUTTE 46,265 12,426 TEHAMA 15,769 4,288 KINGS 41,508 12,386 MODOC 2,072 635 MENDOCINO 19,200 5,931 SISKIYOU 9,107 2,835 STANISLAUS 145,606 45,615 IMPERIAL 51,037 16,795 LAKE 13,319 4,399 MADERA 42,605 14,213 DEL NORTE 5,949 1,989 TRINITY 2,380 798 TULARE 143,355 48,335 KERN 252,109 87,025 FRESNO 276,363 97,470 MERCED 80,297 28,605 95% CONFIDENCE LIMITS PERCENT NONE 9.8 9.8 10.8 12.4 13.2 14.6 15.2 15.7 16.1 16.3 16.5 16.6 17.0 17.2 17.6 17.8 17.8 18.3 18.5 18.9 19.0 19.5 19.6 19.8 19.9 20.2 20.7 21.5 22.6 23.0 23.7 24.3 24.5 24.5 24.6 24.7 24.8 25.3 25.6 25.7 26.0 26.4 26.8 26.9 27.2 29.8 30.7 30.9 31.1 31.3 32.9 33.0 33.4 33.4 33.5 33.7 34.5 35.3 35.6 LOWER 9.6 9.6 10.5 12.3 12.9 14.5 15.0 15.5 16.0 14.8 16.0 16.4 16.6 16.6 16.9 17.7 17.5 18.0 17.4 17.8 18.9 15.8 18.5 18.9 19.5 20.0 19.3 20.0 22.6 22.8 22.7 24.0 23.8 22.7 24.1 24.5 24.6 24.7 19.6 25.7 25.9 25.2 26.1 26.4 26.4 29.3 28.3 30.1 30.0 31.0 32.4 32.1 32.8 32.0 31.2 33.4 34.3 35.0 35.2 UPPER 10.0 10.0 11.1 12.5 13.6 14.8 15.5 16.0 16.3 17.7 16.9 16.7 17.3 17.8 18.3 17.9 18.2 18.6 19.6 20.0 19.1 23.7 20.7 20.7 20.4 20.5 22.2 23.0 22.7 23.1 24.6 24.6 25.1 26.2 25.1 24.9 25.1 25.9 32.8 25.8 26.1 27.5 27.6 27.3 28.0 30.4 33.0 31.7 32.3 31.6 33.4 34.0 33.9 34.9 35.9 34.0 34.7 35.5 36.0 Note: Counties were rank ordered first by increasing percentage of persons under 18 in poverty (calculated to 15 decimal places), second by decreasing size of the same age group population. Percentage based on the population under 18 years of age for which the poverty status was determined and excludes persons of unknown poverty status. Sources: U.S. Census Bureau, Small Area Income and Poverty Estimates. http://www.census.gov/did/www/saipe/data/statecounty/data/2011.html Accessed December, 2013. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health 72 County Health Status Profiles 2014 TABLE 30 A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA AGE-ADJUSTED DEATH RATES ALL CANCERS (THREE-YEAR AVERAGES) 2007-2009 161.0 157.5 88.4 * 164.0 192.4 163.1 142.2 163.0 197.9 167.3 160.3 175.7 192.6 138.4 138.5 172.9 160.9 197.3 115.7 156.5 153.9 141.5 171.3 167.4 160.6 152.4 102.8 * 139.9 179.1 154.0 152.7 171.1 149.7 164.6 173.1 169.7 172.1 165.7 155.3 173.0 159.6 152.0 154.6 144.1 159.6 198.3 127.5 * 188.9 177.7 176.4 171.9 155.9 205.8 202.1 163.1 165.8 155.2 165.0 205.4 2010-2012 153.3 149.3 343.4 * 181.0 180.8 161.7 175.1 153.2 188.5 148.7 149.6 159.4 176.2 135.8 132.9 157.0 143.6 195.9 128.8 149.3 148.6 144.3 138.9 164.4 161.1 159.7 58.9 * 146.2 166.3 154.9 144.8 153.3 138.8 157.0 171.8 150.0 167.0 158.7 148.9 169.9 150.2 142.9 141.8 136.5 144.3 182.7 81.3 * 188.1 175.6 162.2 163.1 160.6 188.4 178.8 153.5 156.5 141.4 155.4 182.6 AGE-ADJUSTED DEATH RATES COLORECTAL CANCER (THREE-YEAR AVERAGES) 2007-2009 15.1 16.1 15.2 * 14.7 16.3 * 13.3 * 16.8 16.1 * 12.9 13.8 15.0 * 17.1 9.9 * 16.9 * 14.5 15.1 * 16.1 * 7.8 * 15.6 19.0 13.6 7.9 * 15.4 * 15.5 18.2 * 15.3 * 11.4 16.9 13.4 13.5 14.0 13.5 * 16.2 16.0 12.1 * 16.6 14.6 14.7 14.2 12.6 15.4 12.3 13.7 13.7 16.8 4.5 * 19.0 * 16.4 15.4 18.5 12.8 * 15.8 * 13.3 * 13.3 14.3 * 15.6 15.9 17.9 * 2010-2012 14.2 13.7 26.3 * 12.4 * 13.9 13.5 * 5.7 * 14.8 16.2 * 13.8 13.5 12.4 * 15.1 13.7 14.7 * 13.8 11.0 * 16.7 * 11.2 * 14.4 13.7 * 10.8 4.9 * 15.6 * 18.0 26.7 * 6.2 * 10.6 13.2 11.5 * 12.4 11.9 12.4 * 16.2 16.1 11.6 * 17.8 14.4 15.5 15.0 13.0 12.8 13.2 12.4 12.5 17.4 13.4 * 15.4 13.9 17.4 11.5 * 18.5 * 10.1 * 13.3 16.3 * 13.0 12.7 15.3 * AGE-ADJUSTED DEATH RATES LUNG CANCER (THREE-YEAR AVERAGES) 2007-2009 38.8 37.0 23.8 * 43.3 52.9 48.2 52.5 * 38.3 58.4 * 41.5 39.2 55.9 * 50.3 29.3 38.0 * 47.5 38.0 63.5 32.7 * 34.4 35.6 30.4 59.6 * 41.0 44.9 49.9 * 23.1 * 31.6 46.5 38.2 36.7 42.0 35.9 * 41.1 46.9 35.6 * 42.0 39.9 37.5 48.0 40.6 35.2 35.5 32.3 36.6 60.4 28.9 * 57.2 46.6 43.1 45.8 48.9 60.6 72.8 * 43.4 47.2 36.2 42.0 76.9 2010-2012 34.8 32.9 33.1 * 51.0 45.1 37.1 54.7 * 36.3 61.9 32.4 35.3 35.3 * 42.8 28.2 40.2 * 40.6 33.1 55.1 34.1 * 31.4 38.5 32.5 44.0 * 42.2 39.5 29.4 * 6.9 * 33.8 37.4 34.0 32.7 33.1 31.0 * 37.6 43.6 31.5 * 38.8 36.1 34.7 45.7 33.5 31.4 29.2 28.1 26.3 43.3 17.9 * 51.4 44.1 38.9 40.3 47.1 53.0 50.2 * 40.1 34.9 28.8 32.1 50.4 ottee * Rates and percentages are deemed unreliable based on fewer than 20 data elements. ottee - Rates and percentages are not calculated for zero events. Note: Age-adjusted death rates are per 100,000 population and exclude multiple causes of death. California Department of Public Health 73 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA AGE-ADJUSTED DEATH RATES FEMALE BREAST CANCER (THREE-YEAR AVERAGES) 2007-2009 22.1 21.4 25.0 * 26.1 24.5 * 14.0 * 22.8 18.5 * 22.6 20.8 16.2 * 29.5 17.0 * 22.2 * 22.7 24.8 * 16.8 * 11.5 * 22.4 14.5 * 19.3 29.1 * 27.9 * 20.5 18.3 * 25.6 * 19.7 18.6 * 22.4 * 20.9 22.2 29.6 * 24.4 21.7 25.7 * 24.6 23.0 18.3 22.4 22.0 19.7 18.8 19.6 25.2 21.1 10.1 * 23.6 * 22.6 25.3 24.4 20.2 * 23.4 * 22.4 * 20.4 18.7 * 20.6 23.4 21.8 * 2010-2012 20.9 21.0 32.2 * 23.0 23.6 * 26.2 * 22.2 21.3 * 18.3 19.0 20.2 * 23.1 * 20.7 * 17.4 * 20.2 21.0 * 22.9 * 10.4 * 21.4 14.9 * 19.2 10.0 * 20.6 * 20.7 27.2 * 3.1 * 20.3 19.4 * 16.8 * 19.5 26.0 8.8 * 20.8 22.0 19.5 * 23.6 21.6 17.7 21.5 22.1 19.6 17.7 17.8 24.1 23.3 8.3 * 28.0 * 23.4 24.8 18.6 16.9 * 17.2 * 5.7 * 19.2 15.7 * 21.5 15.8 * 21.1 * AGE-ADJUSTED DEATH RATES PROSTATE CANCER (THREE-YEAR AVERAGES) 2007-2009 22.7 24.9 89.3 * 17.4 * 30.2 27.6 * 16.4 * 22.5 23.9 * 24.9 * 21.2 26.2 * 25.4 * 24.3 * 11.2 * 27.0 24.4 * 19.0 * 11.2 * 23.0 25.1 * 21.8 36.9 * 24.4 * 21.2 * 14.8 * 9.9 * 21.3 22.9 * 19.1 * 21.3 23.7 33.7 * 22.8 22.5 6.0 * 27.1 23.7 16.6 21.2 22.1 19.5 25.5 16.9 19.0 * 25.7 12.7 * 29.6 * 25.1 25.9 24.6 23.6 * 31.3 * 20.1 * 21.7 23.5 * 24.1 21.8 * 20.4 * 2010-2012 20.5 20.3 23.6 * 24.6 21.1 * 19.5 * 21.3 23.3 * 17.0 * 18.2 9.9 * 23.7 * 21.2 * 26.5 * 22.8 21.3 * 27.1 * 4.1 * 20.3 16.0 * 16.3 15.0 * 15.2 * 17.7 * 11.3 * 9.7 * 21.0 22.1 * 28.1 * 19.1 18.8 7.6 * 22.0 20.7 39.0 * 24.5 22.4 16.2 22.3 22.0 19.2 22.6 17.1 20.2 23.4 40.4 * 24.8 * 23.8 19.1 19.6 21.9 * 23.7 * 19.0 * 22.3 14.5 * 19.4 19.8 * 28.7 * AGE-ADJUSTED DEATH RATES DIABETES (THREE-YEAR AVERAGES) 2007-2009 21.2 21.8 23.8 * 10.6 * 16.4 16.4 * 9.3 * 17.9 20.7 * 12.8 29.2 26.7 * 24.5 35.7 14.5 * 32.9 34.4 18.8 * 28.0 * 24.1 21.6 8.9 18.0 * 14.3 * 24.7 19.0 * 6.0 * 19.5 21.6 11.9 * 14.6 15.7 17.1 * 20.9 20.0 17.0 * 30.9 19.1 11.5 32.5 11.9 12.3 13.9 23.4 17.5 13.3 22.0 * 29.4 16.7 23.7 16.7 * 18.4 * 10.1 * 28.1 15.2 * 19.0 19.2 17.2 * 2010-2012 20.4 20.7 20.9 * 6.4 * 17.3 15.4 * 10.5 * 16.7 15.4 * 12.5 28.8 29.3 * 26.4 28.2 15.3 * 33.0 28.6 18.5 * 18.3 * 22.5 16.0 8.9 12.5 * 17.0 * 27.2 10.2 * 7.9 * 16.9 13.4 10.2 * 14.9 13.2 12.3 * 19.1 21.1 18.1 * 34.2 19.5 11.9 28.4 13.9 11.9 16.4 22.2 14.0 16.7 15.4 * 20.5 * 24.1 16.7 21.0 19.3 * 19.9 * 10.8 * 22.6 12.8 * 15.8 22.1 22.6 * ottee * Rates and percentages are deemed unreliable based on fewer than 20 data elements. ottee - Rates and percentages are not calculated for zero events. Note: Age-adjusted death rates are per 100,000 population and exclude multiple causes of death. California Department of Public Health 74 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA AGE-ADJUSTED DEATH RATES ALZHEIMER'S DISEASE (THREE-YEAR AVERAGES) 2007-2009 28.1 21.6 26.1 * 33.2 12.6 * 21.9 * 32.1 14.8 * 31.5 29.6 21.1 * 36.0 12.1 * 2.3 * 36.9 17.9 * 19.2 * 14.9 * 23.6 30.8 30.8 14.7 * 16.2 * 20.2 20.0 * 4.2 * 16.5 32.0 17.5 31.5 34.2 18.8 * 30.3 26.4 14.1 * 29.2 36.6 20.6 28.2 19.0 27.2 23.3 37.7 26.1 26.6 5.6 * 18.4 * 45.1 35.7 35.0 26.6 28.6 9.8 * 13.2 9.9 * 26.8 34.7 28.0 * 2010-2012 30.5 26.7 30.3 * 42.8 15.1 * 29.5 * 31.3 23.8 * 31.4 33.9 21.1 * 28.7 14.1 3.2 * 34.8 40.3 31.5 13.4 * 25.1 38.5 36.4 28.1 * 17.4 * 24.4 10.1 * 15.3 * 18.6 30.5 32.8 35.7 34.8 16.1 * 30.5 26.3 11.5 * 28.5 36.6 23.7 41.8 21.6 30.2 30.8 39.1 36.0 42.2 14.8 * 24.0 * 48.5 39.5 39.6 25.5 31.9 30.8 * 23.4 17.2 * 28.8 41.1 23.0 * AGE-ADJUSTED DEATH RATES CORONARY HEART DISEASE (THREE-YEAR AVERAGES) 2007-2009 122.9 100.2 57.7 * 110.2 137.3 110.6 106.5 86.7 120.2 107.4 131.7 111.1 117.6 105.3 153.7 169.7 125.2 161.4 97.3 144.7 142.5 70.3 105.6 134.1 138.9 91.2 * 50.1 * 101.1 95.5 102.2 115.5 109.2 76.9 138.7 127.6 71.0 153.7 109.1 85.0 152.5 86.9 85.0 105.8 88.7 101.6 138.3 129.5 * 115.9 100.3 99.9 162.8 137.0 122.4 87.7 * 136.7 104.3 120.1 88.9 148.0 2010-2012 106.2 80.8 24.3 * 102.5 105.3 100.6 99.3 77.9 105.2 88.2 114.8 111.0 103.8 106.8 91.0 136.4 111.3 134.8 80.2 124.9 135.8 64.2 107.7 105.5 119.3 141.0 * 64.0 * 79.7 87.6 93.7 99.2 98.7 100.6 125.0 110.0 62.6 130.1 96.1 69.9 117.9 82.8 76.3 96.8 73.6 83.9 116.9 109.0 * 99.2 81.2 94.9 153.3 117.3 98.4 105.6 137.3 96.0 89.8 72.8 161.3 AGE-ADJUSTED DEATH RATES CEREBROVASCULAR DISEASE (STROKE) (THREE-YEAR AVERAGES) 2007-2009 40.2 42.0 36.6 44.3 27.6 * 25.8 * 43.2 52.3 * 28.9 50.0 31.8 * 50.7 49.4 28.5 * 45.6 44.0 50.3 32.1 * 38.3 36.2 33.4 32.8 * 38.1 43.2 34.2 * 1.6 * 38.6 40.7 38.6 37.9 43.7 24.7 * 42.2 44.4 33.8 * 46.1 37.8 36.3 45.8 50.1 34.6 39.4 31.2 36.4 46.9 30.8 * 42.4 43.7 47.0 46.5 38.0 52.9 31.8 * 48.8 39.4 38.0 43.3 42.6 2010-2012 36.6 38.0 12.2 * 33.1 44.4 32.2 45.7 * 38.8 45.6 * 25.1 44.7 29.8 * 55.7 35.5 38.6 * 40.6 37.6 48.0 25.5 * 35.4 43.4 27.5 44.2 * 33.5 45.6 52.0 * 25.5 * 38.3 38.0 36.3 34.7 33.4 29.8 * 37.1 40.3 41.4 40.4 32.5 34.7 44.8 56.7 31.4 36.4 26.5 32.7 47.0 45.6 * 45.1 37.0 37.8 42.8 43.7 52.0 21.2 * 48.8 35.7 35.2 40.1 52.9 ottee * Rates and percentages are deemed unreliable based on fewer than 20 data elements. ottee - Rates and percentages are not calculated for zero events. Note: Age-adjusted death rates are per 100,000 population and exclude multiple causes of death. California Department of Public Health 75 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA AGE-ADJUSTED DEATH RATES x INFLUENZA/PNEUMONIA (THREE-YEAR AVERAGES) 2007-2009 19.1 16.8 26.2 * 15.1 22.2 * 10.3 * 14.6 15.6 * 12.3 23.9 23.6 * 12.6 * 14.0 * 11.4 * 23.1 19.4 * 22.1 * 5.7 * 25.1 20.0 13.7 16.1 * 15.2 * 16.2 22.7 * 12.0 19.4 14.3 19.4 12.9 12.1 * 14.1 21.4 21.3 * 16.3 10.7 21.2 16.5 12.4 23.9 12.9 18.0 13.8 16.3 16.6 * 24.6 15.1 22.2 20.3 * 24.1 * 23.8 * 23.3 19.4 * 12.9 27.7 22.2 * 2010-2012 16.1 14.0 23.5 * 15.1 14.4 * 11.9 * 10.9 15.3 * 12.7 21.5 15.0 * 11.6 * 11.2 * 8.3 * 18.9 17.7 * 20.7 * 14.7 * 21.8 15.9 12.0 14.2 * 12.2 * 15.6 12.2 * 5.8 * 11.3 15.2 14.5 17.3 14.0 11.7 * 11.7 19.1 16.2 * 12.0 9.4 14.6 17.0 9.1 17.5 11.9 13.3 13.2 11.1 24.2 * 12.4 * 19.0 8.2 18.3 15.1 * 12.3 * 8.5 * 23.9 14.5 * 9.9 20.5 21.4 * AGE-ADJUSTED DEATH RATES CHRONIC LOWER RESPIRATORY DISEASE (THREE-YEAR AVERAGES) 2007-2009 38.7 32.0 46.3 60.2 41.6 47.9 * 39.1 67.2 * 40.7 40.4 50.0 * 60.3 29.4 49.8 * 71.7 51.3 64.2 52.5 * 34.9 44.8 25.3 55.3 * 48.7 47.3 60.9 * 32.8 38.3 39.1 33.5 39.8 50.7 * 48.6 40.0 32.7 * 57.2 35.2 24.1 47.8 36.7 29.1 32.5 27.5 36.2 69.8 46.7 * 49.0 40.8 39.3 48.3 50.3 71.5 51.7 * 49.3 37.0 37.1 45.7 59.8 2010-2012 36.2 28.9 47.8 58.4 45.6 55.0 * 34.1 54.7 * 41.3 35.7 56.0 * 56.7 19.6 48.5 * 62.3 43.2 69.3 25.6 * 31.1 43.8 22.0 33.0 * 50.0 44.3 65.4 * 7.9 * 29.9 33.6 43.4 31.4 37.3 51.0 * 46.1 42.9 30.5 * 56.1 34.3 21.2 45.1 37.3 25.8 25.6 24.5 28.6 70.8 52.1 * 58.2 43.3 39.4 51.7 52.0 74.0 31.4 * 47.9 41.5 32.5 52.3 66.6 AGE-ADJUSTED DEATH RATES CHRONIC LIVER DISEASE AND CIRRHOSIS (THREE-YEAR AVERAGES) 2007-2009 11.4 9.5 16.5 * 13.6 9.5 * 6.6 * 9.2 8.5 * 9.4 13.1 12.4 * 16.6 15.0 27.3 * 12.8 11.1 * 23.6 7.5 * 12.5 14.5 7.8 7.5 * 15.4 * 12.4 17.3 * 11.9 * 10.2 10.9 * 8.0 * 9.8 7.0 9.3 * 10.2 11.2 16.2 * 12.9 10.6 8.4 17.0 11.0 10.7 11.4 9.3 13.3 15.8 18.8 * 23.0 * 8.7 10.9 12.7 13.9 * 18.9 * 20.4 * 16.6 11.0 * 9.7 11.5 17.7 * 2010-2012 11.5 9.1 13.3 * 15.8 10.5 * 11.0 * 9.2 17.5 * 10.4 15.1 7.7 * 16.3 15.3 15.6 * 12.7 16.0 23.2 8.8 * 12.4 14.9 7.1 11.7 * 13.9 * 14.5 10.4 * 3.0 * 10.2 12.3 * 10.5 * 9.4 9.2 5.7 * 11.8 10.9 10.0 * 13.1 10.3 8.3 15.7 12.1 9.0 12.5 9.1 12.7 16.4 11.6 * 17.5 * 12.2 11.9 13.5 11.9 * 19.5 * 23.2 * 16.4 16.6 * 10.3 13.2 13.9 * ottee * Rates and percentages are deemed unreliable based on fewer than 20 data elements. ottee - Rates and percentages are not calculated for zero events. Note: Age-adjusted death rates are per 100,000 population and exclude multiple causes of death. California Department of Public Health 76 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA AGE-ADJUSTED DEATH RATES ACCIDENTS (UNINTENTIONAL INJURIES) (THREE-YEAR AVERAGES) 2007-2009 29.9 26.3 54.1 58.7 57.2 30.4 * 27.1 75.3 44.3 41.5 59.4 * 69.8 35.7 31.3 * 46.3 41.2 68.1 42.4 * 22.7 45.0 20.8 50.6 * 56.0 42.2 80.5 * 12.6 * 28.2 30.0 37.4 24.1 27.5 47.8 * 33.7 36.1 25.3 * 28.5 31.1 36.1 42.2 36.0 22.5 32.6 23.9 32.2 63.5 10.3 * 62.5 29.6 30.8 41.5 41.5 46.7 66.8 * 39.6 56.3 30.7 27.0 61.2 2010-2012 27.3 20.9 92.8 * 51.7 66.2 43.7 38.1 * 25.1 56.7 * 38.4 36.0 49.9 * 70.0 30.6 35.2 * 41.5 37.5 88.6 42.4 * 19.5 41.9 27.2 45.0 * 51.2 43.8 74.7 * 27.3 * 30.9 29.6 40.1 20.9 28.4 54.9 * 31.3 31.6 32.1 * 24.8 30.4 31.5 41.8 34.1 21.1 26.0 22.9 32.6 60.3 41.1 * 67.6 27.6 26.2 38.1 42.2 66.4 63.7 * 33.7 58.6 28.2 30.9 58.9 AGE-ADJUSTED DEATH RATES MOTOR VEHICLE TRAFFIC CRASHES (THREE-YEAR AVERAGES) 2007-2009 9.5 6.1 19.7 * 15.4 26.9 * 16.7 * 7.9 28.8 * 10.0 * 16.1 17.5 * 17.3 14.5 11.6 * 17.6 18.1 21.6 * 8.5 * 7.9 24.8 4.2 * 23.4 * 19.8 * 16.9 14.7 * 3.9 * 9.6 9.7 * 13.4 * 6.4 6.8 9.1 * 12.5 9.4 11.3 * 13.2 8.7 4.6 13.1 10.4 5.6 8.8 6.3 9.3 13.5 4.5 * 20.9 * 10.6 9.3 13.0 18.9 * 17.0 * 22.5 * 18.2 13.5 * 9.4 7.8 * 18.2 * 2010-2012 7.3 4.3 42.9 * 14.3 * 13.7 20.1 * 19.8 * 5.5 23.0 * 8.4 * 12.2 12.4 * 17.6 9.1 * 6.2 * 12.4 14.1 24.2 * 12.1 * 6.2 16.4 3.0 * 18.1 * 16.5 * 14.0 26.3 * 13.8 * 8.3 8.4 * 13.4 * 4.6 7.6 10.5 * 9.5 8.2 10.9 * 9.8 6.3 2.6 10.7 7.7 4.4 6.7 5.1 4.8 * 13.4 19.6 * 7.2 5.2 12.0 14.7 * 19.7 * 22.2 * 13.4 15.1 * 6.8 8.5 * 9.5 * AGE-ADJUSTED DEATH RATES SUICIDE (THREE-YEAR AVERAGES) 2007-2009 10.0 8.9 50.8 * 19.8 * 17.1 16.5 * 14.8 * 10.3 10.6 * 12.7 8.8 7.5 * 22.8 6.5 * 18.4 * 11.3 8.8 * 29.5 * 14.0 * 7.7 9.4 * 13.2 21.9 * 25.1 9.1 15.7 * 4.8 * 9.8 10.4 * 19.9 9.0 13.0 13.2 * 10.3 12.0 8.9 * 10.6 11.7 10.6 10.4 14.5 9.0 9.7 8.5 13.0 21.0 5.9 * 30.5 * 10.1 12.8 11.3 12.9 * 17.0 * 39.2 * 10.3 18.2 * 11.0 10.0 * 15.4 * 2010-2012 10.1 8.6 26.9 * 17.3 28.3 * 13.5 * 10.8 23.3 * 19.7 8.4 7.1 * 23.4 7.2 * 17.8 * 11.6 7.9 * 24.6 * 11.8 * 7.7 17.4 12.9 25.7 * 19.2 * 12.2 21.4 * 9.1 * 9.1 12.7 * 19.0 9.4 13.0 18.4 * 10.3 12.6 8.9 * 10.6 11.8 9.8 10.9 16.9 8.5 10.4 8.1 13.4 22.6 25.1 * 22.2 * 12.3 12.8 10.7 12.2 * 19.2 * 28.4 * 10.6 18.6 * 10.5 8.9 * 14.1 * ottee * Rates and percentages are deemed unreliable based on fewer than 20 data elements. ottee - Rates and percentages are not calculated for zero events. Note: Age-adjusted death rates are per 100,000 population and exclude multiple causes of death. California Department of Public Health 77 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA MORBIDITY RATE REPORTED INCIDENCE OF AIDS (AGED 13 AND OVER) (THREE-YEAR AVERAGES) 2007-2009 11.9 17.9 1.0 * 3.2 * 2.0 * 9.4 5.5 * 3.4 * 11.9 1.5 * 1.7 * 11.2 * 4.3 * 10.7 3.0 * 3.7 * 2.2 * 16.5 7.6 * 9.9 2.1 * 5.4 * 3.8 * 2.8 * 6.7 5.1 * 2.0 * 7.9 1.7 * 1.9 * 9.8 6.9 4.6 * 7.5 14.0 55.5 8.5 5.2 * 4.4 4.1 * 8.4 4.7 * 2.5 * 1.7 * 10.2 8.7 7.3 2.7 * 1.3 * 2.7 * 2.7 * 3.6 3.0 * 1.2 * MORBIDITY RATE REPORTED INCIDENCE OF CHLAMYDIA (THREE-YEAR AVERAGES) 2010-2012 2007-2009 8.6 10.6 2.0 * 1.2 * 0.8 * 2.0 * 6.7 1.4 * 1.7 * 8.5 1.5 * 1.4 * 6.6 * 7.2 3.6 * 2.4 * 3.3 * 12.7 2.7 * 4.5 * 6.3 * 0.9 * 3.5 * 4.0 * 4.9 * 1.5 * 5.9 1.2 * 6.3 6.7 0.7 * 6.1 10.0 35.1 5.6 2.4 * 4.1 2.8 * 7.7 2.9 * 0.9 * 5.2 * 5.5 * 5.2 3.2 * 1.3 * 0.6 * 5.6 * 4.0 * 3.4 * 2.8 * 1.8 * 2.3 * 397.8 465.8 55.2 * 202.5 323.9 83.1 108.6 342.5 137.7 132.0 597.9 207.4 286.8 386.6 186.8 627.9 351.3 176.1 116.7 468.3 465.6 209.6 88.8 * 252.1 349.0 110.8 * 156.3 322.1 176.3 131.7 277.8 188.3 227.5 296.2 532.1 267.1 410.6 448.6 509.8 522.2 240.5 261.3 287.6 318.6 254.7 248.7 101.5 * 191.7 479.4 188.0 366.2 227.2 219.0 97.1 * 394.3 118.9 258.8 271.1 293.6 2010-2012 434.5 441.0 89.4 * 173.4 383.5 146.2 142.6 381.3 163.8 142.1 647.4 241.8 281.0 372.0 237.2 665.1 364.2 269.6 184.6 506.1 449.3 213.3 100.1 * 332.7 404.7 55.8 * 191.1 374.6 224.8 156.9 270.4 196.7 257.3 375.1 602.8 362.2 507.6 504.4 584.2 532.4 290.9 262.3 386.2 308.8 297.6 296.3 74.2 * 176.8 452.0 281.6 375.8 245.5 289.7 105.8 * 405.0 190.2 298.2 298.2 287.8 MORBIDITY RATE REPORTED INCIDENCE OF FEMALE GONORRHEA AGES 15-44 (THREE-YEAR AVERAGES) 2007-2009 144.6 275.1 35.7 * 100.1 21.1 * 24.8 * 217.2 30.3 * 32.4 * 224.0 57.2 * 67.3 * 70.3 58.5 * 313.4 135.1 90.5 * 14.6 * 172.4 191.4 55.9 38.0 * 53.2 * 111.0 136.5 * 12.5 * 63.5 32.4 * 31.8 * 47.2 45.5 34.1 * 97.7 312.3 68.0 * 180.8 112.3 122.5 271.8 37.3 * 49.2 32.4 76.9 47.1 67.2 75.0 * 39.3 * 211.7 33.8 133.9 44.6 * 48.1 * 52.7 * 114.8 52.0 * 39.2 50.8 70.2 * 2010-2012 139.6 212.0 51.1 * 74.4 48.5 * 232.7 15.8 * 27.1 * 319.4 76.3 * 87.9 39.0 * 11.4 * 286.8 55.6 * 232.5 7.6 * 162.8 175.6 59.8 13.2 * 78.2 * 70.7 12.0 * 65.1 47.1 * 40.7 * 54.1 57.9 93.9 330.5 90.0 * 171.1 93.8 112.6 248.6 40.9 43.3 58.1 69.6 57.3 145.5 85.8 * 45.7 * 237.0 50.5 87.4 76.9 * 63.4 * 56.7 97.7 * 70.7 51.6 94.1 * xxxxx * Rates are deemed unreliable based on fewer than 20 data elements. xxxxx- Rates are not calculated for zero events. Note: The morbidity rates are crude case rates per 100,000 population. California Department of Public Health 79 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA MORBIDITY RATE REPORTED INCIDENCE OF MALE GONORRHEA AGES 15-44 (THREE-YEAR AVERAGES) 2007-2009 160.2 270.1 25.9 * 85.5 25.1 * 22.9 * 135.8 9.0 * 25.8 * 168.2 24.0 * 44.0 * 50.0 11.2 * 193.4 68.2 77.2 * 7.8 * 213.6 33.8 * 84.8 11.4 * 34.4 * 63.4 86.5 * 9.7 * 64.6 30.0 * 21.2 * 74.1 42.8 32.8 * 86.8 264.4 40.2 * 124.4 153.8 651.9 227.8 28.4 * 89.1 42.3 84.0 50.5 47.1 * 23.4 * 144.5 41.2 131.9 51.7 * 46.1 * 90.3 21.0 * 48.0 65.4 47.4 * 2010-2012 186.6 241.0 18.8 * 52.6 20.3 * 15.0 * 150.1 23.6 * 221.5 42.0 * 66.4 * 40.4 * 31.6 * 244.5 39.8 * 140.9 * 19.1 * 272.2 78.5 85.6 38.0 * 36.3 * 63.8 21.6 * 10.0 * 63.3 37.8 * 25.3 * 96.8 57.2 45.4 * 86.9 265.5 70.2 * 140.1 182.3 784.9 197.5 46.7 92.7 54.5 98.4 62.2 107.8 77.1 * 65.3 * 153.0 63.9 79.8 49.7 * 69.1 * 31.9 * 57.4 41.5 * 66.9 67.5 37.0 * MORBIDITY RATE REPORTED INCIDENCE OF TUBERCULOSIS (THREE-YEAR AVERAGES) MORTALITY RATE INFANT MORTALITY ALL RACE/ETHNIC GROUPS (THREE-YEAR AVERAGES) 2007-2009 2006-2008 7.1 10.1 1.2 * 2.2 * 1.6 * 5.7 1.2 * 1.5 * 6.6 3.6 * 0.5 * 16.9 1.8 * 5.2 3.3 * 1.6 * 0.9 * 8.3 6.5 * 4.8 * 3.8 * 2.8 * 5.0 4.5 * 1.0 * 7.0 2.3 * 3.6 7.5 0.6 * 3.5 8.4 15.7 9.5 0.9 * 10.3 5.6 12.0 3.2 * 1.3 * 7.5 2.2 * 3.7 * 2.9 * 3.7 * 6.3 0.6 * 7.0 4.9 * 5.1 * 2010-2012 6.1 10.1 1.8 * 0.9 * 1.5 * 7.8 * 4.6 1.1 * 4.8 4.7 * 1.7 * 15.2 1.8 * 4.3 3.3 * 2.6 * 1.9 * 7.1 5.5 * 5.0 * 1.5 * 4.0 * 5.1 3.6 * 0.7 * 6.8 1.4 * 3.0 4.7 2.4 * 2.8 7.7 13.2 6.4 1.6 * 7.9 5.9 10.1 3.4 * 0.6 * 5.7 2.5 * 2.1 * 4.9 * 0.5 * 4.3 * 4.1 2.3 * 1.8 * 5.3 4.4 5.8 * 6.8 * 1.7 * 1.8 * 4.0 8.7 * 4.7 * 6.3 5.9 * 6.2 * 5.1 * 10.2 * 7.0 5.9 * 4.7 * 9.4 * 5.4 5.0 * 3.0 * 8.9 * 8.5 * 6.4 7.9 * 13.2 * 4.6 5.5 * 3.2 * 4.8 4.8 * 1.9 * 5.4 5.8 4.3 * 6.4 5.0 4.4 6.2 3.4 * 4.1 5.1 3.8 4.7 * 5.4 * 16.7 * 3.3 * 6.1 3.9 6.3 5.1 * 5.9 * 8.1 * 6.3 3.4 * 5.5 4.2 * 5.6 * 2009-2011 4.9 4.5 2.4 * 4.9 * 6.9 * 6.0 * 5.0 7.7 * 3.4 * 7.0 5.6 * 5.7 * 4.5 * 3.1 * 6.2 6.0 * 7.4 * 5.3 * 4.9 6.1 * 3.0 * 6.8 * 5.3 10.3 * 4.5 * 4.6 5.1 * 5.6 * 4.0 4.3 * 8.2 * 5.0 5.4 5.8 * 6.5 4.4 3.1 6.0 5.3 * 2.9 4.5 3.3 3.0 * 6.3 * 7.2 * 5.5 4.7 5.3 4.6 * 8.2 * 2.9 * 5.0 2.2 * 4.5 3.0 * 4.0 * xxxxx - Rates and percentages are not calculated for zero events. xxxxx * Rates and percentages are deemed unreliable based on fewer than 20 data elements. Note: The morbidity rates are crude case rates per 100,000 population. xxxxxxxx The infant mortality rates are per 1,000 live births. California Department of Public Health 80 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA PERCENT LOW BIRTHWEIGHT INFANTS (THREE-YEAR AVERAGES) 2007-2009 6.8 7.1 3.3 * 4.9 * 5.7 5.5 6.3 6.6 5.5 * 6.1 7.5 4.7 5.6 6.4 8.9 7.2 6.4 5.4 5.6 * 7.3 6.4 6.4 5.6 * 6.1 6.6 6.6 * 8.9 * 5.7 6.1 5.6 6.5 5.9 5.2 * 6.6 6.8 6.3 7.1 6.7 7.1 6.9 6.1 6.7 6.0 6.8 6.1 6.1 10.4 * 7.3 7.0 5.8 6.5 5.6 5.4 5.6 * 6.2 4.3 * 6.4 5.2 6.2 2010-2012 6.8 7.4 11.1 * 7.4 5.8 4.4 * 6.2 * 6.9 4.4 * 6.3 7.7 5.9 5.2 5.6 8.5 * 7.0 6.4 6.4 6.8 7.1 6.6 5.8 7.1 * 5.6 6.8 6.4 * 6.2 * 5.8 5.9 5.5 6.5 5.9 6.6 * 6.4 6.9 5.9 7.2 6.5 7.0 7.0 5.5 6.8 5.9 6.8 5.6 6.0 4.6 * 7.3 6.7 5.7 6.1 6.0 6.2 4.5 * 6.1 4.4 6.3 5.6 5.6 AGE-SPECIFIC BIRTH RATE BIRTHS TO ADOLESCENT MOTHERS, 15 TO 19 YEARS OLD (THREE-YEAR AVERAGES) 2007-2009 37.8 25.0 86.8 * 27.5 22.0 31.1 60.1 26.1 56.3 22.4 56.7 56.4 24.7 67.6 49.7 68.0 68.5 49.8 38.9 38.5 65.1 17.4 26.2 * 45.1 53.1 40.6 * 26.2 * 56.4 27.8 20.4 27.5 18.2 25.4 * 43.4 38.5 46.8 49.6 34.2 15.5 48.6 16.0 25.0 31.6 26.2 24.4 38.4 11.6 * 48.1 34.3 24.6 47.8 42.9 53.1 46.3 * 71.4 31.5 38.3 15.0 52.8 2010-2012 28.3 19.4 22.2 * 18.9 * 23.7 19.1 34.1 17.1 52.6 12.8 46.4 38.6 24.1 50.4 32.4 * 53.2 50.5 38.5 34.3 28.9 49.5 9.9 23.3 * 37.4 41.4 30.0 * 19.4 * 44.5 21.4 14.8 20.5 11.6 25.0 * 28.5 28.4 21.6 35.6 26.3 12.6 33.6 15.9 15.2 29.4 18.9 23.1 30.3 8.4 * 36.9 24.1 19.0 35.7 29.5 35.7 38.7 * 53.5 16.0 26.9 15.9 41.0 PERCENT FIRST TRIMESTER PRENATAL CARE (THREE-YEAR AVERAGES) 2007-2009 82.7 86.5 58.6 * 86.8 71.5 79.8 67.9 83.4 56.5 79.7 87.8 70.0 78.5 60.2 76.9 75.3 74.7 69.1 74.5 86.3 74.1 93.2 71.3 68.5 62.7 76.5 77.7 75.8 82.8 77.1 88.5 84.2 72.6 83.2 79.7 86.0 81.4 81.9 85.8 72.5 78.2 88.1 74.3 83.9 80.4 68.7 79.1 * 81.5 76.6 81.6 78.4 56.9 66.2 60.9 76.1 78.9 79.5 76.9 58.9 2010-2012 83.6 88.7 64.7 * 87.0 74.6 79.8 72.0 84.4 78.6 78.6 88.3 67.3 79.8 55.7 79.2 75.9 75.4 68.4 75.7 85.6 74.8 93.9 71.9 67.7 63.3 71.6 76.2 72.3 85.1 75.0 89.7 85.3 75.8 84.7 81.4 85.0 83.1 83.5 88.5 77.0 80.4 90.2 75.0 85.2 82.6 68.3 72.4 * 77.1 77.8 83.5 78.0 69.2 70.2 56.2 80.5 81.9 82.2 82.7 69.8 xxxx * Rates and percentages are deemed unreliable based on fewer than 20 data elements. Note: Age-specific birth rates are per 1,000 female population in the 15 to 19 year old age group. California Department of Public Health 81 County Health Status Profiles 2014 TABLE 30 (continued) A COMPARISON OF THREE-YEAR AVERAGE RATES OR PERCENTAGES AMONG SELECTED HEALTH STATUS INDICATORS COUNTY OF RESIDENCE CALIFORNIA ALAMEDA ALPINE AMADOR BUTTE CALAVERAS COLUSA CONTRA COSTA DEL NORTE EL DORADO FRESNO GLENN HUMBOLDT IMPERIAL INYO KERN KINGS LAKE LASSEN LOS ANGELES MADERA MARIN MARIPOSA MENDOCINO MERCED MODOC MONO MONTEREY NAPA NEVADA ORANGE PLACER PLUMAS RIVERSIDE SACRAMENTO SAN BENITO SAN BERNARDINO SAN DIEGO SAN FRANCISCO SAN JOAQUIN SAN LUIS OBISPO SAN MATEO SANTA BARBARA SANTA CLARA SANTA CRUZ SHASTA SIERRA SISKIYOU SOLANO SONOMA STANISLAUS SUTTER TEHAMA TRINITY TULARE TUOLUMNE VENTURA YOLO YUBA PERCENT ADEQUATE/ADEQUATE PLUS PRENATAL CARE (THREE-YEAR AVERAGES) 2007-2009 79.0 79.3 34.5 * 88.4 73.3 77.8 77.4 76.1 74.0 73.7 84.9 77.8 75.2 59.5 69.1 69.7 73.6 69.8 72.1 83.3 69.1 87.8 68.3 73.9 59.4 56.1 82.8 74.1 76.8 75.9 86.9 79.4 61.7 77.5 75.9 78.2 75.7 74.0 81.6 70.8 83.4 84.2 77.5 79.9 82.0 71.5 71.6 * 74.7 71.2 74.7 72.5 70.5 72.6 54.2 76.8 77.1 81.0 76.7 68.2 2010-2012 79.5 78.9 76.5 * 85.3 77.5 80.8 79.1 76.6 81.6 78.8 89.6 77.9 77.5 58.1 78.9 72.8 72.5 66.3 64.9 82.4 68.7 86.3 67.7 76.1 61.6 64.6 81.5 71.8 77.3 76.5 88.8 83.4 71.9 81.5 78.3 78.1 76.3 73.9 80.7 71.8 86.6 84.2 81.4 77.3 84.3 73.3 70.7 * 76.5 66.9 75.0 70.1 79.9 75.0 64.3 79.2 81.1 82.3 80.3 78.8 xxxxxxxxxxxxxxxxxxxxxxxx * Rates and percentages are deemed unreliable based on fewer than 20 data elements. California Department of Public Health 82 County Health Status Profiles 2014 TECHNICAL NOTES DATA SOURCES The Center for Health Statistics and Informatics, Vital Records, was the source for the birth and death data in this report. Data were tabulated from the Birth and Death Statistical Master Files for the years 2007 through 2012 and from the linked births-deaths in the Birth Cohort-Perinatal Outcome Files for the years 2006 through 2011, which are based on the Statistical Master Files. For additional information, please visit Vital Statistics Data. The Division of Communicable Disease Control, Sexually Transmitted Diseases Control Branch and the Tuberculosis Control Branch, were the sources for the reported case incidence of chlamydia, gonorrhea, and tuberculosis. The Office of AIDS Surveillance Section, provided incidence data of diagnosed AIDS cases. The Center for Family Health, Maternal, Child and Adolescent Health Program, prepared the breastfeeding initiation data, utilizing information collected by the Genetic Disease Screening Program. The State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013, provided by the Demographic Research Unit, were used in the development of the age-adjusted rates, crude case rates, and age-specific birth rates for the current period, 2010-2012. This represents the first application of these projections. Caution should be exercised when rate comparisons are constructed from different population data files. The State of California, Department of Finance, Race/Hispanics Population with Age and Gender Detail, 2000–2010. Sacramento, California, September 2012, provided by the Demographic Research Unit, was used in the development of the age-adjusted rates, crude case rates, and age-specific birth rates for the previous period, 2007-2009. Estimates of persons under age 18 in poverty are obtained from the U.S. Census Bureau at http://www.census.gov/did/www/saipe/data/statecounty/data/2011.html. Tables in this report may reflect small undercounts where case data were received late or vital event data were registered after the cutoff date for creation of the data files. DATA DEFINITIONS Mortality (Tables 1-19): Use of the consensus set of health status indicators has been facilitated by reference to the causes of mortality coded according to the ICD-10. Beginning with 1999 mortality data, the change to ICD-10 follows a worldwide standard created by the World Health Organization. Standards for ICD-10 implementation were set by the National Center for Health Statistics (NCHS). A small number of non-traffic deaths have previously been reported along with traffic deaths in prior publication tables titled “Deaths Due to Motor Vehicle Crashes.” A non-traffic accident is any vehicle accident that occurs entirely in some place other than a public highway. An average of 122 non-traffic deaths during 2010 through 2012 was not included in Table 15, which was re-titled “Deaths Due to Motor Vehicle Traffic Crashes.” This change aligns the data for direct comparison with HP 2020 objectives. California Department of Public Health 83 County Health Status Profiles 2014 Following is a list of the mortality tables in this report and the ICD-10 codes used to create these tables. The ICD-10 codes used to collect the mortality data for the tables, per Healthy People 2020 Objectives, where applicable, are current as of December 30, 2013. Table 1: Table 2: Table 3: Table 4: Table 5: Table 6: Table 7: Table 8: Table 9: Table 10: Table 11: Table 12: Table 13: Table 14: Table 15: Table 16: Table 17: Table 18: Table 19: All Causes of Death ........................................... A00-Y89 All Cancers ........................................................ C00-C97 Colorectal Cancer .............................................. C18-C21, C26.0 Lung Cancer ...................................................... C34 Female Breast Cancer....................................... C50 Prostate Cancer................................................. C61 Diabetes ............................................................ E10-E14 Alzheimer’s Disease .......................................... G30 Coronary Heart Disease .................................... I20-I25 Cerebrovascular Disease (Stroke)..................... I60-I69 Influenza/Pneumonia ......................................... J09-J18 Chronic Lower Respiratory Disease .................. J40-J47 Chronic Liver Disease and Cirrhosis ................. K70, K73-K74 Accidents (Unintentional Injuries) ...................... V01-X59, Y85-Y86 Motor Vehicle Traffic Crashes…………………... V02-V04 (.1, .9), V09.2, V12-V14 (.3-.9), V19 (.4-.6), V20-V28 (.3-.9), V29-V79 (.4-.9), V80 (.3-.5), V81.1, V82.1, V83-V86 (.0-.3), V87 (.0-.8), V89.2 Suicide............................................................... U03, X60-X84, Y87.0 Homicide ........................................................... U01-U02, X85-Y09, Y87.1 Firearm-Related Deaths .................................... U01.4, W32-W34, X72-X74, X93-X95, Y22-Y24, Y35.0 Drug-Induced Deaths ........................................ D52.1, D59.0, D59.2, D61.1, D64.2, E06.4, E16.0, E23.1, E24.2, E27.3, E66.1, F11.0-F11.5, F11.7-F11.9, F12.0-F12.5, F12.7-F12.9, F13.0-F13.5, F13.7-F13.9, F14.0-F14.5, F14.7-F14.9, F15.0-F15.5, F15.7-F15.9, F16.0-F16.5, F16.7-F16.9, F17.0, F17.3-F17.5, F17.7-F17.9, F18.0-F18.5, F18.7-F18.9, F19.0-F19.5, F19.7-F19.9, G21.1, G24.0, G25.1, G25.4, G25.6, G44.4, G62.0, G72.0, I95.2, J70.2-J70.4, L10.5, L27.0, L27.1, M10.2, M32.0, M80.4, M81.4, M83.5, M87.1, R78.1-R78.5, X40-X44, X60-X64, X85, Y10-Y14 California Department of Public Health 84 County Health Status Profiles 2014 Morbidity (Tables 20-23): In general, the case definition of a disease means laboratory test results, or in their absence, a constellation of clearly specified signs and symptoms that meet a series of clinical criteria. Centers for Disease Control and Prevention (CDC) online case definitions may be found at http://www.cdc.gov//DiseasesConditions/. Due to incomplete reporting of infectious and communicable diseases by many health care providers, caution is advised in interpreting morbidity tables. Many factors contribute to the underreporting of these diseases. These factors include lack of awareness regarding disease surveillance; lack of follow-up by support staff assigned to report; failure to perform diagnostic lab tests to confirm or rule out infectious etiology; concern for anonymity of the client; and expedited treatment in lieu of waiting for laboratory results because of time or cost constraints. County designation depicts county of residence. Although table headings indicate the data shown are reported cases, please contact the Division of Communicable Disease Control and the Office of AIDS for complete morbidity reporting technical definitions and procedures. Birth Cohort Infant Mortality (Tables 24A-24E): The infant mortality rate is the number of deaths among infants under one year of age per 1,000 live births. It is a universally accepted and easily understood indicator, which represents the overall health status of a community (MacDorman and Mathews, 2008). Studies of infant mortality that are based on information from death certificates alone have been found to underestimate infant death rates for infants of all race/ethnic groups and especially for certain race/ethnic groups, due to problems such as confusion about event registration requirements, incomplete data, and transfers of newborns from one facility to another for medical care. Infant mortality rates in this report are based on linked birth and infant death records in the Birth Cohort-Perinatal Outcome Files, which generate more accurate estimates of the total number of infant deaths as well as more accurate race-specific infant mortality rates. The race used on the race-specific infant mortality tables reflected the race of the mother, thus the rate calculation’s numerator and denominator reflect only the mother’s race. Because birth and death certificate registration data are included in the Birth Cohort-Perinatal Outcome Files after the Birth and Death Statistical Master Files have been closed to further processing and hospital follow-back is conducted to resolve questionable cases, cohort files cannot be as timely as the Statistical Master Files. However, the Birth Cohort-Perinatal Outcome Files are more complete and accurate. Race/Ethnicity: Tables 24A-24E align with the 1997 Office of Management and Budget (OMB) revised minimum standards for collecting, maintaining, and presenting data on race and ethnicity as described in the 1997 OMB Directive 15, which may be reviewed at URL: http://www.whitehouse.gov/omb/fedreg_1997standards. The mother's Hispanic origin was determined first, irrespective of race, and then the race categories for the remaining non-Hispanics were determined. The Hispanic ethnic group includes any race, but is made up primarily of the White race. The remaining mother’s race data were sorted as follows: two or more race groups (includes any combination of OMB race categories); American Indian/Alaska Native (includes Aleut, American Indian, and Eskimo); Asian/Pacific Islander (includes Asian Indian, Asian specified/unspecified, Cambodian, Chinese, Filipino, Guamanian, Hawaiian, Hmong, Japanese, Korean, Laotian, Samoan, Thai, Vietnamese, and Other Pacific Islander); Black (includes Blacks or African Americans); White (includes White and Other-specified); and Not Stated and California Department of Public Health 85 County Health Status Profiles 2014 Unknown (includes data for mothers who declined to state their race or for whom the data were not obtainable for other reasons). Table 24B Asian/Pacific Islander Infant Mortality rates should not be compared with the Asian/Other Infant Mortality rates in reports issued prior to 2005 because these data now exclude the Aleut, American Indian, and Eskimo statistics previously reported in this table that could impact rates for these small numbers. In contrast, while Table 24E White Infant Mortality now excludes data for the Not Stated and Unknown race groups included in previous reports, the relatively small number of these events in this large group may not substantially impact a county’s rate. American Indian/Alaska Native and Not Stated/Unknown race groups are not shown independently due to unreliable rates, but are included in Table 24A Infant Mortality, All Race/Ethnic Groups. Effective with the 2000 data year, California began collecting up to three races on birth and death certificates. To permit comparison with race data found in the Birth CohortPerinatal Outcome Files for the 1999 and prior data years, which identify only a single race for the mother, first listed race was used in reports issued 2003 through 2006. Race/ethnic groups in reports issued since 2007 are compiled using the multi-race (two or more races) indicator as stated above, thus slight reductions may occur in total numbers previously reported for single races. Since the two or more races group is currently very small, the impact of this change should be negligible. Natality (Tables 25-27B): The natality data were obtained from Birth Statistical Master Files for 2010 through 2012. Records with unknown attributes were excluded from the total number of live births in developing certain tables, as follows: Table 25 excludes unknown birthweights; Table 27A excludes unknown prenatal care; and Table 27B excludes unknown adequacy of prenatal care. Low birthweight has been associated with negative birth outcomes, and may be an indicator of access problems and/or the need for prenatal care services. Prevalence of low birthweight is defined as the percentage of live births weighing less than 2,500 grams (approximately 5.5 pounds). Birth rates to adolescents are an indicator for other high-risk pregnancy factors (Hamilton, Mathews, & Ventura, 2013). Adolescent birth rate is defined as the number of births to mothers 15 to 19 years of age per 1,000 female population. The prenatal care indicator, Month Prenatal Care Began, has been associated with access to care. However, the percentage of births in which the mother's prenatal care began in the first trimester, as a health indicator, does not readily permit an unambiguous interpretation. According to some researchers, it fails to document whether or not prenatal care actually continues throughout the pregnancy. Therefore, in addition to Prenatal Care Begun During The First Trimester of Pregnancy, this report includes adequacy of prenatal care based on the Adequacy of Prenatal Care Utilization Index. For further information on the Adequacy of Prenatal Care Utilization Index, see the "American Journal of Public Health" article by Kotelchuck listed in the bibliography. In reports published in 1995 through 1998, the Kessner Index was used to measure the adequacy of prenatal care (Kessner, 1973). The Kessner Index was replaced in the 1999 report by the Adequacy of Prenatal Care Utilization Index, which is the methodology specified in HP 2020 Objectives. California Department of Public Health 86 County Health Status Profiles 2014 The Adequacy of Prenatal Care Utilization Index developed by Milton Kotelchuck attempts to characterize prenatal care utilization in two independent and distinctive dimensions: adequacy of prenatal care initiation and services received (once prenatal care has begun). The initial dimension, adequacy of prenatal care initiation, characterizes the month prenatal care began and its timeliness. The second dimension, adequacy of received services, characterizes the number of prenatal care visits received from the time the mother began prenatal care until delivery. The adequacy of prenatal visits is based on the recommendations established by the American College of Obstetricians and Gynecologists. These two dimensions are then combined into a single summary prenatal care utilization index, which contains the following five categories for adequacy of prenatal care: (1) Adequate Plus: Prenatal care begun by the fourth month and 110 percent or more of the recommended visits received. (2) Adequate: Prenatal care begun by the fourth month and 80 to 109 percent of the recommended visits received. (3) Intermediate: Prenatal care begun by the fourth month and 50 to 79 percent of the recommended visits received. (4) Inadequate: Prenatal care begun after the fourth month, or less than 50 percent of the recommended visits received. (5) Missing Information: Unknown adequacy of prenatal care. Only adequate and adequate plus prenatal care is used in Table 27B to measure the adequacy of prenatal care utilization. Also, please note the two-factor index does not assess the quality of the prenatal care that was delivered, but simply its utilization. For further information on the Adequacy of Prenatal Care Utilization Index, see the "American Journal of Public Health" article by Kotelchuck listed in the bibliography. Breastfeeding Initiation During Early Postpartum (Table 28): The 2010 data serve as the new baseline for future comparisons and trends of in-hospital breastfeeding practices in California. The 2010 data should not be compared to data published in prior years (2004-2009) due to revisions to the Newborn Screening Program (NBS) data collection tool (NBS Form), as well as changes in the data analysis methodology during this time period. The primary change, the exclusion of data for infants who were in a Neonatal Intensive Care Unit (NICU) nursery at the time of specimen collection, was done in order to better align with the new perinatal quality measure on exclusive breast milk feeding endorsed by the National Quality Forum, the Joint Commission and the Leapfrog Group. For additional information on the methods used to compute this indicator, visit the CDPH Breastfeeding Data webpage at: www.cdph.ca.gov/breastfeedingdata. Extensive research demonstrates the diverse and compelling advantages to infants, mothers, families, and society from breastfeeding and the use of human milk for infant feeding. Breastfeeding provides advantages with regard to the general health, growth, and development of infants, while significantly decreasing their risk for a large number of acute and chronic diseases. There are also a number of studies that indicate possible health benefits for mothers, such as less postpartum bleeding, rapid uterine involution, and reduced risk of ovarian cancer and post-menopausal breast cancer. In addition to individual health benefits, breastfeeding provides significant social and economic benefits to the nation, including reduced health care costs and reduced employee California Department of Public Health 87 County Health Status Profiles 2014 absenteeism for care attributable to child illness. Breastfeeding initiation data are obtained from the Center for Family Health, Genetic Disease Screening Program, Newborn Screening Data with analyses by the Maternal, Child and Adolescent Health Program. All nonmilitary hospitals providing maternity services are required to complete the Newborn Screening Test Form prior to an infant’s discharge. Analysis is limited to cases reported on the Newborn Screening Test Form [Version NBS-I (D) (12/08)]. Infant feeding data presented in this report include all feedings from birth to time of specimen collection, usually 24 to 48 hours. To complete the form, staff must select from the following three categories to describe all feeding since birth: (1) Only Human Milk; (2) Only Formula; and (3) Human Milk & Formula. In Table 28, the number for "BREASTFED" includes records marked 'Only Human Milk' or 'Human Milk & Formula'. The “TOTAL NUMBER” excludes data for infants who were in a Neonatal Intensive Care Unit (NICU) nursery or received Total Parenteral Nutrition (TPN) at the time of specimen collection. Also, excluded are cases with an unknown method of feeding. Statewide, for the 2010-2012 period, approximately 2.3 percent of cases have missing feeding information and/or receive TPN at the time of specimen collection. For this same period, approximately 0.6 percent of cases are missing maternal county of residence data. Caution should be taken when analyzing breastfeeding initiation data alone because breastfeeding duration is not taken into consideration. Examination of breastfeeding initiation data along with duration data is recommended to thoroughly measure the effects of breastfeeding. Breastfeeding duration data are not presented in this report because county level duration data are not available. In Profiles 2014, the Breastfeeding Initiation During Early Postpartum Percentage calculation resumes using a three-year format after a two-year absence. Three years of commensurable data are now available due to consistent comparison measurements. Childhood Poverty (Table 29): Children under the age of 18 living in families with income at or below the poverty level define the category of population under 18 in poverty. The percent of children under 18 in this category is an indicator of global risk factors that have implications for accessibility to health services. CRUDE RATES AND AGE-ADJUSTED RATES Crude rates and age-adjusted rates are calculated for mortality data. The numerator data used to compute mortality rates and percentages were three-year averages compiled by county of residence of the decedent; mother’s county of residence for birth data (including linked birth-death data for infant mortality); and county of residence for morbidity data. Three-year averages tend to reduce the year-to-year fluctuations and increase the stability of estimates. A non-standardized rate (or "crude rate") is calculated by dividing the total number of events (e.g., deaths) by the total population at risk, then multiplying by a base (e.g., 100,000). Sub-populations such as counties with varying age compositions can have highly disparate crude death rates, since the risk of dying is primarily a function of age. Therefore, counties with a large component of elderly experience a higher death rate. The effect of different age compositions among counties or other demographic California Department of Public Health 88 County Health Status Profiles 2014 groups can be removed from the death rates by the “age-adjustment” process. This produces age-adjusted rates that permit comparisons among geographic and demographic groups, which are directly comparable with those HP 2020 National Objectives that are expressed as age-adjusted rates. Age-adjusted death rates are hypothetical rates obtained by calculating age-specific rates for each county and multiplying these rates by proportions of the same age categories in a "standard population," then summing the apportioned specific rates to a county total. The "standard population" used in the age-adjusted rates in this report is drawn from the 2000 U.S. Standard Population distribution that applies the same age groupings and proportions as those established by the National Center for Health Statistics for the Department of Health and Human Services. These age-adjusted rates put all counties on the same footing with respect to the effect of age and permit direct comparisons among counties and other national reports. It is important to understand that age-adjusted death rates should be viewed as constructs or index numbers rather than as actual measures of the risk of mortality. Crude death rates, which include the effect of age, are the rates that should be applied when measuring the actual risk of dying in a specific population. For further information on age-adjusted rates, see the National Center for Health Statistics (NCHS) report by Curtin and Klein on "Direct Standardization," listed in the bibliography. Data for the morbidity tables were not age-adjusted due to the unavailability of the morbidity data by age. Hence, only crude case rates were calculated. Although age and aging do affect morbidity, the effect is not as prominent as their impact on mortality. Birth cohort infant death rates are not age-adjusted. Since the deaths are linked to the births on a record-by-record basis, these rates are based on a numerator (deaths) and a denominator (births) from the same record. Birth cohort comparisons among counties reflect the actual risk of dying within one year of birth, and concurrently, are unaffected by confounding age compositions because the cohorts represent the same age group (under one year). RELIABILITY OF RATES All vital statistics rates and morbidity rates are subject to random variation. This variation is inversely related to the number of events (e.g., deaths) used in calculating the rate. Small frequencies in the occurrence of events produce a greater likelihood that random fluctuations will be found within a specified time period. Rare events are relatively less stable in their occurrence from observation to observation. As a consequence, counties with only a few deaths, or a few cases of morbidity, can have highly unstable rates from year to year. The observation of zero events is especially hazardous, regardless of the population size. This report reduces some year-to-year fluctuation in the occurrence of rare events by basing rates on three-year average numbers of events (e.g., 2010-2012), divided by the population in the middle year (e.g., 2011). The “standard error of a rate” and “coefficient of variation” or relative standard error (RSE) provided the rational basis for determining which rates may be considered “unreliable.” Conforming to NCHS standards, rates that are calculated from fewer than 20 data elements, the equivalent of an RSE of 23 percent or more, are considered unreliable. When rates, percentages, and confidence limits are not calculated due to zero events, they are shown as dashes (-). California Department of Public Health 89 County Health Status Profiles 2014 The 95 percent confidence limits depict the range within which the rate would probably occur in 95 of 100 sets of data (if data similar to the present set were independently acquired on 100 separate occasions). In five of those 100 data sets, the rate or percent would fall outside the limits. Confidence intervals based on 100 or more data elements are calculated utilizing a normal distribution. In cases where there are fewer than 100 data elements, the gamma distribution is used. For appropriate statistical methodologies in comparing independent rates or percentages, please see the NCHS reports listed in the bibliography by Curtin and Klein on “Direct Standardization” and by Kleinman on “Infant Mortality.” RANKING OF COUNTIES Data for each health indicator are displayed with the counties in rank order by increasing rates or percentages (calculated to 15 decimal places) with the exceptions of prenatal care begun during the first trimester of pregnancy (Table 27A), prenatal care adequacy (Table 27B) and breastfeeding initiation (Table 28). The county with the lowest rate or percentage is in the first rank moving down the column to the highest rate or percentage. Data for prenatal care begun during the first trimester of pregnancy, data for adequacy of prenatal care and data for breastfeeding initiation are displayed with the counties in rank order by decreasing percentages (calculated to 15 decimal places). The county possessing the highest percentage is in the first rank and the county with the lowest percentage is in the 58th rank. For all health indicators, counties with identical rates or percentages are ranked first by largest population or number of births. COMPARISON OF RATES AND PERCENTAGES (TABLE 30) Rates and percentages have been calculated for one prior period, which facilitates comparison between the earlier period, and the current reported statistics for selected health indicators. Readers are cautioned that measuring progress toward target attainment for a HP 2020 objective using only one data point is not recommended. HP 2020 provides basic formulas to measure progress toward achieving your target for the selected health outcome. These can be found here: http://www.healthypeople.gov/2020/implement/MeasuringProgress.pdf THEMATIC MAPS ArcGIS, version 10.1, ArcMap software was used to create the thematic maps. Mapped data were derived from the rates/percentages displayed in the column to the immediate left of the 95 percent confidence intervals in the adjacent table. Counties with no events or with rates or percentages based on fewer than 20 data elements are shown with an overlay of diagonal dashes. The mapping methodology strives to illustrate rates/percentages for each indicator in a way that highlights a county’s status in meeting the HP 2020 Objective target, if one exists, and in comparison with the California rate. For example, a typical map for an indicator with an HP 2020 Objective, displays counties that achieved the target in the lightest shade, counties with a rate between the California rate and the target in the medium shade, and counties with a rate above the California rate in the darkest shade (see the Colorectal Cancer map and table on pages 7 and 8). California Department of Public Health 90 County Health Status Profiles 2014 Rates or percentages for health indicators without established HP 2020 Objectives, or with HP 2020 data collection criteria that California was unable to meet, are mapped according to counties with rates/percentages at or below the California rate/percentage with the remaining counties above California’s rate/percentage divided into two groups based on a calculated 50th percentile of the rates/percentages among those counties. California Department of Public Health 91 County Health Status Profiles 2014 FORMULAS USED IN THIS REPORT   CDR   nD   B  Npop  Da  B   Npopa      ADR   W a n  nDa    B ASDR    Npopa   Wa  ASDR 2 CDR  SEx   nD  SEy    SEx  RSEx     100  CDR   SEy  RSEy     100  ADR  Lower 95% CL = ADR – (1.96 x SEy) Upper 95% CL = ADR + (1.96 x SEy)      Where: nDa CDR = Crude Death Rate ADR = Age-Adjusted Death Rate ASDR = Age-Specific Death Rate = Number of Deaths nD Npop = Population Size = Number of Deaths in an Age Group nDa Npopa = Population Size in Same Age Group B = Base (100,000) Wa = Age-Specific Weight (Standard Population Proportion) SEx = Standard Error of a Crude Death Rate RSEx = Relative Standard Error of a Crude Death Rate SEy = Standard Error of an Age-Adjusted Death Rate RSEy = Relative Standard Error of an Age-Adjusted Death Rate CL = Confidence Limit Gamma Distribution Confidence Intervals Lower 95% CL= Rate x GamInv (.025, Numerator of Rate)/ Numerator of Rate Upper 95% CL= Rate x GamInv (.975, Numerator of Rate+1)/ Numerator of Rate Where: Rate is CDR or ADR depending on which table is being calculated. GamInv is the gamma inverse function as used in SAS. California Department of Public Health 92 County Health Status Profiles 2014 PROCEDURE FOR CALCULATING AGE-ADJUSTED RATES BY THE DIRECT METHOD Age-adjusted rates calculated in this report follow the procedure that was used to set the HP 2020 National Objectives. The standard population used the year 2000 U.S. population. The data in the following example were extracted from Table 1: Deaths Due to All Causes, 2010 through 2012 for Alameda County. ALAMEDA COUNTY AGE GROUPS G 2010-2012 DEATHS (AVERAGE) (A) TOTAL Unknown <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 >84 9,147.7 2.7 83.3 13.0 17.0 116.7 151.3 257.3 658.3 1,250.7 1,405.0 2,077.3 3,115.0 (A)/(B) x 100,000) (C) 2011 POPULATION (B) 1,526,220.0 599.4 19,096.7 78,028.8 187,300.9 207,658.1 229,494.8 228,021.0 221,918.2 180,893.4 95,683.1 52,561.8 25,563.4 436.4 16.7 9.1 56.2 65.9 112.9 296.7 691.4 1,468.4 3,952.2 12,185.4 WEIGHTED 2000 U.S. RATE STANDARD FACTORS POPULATION (C)x(D) PROPORTIONS (E) (D) 0.013818 0.055317 0.145565 0.138646 0.135573 0.162613 0.134834 0.087247 0.066037 0.044842 0.015508 6.0 0.9 1.3 7.8 8.9 18.4 40.0 60.3 97.0 177.2 189.0 AGE-ADJUSTED RATE………………………………………………………… 606.8 STEP 1: Arrange the data for the three-year average number of deaths and population for 11 age groups in columns A and B. STEP 2: Calculate age-specific rates by dividing the number of deaths in column A (numerator) by the population in column B (denominator). Multiply the result (quotient) by the base of 100,000 to obtain the rates in column C. STEP 3: Multiply each age-specific rate in column C by the corresponding 2000 U.S. Standard Population proportion in column D and enter the result in column E. STEP 4: The values for each age group in column E are summed to obtain the Age-Adjusted Death Rate for Alameda County of 606.8 per 100,000 population. STEP 5: Repeat Steps 1 through 4 for each county and the statewide total. Note that the 2000 U.S. Standard Population proportions remain the same for each county and the State. Direct comparisons can now be made among the counties, with the removal of the effect that varying county age compositions may have on death rates. California Department of Public Health 93 County Health Status Profiles 2014 APPENDIX A CALIFORNIA'S HEALTH STATUS PROFILE FOR 2014 HP 2020 OBJECTIVE C-1 C-5 C-2 C-3 C-7 HDS-2 HDS-3 SA-11 IVP-11 IVP-13.1 MHMD-1 IVP-29 IVP-30 SA-12 HP 2020 OBJECTIVE HIV-4 STD-6.1 STD-6.2 IID-29 HP 2020 OBJECTIVE MICH-1.3 MICH-1.3 MICH-1.3 MICH-1.3 MICH-1.3 HEALTH STATUS INDICATOR CRUDE DEATH RATE AGE-ADJUSTED DEATH RATE 238,203.3 56,622.3 5,296.3 12,678.0 4,311.7 3,029.3 7,519.0 11,331.3 39,457.0 13,479.7 5,948.3 13,050.3 4,477.7 10,397.3 2,796.7 3,888.0 1,981.0 2,968.7 4,203.7 634.0 150.7 14.1 33.7 22.8 16.2 20.0 30.2 105.0 35.9 15.8 34.7 11.9 27.7 7.4 10.3 5.3 7.9 11.2 641.5 153.3 14.2 34.8 20.9 20.5 20.4 30.5 106.2 36.6 16.1 36.2 11.5 27.3 7.3 10.1 5.2 7.7 10.8 ALL CAUSES ALL CANCERS COLORECTAL CANCER LUNG CANCER FEMALE BREAST CANCER PROSTATE CANCER DIABETES ALZHEIMER'S DISEASE CORONARY HEART DISEASE CEREBROVASCULAR DISEASE (STROKE) INFLUENZA/PNEUMONIA CHRONIC LOWER RESPIRATORY DISEASE CHRONIC LIVER DISEASE AND CIRRHOSIS ACCIDENTS (UNINTENTIONAL INJURIES) MOTOR VEHICLE TRAFFIC CRASHES SUICIDE HOMICIDE FIREARM-RELATED DEATHS DRUG-INDUCED DEATHS HEALTH STATUS INDICATOR INFANT MORTALITY: INFANT MORTALITY: INFANT MORTALITY: INFANT MORTALITY: INFANT MORTALITY: CRUDE CASE RATE 2,668.3 163,240.0 11,035.7 15,390.3 2,279.7 8.6 434.5 139.6 186.6 6.1 2009-2011 DEATHS (AVERAGE) INFANT MORTALITY BIRTH COHORT (BC) INFANT DEATH RATE ALL RACES ASIAN/PI BLACK HISPANIC WHITE 2499.3 247.0 280.3 1222.3 570.3 HP 2020 OBJECTIVE HEALTH STATUS INDICATOR 2010-2012 BIRTHS (AVERAGE) MICH-8.1 MICH-10.1 MICH-10.2 LOW BIRTHWEIGHT INFANTS FIRST TRIMESTER PRENATAL CARE ADEQUATE/ADEQUATE PLUS PRENATAL CARE 34,144.0 413,217.0 388,867.7 HEALTH STATUS INDICATOR 2010-2012 BIRTHS (AVERAGE) HP 2020 OBJECTIVE BIRTHS TO MOTHERS AGED 15-19 HP 2020 OBJECTIVE MICH-21.1 HP 2020 OBJECTIVE HEALTH STATUS INDICATOR BREASTFEEDING INITIATION 38,792.0 2010-2012 BIRTHS (AVERAGE) 399,369 HEALTH STATUS INDICATOR PERSONS UNDER 18 IN POVERTY a b c d Note Sources 2011 NUMBER 2,085,229 95% CONFIDENCE LIMITS LOWER UPPER 638.9 152.0 13.8 34.2 20.3 19.8 19.9 30.0 105.1 36.0 15.7 35.6 11.1 26.7 7.0 9.8 4.9 7.5 10.5 644.1 154.6 14.6 35.5 21.5 21.3 20.9 31.1 107.2 37.3 16.5 36.8 11.8 27.8 7.6 10.5 5.4 8.0 11.1 NATIONAL OBJECTIVE a 160.6 14.5 45.5 20.6 21.2 b a 100.8 33.8 a a 8.2 36.0 12.4 10.2 5.5 9.2 11.3 MORBIDITY 2010-2012 CASES (AVERAGE) AIDS INCIDENCE (AGE 13 AND OVER) CHLAMYDIA INCIDENCE GONORRHEA INCIDENCE FEMALE AGE 15-44 GONORRHEA INCIDENCE MALE AGE 15-44 TUBERCULOSIS INCIDENCE HEALTH STATUS INDICATOR MORTALITY 2010-2012 DEATHS (AVERAGE) 4.9 3.9 10.1 4.7 4.1 95% CONFIDENCE LIMITS LOWER UPPER 8.3 432.4 137.0 183.7 5.8 8.9 436.6 142.2 189.6 6.3 95% CONFIDENCE LIMITS LOWER UPPER 4.7 3.4 8.9 4.5 3.7 5.1 4.3 11.3 5.0 4.4 NATIONAL OBJECTIVE 12.4 c 251.9 194.8 1.0 NATIONAL OBJECTIVE 6.0 6.0 6.0 6.0 6.0 AGE-ADJUSTED DEATH RATE PREVIOUS 677.4 161.0 15.1 38.8 22.1 22.7 21.2 28.1 122.9 40.2 19.1 38.7 11.4 29.9 9.5 10.0 5.9 8.4 11.1 CRUDE CASE RATE PREVIOUS 11.9 397.8 144.6 160.2 7.1 BC INFANT DEATH RATE PREVIOUS 5.3 4.5 12.3 5.2 4.6 NATALITY PERCENT 6.8 83.6 79.5 AGE-SPECIFIC BIRTH RATE 28.3 BREASTFEEDING PERCENT 91.6 CENSUS PERCENT 22.6 95% CONFIDENCE LIMITS LOWER UPPER 6.7 83.3 79.3 6.8 83.9 79.8 95% CONFIDENCE LIMITS LOWER UPPER 28.1 28.6 95% CONFIDENCE LIMITS LOWER UPPER 91.3 91.9 95% CONFIDENCE LIMITS LOWER UPPER 22.6 22.7 NATIONAL OBJECTIVE 7.8 77.9 77.6 NATIONAL OBJECTIVE a NATIONAL OBJECTIVE 81.9 NATIONAL OBJECTIVE a PERCENT PREVIOUS 6.8 82.7 79.0 AGE-SPECIFIC BIRTH RATE PREVIOUS 37.8 PERCENT PREVIOUS d PERCENT PREVIOUS 21.8 Healthy People 2020 (HP 2020) National Objective has not been established. National Objective is based on both underlying and contributing cause of death which requires use of multiple cause of death files. California's data exclude multiple/contributing causes of death. Prevalence data are not available in all California counties to evaluate the Healthy People 2020 National Objective STD-1, as the Health People objective is restricted to females who are 15-24 years old and identified at a family planning clinic, and males and females under 24 years old who participate in a national job-training program. Data not available. Crude death rates, crude case rates, and age-adjusted death rates are per 100,000 population. Birth cohort infant death rates are per 1,000 live births. Age-specific birth rates are per 1,000 population. Previous refers to previous period rates. These periods vary by type of rate: Mortality 2007-2009, Morbidity 2007-2009, Infant Mortality 2006-2008, Natality 2007-2009, Census 2010. State of California, Department of Finance, Race/Hispanics Population with Age and Gender Detail, 2000–2010. Sacramento, California, September 2012. State of California, Department of Finance, Report P-3: State and County Population Projections by Race/Ethnicity, Detailed Age, and Gender, 2010-2060. Sacramento, California, January 2013. California Department of Public Health, 2010-2012 Death Statistical Master Files. California Department of Public Health, Office of AIDS, HIV/AIDS Surveillance Section, data as of 12/27/2013. California Department of Public Health, STD Control Branch (data reported through 08/19/2013). Chlamydia data. California Department of Public Health, STD Control Branch, Data Request, August, 2013. Gonorrhea data. California Department of Public Health, Tuberculosis Control Branch, Report on Tuberculosis in California, 2012. Richmond, CA, July 2013. California Department of Public Health, 2009-2011 Birth Cohort-Perinatal Outcome Files. California Department of Public Health, 2010-2012 Birth Statistical Master Files. California Department of Public Health, Center for Family Health, Genetic Disease Screening Program, Newborn Screening Data, 2010-2012. California Department of Public Health, Center for Family Health, Maternal, Child and Adolescent Health Program. U.S. Census Bureau, Small Area Income and Poverty Estimates. http://www.census.gov/did/www/saipe/data/statecounty/data/2011.html. Accessed December 2013. California Department of Public Health 94 County Health Status Profiles 2014 BIBLIOGRAPHY American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics, Vol. 115, No. 2, February 2005: pp. 496-506 (doi:10.1542/peds.2004-2491). Armitage P, Berry G, Matthews JNS. Statistical Methods in Medical Research (4th edition). Oxford: Blackwell Science 2002. Curtin LR, Klein RJ. Direct Standardization (Age-Adjusted Death Rates), Healthy People 2000 Statistical Notes. National Center for Health Statistics, DHHS Pub. No. (PHS) 95-1237, March 1995; No. 6-Revised. Fleiss JL. Statistical Methods for Rates and Proportions, second edition. New York: John Wiley and Sons, 1981. Foster JE. Using Natality Data in Health Planning. Statistical Notes for Health Planners, No. 12. National Center for Health Statistics. November 1980. Hamilton BE, Mathews TJ, Ventura SJ. Declines in State Teen Birth Rates by Race and Hispanic Origin. NCHS Data Brief, no 123. Hyattsville, MD: National Center for Health Statistics. 2013. Institute for Medicine. The Future of Public Health. Washington, D.C.: National Academy of Science Press, 1988; pp. 13-15. Kessner DM, Singer J, Kalk CE, Schlesinger ER. Infant Death: An Analysis by Maternal Risk and Health Care. Contrasts in Health Status; Vol. I. Washington, DC: Institute of Medicine, National Academy of Sciences; 1973. Klein RJ, Schoenborn, CA. Age Adjustment Using the 2000 Projected U.S. Population. Healthy People 2010 Statistical Notes. National Center for Health Statistics, DHHS Publication, Number 20, January 2001. Kleinman JC. Mortality. Statistical Notes for Health Planners, No. 3. National Center for Health Statistics. February 1977. Kotelchuck M. An Evaluation of the Kessner Adequacy of Prenatal Care Index and a Proposed Adequacy of Prenatal Care Utilization Index. American Journal of Public Health, Vol. 84, No. 9, pp. 1414-1420. September 1994. Lilienfeld AM, Lilienfeld DE. Foundations of Epidemiology, second edition. New York: Oxford University Press, 1980. MacDorman MF, Mathews TJ. Recent Trends in Infant Mortality in the United States. NCHS Data Brief, no 9. Hyattsville, MD: National Center for Health Statistics. 2008. Tashiro M. A Description of the California Birth Cohort-Perinatal File. Data Matters #83-11078. Center for Health Statistics, California Department of Health Services (now California Department of Public Health). February 1984. U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. http://www.healthypeople.gov/2020/default.aspx California Department of Public Health 95 County Health Status Profiles 2014 World Health Organization. International Statistical Classification of Diseases and Related Health Problems, tenth revision. Geneva: World Health Organization, 1992. California Department of Public Health. Programs Page, A to Z index for data sources. California Department of Public Health 96 County Health Status Profiles 2014