INTRODUCTION

National statistics provide an overview of women’s health across the nation. It is unclear, however, how accurately these statistics reflect the status of women’s health in California because of its unique population. This report provides a snapshot of women’s health in California so that state and county officials, policymakers, and health advocates can better understand the health status and needs of women in the state.

POPULATION CHARACTERISTICS

The demographics of California reflect its rich diversity. They tell the story of California women and provide some insight into the source of health disparities, which are linked to differences in education levels, socioeconomic status, and race.

California is home to 27.9 percent (9.5 million) of the nation’s 34.2 million foreign-born population. These 9.5 million foreign-born people make up 27 percent of California’s population. The number of foreign-born men and women is about equal. Nearly 80 percent of foreign-born women are between the ages of 18 and 64 years.

Females make up 51 percent of the state’s population, with over 17 million women and girls. The majority of women are married, but a significant percentage (17 percent) live alone, and 15 percent are heads of households. Poverty is a problem for nearly 3 million adults in California; almost 60 percent are women.

Although 56.9 percent of women are employed, women still are not paid the same as men in comparable positions. Economic, racial, and ethnic disparities continue to make women vulnerable. Racial and economic disparities also have implications for women’s health.

HEALTH STATUS

Trends in health status help to identify new issues as they emerge. This report highlights various health behaviors, health indicators, reproductive and maternal health issues, and issues applicable to special populations that provide insight into the unique health care needs of California women.

Although Californians are reputed to be healthy and active, a growing trend towards obesity is affecting health and health care costs. Heart disease is the leading cause of death among women, and strokes are the third leading cause; together they account for 40 percent of deaths among women in California.

Breast cancer is the most common cancer among California women, followed by cancers of the digestive, reproductive, and respiratory systems.

Arthritis is one of the most prevalent chronic health problems and is a leading cause of disability among Americans over age 15. In California, 23.0 percent of women report having been diagnosed with arthritis compared with 15.9 percent of men.

While men still account for the majority of AIDS cases in California, and women make up only 8 percent of AIDS cases, women’s disease rates are increasing faster than men’s in California.

The rate of pregnancy-related mortality in California has been increasing since the late 1990s. Black/African American women have higher pregnancy-related mortality than Hispanic and White women.

California’s teen birth rate has dramatically declined since its peak in 1991. In 1999, it fell below the national average. This improved outcome is one of the bright spots in women’s health in California.

The risk of postpartum depression is higher for women younger than 20 compared with older women of childbearing age. Uninsured women are more at risk than insured women.

Mental health disorders disproportionately affect women. Native American women have the highest rates of emotional or mental health problems, and Asian women have the lowest.

Native American women have the highest rate of mental health care use compared with other racial/ethnic groups. Black/African American and Hispanic women are least likely to seek mental health services.

Women with disabilities are more likely to experience intimate partner violence than are other women. Seventyone percent of women experiencing either intimate partner violence or frequent mental distress want mental health assistance, but less than half (46.5 percent) receive it. This level of unmet need has hidden consequences for women’s health.

Homelessness and housing insecurity affect the health of both women and children in California. Nearly 8 percent of women aged 18 years and older report experiencing housing insecurity. Sixty-four percent of those women have children under age 18 in their household. Women under age 44, Black/ African Americans, and Hispanics are more likely than older women, Whites, and Asians to report housing insecurity.

Border populations and human trafficking are two special issues of concern for women’s health in California. Human trafficking, a modern form of slavery, predominantly targets women. Years of abuse and trauma add stress to these women who suffer from a wide range of health problems.

HEALTH SERVICES USE

The availability of and access to quality health services directly affect the health and well-being of women. This report presents data on women’s health services use, including indicators of access to care, health insurance coverage, hospitalizations, mental health care use, and usual source of care by age, race/ ethnicity, and income.

Women make up 59 percent of patients discharged from hospitals. Pregnancy-related hospitalizations account for 30 percent of discharges. Black/African American women have the highest rates of conditions that can sometimes be prevented with proper primary care, such as asthma, congestive heart failure, chronic obstructive pulmonary disease, diabetes, and hypertension.

Teens between 12 and 17 years are the least likely among California females to have a usual source of care, while girls under age 11 and women 65 and older are the most likely. Hispanic and Native American women are less likely to have a usual source of care than White, Black/African American, and Asian women.

Women with low incomes are less likely than those with higher incomes to have a usual source of care. Women without insurance are less likely than those with insurance to seek preventive care services. Almost one-third of Hispanic women and nearly one-fifth of American Indian/Alaska Natives report being uninsured.

CONCLUSION

These trends in women’s health have profound implications for future and ongoing health policy. It is important to understand the variations by race and ethnicity, age, and disease or condition among California women. Policies must address these variations; a one-size-fits-all approach will not work.

Despite the wide variety of health programs in California, many women are still falling through the cracks. There is a great need for expanding access to preventive care that in the long run will improve the health of women and provide savings to the state’s health care system.

Download California Women's Health 2007

PDF format, 2.5MB, 104Pages.

California Department of Health Services
OFFICE OF WOMEN’S HEALTH
TERRI THORFINNSON
J.D. Chief
ZIPORA WEINBAUM
Ph.D. Research Scientist
RENEE WAGNER
M.S.W. Research Assistant

TABLE OF CONTENTS:
ACKNOWLEDGMENTS ...................... v
PREFACE .................................................viii
INTRODUCTION ................................... x
POPULATION CHARACTERISTICS
Introduction ....................................................1
California Female Population, by Age Group ..2
California Female Population, by
Race/ Ethnicity .........................................3
Asian Female Population ...............................4
Educational Attainment ..................................5
Foreign-Born Females ...................................6
Poverty Status ................................................7
Labor Force Participation ...............................9
Household Composition/Marital Status ........ 11
HEALTH STATUS
Introduction ...................................................13
HEALTH BEHAVIORS
Nutrition ........................................................16
Physical Activity ............................................18
Obesity .........................................................20
HEALTH INDICATORS
AIDS .....................................................................24
Human Immunodefi ciency Virus (HIV) .........26
Health Care Provider Discussion
About HIV Risk .............................................28
Arthritis .........................................................29
Asthma .........................................................30
Diabetes .......................................................31
Cancer ..........................................................32
Osteoporosis ................................................34
Hypertension ................................................35
Heart Disease and Stroke ............................36
Oral Health and Dental Care ........................37
Sexually Transmitted Disease-Chlamydia ...38
Self-Reported Health Status ........................40
Injury ............................................................41
Intimate Partner Violence and Disabilities ...42
Intimate Partner Violence and
Mental Health .........................................44
Leading Causes of Death ............................45
Mental Health ...............................................46
Suicide .........................................................47
REPRODUCTIVE/MATERNAL HEALTH
Breastfeeding ...............................................50
Contraception ...............................................52
Infertility ........................................................54
Live Births ....................................................56
Postpartum Depression ...............................58
Pregnancy-Related Mortality ........................60
Prenatal Care ...............................................62
Teen Births ...................................................63
SPECIAL POPULATIONS
Border Health .................................... 66
Women Aged 65 and Older ..........................68
Housing Insecurity ........................................69
Human Traffi cking Victims ............................70
HEALTH SERVICES USE
Introduction ..................................................73
Health Insurance Coverage .........................74
Usual Source of Care by Age Group
and Race/Ethnicity..................................76
Usual Source of Care by Race/Ethnicity
and Income Level ...................................78
Access to Care .............................................79
Mental Health Care Use ...............................80
Hospitalizations ............................................81
SOURCES ................................................83

Visit Office of Women's Health Website

PREFACE

Improving the health of women and girls is one of the founding principles that guide the work of the California Department of Health Services (CDHS) Office of Women’s Health (OWH). The OWH is charged with recommending and monitoring women’s public health policies, promoting more comprehensive and effective approaches to improve women’s health, enhancing the visibility and prominence of women’s health needs, and advancing cost-effective and innovative solutions to address women’s health problems.

In addition, the OWH’s mission includes guiding women’s health policy in an effective and comprehensive fashion to promote health and reduce the burden of preventable disease and injury among the women and girls of California. The OWH fulfills these responsibilities through developing policy and resources, disseminating women’s health resources to policymakers and the public, and developing a comprehensive framework for women’s health policy and programs.

The OWH is pleased to present the first edition of California Women’s Health 2007. This report was inspired by Women’s Health USA 2005, which is issued annually by the Health Resources and Services Administration’s (HRSA) Office of Women’s Health. To reflect the ever-changing, increasingly diverse population and its characteristics, California Women’s Health 2007 includes emerging issues and trends in women’s health.

Information on household type, contraception, human trafficking, and border health are just a few of the California-related topics included in this edition. Where possible, we have attempted to highlight racial and ethnic disparities as well as gender differences.

The OWH developed California’s Women’s Health 2007 to provide readers with an easy-to-use collection of current and historical data on some of the most pressing health challenges facing women, their families, and their communities. The report is intended to be a concise reference for policymakers and program managers at the federal, state, and local levels to help identify and clarify issues affecting the health of women and girls.

In these pages, readers will find a profile of women’s health at the state level from a variety of data sources. This data book uses the latest available information from various departments within the California state government, including Health Services and Finance.

Although we attempted to standardize terms and nomenclature, some variability was unavoidable due to the nature of the different sources. For example, the California Health Interview Survey (CHIS) has a large sample size that allows information access on a number of smaller race/ethnicity groups such as American Indian/Alaska Natives or Asians, whereas the California Women’s Health Survey (CWHS) allows race/ethnicity breakdown to only four groups (White, Hispanic, Black/African American and Asian/Other). In other data sources, American Indian/Alaska Natives are sometimes referred to as Native Americans.

In this report, the term “women” refers to women aged 18 and older, and the term “females” designates the entire age spectrum (children and adults).

Please provide any feedback on this publication to the OWH at:
Office of Women’s Health
P.O. Box 997413, MS 0027
Sacramento, CA 95899-7413
(916) 440-7626

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