Final Report—Executive Summary
Infant and Child Health
Although Bexar County birth characteristics look good when compared to Texas and Harris County, teenage pregnancy remains a concern. It is important that mothers receive early prenatal care to reduce risks to the baby and the mother. Teenage mothers have somewhat worse pregnancy outcomes than older mothers. It is difficult for young parents to provide the financial and emotional support needed to care for a baby while completing their education. Support and encouragement should be given to mothers younger than 18 to complete their high school education.
Births to single mothers are also a concern. Thirty-nine percent of births in Bexar County occur to single mothers. Pregnancy outcomes for these mothers are worse than for married mothers. Single mothers tend to have less financial, emotional and physical support to help care for their child. These situations can contribute to poor health and lower educational performance for their children. The community would benefit from finding better ways to strengthen and support these families.
The Bexar County fertility rate in 2004 was 73 births per 1,000 women of childbearing age, a decrease from 75 births per 1,000 women of childbearing age in 2000.
Teenage fertility (12 to 17 years old) rate was 21 births per 1,000 females in 2004, down from 25 births per 1,000 females in 2000.
The low birth weight births were 8.8 percent of total births in 2004. This is a noticeable increase from 7.5 percent low birth weight births in 2000.
In 2004, 86 percent of mothers began prenatal care in the first trimester of pregnancy. This is the same rate as in 2000.
The infant mortality rate is 6.2 deaths per 1,000 live births, which is elevated for Bexar County and is an increase of the rate in 2000 of 4.9 deaths per 1,000 live births as published in the 2002 Community Health Assessment. Infant mortality is also elevated for Harris County (6.5 in 2004 and 4.9 in 2000) and for Texas as a whole (6.3 in 2004 and 5.7 in 2000). This elevation may be a consequence of random variation where the number of infant deaths each year is relatively small. Nonetheless, the fact that infant mortality is elevated in so many of the Sectors, as well as Bexar County, Harris County and Texas suggests that something may be occurring that warrants close monitoring of this vital indicator of public health for an enduring increase.
Oral Health
Oral health is frequently overlooked as a community health concern. The scientific literature indicates that dental caries in children is five times more common in the community than asthma. In Bexar County only 59 percent of adults and 77 percent of children had a dental visit in the last six months.
Mental Health
The 2000 Surgeon General’s report on mental illness indicates that mental illness is the second leading cause of disability. People who live on incomes lower than the federal poverty guidelines are 50 percent more likely to be depressed. The number of people dying from suicide is substantially smaller than heart disease or cancer, but is the twelfth leading cause of death in Bexar County. A person who dies prematurely as a result of suicide loses an average of 26 years of life. The leading cause of suicide is depression. A suicide death is a signal to the community that residents are in distress and need help. In 2004 suicide mortality claimed 221 years of potential life per 100,000 population. This is down from 281 years of potential life lost per 100,000 population in 2000.
In Bexar County 24 percent of adults reported that they have experienced chronic depression (feeling depressed for two years or longer). The National Institute of Mental Health reports that depression ranks second in terms of disease burden. Depression is associated with physical symptoms and may be a precursor to other physical diseases. Physical activity has been shown to improve mental health status. Supporting physical activity is good for both the physical and mental health of our community.
In 2004-05 Bexar County residents reported an increase in the number of poor mental health days they experience a month. The average number of poor mental health days increased from 3.4 days to 4.0 days per month. Although this is a small increase numerically, it results in many hours of production lost each month.