2007 Community Health Assessment
Mortality Data Key Findings

Building a Healthier San Francisco (BHSF) continually seeks new methods of identifying and assessing the health needs and priorities of city residents. The last Assessment in 2004 produced a cross-section of health and social conditions, neighborhoods, ethnicity, and demographics.

The 2007 Community Needs Assessment again examines the health conditions in San Francisco (SF), now in a dynamic new web-based format. The 2007 Assessment is a "live" interactive website containing many features to improve access to these data by everyone concerned with health in SF. Remaining at the core are national, state, and local data. The intent is to present a compilation of information, update and renew the data periodically, and offer observations o­n the state and direction of the health status in our community.

We use two measures of mortality: age-adjusted death rates, which allow for comparisons of the overall burden of mortality across groups or years (controlling for differences in groups’ age structures, which otherwise would make it impossible to compare them); and years of life lost (YLL), a measure of premature mortality based o­n expected years of life remaining at the time of death. YLLs give greater weight to deaths the younger (and therefore generally more preventable) they are, and so can be considered a measure of the burden of premature mortality in a population or population group. (Numbers of YLLs are not directly comparable across groups, though.)

Age adjusted death rates are shown in Tables 1-5, and leading causes of YLLs in Tables 6-10. Links to the tables can be found at the bottom of this page. In order to assist you with interpreting the data, please click here for information about the mortality measures.

Key Findings

1. The age adjusted death rates for all SF fell, as did the rates for each ethnic except for African Americans. (table 1).
   
   
   
   • African American men continue to have the highest age-adjusted death rate, 1302 (per 100,000 persons) in 2004, compared to men and women in all other ethnic groupings measured.
   
   
   • Asian/Pacific Islander women continue to have the lowest age-adjusted death rate compared to men and women in all other ethnic groupings, 361 in 2004.


2. Prevention was o­ne of the 2004 Key Findings and continues to be a dominant finding in 2007.The majority of the leading causes of years of life lost (YLL) are preventable conditions: heart disease, HIV/AIDS, lung cancers, stroke, violence, hypertension, suicide, and drug overdoses. (tables 6-8).


3. Ischemic heart disease (IHD) is the leading cause of years of life lost overall and among both men and women (tables 6-8) and is the leading cause of years of life lost in Whites, Asians and Latinos and the second cause of YLL among African Americans (table 9). It is among the top 3 leading causes of years of life lost in every zip code in San Francisco. (table 10).
   
   
   
4. Not only does disease disproportionately affect the African American community, violence is also a major factor.Violence is the leading cause of YLLs for African Americans, and the third leading cause of age-adjusted death for males. YLLs for African American males increased by 56% from 2000 to 2004. (tables 5-9).


5. Violence is the third leading cause of YLLs among all males and for Latinos. (tables 7,9). Violence is in the top five leading causes of YLL in South of Market, Western Addition, Mission, Excelsior, Visitation Valley, and Bayview. (table 10). The high ranking of violence as a cause of YLLs reflects not just the number of deaths from it, but also the fact that victims of death from violence are overwhelmingly younger than those dying from other high-ranking causes of premature mortality.


6. Cerebrovascular disease is the fourth leading cause of YLL overall, is the 6th leading cause of YLL among males, 2nd among females, 6th among whites, 2nd among Asian Pacific Islanders, 5th among African Americans and Latinos. (tables 6-9).


7. Suicide (intentional self-inflicted injury) is the fourth leading cause of years of life lost among Whites, the fifth leading cause of years of life lost among Asian/Pacific Islanders, and the eighth leading cause of death among Latinos. Suicide is the fifth leading cause of years of life lost in males and the 10th cause of years of life lost in females. (tables 7-9).
   
8. Road traffic accidents are in the top five causes of YLL in the Excelsior, Twin Peaks, and the Outer Richmond, and in the top ten in the Potrero Hill neighborhood. It was the fourth leading cause of YLL among Asian/Pacific Islanders, and the seventh leading cause of YLL among Latinos. (tables 9, 10).
   
9. Despite the number of excellent HIV/AIDS educational programs, several segments of the population continue to suffer from this disease.The YLL for HIV/AIDS ranks number 2 among males, number 2 among whites, and Hispanic males, number 3 among African Americans. HIV/AIDS is among the top ten causes of YLLs in 13 out of 21 zip codes in SF. (tables 7-10).


10. Six of the 10 leading causes of preventable mortality are related to smoking: IHD, lung cancer, stroke, hypertension, COPD, and lower respiratory infections. Tracheal/bronchial/lung cancer, which is largely due to smoking, is the third leading cause of age-adjusted death among Whites and Asian/Pacific Islanders. COPD remains the fifth leading cause of age-adjusted death for Whites, and the seventh for Asian/Pacific Islanders. (tables 6-9).
    
    
    


11. The 94102 and 94103 zip codes include the Tenderloin and South of Market neighborhoods, where many very marginalized residents reside, including homeless, low-income, and elderly. Many of the leading causes of death can be attributed to drug overdose and alcohol use.The leading causes of preventable death among these persons include HIV/AIDS, ischemic heart disease, suicide, alcohol related conditions, and Hepatitis B & C. (table 10).


12. Breast cancer is the fourth leading cause of years of life lost among women, second among White and African American women, fourth among Asian Pacific Islanders and seventh among Latino women. (tables 8, 9).


13. Alcohol contributes greatly to the burden of premature mortality in San Francisco. Ten of the 17 leading causes of preventable mortality are related to alcohol: cerebrovascular disease, violence, hypertensive heart disease, suicide, poisonings, alcohol use disorder, breast cancer, road traffic accidents, cirrhosis, and liver cancer. Alcohol use disorder, a psychiatric diagnosis, is the 9th leading cause among males, 10th among Whites, 6th among Latinos (for whom cirrhosis is 4th), and 10th among African Americans. (tables 6-9).


14. Unintentional poisoning (many of which are drug overdoses) is the 8th leading cause of YLL overall, it ranks 3d in 94102, which includes the Tenderloin. It is 7th among all males, 13th among females, 5th among whites and 6th among African Americans. (tables 6, 8-10).


15. Liver cancer is the tenth leading cause of death among the Asian/Pacific Islanders but was not among the top ten list for any other ethnic group. (table 9).
    
    

Last updated September 20, 2007.