Risk Factors

There are great disparities in health among the various neighborhoods and ethnic groups in San Francisco. To a considerable extent, these disparities can be attributed to a relatively small number of risk factors. How can communities reduce their exposure to these risk factors?

Tobacco

Tobacco is probably the single most important cause of poor health and shortened life span.

Alcohol

Unhealthy alcohol use is a leading health problem in several neighborhoods.

Physical Inactivity

Our bodies are designed for movement, and there is abundant scientific evidence that failure to be physically active on a regular basis increases the risk for diabetes, high blood pressure, high cholesterol, colon cancer, breast cancer, depression, falls, and other health problems.

Availability of Healthy & Inexpensive Food

In some neighborhoods, there is poor access to healthy, sustainable, and inexpensive foods. Instead, "junk food" is abuntantly available.

The "Built Environment"

Some neighborhoods are less healthy than others because of the ways they are built. Healthy neighborhoods are those designed and built to improve the quality of life for all people who live, work, worship, learn, and play within their borders. The "walkability" of a neighborhood is an important measure of how healthy it is.

Social Isolation

People who are not well connected with others (family members, fellow workers, neighbors, friends) have more illness and lead shorter lives.

Lower Socioeconomic Status

Lack of economic resources is often (but not always) associated with more illness and shorter life span. Education improves both social standing and financial security, and longevity is directly correlated with educational status.

Racism

Experience of racism is associated with some health problems, such as high blood pressure and low birthweight infants. Institutional racism contributes to poverty and deprivation, poor access to educational resources, differential care in health settings, and to social exclusion.

Please suggest some key risks

What are some major risk factors that have led to our mix of programs? Do these capture the main risks? Suggestions?

Risk Is a Complex Subject

Risk factors are related to one another. For example, being overweight is a risk factor for diabetes, which in turn is a risk factor for heart disease. Lack of access to healthy and inexpensive food (lack of food security) is a risk factor for being overweight. Public health professionals sometimes talk about looking "upstream" for the risks that lead to other risks. Examples of major "upstream risks" (sometimes called "determinants") that were identified in our prevention strategic planning are lack of social connectedness, institutional racism, the physical environment, and lack of social equality. In terms of "downstream" effects, social risk factors like these lead to unhealthy behaviors, which in turn lead to clinical risks such as high blood pressure or diabetes or high cholesterol. Social risk factors also have direct effects on cardiovascular health.