Assess the health issues of mothers, children, and adolescents in San Francisco.
Inform 5-year strategic plan (2015-20) of Maternal, Child & Adolescent Health (MCAH) programs in San Francisco and California.
Inform planning of San Francisco Department of Public Health (SFDPH) and its partners, including healthcare systems, healthcare providers, policymakers, First 5, Human Service Agency, Department of Children Youth and Families, San Francisco Unified School District (SFUSD), foundations, child care agencies, and other services.

The 2014 Needs Assessment process featured 4 primary methods:

Systematic Review of Reports by Other SF Agencies & Organizations: Reviewed and summarized relevant maternal, child, and adolescent health findings from over 30 reports.
Epidemiological Data: Compiled and analyzed epidemiological data from 30+ sources
Survey of key stakeholders: Asked hundreds of community and clinical stakeholders about health
problems, causes, and strategies.
Focus group discussions: 24 groups convened for community stakeholders and staff.

Results

Information gathered during the Needs Assessment pointed to disparities in maternal, child and adolescent health.
The process contributed to a broader perspective of health disparities and affirmed some common causes and
strategies critical to improving health. Analyzing the key stakeholder survey with epidemiological
data yielded 15 priority health problems.

15 Health Problems affecting Mothers, Children & Adolescents in San Francisco
Prioritized by Key Stakeholders in 2014

Preterm Births. Babies were more likely to be born preterm or with low birthweights among women with specific risk factors (those with Medi-Cal, Latina, Black, working during the 9th month, smoking, and obese), due to inequities in psychosocial, behavioral, socio-demographic, medical, and healthcare conditions.

Infant formula and breastfeeding disparities. By 2 months old, 77% of infants of low-income families are fed infant formula, instead of exclusively breastfed as recommended.

Early childhood obesity. Nutrition and physical activity inequities are causing overweight (13%) and obesity (18%) among young children in San Francisco. (3-4 year old children in SF Head Start)

Childhood dental decay. 34% of SFUSD kindergarteners have already experienced dental caries.

Child Abuse. 5.5% of children in San Francisco have experienced substantiated abuse or neglect.

Stress of special health care needs. Parents of children with special health care needs have increased stress because of the health condition, fragmented health services, and lack of support.

Physical Inactvity. Half of Latino (51%) and Black (48%) SFUSD 5th graders failed the Fitnessgram standards for aerobic capacity, compared to one-quarter of White (26%) and Asian (23%) 5th graders.

Adolescent Depression & Suicidality. 26% of high school students (SFUSD) are feeling sad or hopeless.

Black maternal and infant health. Black women and infants have worse health outcomes, including maternal obesity and hypertension; and preterm birth and infant mortality.

Preconception & Prenatal Drug Abuse. Women abusing drugs have poor health and social outcomes for themselves, but also poor pregnancy, birth, and infant outcomes.

Intimate Partner Violence. 1 in 10 women with Medi-Cal in SF experience intimate partner violence during pregnancy.

Perinatal depression. 1 in 6 mothers with Medi-Cal in SF suffer from postpartum depression, three-times higher than those with private insurance (18.2% vs 5.5%).

Primary care utilization for young women. Only 12% of low-income women (<100% FPL) have a medical home. Among San Francisco Health Plan female members age 20-29 years old, only 7% had a preventive health visit within the past year.

Prenatal care disparities. 30% of pregnant women with Medi-Cal missed first-trimester prenatal care, six-times higher than those with private insurance (30% vs 5%).

Inadequate and expensive housing conditions disproportionately affect the health of low-income families.