San Francisco Department of Public Health statistical report

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SAN FRANCISCO PUBLIC LIBRARY

REFERENCE BOOK Not

to be

taken from the Library

SAN FRANCISCO PUBLIC LIBRARY mniiiiii'iiiiiiiiii

3 1223 90187 2813

DOCUMENTS DEPARTMENT

AUG 3

1

Digitized by the Internet Archive in

2012 with funding from

California State Library Califa/LSTA Grant

http://archive.org/details/sanfranciscodepa19591965s

HEALTH SAN FkANClSCO DEPARTMENT OF PUBLIC

STATISTICAL REPORT

/95 9

DOCUMr.nTS DEFT.

CAN FRANCISCO

DOCUMENTS FRANCISCO

PUSU

)

95-9-

(S

City

and County of San Francisco DEPARTMENT OF PUBLIC HEALTH

Central Office 101

GROVE STREET Zone 2

June 15,

1960

The chief sources of data for the Statistical Report of the San Francisco Department of Public Health are the birth and death

certificates registered in San Francisco or reallocated to us by the State Department of Public Health and morbidity reports re-

ceived from practicing physicians.

Constant endeavors are being

made to improve the quality of recording so that valid conclusions may be drawn from these statistics; however, the limitations of the data and the need for further study and analysis should be

always kept in mind.

In this report, we have tried to present

material for periods of five years or longer as well as for the calendar year 1959,

Further information is available from the

/ ""'*

Bureau of Records and Statistics.

c ELLIS D. SOX, M. D. Director of Public Health

.

CONTENTS SUBJECT

PAGE

Births Communicable Diseases Deaths Fetal Deaths Infant Deaths Marriages & Divorces Maternal Deaths Population Estimates Premature Births Tuberculosis Venereal Disease

15 23

PAGE

CHARTS, GRAPHS AND MAPS

Deaths from Respiratory Tuberculosis and Cancer, 19UO-1959 Causes of Death by Age Groups from 1 - h, to 65 and Over

12

2

Cases of Tuberculosis by "lealth District

3U

5 1

Cases of V.D. by Health District

39

3

22

9

20

18 25 35

Gonorrhea, Syphilis,

UO Ul

1955-1959 1955-1959

PAGE

TABLES 1. 2. 3. h. 5. 6. 7.

8. 9.

10. 11. 12. 13. lit.

15. 16. 17. 18. 19. 20. 21. 22. 23. 21;

25. 26.

27. 28. 29. 30. j?

32. 33. 3h. 35. 36. 37. 38. 39. 1*0.

San Francisco, Calif ornia & U.S., 1959 Deaths from important causes, Causes of death, all ages, 1955-1959 Causes of death by sex, rates and percent Maternal deaths, 1?5U-1959 Death rates for Whites, Chinese and Negroes Causes of death, residence, and occurrence, 1958-1959 Deaths from important causes by age group Selected morbidity and mortality data for health districts, 1959. Recorded, resident and non-resident births by place Resident live births by place and race Birth rates by race and sex, 1958-1959 Resident births by race and health district Live births by month prenatal care began by race Live births by trimester prenatal care began by place of bir^n Place of birth of premature infants by race Resident live births by weight, sex, and race Infant and fetal deaths by health district Infant deaths by race and age Infant deaths by race and sex rates Infant mortality by age and cause Fetal deaths by health district and race Fetal deaths by place of delivery and race Cases and deaths from communicable diseases, 1955-1959 X-Ray minifilm programs Chest Clinic and Tuberculosis Division, San Francisco General Hospital Tuberculosis cases and dea + hs, 1920-1959 New cases of Tuberculosis, by raos, and type Tuberculosis cases, deaohs, and *ates by race New oases of Tuberculosis by health district New cases of Tuberculosis, by age group and race Percent of cases in each stage of Respiratory Tuberculosis Interval between reporting of disease and death Other causes of death for persons having had tuberculosis Venereal Diseases cases by stage and sex Venereal Disease cases and rates by race and stage Venereal Disease by race and stage of disease Venereal Dise.'^e by age group and stage or type Venereal Disea e by source of report Ven3real Disease by health district Venereal Disease, 1955-1959 .

h 5 5 5 8

.

.

10 13 lU 16 16 16 17 17 18 18

19 19 20 20

.21 22 22

.

.

2U 27 29

30 31 32 32 33 33 33 33 36 37 37 37 38 38

38

GENERAL INFORMATION

San Francisco, one of the original 27 counties in the State, was also incorporated as a city in 1850. Located on the tip of a hilly peninsula, its total area is 93.1 square miles of which less than one-half, or Mi. 8 square miles is land. Excluding islands, its land area is 28,3^0 acres. The population density in 1959 was 17,650 people per square mile, the highest in the state; in area, it is in sixth place. It has an equable climate with an average daily temperature range of 12.2 degrees, from a daily mean maximum temperature of 62.6 to a daily mean minimum temperature of 50. h degrees; rain fall averages about 22 inches yearly. The city enjoys about 66$ of all possible sunshine. The population on July 1, 1959 as estimated by the California State Department of Finance was 790,700, about the same as the 1958 estimate of 791,100 and an increase of 2% over the 1957 estimate of 776,000 and the 1950 census figure of 775,357. Estimated figures for racial groups are:

NUMBER

PERCENT

790,700

100.0

White

686,200

86.8

Negro

56,000

7.1

Chinese

32,UOO

k.l

Japanese

7,600

0.9

Other

8,500

1.1

TOTAL

POPULATION ESTIMATES BY AGE GROUP

AGE GROUP

PERCENT OF TOTAL

EST. POPULATION

Under 5

8.2

6U,800

m

11.8

93,300

15 - 21

12.1

95,700

25 - kh

30.9

2U*,300

U5 - 6k

27.1

2114,300

65 and Over

9.9

78,300

5 -

-1-

POPULATION ESTIMATES FOR HEALTH DISTRICTS

HEALTH DISTRICT

POPULATION

TOTAL

Alemany Central Eureka-Noe

790,700

7ii,800

86,200 78,000

Hunters Point Marina-Richmond Mission

56,200 125,000 69,000

North East Sunset Festside

105,800 13U,500 61,200

Selected mortality and morbidity data for health districts are presented in Table 7. MARRIAGE S ;

The number of marriage licenses issued during the calendar year 1959 was 6,723, an increase of 231 or 3.6/6 higher than the 1958 figure of 6,1*92, the lowest number in any year since 19l*l. The rate increased tc 8.5 per 1,000 population, as compared to 8.2 in 1958.

DIVORCES t

Along with the increase in marriage licenses there was a slight decrease in number of divorce actions filed. For the calendar year 1959 the figure was 3,319 compared to 3,1*87 in 1958, a h,Q% decrease.

Reverting to fiscal year data, 3,l*3l* divorce actions were filed as against 3,508 for the preceding year. There were 1*97 suits for annulment and 38O for separate maintenance. Interlocutory decrees of divorce were granted in 2,57l* cases in 1958-59. Again in this fiscal year more than one divorce action was filed for every two marriages. The following table illustrates another evidence of social illness in San Francisco. FISCAL YEARS 1950-51 1951-52 1952-53 1953-51 1951*-55

1955-56 1956-57 1957-58 1958-59

LICENSES ISSUED 8328 7306 7395 6860 6631 661*5

6965 6526 6665

DIVORCE ACTIONS FILED

FINAL DECREES OF DIVORCE

ANNULMENTS GRANTED

1*51*3

281*2

1*68

1*391 1*327 1*096

29hO 2917

1*78

3867 3676 3500 3508 3U3U

-2-

3088 2598

552 517 1*99

2601*

1*83

21*32

1*63

21*1*2

1*77

2257

1*99

3

BIRTHS:

During 1959 there were lU,63U resident live births with a birth rate of 18.5 per 1,000 papulation as against 15,101; in 1958 when the rate was 19.1. Twice before during the decade, in 1955 and 1956, the rate was lower than in 1959. The percent of first births decreased by and the number of second births by nearly 6% from 1958 to 1959.. Provisional figures show a slight increase in rate for the United States as a whole and a drop for California.

%

BIRTH RATES

United States California San Francisco Alameda County Contra Costa Co. Marin County San Mateo Co.

PER 1,000 POPULATION

DEATH RATES

1959

1958

1959

1958

2lub

21;.

23.5 18.5

23.7 19.1 23.0 2U.0 22.7 23.1

9.U B.U 12.1 9.1 6.3 6.7 6.5

9.5 8.5 11.8 9.2 6.5

22.9 23.6 22.3 23. k

6.8

6.5

The following table shows the pattern of births and deaths in San Francisco from 1950 on, with rates per 1,000 population.

YEAR 1950 1951 1952 1953 195U 1955 1956 1957 1958 1959

DEATHSx

ESTIMATED POPULATION 775,357 776,200 791,500 795,900 798,300 79U,900 798,900 776,000 791,100 790,700

RESIDENT BIRTHS 15,U77 15,505 15,710 15,361;

15,171 iU,5Uo lU,565 I5,2li0 15,101; lU,63l;

BIRTH RATE 20.0 20.0 19.8 19.3 19.0 18.3 18.2 19.6 19.1 18.5

RESIDENT DEATHS 9,201;

9,527 9,693 9,U35 9,160 9,161 9,5U8 9,600 9,375 9,559

DEATH RATE 11.9 12o3 12 u 2 11,8 11.5 11,5 12 oO 12 11„8 12.1

M

During 1959 there were 9,559 San Francisco resident deaths, a 2% increase in number over 1958 j the crude death rate increased from 11.8 to 12.1 per thousand population. During the decade the rate varied from 11.5 to 12.1; and the number of deaths in 1959 was within the expected range. Crude death rates for both California and the United States decreased slightly," the United States decrease was only fer the non-white population while in San Francisco both the Negro and white rates increased. The all-time low rate for the United States was 9.2 in 195U. As in former years, all three jurisdictions had the same four leading causes of death, though in each case qan Francisco's rate was considerably higher than the other tw.% Cirrhosis of the liver, the 5th cause in San Francisco, advanced fr>m 10th to 9th cause on the United States list. San Francisco maintained its relatively low rate for "certain diseases of early infancy", 7th place locally whereas it was 5th in the United and California. Suicide rates dropped slightly to 9th place in San Francisco, remained in 9th place in California and 11th place nationally. The death rate for tuberculosis continued to decline in all three jurisdictions. In San Francisco the was onj^- me- third of the 10^0 1959 figure of 9.1 per 100,000 pop. rtfl.-vhh rat© f<\r +.he> di-nease. -3-

5

Table 1 DEATHS FROM IMPORTANT CAUSES SAN FRANCISCO, CALIFORNIA & UNITED STATES, 1959

RATE PER 100, 000 EST. POP.

RANK CAUSE OF DEATH

S.F. Cal. U.S.

S.F.

PERCENT OF TOTAL DEATHS

Cal.

U.S.

S.F.

Gal.

U.S.

8U0.6

9U2.U

100.0

100.0

100.0

-

_

_

1208.9

Heart Diseases

1

1

1

U7X.U

313.2 36U.O

39.0

37.3

38.6

Malignant Neoplasms

2

2

2

209.7

139.7 1U8.0

17.3

16.6

15.7

Vascular Lesions C.N.S.

3

3

3

120.0

92.8

108.3

9.9

11.0

11.5

Accidents

h

k

il

59.6

h9.9

50.U

1.9

5.9

5.U

Cirrhosis of Liver

5

8

9

52.0

17.1

11.0

b.3

2.0

1.2

Influenza & Pneumonia

6

6

6

37.il

27.8

32.5

3.1

3.3

3.5

Certain Diseases of Early Infancy-

7

5

5

27.6

3U.1

38.5

2.3

Jul

iul

Arteriosclerosis

8

7

7

25.7

19.1

19.7

2.1

2.3

2.1

Suicides

9

9

11

2k.

15.2

10.1

2.0

1.8

1.1

Diabetes

10

11

8

12.3

8.8

16.0

1.0

1.0

1.7

& Duodenum

11

12

13

12.1

6.8

S.9

1.0

0.8

0.6

Congenital Malformations

12

10

10

11.1

12. h

12.3

0.9

1.5

1.3

Tuberculosis

13

13

12

9.1

S.U

6.7

0.8

0.6

0.7

136.1*

98.3

119.0

11. h

11.7

12.5

ALL CAUSES

Ulcers of Stomach

All Other Causes

Sources:

-

City and County of San Francisco Department of Public Health records. California:

United States:



Communication from State Department of Public Health Deaths by occurrence. Percents rounded independently.

Monthly Vital Statistics Report, Volume 9, No. March 21, I960. -h-

1,

9 4

Table

2

DEATHS FROM IMPORTANT CAUSES, ALL AGES San Francisco Residents 1955-195?

NUMBER

ALL CAUSES

Heart Diseases Malignant Neoplasms Vascular Lesions of C.n.S.

Accidents Cirrhosis of Liver Influenza and Pneumonia Certain Diseases of Early Infancy Arteriosclerosis Suicides

Diabetes Ulcers of Stomach and Duodenum Congenital Malformations tu8ercul0sis All Others

RATE

-1252

J25J

1251

I25i

J25S

J252

J25S

1251

J25£

9559

9375

96w

_2S*i_

91 61

i?n«.q

nm.i

12^7-1

iiqq.i

mg.s

471.4 209.7 120.0

459.5 203.8 121.7

*7*.7 224.6 125.1

469.0 205.8 118.8

*57.3 200.9 100.9

59.6 52.0 37.*

62.2 45.9 36.2

69.2 47.3 39.0

66.8 42.6 28.9

58.4 56.2 28.8

27.6 25.7 24.5

33.* 21.5 25.0

31.7 24.4 25.0

27.7 22.8 29.*

30.1 26.5

194 128

12.3

13.3

12.0

11.0

16.1

101

12.1 11.1 9.1

9.1

11.1 11.6 10.0

10.6 8.5 11.5

12.7 10.1 14.6

1077

3684

37*7

3^35

1743 971

9*9

1597 802

9^9

3635 1612 963

Ml

492

296

286

303

231

288 229

218 203 19*

261 170 198

246 189 194

221

239

182 235

211

97

105

93

96

1

86

3727 1658

464

53* 340

?I 77

92 78

25 68 92

1031

1019

1132

88 72

1079

\m

116

136.4

9.7 130.3

13L*

1*1.7

1955

24.4

135.5

Rate per 100,000 Estimated Population

Table 3

IMPORTANT CAUSES BY SEX.

195?

FEMALE

MALE NUMBER ALL CAUSES

Heart Diseases Malignant Neoplasms Vascular Lesions of C.N.S. Accidents Cirrhosis of Liver iInfluenza and Pneumonia

Suicioes Diseases of Early Infancy Arteriosclerosis Ulcers of Stomach 4 Duooenum Tuberculosis Ccn genual Malformations DIA3ET6S All Other Causes

PERCENT

NUMBER

RATE

PERCENT

5f?0

1388.8

100.0

4069

1PJ2J-

1"0.P

2213 910 417

559.8

40.3 16.6 7.6

1514 748

382.9 189.2 13*.5

'2»? 18.4

0O.2 105.5

532

42.2 37.9

261 181

76.9 66.0 45.8

3.3

167 150 115

127 122 99

32.1 30. 25.0

2.3 2.2 1.8

3

2*. 3

104

26.3

71

18.0 13,4 12.9 10.9

1.3 1.0 0.9 0.8

\l

11.6

441

304

53 51

43

638

161.

29.1

16.9

fl

0.6

13.7

0.9 '.3

111.5

10.8

RATIO PER io,nnn live fURTHS 3.1 2.1

1:1

-5-

1.6 2.4 2.6

6.3 4.8

Table 4 MATERN AL, DEAT HS

NUMBER OF MATERNAL DEATHS

4.1

a

9.4

Rate per 100,000 Estimated Population, as calculated.

YEAR

13.1

Again in 1959 as in previous years of the decade, about Sk% of deaths at all ages were ascribed to cardiovascular renal diseases. The rate increased from 635 per 100,000 population to 6lj8 from 1958 to 1959, reflecting increases in almost all the component parts of the gr^up. Heart disease, the leading cause, accounted for 39$ of the deaths at all ages. Arteriosclerotic heart disease, including coronary arteriosclerosis, was the single most important cause of death, accounting for nearly 31$ • About 17$ of the deaths were caused by malignant neoplasms. Accidents decreased slightly from 5.2$ in 1958 to h*9% in 1959 and cirrhosis of the liver, in 5th place throughout the five year period, increased percentagewise to li.3» Male death rates were higher for each cause than those for females with the exception of vascular lesions of the central nervous system, general arteriosclerosis and diabetes. The sex-specific rate was 13.9 per 1,000 for males and 10,3 for females, compared to 13.8 and 9.9 respectively in 1958. Particularly striking were the differences in heart disease, 5.6 for males against 3.8 for females; for accidents 7.7 and It.2j cirrhosis 6.6 and 3.8 and suicides 3.0 for males and 1.7 for females. Numbers, rates and percents for important causes by sex are found in Table 3.

ETHNIC GROUPS Table h shows the leading causes of death for the three major ethnic groups in San Francisco. Overall rates increased for the white group from 12.5 in 1958 to 12.8 in 1959, and for Negroes from 7.2 to 8.3$ the Chinese rate continued to decline from a high of 10,5 in 195U to a low of 6.7 in 1959. Heart disease was the most important cause of death in every ethnic group but with considerable variation in rates; malignant neoplasms were second for the whites and Chinese but among the Negroes were third in rank. "Certain diseases of early infancy" were again the second important cause of death among the Negroes with a rate of nearly 12 per 1,000 deaths, more than five times as high as the whites and Chinese. Both accident and homicide rates were again considerably higher among Negroes than the population as a whole or any other part of it. Both Negroes and Chinese experienced decreases in cancer rates and increases in cirrhosis of the liver; rates for the latter increased about two and one-half times over 1958 for each. Suicides among the Chinese reached an all-time low but tuberculosis was the 5th cause of death with a rate of 27.8 per 100,000 population, nearly three times as high as the overall rate of 9.1 •

AGE GROUPS

Deaths under one year of age are included in another section of this report. In 1959, accidents were the leading cause of death among our children and youth, from age one through 2h, and the second cause in the 25-UU year age group. More than half of the accidental deaths in the 15-2^ year age group were caused by motor vehicles. Accidents were the 5th cause of death in those U5-6U years and the 6th cause among those 65 and over. Home accidents accounted for 37$ of all accidents and motor vehicles for 29$. Falls, the most common accident, caused kl$ of the accidental deaths.

Malignant neoplasms were the 2nd or 3rd cause of death in all age groups.

Thirty percent of the deaths in ages £ -lh year* were coded to cancer with laukeraias the most common form. The digestive system as a whole- was the site af about 3h% of the canned and the lungs abort. 17$. -6-

AGE GROUPS

(Continued)

Heart diseases were the leading cause of death in all groups over 25 years of age. The proportions increased steadily from 17$ in those 25-^U to 36$ in those kS-^h and h6% in those 65 years and over. Vascular lesions of the central nervous system also increased in each advancing age group accounting for 13$ of the deaths in those 65 and over c Cirrhosis of the liver was the Uth cause in the age group 25-hU years of age, accounting for 13$ of the deaths; it was the 3rd cause of death in the U5-6U year group, lower percentagewise, but with a rate four times as high as in those aged 25 to hh years. Cirrhosis deaths with mention of alcohol increased from 31$ in 1958 to Cirrhosis deaths as a whole increased almost k3% since 1955 with the 35$ in 1959. rates increasing from 36 to 52 per 100,000 population. The death rate for suicides increased steadily with age, from 6.3 per 100,000 population in the l5-2h year age group to 67.7 in those 65 and over. It was the 3rd leading cause in the age group l5-2u, 5th in those 25-Ui, and 6th in those U5 to 6ii years of age. The overall rate decreased slightly from 25.0 in 1958 to 2lu 5 in 1959. Seventy-five percent of the suicides whose length of stay in San Francisco county was reported had lived in the county at least five years and 6h% had lived here at least ten years. Only 10 of the 17k residents whose length of stay was reported had lived in San Francisco less than one year.

The age-adjusted death rate for San Francisco in 1959 was 8.9, about 16$ higher than the national figure of 7.7. The average age of death for males was 63 years and for females 67 years. The median ages at death were considerably higher, 67 years for men and 72 years for women.

-7-

7

Table

5

LEADING CAUSES OF DEATH FOR SiN FRANCISCO WHITES, NEGROES AND CHINESE KITH RANK ORDER AND RATE* PER 100,000 POPULATION, 1959

WHITE NUMBER

RATE

Im

8767

1277.6

1

3506

2

151*8

RANK

ALL CAUSES Heart Diseases Malignant Neoplasms Vascular Lesions Accidents

NEGROES

RANK

1

6tt

2 3

38 19

7

7

197.5 117.3 58.6 21.6

1*1*.6

It

13

1*0.1

19.6 8.9 8.9

6

8

-

2

3

123 56

5 h

1*7

219.6 100.0 53.6 83.9

25 11 5 5

67

3

890 1*06

Cirrhosis of Liver 5 Influenza & Pneumonia 6 Arteriosclerosis 7 Suicides 8

370 2lh 196 185

53.9 39.9 28.6 27.0

6 8

•-

30

RATE 666.7

ma

1

NUMBER 216

832.1

1*

Tuberculosis Intestinal Obstruction & Hernia Nephritis Homicides

RANK

RATE

U66

510.9 225.6 129.7 59.2

Diseases of EarlyInfancy Diabetes Ulcers of Stomach & Duodenum Congenital Malformations

NUMBER

CHINESE

21*.

2

6.2 6.2

9

135

7

21.6

-

1*

119.6 7.1

7

87

19.7 12.7

2

10

-

5

15.1*

11

86

12.5

-

1*

7.1

8

6

18.5

12

Ik

10.8

9

7

12.5

8

6

18.5

13

56

8.2

_

k

7.1

5

9

27.8

Ik 15 16

55 3k

10 -

6

10.7 5.1*

1

7

16

28.6

-

1

3

22

8.0 5.0 3.2

-

3.1 3.1 -

81*3

122.9

53

91*.

28

86.1*

All Other Causes

6

There were 1*6 deaths of Japanese; among them 13 from heart diseases, 6 each from vascular lesions and accidents and 5 from malignant neoplasms; the rate was 6 per thousand estimated population. There were 1*5 Filipino deaths; among them 17 from heart diseases, 8 from cancer, from vascular lesions and 3 each from accidents and certain diseases of early infancy. In the "other non-white" group 1* each of the 19 deaths were from heart disease and certain diseases of early infancy and 3 were from cancer.

1*

*

Rates as calculated.

-8-

DEATHS FROM RESPIRATORY TUBERCULOSIS AND RESPIRATORY CANCER

(J-YEAR MOVING AVERAGES

.

191*0

TO 1959)

SAN FRANCISCO RESIDENTS

NUMBER OF DEATHS

-

1*00

RESPIRATORY TUBERCULOSIS 300

/ 200

100

-U 19*1

19*5

1950

YEAR



Figures prior to 1951 00 not inoiuoc Saw Frawcjsco residents MHO DIED OUTSIDE OF San FRANCISCO.

-9-

1955

1958

Table 6

DEATHS FROM SELECTED CAUSES,

CITY 4 COUNTY OF SAN FRANCISCO

BY PLACE Df RESIDENCE AND OCCURRENCE,

TOTAL,

ALL CAUSES

9W

UL5L3

SEVENTH REVISION INTERNATIONAL tIST NUMBER

1

DEATHS BY RESIDENCE

1

DEATHS

9 S t

BY

NUMBER

RATE*

PERCENT'

OCCURRENCE

NUMBER

RATE

2552-

taaka

ipq«q

1Q,11$

9375

1185.1

S12L

6>7.7

53jA

Sid

5026

Ss»3

949

120.0 0.5 471.4

912

963

113

121.7 0.3 *59.5 14.3

293«

2885

364.7

SELECTED DISEASES USUALLY CHRONIC IN NATURE CARDIOVASCULAR RENAL DISEASES,

TOTAL

Vascular Lesions, C.N.S. Rheumatic Fever Diseases or the Heart Chronic Rheumatic Heart Arteriosclerotic Heart Disease including Coronary Arteries Chronic endocarditis ano Myocarditis Other Diseases of the Heart Hypertension with Heart Disease

Hypertension without Mention of Heart General Arteriosclerosis Other Diseases of Circulatory System Nephritis, Chronic and Unspecified

MALIGNANT NEOPLASMS.

TOTAL

Buccal Cavity and Pharynx Digestive Organs and Peritoneum not specified as Secondary Respiratory System, not specified as Secondary Breast Cervix Uteri Other Uterus Other Female Genital Organs Male Genital Organs Urinary Organs

330-334 400-402 410-443 410-416

ii

12.1

9.9 0.0 39.0 1.0

2949

373.0

30.9

W1-W2

199

2.1

430-434 440-443

400

25.2 10.5 50.6

444-447 450

42

5.3

0.4

203

25.7

2.1

151-468

158

20.0

1.7

592-59*



4.8

0.4

-LUI

120

37

140-205

0.9 4.2

2

3635

186 80

23.5

371

46.9

40

38

181

170

4.8 21.5

183

169

21.4

50

49

6.2

.2M2

1612

?rn.fl

V> 381

10.1

140-1*6 150-I56-A

0.8

79

73

9.2

57- 1 59

5.9

679

533

67.4

160-164

2.9

357

286

36.2

1?0

166

18.2

171 I 2 1 l!t

175-17°

1.4 0.4 0.3 0.6

177-179 180-181

0.8 1.0

1

1

50

144 42

28 73

11

.55

It

9.4 10.9

Hoogkin's Disease Leukemia and Aleukemia Other Lymphatic 4 Hematopoietic Tissues

201

0.1

14

1.8

204

o.7

,y

74

9.4

200, 202, 203, 205

o.7

90

K

7.0

Other and Unspecified Sites

156B 165, 190-199

\.t

214

150

19.0

151

* Rate per 100,000 Estimated Population. ** ERCENTS AND RATES AS CALCULATED. PeRCTNTS less than 0.1 I

-10-

19.1

not listed.

Table

6,

Continued

DEATHS FROM SELECTED CAUSES

-1252.

SEVENTH REVISION INTERNATIONAL LIST NUMBER

Benign and Unspecified Neoplasms Diabetes Mellitus

210-239 260

DEATHS BY RESIDENCE

NUMBER

RATE*

PERCENT**

1958

DEATHS

BY

OCCURRENCE

RESIDENT

NUMBER

RATE

3.9 13.3

26 97

3.3 12.3

0.3 1.0

4-0

3<

100

105

581

Ml

44-1

268

52.0 33.9

'•.3

581.0 581.1

18.1

2.8 1,5

285 156

363 249

14-3

540-54-1

96

12.1

560-561,570

62

7.8

1.0 0.6

103 67

800-962

4-71

59.6

».9

810-835 870-936 with .0 Residual

136

1.4-

SUICIOES HOMICIDES

Cirrhosis of the Liver 'J(thout Mention of Alcohol with Mention of Alcohol !

Ulcer of Stomach and Duodenum Hern:a and Intestinal Obstruction

11i*

^5.9 51-5 14.4

4-21

4-92

62.2

16*1

175

19.3 20.7 22,1

ACCIDENTS, POISONINGS AND VIOLENCE

ACCIDENTS Motor Vehicle Accidents Home Accidents Other Accidents

in

17.2 22.0

161

20.4-

1.8 1.7

100 182 139

963,970-979

194-

24-. 5

2.0

207

198

25.0

96f,980-985

4-0

5.1

0.4-

36

*3

5.*

0.8 0.7 0.0

77 72

9.7

1:1 0.5

5?

II

J

5

0.6

3.3

0.3

20

21

2.7

1

0.1

0.0

1

0.1

0.3

SELECTED COMMUNICAUE DISEASES Tuberculosis, *ll Forms Respiratory System Other Forms

001-019 001-008 010-019

Syphilis Poliomyelitis Encephalitis, Infectious

020-029 080-081 082-083

Hepatitis, Infectious Other Infective and Parasitic Diseases

092 Residual 001-13&

Influenza & Pneumonia, exc. of New Born Influenza Pneumonia except of New Born

4-80-4-93 4-80-4-83 4-90-1*93

4-

26

5

1 1

5

0.6

0.1

7

2

18

2.3

0.2

17

9

1.1

J

37.*

224-

286

36.2

2

4-

290

36.7

3.1 0.1 0.1

222

232

0.5 35.6

0.8

ALL OTHER CAUSES

Complications of Pregnancy, Childbirth AND THE PuERPERIUT-1

640-689

3

0.4-

0.0

5

5

0.6

Certain Diseases of Early Infancy

760-776

218

27.6

2.3

286

264

33.^

Congenital Malformations

750-759

88

11.1

0.9

183

72

9.1

Gastritis, Duodenitis, Enteritis, Colitis all "ther Specified Causes

Symptoms, Senility, Ill-Defined and Unknown Causes

5^3,571-572

28

3-5

0.3

3*

29

3.7

Residual

614

77.7

6.4

659

55*

70.0

780-795

14-

1.8

0.1

24

3.0

* Rate per 100,000 Estimated Population, ** Percents and rates as calculated. Percents less THAN 0.1

-11-

NOT LISTED.

PERCENTAGE OF DEATHS FROM IMPORTANT CAUSES DY AGE GROUP SAN FRANCISCO RESIDENTS 1

-

ACCIDENTS

-

19S9

YEARS

h,

31*

?t;

I

-

W

YEARS

HEART DISEASES

1$

ACCIDENTS

15*

!

is*

!

NON.MENINGO. CDCCAL MENINGITIS

JW^

MALIGNANT NEOPLASMS

T4\

MALIGNANT NEOPLASMS

CONGENITAL MALFORMATIONS

Z?J

CIRRHOSIS OF LIVER

"~i3?l

SUICIDES

151

NEPHRITIS ~7?>J

q -

1H.

ACCIDENTS

YEARS

4S - 6^ YEARS

HEART DISEASES

37/

MALIGNANT NEOPLASMS

|

3#

MALIGNANT NEOPLASMS

29$

PNEUMONIAS

VASCULAR LESIONS C.N.S.

CONGENITAL MALFORMATIONS

IVfr

CIRRHOSIS OF LIVER

2L

VASCULAR LESIONS C.N.S.

a

ACCIDENTS

m ACCIDENTS

-

?i|.

6S YEARS 4 OVER

YEARS

HEART DISEASES

<*j£

sr

MALIGNANT NEOPLASMS

i

SUICIDES

sTl

MklIGNANT NEOPLASMS

2

:

VASCULAR LESIONS C.N.S.

PNEUilONIAS

INFLUENZA 4 PNEUMONIA

HOMICIDES

ARTERIOSCLEROSIS

-12-

Itfg

Table 7 DEATHS FROM IMPORTANT CAUSES BY AGE GROUP Sam Francisco Residents, 1351

1

S - 14 YEARS

_ H YEARS

CAUSE OF DEATH

NO.

ALL CAUSES

Accidents 13 Non-Men ingococcal Meningitis Malignant Neoplasms I b Congenital Malformations Nephritis 3 Gastro-Enteritis 4 Colitis 2 Pneumonias 2 All Other Causes 9

i 100.0

8f.3

31.0

26.1 10.0

11.9

9.5 9.5 7.1

4.8

M

21 .b

CAUSE OF DEATH

RATE

8.0 S.o 6.0 b.o b.o 18.2

Accidents Malignant Neoplasms Pneumonias Vascular Lesions C.m.S, Congenital Malformations All Other Causes

15 - 2b YEARS

CAUSE OF DEATH

2<;

NO.

i

66

100.0

Accidents Malignant Neoplasms Suicides Pneumonias Homicides Vascular Lesions C.N ,S. Other Neoplasms

30

2

^5.5 12.1 9.1 *.§ *.5 3.0 3.0

All Other Causes

12

18.3

ALL CAUSES

U

- 64

8 6

3

3 2

69.

M 12.6

Heart Diseases Accidents Malignant Neoplasms Cirrhosis of Liver Suicides Vascular Lesions C.M.S, Homicides Pneumonias Tuberculosis All Other Causes

RATE

CAUSE OF DEATH

6.3 3.1 3.1 2.1 2.1

ALL CAUSES

Heart Diseases i'-'alignant Neoplasms Cirrhosis of liver Vascular Lesions C.N.S. Accidents Suicides Influenza 4 Pneumonia Other Respiratory Diseases Ulcers Stomach 4 Duodenum Tu8Erculosis All Other Causes Diabetes

RATE

fl

f3.9

15 12

3606

16.1

12.9

2

29.2 &.9 *.9 *.9

8

19.5

8.6

bit

2 2

2.1 2.1 2.1

YEARS NO.

ALL CAUSES

YEARS

CAUSE OF DEATH

-

CAUSE OF DEATH

RATE

i 100.0

NO.

ALL CAUSES

i

RATE

wo

100.0

?16.9

89

16.8 15.3

36.b 33.2

81

80 69 53 25 22 15

15.1

13.0 10.0 1.1 b.2 2.8

11

2.1

*5

16.0

28.2 21.7 10.2 9.0

M

6.1

3*.9

6S YEARS and OVER NO.

<

2751

100.0

128*.7

979

35.6 23.7 9.5

*56.8 303.8 119.5

651

256 167 1*3

6.1

81

Li

62 50 32

l

5.2 *l 1.8 1.2

31

1.1

269

9.7

30

1.1

m

37.8 28.9 23.3 1b.9

IM

125.6 lb.0

-13-

ALL CAUSES

NO.

SIM

100.0

7381.9

Heart Diseases 2657 Malignant Neoplasms 901 Vascular Lesions C.n.s. 753 Influenza 4 Pneumonia 193 Arteriosclerosis 185 Accidents 170 Other Respiratory Diseases 12J Cirrhosis of Liver 86 Suicides 53

b6.o 15.6 13.0 3.3 3.2 2.9 2.2 1.5 0.9

3393.*

All Other Causes

11.4

839.1

657

1150.7 961.7 2"6.5 236.3

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»^

-15BIRTHS

During 1959, the total number of births occurring and recorded in San Francisco was 20,1*76, only 36 fewer than the high of 20,512 recorded in 1957. The number of nonresident births was a peak figure of 6,133 or nearly 30$ of the total born in San Francisco in 1959 compared to S,SH and 21,1% in 1958. San Francisco resident births outside the city decreased to 291 in 1959 from 316 in 1958. The number of resident live births was therefore 15,101* with a rate of 18.5 per 1,000 estimated population. The ratio of males to females was 105 to 100 with 7,507 male and 7,127 female births. Vhite births decreased from 11,008 in 1958 to 10,1*1*2 in 1959, about 5$, and the birth rate decreased from 16,0 to 15.2 per 1,000 estimated population.

Negro births remained the same, 2,1*62 in 1959 and 2,1*60 in 1958, but because of the estimated increase in the total population, the rate declined from 1*1*. 6 to 1*1*. 0. The number of Chinese births increased slightly, from 867 to 889, with rates of 27.1 and 27. 1* respectively. Seventy-one percent of the births were white, almost 17$ Negro, 6$ Chinese, 1.6$ Japanese, 2.7$ Filipino, and 1,1$ other races.

During 1959, 7.9$ of the re .ident live births were to unmarried parents, an increase from the 7.5$ figure in 1958 and 7.3$ in 1957 } 1*.8$ of all white births and 2l*.5$ or nearly a quarter of the Negro births were out of wedlock as were 2.9$ of the other non-white groups. Of the 1, 160 unmarried mothers, 1*3.5$ were white, 52$ Negro, and the remainder other non-white. Fifty-one percent of the deliveries took place at San Francisco General Hospital; of these, 22$ were white and 75$ were Negro; 11$ took place at the University of California Hospitals where the racial proportions were reversed, 72$ being white and 2l*$ Negro. Birth weight continued to be uniformly well reported and information on this item was available on 99.8$ of the certificates. By this criterion of prematurity, 7.9$ of all births weighed 5? pounds or less as did 6.9$ of the white births, 12.1$ of the Negro births and 7.U$ of the Chinese. "The first day of the last normal menses" was entered on 85$ of the certificates. Calculation of the period of gestation showed 1,386 births or 11$ with gestation periods of less than 37 weeks. Twenty-two percent reported 1*0 completed weeks of gestation in 1959 as compared to 7l*$ for this period of time in 1956, the last year that gestation was entered directly in weeks. Failure to report the item was again true for the Chinese where 1*2$ of the certificates did not include it. Birth rates by health district did not differ markedly in 1959 from the 1957 and 1958 experience, with the Mission Health district again having the highest rate and North East the lowest. Seventy percent of the Chinese births were to residents in the North East district compared to 73$ in 1958 and 81$ in 1953. In March 19 60, the State Department of Public Health released a summary of the San Francisco Matched Birth Certificate and Hospital Record study, based on live birth certificates registered in San Francisco during April 1957. The main conclusion is that "the medical information presently reported on birth certificates is often incomplete and sometimes inaccurate". Three items, race of mother, birth weight and length showed better than 9l*$ agreement between the birth certificate and the hospital record and more than 99$ of the certificates included these items.

Items such as maternal conditions complicating pregnancy were entered in less than 20$ of the cases where there were complications. Infant conditions as birth injuries were entered on only 9$ of the certificates.

Table 9 RECORDED, RESIDENT AND NON-RESIDENT BIRTHS BIRTH. SAN FRANCISCO, 19S8 A 1959

BY PLACE Of

RESIDENT

RECORDED

TOTAL

NON. RESIDENT

12M

.Lisa

125g

_jJLi3A_ L5»JUtt

6m

«TC11

1959

1353

1958

20,476

20,299

2687

1439 1257 1213 1219 1740

1411

Z % 851

1416 1007 662 1256

Kaiser Foundation Hospital Children's Hospital U. C. Hospitals St. Mary's Hospital San Francisco General Hospital

1778 1757

2451 1912 1623 1372 1639

Mary's Help Hospital St. Luke's Hospital Letterman General Hospital Stanford Hospital of San Francisco Mt. Zion Hospital 4 Medical Center

1618 1392 135b 1294 1233

1795 1375 952 1782 1097

1229 976

914

823

St. Francis Memorial Hospital St. Joseph's Hospital

1164 1124 605 457 255

1220 1155 659 427 246

879 815 407 440 56

S96 849 479

63 9 4

70

1

3

10

1

3 3

291

5.J

im iaw

French Hospital Chinese Hospital St. Elizabeth's Infant Hospital Home Emergency Hospitals Elsewhere Out of Town

1248 606

1355 1122 162S

-

NEGRO 2462

San Francisco General Hospital Kaiser Foundation Hospital Children's Hospital Mary's Help Hospital St. Mary's Hospital

1740 1439 1257 1229 1219

640

1022 217 98 12

9

33

102 119 12

8

41

21

U. C. Hospitals

1213 976

St. Luke's Hospital Mt, Zion Hospital A Medical Center St. Francis Memorial Hospital Stanford Hospital of San Francisco

914 879 851

Letterman General Hospital St. Joseph's Hospital Chinese Hospital French Hospital Home St. Elizabeth Infant Hospital

Emergency Hospital Elsewhere Out of Town

860 637 733 498

CHINESE

FILIPINO 401

324 306

198

180 10 179

s

JAPANESE -23J_

\t

40 3

11

28

5

4 10

a

1

11

233

49

26

39

g

41

20

M

4

9

n

61

11

11

21

14 T

2 P 315

546 767

tg

2

16

9

440 407 63

15

11

370

51

308

88

31

18

7 8

3

56

39

11

1

4

9 4 291

2

_

-

244

1%

9

1

4

1

285 309

18 10 20 26

209

5

368 290 526 274

-L252

WHITE

194

504 443 319

2

LQ»M2

945

11

199

TOTAL

1107 1122

17

in

I'^fr*

1011

557 501

557

17

Table 10 SAN FRANCISCO RESIDENT LIVE BIRTHS BY PLACE AND RACE

Ml

1040

620 559

'I 1

4 2

1

Table 11 RESIDENT LIVE BIRiHS 4 BIRTH RATES* BY RACE AMD SEX SAN FRANCISCO 1958 and 19 c 9

19 TOTAL

White Negro Chinese Japanese Others Rates per 1,000 estimated population.

5

Li-SJ

9

uams

RATE

JL4J34

18.5

75Q7

10,442 2462 889

53*1 1263

237

15.2 44.0 27.4 31.2

604

71.1

-16-

458 119 326

BIRTHS

RATE

7127

15,104

.12*1

5101 1199 431 118

11,008 2460 867 231

27 'i 30. S

278

538

64.0

16.0 44.6

4

Table 12

RESIDENT BIRTHS BY HEALTH DISTRICT & RACE SAN FRANCISCO.

TOTAL TOTAL

11. ft*

BIRTH RATE

FILIPINO

OTHER NON-WHITE

WHITE

NEGRO

CHINESE

<;

10,442

2462

889

401

217

20.4

1223

220

26

36

7

17

30

32

18.

JAPANESE

201

ALEMANY

1529

CENTRAL

1681.

19.5

959

496

38

129

EUREKA-NQE

1743

22.3

1648

25

12

25

16

17

HUNTERS POINT

H06

25.0

657

662

13

31

7

36

MARINA-RICHHOND

1817

14.5

1535

70

81

46

68

17

34

59

16

*5

626

14

10

21

MISSION

1953

28.3

15*5

214

NORTH EAST

1233

11.7

5*3

19

SUNSET

1938

14.4

1872

11

25

11

14

5

WESTS IDE

1250

20.4

352

736

30

50

69

15

DISTRICT NOT REPORTED

6a

Table 13 live births by month prenatal care began and by race s am Francisco Residents, 1252

RACE MONTH PRENATAL CARE BEGAN

NEGRO

TOTAL

TOTAL

CHINESE

FILIPINO

W

2462

JAPANESE

OTHER NON-WHITE

m

14,^4

10,442

1st Month 2nd Month

1012

3rd Month

3240

844 3022 2403

4th Month 5th Month 6th Month

2035 1373 1128

881

7th Month 8th Month 9th Month

*>\ 507

390 276

180

184

105

61

No Care or Month of Care Not Reported

816

545

1

79

32

24

12

24

Percent of Total Not Reported

5.6

5,2

7.3

3.6

6.0

5.1

11.8

13,818

9897

2283

857

377

225

179

7951 4541 1326

6269 2857

691

562 257 38

203 146

155 55

J!

28

15

37

53.8 38.7 7.5

68.9

Number Reported as Receiving Prenatal Care 1st Trimester 2nd Trimester

3rd Trimester

627

771

2 66

36 235

33*

291

9

2 37

16 80 107

176 5* 409

27

20 'fflf

1155 437

1

PERCENT RECEIVING PRENATAL CARE IN EACH TRIMESTER OF THOSE REPORTED AS RECEIVING CARE 1st Trimester 2nd Trimester 3rd Trimester

57.5 32.9 9.6

63.3 28.9 7.8

-17-

30.3 50.6 19.1

65.6 30.0 4.4

2t*.

6.7

TA8LE 1* LIVE BIRTHS BY TRIMESTER PRENATAL CARE MEGAN AND BY PLACE OF BIRTH San Francisco Residents, 1252 CARE BEGAN

2nd TRIMESTER

1ST

PLACE OF BIRTH

TOTAL TOTAL

TRIMESTER

14,634

H26

!tSM

1253

NO CARE OR NOT REPORTED

TRIMESTER

San Francisco General Hospital Kaiser Found/it ion Hospital Children's Hospital Mary's Help Hospital

&

1*50

420

64

St. Mary's Hospital University of California Hospitals St. Luke's Hospital Mt. Zion Hospital 4 Medical Center

203 551 257 213

St. Francis Memorial Hospital

131 211

JUL

181

28

Stanford Hospital of San Francisco Letterman General Hospital St. Joseph's Hospital Chinese Hospital French Hospital Home St, Elizabeth's Infant Hospital

40 SI

2

\l

4

53

1

?5 49

1?

326

58

10

160

21

3

ns

24

68

11

21

3

31

11

Emergency Hospitals Elsewhere Out of Town Out of State

6 1

4

Unknown

TAote 15 PLACE OF BIRTH OF PREMATURE INF'iNTS BY RACE San Francisco Residents 1.953

RACE PLACE OF BIRTH

TOTAL

WHITE

NEGRO

XOL

_&2-

Jt23-

San Francisco General Hospital Mary's Help Hospital Kaiser Foundation Hospital Children's Hospital

345 122 112

120

213

111

73

University of California Hospitals St. Mary s Hospital Stanford Hospital of San Francisco Mt. Zion Hospital 4 Medical Center

102 100

TOTAL

Letterman General Hospital St. Luke's Hospital St. Francis Memorial Hospital St. Joseph's Hospital

French Hospital Chinese Hospital Home St. Elizabeth's Infant Hospital

Emergency Hospitals Elsewhere Out of Town Out of State

'8

94

8 40

88

55

72

l \

\

a

n

16 _

4

28

-18-

FILIPINO

JAPANESE

Jt£L

_LL

OTHER

21.

4

_

l

29

8

7

2

_

18

12

5

2

1

31

2

1

_

2

1

3

42

4

3

29

1

30



3

.

5

1

9

1

3 3

1

1

1

1

1

2

3

2

4

1

-

1

3

-

1

-

m

_

m

1

m

2

1

1

s

1

4

5

14

3

n

6

SL

6 8

2

'2

CHINESE

m 1

-

1

-

-

-

1

-

-

-

-6LI

»- ^\»-

.-Ost^US *-

US^-

I

USt—<\J »-»•d'ftl

S

»-

Vf>SOOsS£> i-

u-

X
X

»- N-\

CMSO



I

f*M*-\

OsCM»-r— *-

\x>

*- i~ LCSCM

.-

cm to

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INFANT DEATHS

There were 3U8 resident deaths under one year of age in 1959 with a rate of 23.8 per 1,000 live births, an encouraging decrease from rates of 25.8 in 1958 and 25.3 in 1957. The decrease was chiefly in the deaths under 28 days of the white infants; Negro deaths increased by h% with the increase mainly in the age group 7-28 days. The 20$ decrease in deaths coded to ill-defined diseases and unqualified prematurity was partly the effect of trying to improve reporting and resulted in deaths coded to more specific causes such as congenital malformations, hemolytic diseases and birth injuries.

Prematurity was mentioned as a causal factor in 50$ of the deaths and in the most frequent cause, atelectasis, was mentioned in 80$ of the deaths. Congenital malformations caused 18% and birth injuries 1$% of the deaths. Accidents decreased numer*ically from 1958 but accounted for S%, There was no decrease in deaths for respiratory infections as a whole. Westside Health District again showed the highest rate of infant deaths, 38 .ii per 1,000 live births, slightly higher than the Negro rate of 32.8; almost 60% of the infant deaths were in the neonatal period. Central Health district had the next highest rate for both categories, and the highest number of premature births though Westside's rate for premature births was considerably higher than Central. Five health districts had lower rates than the city as a whole, Marina-richmond, Sunset, Alemany, Eureka-Noe and Mission. North East and Central had lower rates than in 1958 while Hunters Point remained the same. The birth mortality index was highest in Westside and Central, because of the high fetal death ratios in those districts, both considerably higher than the city rate of 32.6 per 1,000 live births. Marina-Richmond, with the lowest fetal death ratio of 9 per 1,000 live births also had the lowest birth mortality index. Table 18 INFANT DEATHS BY RACE AND AGE

TOTAL

TOTAL

White Negro Chinese

Japanese Filipino Other Non-White

1-6

UNDER 2f HRS.

mi

DAYS

7-2S DAYS

MONTHS

^g

140

in

11

ftt

225

91

64

16

b

21

n

S4 20

5

3

7

93 19

2

3 3

1

1

5

3

1

1

T 1

Table 19 INFANT DEATHS BY RACE AND SEX ?.AN_fRMCISCO, _. 19V?

TOTAL

RATE PER 1,000 LIVE BIRTHS

HALE

m White Negro Chinese

Japanese Filipino Other Non-Wh TE

225 93

132 50

19

13

3 3

1

2S.

II:!

2

24.6

-20-

Table 20 INFANT DEATHS FROM SELECTED CAUSES BY AGE SAN FRANCISCO 19R9

NEO-NATAL SUB-TOTAL

UNDER 24 HOURS

1

X-?g DAYS

lAfl

2!t

jj

Si

-LOJ.

-&_

\i

25

TOTAL

ALL CAUSES

JUL

^£SL

TOTAL WITH MENTION OF PREMATURITY

-1XL

-US-

267

212

133

66

63 53

40

762 770

64

62

10

10

771-773

31

31

14

46

46

3'

PRENATAL and NATAL CAUSES and DISEASES OF EARLY INFANCY, EXC.

INFECTIONS

Congenital Malformations Injury at Birth

mi

Atelectasis Hemolytic Diseases Ill-Defined Diseases Prematurity Unqualified or Subsidiary

776,

77^

INFECTIONS

Other Respiratory meningitis, No Organism Specified

J3_ 12

490-493 500-527

1

3^0.3

2

Late Effects Intracranial Abscess or Pyogenic Infection Oiarrhea of Newborn or

344.1

Other Sepsis

764-768

.

.

2

ACCIDENTS

_J_

Falls

902-904

Suffocation or Obstruction: Inhalation or Ingestion

921-922

Suffocation: In Bed or Cradle Other and Unspecified

924 936

_12__

ALL OTHERS

Diseases of Adrenal Glands Iron Deficiency Anemia

274 291

Other Diseases of Brain Hernia

Intestinal Obstruction without Hernia Gastro-Enteritis and Colitis

MONTHS

53

-5JL

Pneumonia of Newborn Other Pneumonia

- 11

1-6 DAYS

CAUSE OF DEATH

570 571

Other Diseases of Pancreas Other Diseases of Bladder

537,2 606

Malignant Neoplasm of Brain Lymphoma

193.0 202.1

-21-

JJL

Table 21 RESIDENT FETAL DEATHS BY HEALTH DISTRICTS & RACE SAM FRANCISCO, 19 09

TOTAL

VHITE

TOTAL

212

150

RATIO PER 1,000 LIVE BIRTHS

3iu5

lii.il

NEGRO

JA PANESE

OTHER

U8

k

5

3

2

19.5

U.5

12.5

12.7

9.9

Alemany Central Eureka-Noe

27

20

7

33 2U

19 2h

12 -

Hunters Point Marina- Ri chmond Mission

16 16 28

5 lit

9 -

2lx

3

North East Sunset Westside

Ik 27 2U

8

1 -

27 6

CH INESE FI LIPINO

16

District Not Reported

Table 22 RESIDENT FETAL DEATHS BY PLACE OF DELIVERY AND RACE SAN FRANCISCO, 1959

R TOTAL

WHITE

NEGRO

212

150

U8

3U 25 19

10

22 6

University of California Hosps. 16 Stanford Hospital of S.F. 15 Children's Hospital 15

1U 11 10

2

9

3

12 10

2

TOTAL San Francisco General Hospital Kaiser Foundation Hospital Mary's Help Hospital

St. Mary's Hospital St. Francis Memorial Hospital

12 12 Mt. Zion Hospital & Medical Ctr.12 12 St. Joseph's Hospital French Hospital Letterraan General Hospital

St, Luke's Hospital

Home Chinese

Elsewhere Other California Out of State

10 9 8

19 16

10 6 5

1

3 2

-

_ 3 3

_

6 6

6 6

5

-

k

2

1

2

2

-

2

2

-22-

-

ACE

CHINESE FILIPINO

JAPANESE

OTHER

REPORTABLE DISEASES

More than 10,000 cases of communicable diseases were reported in 1959, about 9% less than in 1958. Cyclical decreases in reported cases of measles, German measles and mumps were chiefly responsible for the overall decrease but increases in infectious hepatitis, gonorrhea and syphilis need to be studied carefully. Tuberculosis and the venereal diseases are discussed later in this report.

Deaths coded to reportable diseases were greater in number than for any year since 195U when about 30% of the deaths were from tuberculosis; in Increases in number 1959, 16% of the deaths were coded to tuberculosis. of deaths over 1958 were noted chiefly in encephalitis, infectious hepatitis, aseptic or viral meningitis, pneumonia and syphilis. Only 3 cases of typhoid fever were reported in 1959 ; diphtheria reappeared on the list after our first year (1958) without any cases. Infectious hepatitis increased 1*2$, from 70 cases in 1958 to 100 in 1959 but the percentage increase was less than half of the 1958 increase over 1957, 89#. Poliomyelitis experience continued to be quite favorable; there were 13 cases during 1959, 11 spinal paralytic, one bulbo-spinal and one nonparalytic, but for the second consecutive year, no deaths were reported from the disease. Ten of the 13 cases had not received polio vaccine and one case had only one dose; 7 of the 13 were over 21 years of age.

-23-

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TUBERCULOSIS The number of newly reported cases of tuberculosis in San Francisco during 1959 was k9$, compared to U9U in 1958. This is the first time since 19li9 that the incidence However, the mortality rate from the disof new cases failed to shew a decrease. ease continued to decline: from 77 deaths with a mortality rate of 9.7 per 100,000 population in 1958 to 72 deaths and a rate of 9.1 per 100,000 population in 1959.

The failure of the morbidity rate to decline during 1959 does not indicate an absolute increase in tuberculosis in the community, but merely reflects an intensification and concentration of casefinding in known high incidence groups and areas. The highest incidence of tuberculosis continues to be found in the Central, North East, Mission and Westside Health Districts. There are the older portions of the city in which there is overcrowding of people from the lower socio-economic and minority groups. The Urban Renewal and Slum Clearance Program, which is particularly active in Westside Health District, is primarily responsible for the decrease in the case rate in Westside and the increase in the Mission Health Districts. There has been an extensive demolition of old, condemned, multiple dwelling residences which has resulted in the shifting of a large portion of the population. Of the U95 newly diagnosed cases, 87$ reside in the eastern half of the city which has 75$ of the total population. The ratio of males to females remained the same as S/i 1958: 2.2i5 males to one female. Fifty-three percent, or 26U patients, were 1;5 years or older in 1959, in contrast to 50.2/5 being kS years or older in 1958. This is in keeping with the national trend of finding tuberculosis in the older age groups. However, 13*9% , or 69 cases, were 19 years of age or younger. The latter figure is high due to our intensified School Tuberculin Skin Testing Program. Although the greatest number of cases were found among the white population, the nonwhite races, representing 13.2$ of the total population, had 157 cases or 31*7$. The Negro population showed a marked decrease in the case rate: from 166,7 per 100,000 in 1958 to 110.7 per 100,000 in 1959. The number of cases in the Negro group dropped from 92 in 1958 to 62 in 1959. The increased incidence among the Chinese reflects the efforts of Chinese professional, business, cultural and religious groups cooperating with the San Francisco Tuberculosis Association and the San Francisco Health Department in community education and casefinding programs. The number of cases among the Chinese will probably continue to rise for a year or two until all the reservoir advanced cases are located and placed under treatment. Then there will be a precipitous decline.

During 1959 there were 230 people who died with tuberculosis, but in only 72, or However, in 65, or 28.3$, 31.3$, was tuberculosis the primary cause of death. clinically active and significant tuberculosis was reported for the first time at or after death. This indicates two important facts: One, patients under modern chemotherapy are not dying from tuberculosis, but live longer to die of other diseases; two, that a large number of people with clinically active and significant disease are apparently relatively asymptomatic and remain undiagnosed and infectious until the end of their lives. The latter group usually have unsuspected advanced tuberculosis, which can be diagnosed in the living only with a chest x-ray. The finding of U5 unknown and unsuspected cases of tuberculosis among the admissions to the General Medical and Surgical V.ards at San Francisco General Hospital by the Admission Chest X-ray Program confirms the magnitude of the problem of discovering Furthermore, of lOli patients the hidden reservoirs of the disease in the community. who were 65 years of age or -older when firtft -diagnosed as having tuberculosis in 1959, 39 are' dead.

-25-

TUBERCULOSIS CASEFINDING BY X-RAY; The Health Department Unit took 30,800 minifilms, finding 37 previously unknown active cases. This group includes only those who admit no contact with disease, and who have no symptoms. In addition, I896 individuals with symptoms requested a chest film. Since the incidence of suspicion is very high in such a group, large chest films were taken, revealing 61 with active tuberculosis of whom U6 were previously unknown. Furthermore, U21 of the I896 were found to have inactive tuberculosis. Therefore, of the total 32,696 chest films taken by this unit, 98 active cases were found of which 83 were previously unknown. THE ADMISSION CHEST X-RAY PROGRAM AT SAN FRANCISCO GENERAL HOSPITAL took 11,1*72 films finding h5 unsuspected cases of active tuberculosis in the General Medical and Surgical Yards. Excluded from this program are all patients with a pulmonary disease problem, known or suspected tuberculosis, children in the Pediatric Ward, acute medical and surgical problems requiring lifesaving procedures, women in precipitate labor, and disturbed psychiatric patients.

THE SAN FRANCISCO JAIL NO. 1 CHEST MINIFILM X-RAY PROGRAM was started in February 1959 by the San Francisco Tuberculosis Association in cooperation with the Health Department. There were 5,156 films taken, which revealed 27 cases of active tuberculosis, of which lh were previously unknown and undiagnosed. THE MEDICAL SOCIETY CHEST X-£AY UNIT took 19,063 chest minifilms, finding five new cases. This unit is used primarily by the medical profession for the referral of private patients who do not have symptoms of pulmonary diseases or tuberculosis. Symptomatic patients are referred to a radiologist for a large chest film. Hence, the low yield in this particular program is expected. THE MOBILE UNIT OF THE SAN FRANCISCO TUBERCULOSIS ASSOCIATION does the community and industrial survey in Ssn Francisco. During the past two years they have been cooperating very closely with the Health Department's program of concentration and intensification in high incidence areas, and have been of invaluable assistance to the tuberculosis casefinding programs. However, the Tuberculosis Association supplies their mobile unit for industrial and college students' surveys upon request, even though the expected yield will be very small. They have participated, upon request, in two college programs involving about 10,000 chest films with a yield of only two active cases of tuberculosis. The Tuberculosis Association and the Health Department have felt that this was a community service, granted only upon request, which was non-productive from the casefinding standpoint. The Mobile Unit took a total of 57,301 chest films, finding 37 cases of previously unknown active tuberculosis. The results of 1959 chest x-ray casefinding have been good. Through the cooperative efforts of private physicians, the Medical Society, Tuberculosis Association and Health Department, x-ray casefinding is confined to individuals, groups and areas of expected high incidence. This type of programming will increase the case yield, while decreasing repeated surveying of known low incidence groups and areas.

TUBERCULIN SKIN TESTING; The tuberculin skin testing program in our schsols has proved to be most productive. During the past three years 166 new cases of tuberculosis were found through the program: 120 in students and 1*6 in familial contacts. In reviewing the entire group of 120 children found to have tuberculosis, it was noted that there were 68 males and 52 females. The racial distribution was surprising in that there were 50 whites, of whom 29 were Spanish-Americans, 39 Negroes, 17 Chinese, R -Samoan, 5 Filipino, anrt oue Japanese. All of the Samoan6, Filipinos, and

-26-

Japanese were new to San Francisco schools. Many of the Negroes and few of the Chinese and Spanish-Americans had recently moved into the area. The program will not only detect all active cases among the group tested, but will give an accurate index of the rate of infection in our school children. Furthermore, children no longer receive chest films unless they are found to be positive reactors. In addition, it has awakened an interest in tuberculin testing among private physicians of the community, A very large number of students are now receiving their tests privately from the medical profession. Therefore, the program has also served to educate the child, the parent and the physician.

CHEST CLINIC; Tuberculosis still requires a minimum of two years of treatment. However, only 2$% of this care is in the hospital, whereas 75$ is in the Chest Clinic Cvt-Patient Department, There has been a marked increase in the number of patient visits for active therapy and a sharp decrease in observation cases. This means that there is an increased work-load not only in the clinic, but also in the field to keep the patients under care until treatment is completed. There are approximately 30$ missed appointments during the year, of which one-third or 10$ are in the more difficult or uncooperative patient group. The latter is composed primarily of the single, indigent, alcoholic male, who will reactiviate and spread his disease unless kept under treatment. Hence, the work of the Health Department with non-hospitalized tuberculosis patients has risen sharply during the past seven years.

Table 2l* X RAY MINIFILM PROGRAMS

UNIT LOCATION

X-RAYS TAKEN

TOTAL

PREVIOUS RATES PER 1,000 X-RAYS

CALENDAR YEAR 1959 NEW ACTIVE CASES FOUND

RATE Per 1,000 X-RAYS

1958

1957

1956

1955 195L

125,688

212

1.69

101 Grove Street

32,696

98

3.00

1.57

1.26

1.89

1.71 2.56

Mobile Unit

57,301

37

0.65

0.86

0.86

1.02

0.60 0.65

S.F. Medical Society

19,063

5

0.26

0.96

0.9k

1.30

0,96 1.1k

S.F. General Hospital

11,1*72

1*5

3.92

1.1*6

1.37

1.31*

5,156

27

5.2U

S.F. Jail

#1

-27-

-

.

SAk

Fi

;

-VCIoCO

TUBuACULIa SKIN TESTING

Grades Tested:

SCHGGj-.

jpROGILJi

1958 - 1959

7» 10, and 12; entire grade level once per year; and all students new to San Francisco schools.

1,

All previously known Positive Reactors who had 10 mm. or more of induration were excluded from the testing. All previously known Positive Reactors wno had re >- tested

6-9

of induration were

mm.

Students tested 29,541

RESULTS:

Positive tuberculin 1,765

=

6$ of group tested

High School

=

14.4$ at 12th grade level

Junior High School

=

7.5$ at 7th grade level

Elementary

=

2.9$ at 1st grade level

The follow-up of Positive tuberculin reactors and their family contacts revenled forty-four (44) cases in school children, and eighteen (18) cases in the homes; a total of 62 newly diagnosed active cases.

Cases found in School Children:

High School

14

Kin. Pul. Tbc. Mod. Adv. Pul. Tbc. Far Adv. Pul. Tbc. Tbc. iieningitis Tbc. Lymphadenitis G u Tbc. »

-

Junior High School Active Primary *

Elementary Active Primary Miliary Tbc. Tbc. lymphadenitis

- 5

-

2 2 1

27 - 23 1 - 3

21

Contacts* Active Primary Miliary-Meningitis

3 - 1 3

-

8

-

2

Mod. Adv. Pul. Tbc. Far Adv. Pul. Tbc.

6

-5

- 3

Three of the family contacts were also school children and were counted as part of the active cases found in the school.

The Tuberculin Skin Testing Program in San Francisco Sohools has provun to be an excellent case-finding procedure.

TABLE

Family Contact Cases Plus School Cases

Cases School Year

In School

Case Rate

Case Rate

1956 - 1957

44

1.8/1,000

62

2.4/1,000

1957 - 1958

22

1.8/1.000

42

2.4/1,000

19,58^- 19^9

44

1,5/1. 000

.62

,

-28-

,



2

l/1.000 T

SAN FRANCISCO SCHOOLS TUBERCULIN SKIN TESTING PRCGRAM SCHOOL YEARS 19 56-1957 THROUGH 1958-59

SCHOOL YEAR

TOTAL Students tested Positive reactors found Percent positive reactors

71,731 U,382 6.0$

1956-57

1957-58

.1958-59

25,286

16,901*

29,51*1

1,1*92

5.7$

1,765 6.0$

1,125 6.7$

CASES OF TUBERCULOSIS FOUND THROUGH PRCGRAM

SCHOOL PLACEMENT

TOTAL TOTAL

High School Junior High School Elementary School Contacts

SCHOOL YEAR 1956-57 1957-58

1958-59

166

62

1*2

62

33 16 71

10 11 23 18

9

Hi

1*6

2

3

21 10

27 18

SCHOOL PLACEMENT AND RACE FOR THE PERIOD 1956-1959

TOTAL

RACE

TOTAL

White Negro

16

27

1*

26,139

2

Table 25 CHEST CLINIC SAN FRANCISCO HOSPITAL Pt. Visits for Treatment Pneumoperitoneum, and Chemotherapy ll*.6$

3,833 U,122 5,771 8,231*

13,731

1*3.7$

33,262

19,975

36,71*2 32,371*

21,1*92

60.0$ 66.6$ 78.8$ 83.5$ 81.8$

27,598 31,U09

31,685 33,786

25,518 26,UUl 28,579

-29-

8

1

3 2

2

1

1

17.6$ 23.5$ 30.0$

23,1*01 2l*,577

33 19

7 2

2l*

12 5

8

YEAR

1955 1956 1957 1958 1959

71

5 l

TOTAL PT. VISITS

1951*

120 50 39 17

Chinese Samoan Filipino Japanese

1950 1951 1952 1953

SCHOOL PLACEMENT Junior High High School School Elementary

Pt.

ftsits for Follow-up, Without Treatment Observation and

Contacts

22,306 19,279 18,806 19,36U 17,678 13,287 12,250 6,856 5,21*1*

5,207

85.1*$ 82.14$

75.5$ 70.0$ 56.3$ 1*0.0$ 33.1*$

21.2$ 16.5$ 18.2$

^

Table 26

NEWLY REPORTED CnSES d TUBERCULOSIS DEATHS OCCURRING IN SAN FRANCISCO 1920 - 19 59 YEAR

POPULATION

1920 1922 1923 192*

506 676* 5 2 § 777 538 512 551 2*7 5&3 982

1925 1926 1927 1928 1929

576 539 602 61* 627

1930

63* 39**

1931 1932

63V V11

NEWLY REPORTED CASES NUMBER

1921

1933 193*

717 452 187 911 657

63* *26 63^ W1 63* *55

1*09 1230 1223

251.6 223.1 216.9

in

1179 1032

20*.*

6*>t

175.1

1101

182.8 185.9 232.0

611 593

11*3 1*5? 1309 1317 1199 1026 865 936"

1171

512 63*: 525

1C12 827

19*0

£3* 536* 673 109 711 682 750 ?>l 788 328 827 817 806 796 785

19*5

19% 19*7 19*3 19*9

*00* *00 600 200 300

77$ 357* 776 200

1950 1951

1952 1953 195*

791

1955 195& 1957

79* 900 798 900 776 000

500

795 900 798 300

670

27§.5 256.2

63* 469 63* *8* 63* *98

19*2 19*3 19**

NUMBER

1*11 13*7

1935 1936 1937 1938 1939

19*1

RATE

393

9*5 869 959 337 1033 851

907 1034 976 1002

869 1 2 5

638

661

RATE

2.1 2.1

111.7 103.7

1.3 1.7 1.3 1.3 2.3

98.5 101.1

621

93.9

206.

561

iSA

207.6 189.0 l6l.7 136.3

563 533

88.7 8*.0 7*. 2

*71

*53

71.*

1*7.5 1*0.7 18*.6 159.5

*5*

71.6 72.7

13C3

42*

1*8.9 129.1 13*.8 111.6 131.0

*20 *39

*61

*6o

381

*30

M 66.2 65.1

m

2.1

1.9

hi 2.0 2.2 2.0 2.5 2.3

2.4 1.3 2.3 3.1 2.9 3.3

H.8

301

38.3

112.1 10*. 7

215 180 21* 1**

27.7 23.2 27.0

3*.9 72.7 70.2

2.3 2.3 2.2 2.2 1.9

56.3 43.6

*70 397 350 333

6 25 581

2.2 1.8 1.3

5*. 5

102.9 111.0 13*.* 122.6 127.5

108.4 88.8 93.3

PER DEATH

132.2 121.3 118.3 120.8 117.2

63*

858 707 785

5*5

Newly reported CASES

DEATHS

^3.*

13.1

131

16.*

116 92 78

1*.6 11.5 10.1

*.0 *.5 *.o *.9 6.0 5.8 6.3 7.0

1958

791

100

*9*

62.*

77

9.7

M

1959

790 700

*95

62.6

72

9.1

6.9

*

U.S. Census

Rates Per 100,000 Population

Estimated Population as or July 1, 1951 California State Department or Finance.

-30-

19S9,

TUBERCULOSIS DIVISION, SAN FRANCISCO HOSPITAL YEAR

1952

1953

195U

1955

1956

1957

1958

1959

Total Admissions

882

92U

880

8U5

806

8U9

838

7U3

Discharges and Expirations

851

1,007

897

9lh

865

876

875

7U9

San Francisco Hospital Hassler Health Home

U90

UU6

383

3U7

227

221

209

171

263

255

252

258

210

167

182

177

TOTAL

753

701

6k2

605

k37

388

391

3U8

AVERAGE CENSUS

Patients on active treatment receive a minimum of two, usually three and occasionally as many as seven clinic services per visit. Patients recei ying follow-up without treatment usually require only one clinic service per visit.

Table 27 NEW CASES OF TUBERCULOSIS REPORTED BY RACE, TYPE & SEX SAN FRANCISCO 1959

RACIAL GROUP

TOTAL

MALE

TOTAL

U95

3U2

153

White

338

236

Negro

62

Chinese

OTHER

PRIMAR Y

PULMONARY

All Cases

T

M

F

T

M_

F

U09 293 116

k9

28

21

37

21

16

102

297

23li

83

23

15

8

18

7

11

111

21

la

29

12

13

5

8

8

7

1

53

36

17

hz

29

13

5

2

3

6

5

l

Filipino

2k

18

6

19

16

3

3

1

2

2

l

l

Japanese

5

2

3

h

2

2

-

-

-

1

-

l

American Indian

1

1

-

-

-

-

-

-

-

1

l

12

8

h

6

3

3

5

5

1

-

Other

FEMALE

-31-

M

T

F

l

Table 28 RESIDENT TUBERCULOSIS CASES REPORTED DURING 1959 DEATHS AND RATES PER 100,000 POPULATION

TOTAL

WHITE

NEGRO

CHINESE

790,700

686,200

56,000

32,1*00

1*95

338

62

1*09

297

1*1

1*2

Primary

1*9

23

13

Other Types

37

18

62.6

ESTIMATED POPULATION

TOTAL CASES

Pulmonary

CASE RATE

TOTAL DEATHS

Pulmonary Other

DEATH RATE

JAPANESE

7,6oo

OTHER

8,5oo

5

37

k

25

5

-

8

8

6

l

1*

1*9.3

110.7

163.6

65.8

1*35.3

72

56

h

9

1

2

68

51*

1*

7

1

2

k

2

-

2

-

-

9.1

8.2

7.1

27.8

13.2

23.5

RATE PER 100,000 POPULATION

PERCENT OF CASES

$3

Table 29 NEW CASES OF TUBERCULOSIS BY HEALTH DISTRICTS San Francisco Residents 1959

ESTIMATED POPULATION

HEALTH DISTRICT

CASES

TOTAL

1*95

790,700

62.6

100

Alemany Central Eureka-Noe

17 131*

7U,800 86,200 78,000

22.7 155.5

27.1

1*3.6

6.9

56,200 125,000 69,000

i*l*.5

28.0 85.5

5.0 7.1 11.9

105,800 13i*, 500 61,200

95.5 27.5 78.1

20.U 7.5 9.7

Hunters Point Marina-Ri chmond Mission

North East Sunset V"'estside

31*

25

35 59 101 37 1*8

District Not Reported

3.1*

1.0

-32-

NUMBER OF NEW TUBERCULOSIS CASES AGE GROUP BY COLOR 1959 San EBMSlSfifl REPENTS AGE GROUP

ALL

TOTAL

Jfii.

UNDER

YEAR

1

WHITE

IN

NEGRO ft

EACH

CHINESE 53

OTHER

m

2

1 - 4 " 9 5 19 - 14 ,

26 22

17 12

10

4

2?

12

4

15 - 1? 20 - 24 25 - 29

24

30-34

\l

40-44

5?

11

50 - 54

5?

s

5 5 " I? -

47 2a

45 - 49

60 64 65 - 69 70 4 Over

40

64

I

TA8LE 31 PERCENT OF CASES IN EACH STAGE OF DISEASE NEWLY REPORTED CASES OF RESPIRATORY TUBERCULOSIS San Francisco 1355sl253 1959

1958

1251

1956

125£

100

100

100

100

27

32

42 3T

¥>

41

30 38

27

32

ALL CASES - TOTAL

Minimal Moderate Far Advanced

42 35

24

39 37

Table 32 INTERVAL BETWEEN REPORTING OF DISEASE AND DEATH San Francisc o 1252 INTERVAL

NO. DEATHS

TOTAL

-210-

Less than 6 Months 6-11 Months 12-17 Months 18-23 Months 2

PERCENT OF DEATHS 1QP..P.

4.8 3.0 3.5 2.2

Years

9

3 Years 4 Years

u §- 9

5-9 -

Years 10 14 Years <5 Years 4 Over

28.3 22 11

Reported Only on Certificate or After Death

65

28.3

Table 33 PERSONS HAVING HAD TUBERCULOSIS WHOSE DEATHS WERE CODED TO OTHER DISEASES San Francisco Residents 1959 NUflBER

CODED CAUSE OF DEATH

INTERNATIONAL LIST NUMBER

TOTAL

Heart Diseases Malignant Neoplasms Cirrhosis of the Liver Diseases of Respiratory System Accidents Vascular Lesions of C.N.S. Suicides Ulcers of Stomach 4 Duodenum Diseases of Arteries Diabetes Mellitus All Others

DEATHS 154

il

1 450-456 260 10

-33-

OF

REPORTED CASES CF TUBERCULOSIS BY HEALTH DISTRICTS RATES PER 100,000 POPULATION

SAN FRAMCISCO,

i

WOfl

|;

,:,v

*£]

iHi

f

\\

MARINA RirminNn

\

*

J

50

50 to ?o

//to i

*

1959

'

V

OVER 100 i

-3fc-

IO \

V:,.

WRTH

\\

EAST :v

:

5

a

VENEREAL DISEASES

Table Number UO and Charts Number 1 and 2 demonstrate the increasing Venereal Disease problem in San Francisco for the past 5 years. Total reported syphilis has increased 2.5 times, but what is more significant in terms of the community's health, early infectious disease has increased h times during this same period. The comparable increase in gonorrhea has not been as dramatic, but nevertheless represents a significant 2/3 increase over the 1955 low. These are the figures which have placed San Francisco among the cities of the country with the highest rate of early infectious syphilis

VENEREAL DISEASES REPORTED TO HEALTH DEPARTMENT (including Military )

Syphilis (All Stages) Total By Private Physicians Percent

1955

1956

1957

1958

1959

357 50

h9S

571 1U3 25.0

687

892 282 31.6

lit.O

Syphilis (Primary, Secondary and Early Latent) Total li;3 By Private Physicians 26 Percent 18.2

Gonorrhea (All Classifications) Total 1655 By Private Physicians 85 Percent 5.1

72 Hi.

20ii

29.7

87

528 171

18.0

221 50 22.6

2k,h

32.1;

207U 1U6 7.0

2353 1U3 6.1

2520 151 6.0

3078 169 5.5

267 1*8

357

The above table confirms a real increase in gonorrhea. There has been no significant change in the program which would affect reporting of gonorrhea. Health Department facilities continue to report approximately 90$ of the cases and the private physician still reports about 6% of the total. During this same period, programs have been developed to facilitate reporting of syphilis by the private physician, with the results as noted above. This has contributed to the disproportionately higher increase in the rate of syphilis as compared to gonorrhea, but there still has been a very significant increase of syphilis in the community which cannot be explained away by statistical machinations.

REPORTED VENEf.EAL DISEASES IN CIVILIAN MINORS (Under 20)

Syphilis (All Stages ) Total 0-19 Years Percent

Gonorrhea Total

0-19 Percent

1955

1956

1957

1958

1°59

350

u72 22 U.7

570

683 20 2.9

885 17 1.9

13li3

1590

158 11.8

222

1773 220

2050 27u 13.U

12 3. It

22

3.9

(Genito-Ur inary)

Years

1363 130 9.5

-35-

lu.O

12.

Some health jurisdictions have indicated a possible teenage VD problem. The above table does not show any reflection of this in the syphilis figures. There has been some increase in genito-urinary gonorrhea, but the exact significance of this is difficult to determine in the absence of accurate age corrected rates, and other variables. However, there has been a doubling of the number of cases of gonorrhea reported in this age group, which should not be completely last in a too careful statistical analysis.

Despite this demonstrated increase in the total VD problem in San Francisco in the past 5 years, there has been a 30$ reduction in personnel available for VD control activities. Expressed in other terms, there has been a 72% increase in total patient visits per person employed at the City's Venereal Disease Clinic (San Francisco City Clinic). This increase has only been accomplished by compromising a proper VD control program operation which in turn fosters a larger number of infections and case load which in turn reduces personnel time devoted to control activities a never ending cycle







Table jk REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY STAGE & SEX, 5-YEAR MEDIAN 1959 City & County of San Francisco

TOTAL SYPHILIS TOTAL Primary Se condary Early Latent Late Latent Late Congenital All Stages - Report Only*

Genito-Urinary Other Epidemiologically Treated OTHER TYPES TOTAL

Chancroid Lymphopathia Venereum Granuloma Inguinale

*

**

MALE

FEMALE

3827

2759

1068

2377

885

692

193

U72

175

12

175 153 15U 165 35 1

21

9

11 12

2935

2061

87U

1939

2050 3h9 536**

LU99

551

HU5

213

323

7

6

1

16

h 3

3 3

1

13

156

190 291

Uo

GONORRHEA TOTAL



3

36 126 5

1|13

51 52 111 196 57 6

155

3

1

Includes cases treated or diagnosed previously but not reported in California.

Excludes

5-YEAR MEDIAN

TOTAL

males and females treated in jail.

-36-

»

j

7

Table 35

CASE RATES FOR VENEREAL DISEASE BY RACE 4 STAGE OF DISEASE PER 100,000 POPULATION IN 1959 City 4 County of San Francisco

ALL VENEREAL DISEASE SYPHILIS

TOTAL

WHITE

M6.2

271. f

111.9

q?.g

22.1 19.7

2^.0 20.2 21.6 27.0

Primary Secondary Early Latent All Other

2L0

GONORRHEA*

259.3

OTHER TYPES VENEREAL DISEASE

ESTIMATED POPULATION

72.2 16.1

2.1 *.1

26.3 6^.3 273.2

12.4 53.6

2030.

1959.0

'SB

W.1

Other

OTHER 152.6

UL2

303.

Geni to-Urinary

NEGRO

78.3 2.1

id


790,700

56,000

»4.g,500

Excludes Epidemiologically Treated.

Table 36 REPORTED CIVILIAN CASES 4 PERCENT OF VENEREAL DISEASE BY RACE 4 STAGE OF DISEASE City and County of San Francisco

SYPHILIS TOTAL Primary Seconoary Early Latent Iate Latent

3827

100.0

as.

100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

175 156 190

•8

Ure Congenital All Stages - Report Only

12 21

GONORRHEA TOTAL Gen to-Urinary Other Epidemiologically Treated

100.0 100.0 100.0 100.0

293S 2050

m

1

536

OTHER TYPES VENEREAL DISEASES TOTAL

Chancroid Lymphopathia Venereum

1959

WHITE

TOTAL

VENEREAL DISEASE TOTAL

IN

2133

NEGRO i
4?,

72.0

-213.

24JL

9

5.1 9.6 18.9 43.6 27.5

"165

m

139 139 29 6 11

1493 91

89.1

15

77.9 *7.8 72.5 50.0 52.4

36

50.9

§

88.2 50.4

308 270

OTHER

55.7

1

?I 55 10

1397 1097 40 260

1

i

A

5

2

3

1

2 2

-M

jm.

_JL£

»

1

2

1.3

6

25

8.6

T -

8.3

_

M.J 47.6 47.6 53.5 11.5 48.5

-s

1ȣ 1.9

!

?:?

_ _ -

_ _ -

TABLE 37

REPORTED CIVILIAN CASES OF VENEREAL DISEASE IN 1959 BY AGE GROUP 4 STAGE OF DISEASE , SAN FRANCISCO TOTAL TOTAL

SYPHILIS TOTAL Primary Secondary Early Latent Late Latent Late Congenital All Stages - For Report Only

1

5

- 19

j£iL

3827

_Lt

_SJ5_

iS 190

a

2Q -

^

-

_22£_

jfi

_2HiL.

_2iL2. 2

1

1

m. 629 97

1

HO

3

J.

3_

-37-

OVER

_2±. 24 25

21

10

TO-

-53L

111

7

to

%

148 24

1

JA.

a

l&flfi

12

1

25 - 3i

_9i£_

1

?91 ko

GONORRHEA TOTAL 2935 Gen to-Urinary 2050 Other 349 EptOEMIOLOGICALLY TREATED 53b

OTHER TYP E S TOT AL

JJL

1

5

10

-L23i 41

187

208

328

Table 38 REPORTED CASES OF VENEREAL DISEASE IN 1959 BY SOURCE OF REPORT 4 STAGE Of OISEASE City A County of San Francisco OTHETT locaC RIVATE 33 TOTAL HUNT HOSP. M.D. CITY TOTAL

PERCENT OF TOTAL

SYPHILIS

TOTAL

Primary Secondary Early Latent Late Latent Late Congenital All Stages - For Report Only

GONORRHEA TOTAL

Genito-Urinary Other epioemiologically treated OTHER TYPES TOTAL

FEDERAL CIVILIANS

OTK".

JURIS.

DICTIONS

MILITARY

3982

^070

1^1

132

Vfi

1*

29

155

100.0

77.1

3.3

3.3

11.3

0-*

0.7

3.9

JL

_21L

892

JUL

179 158

110

191

129

51

i 24

94

12

4

4

21

5

I?

88 |

_22_

i

8 5

-iQ2£

25Z4

LLL

169

-1A3L

2184

17^3

103

133

13*

3<*9

336 495

2

11

13

25

545

9

_L2_

Table 3? REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY HEALTH DISTRICT City amp County of San Francisco 1253

Excluded are 536 Epidemiologically Treated, 177 Mon-Resioents, and 4 whose residence was not reported.

ESTIMATED POPULATION

Health District ALL SAN FRANCISCO

RATE PER 100,000 POP.

NO. OF CASES

PERCENT OF CASES 100.0

790,700

3,110

393.3

7^,800 86,200 78;000

108

1*M

ffi

871.2 229.5

?' 5 24,1 5.3

Hunters Point Marina-Richmond Mission

56,200 125,000 69,000

223 207 218

296.8 165.6 315.9

7.2 6.7 7.0

North East Sunset Wests ioe

105,800 134,500 61,200

588

555.S 52.0 1192.8

18.9 2.2 23.5

Alemany Central eureka-noe

70

730

S.F. District Not Reported

36

1.1

TABLE 40 VENEREAL DISEASE SAN FRANCISCO

GONORRHEA TOTAL

Genito-Urinary Epidemiological Other

SYPHILIS TOTAL

iq^-^W 19S9

1355.

125£

1251

1797

1889

_2255_

242 8

2 935

1323

13^3

1590

1773

2050

414

391

484

392

536

60

155

181

263

349

1255.

H5i.

1251

1552

350

472

570

6 83

Primary

41

51

58

120

175

Secondary

26

64

52

113

156

69

130

111

121

190

214

227

329

364

.

Early Latent All Others

-38-

349

385

SPORTED CV.LUN OSES

OF VENEREAL DISEASE BY HEALTH O.STR.CTS

EXCLUDING EP IDEOLOGICALLY TREATED RATES PER 100,000 POPULATION

SAN FRANCISCO,

j

1959

UNDER 250 I

KWWW.H

.' ,

1

250 - 499 fl

-3?-

500 - 799

750 4 OVER

REPORTED CIVILIAN CASES OF GONORRHEA

SAN FRANCISCO. 1955 - 1959

1955

Y/////\

1956

Geni to-urinary

1957

I

I

1958

Epidemiological

1959

)...!

Other

REPORTED CIVILIAN CASES OF SYPHILIS SAN FRANCISCO, 1955 - 1959

NUMBER

1000

_

800



600

400

200

-

1956

1955

wm 3

PRIMARY SECONDARY

1958

1957

KSSI ~~1

EARLY LATENT

OTHER

1959

>

SAN FRANC/SCO DEPARTMENT OF PUBLIC HEALTPh

REPORT

STATISTICAL

I960

DOCUMENTS oci

LS19B1

SAN FRANCISCO

PUBLIC LIBRARY-

City

and County of San Francisco DEPARTMENT OF PUBLIC HEALTH

Central Office lOI

GROVE STREET Zone 2

October 18, 1961

The chief sources of data for the Statistical Report of the San Francisco Department of Public Health are the birth and death

certificates registered in San Francisco or reallocated to us by the State Department of Public Health, and morbidity reports re-

ceived from practicing physicians.

Constant effort is made to improve the quality of reporting so that valid conclusions may be drawn from these statistics; how-

ever, the limitations of the data and the need for further study

should be always kept in mind.

By 1962 we expect to have more data on socio-economic

characteristics of the population from the 1960 Census.

Further

information about Census data and birth and death statistics not included in this report is available from the Bureau of Records and Statistics, Miss Mildred Holota, Qiief.

Q ELLIS D. SOX, M. D. Director of Public Health

!

CONTENTS SUBJECT

FAGE

Births Communicable Diseases Deaths Fetal Deaths Infant Deaths Marriages & Divorces Maternal Deaths Population Premature Births Tuberculosis Venereal Disease

1* 22 3 21 19 3 6 1

17

30 23

CHARTS, GRAPHS AND MAPS

Percent of Deaths from Important Causes I960 by Age Group, Death Rates for 5 Causes by 10 year I960 Age Group, Syphilis, 1956 - I960

Gonorrhea, 1956 - I960 Venereal Disease by Health District, I960 i960 Tuberculosis by He- lth District, New Tuberculosis Cases reported i960 by Census Tract,

TABLES 1. 2.

3. k. 5. 6.

7. 8. 9.

10. 11. 12. 13. Ik. 15. 16.

17. 18. 19. 20. 21. 22. 23. 24. 25» 26. 27* 28. 29. 30. 31. 32. 33. 3k. 35« 36. 37. 38. 39*

Deaths from important causes, San Francisco, California & U.S., i960 Causes of death, all ages, 1956-1960 Causes of death by sex, rates and percent, i960 Maternal deaths, 195^-1960 Death rates for Whites, Chinese and Negroes, i960 Causes of death, residence, and occurrence, 1959-1960 Deaths from important causes by age group, i960 Selected morbidity and mortality data for health districts, i960 Recorded, resident and non-resident births by place, 1959-1960 Resident live births by place and race, i960 Birth rates by race and sex, 1959-1960 Resident births by race and health district, i960 Live births by trimester prenatal care began by place of birth, i960 Place of birth of premature infants by race, i960 Infant and fetal deaths by health district, i960 Infant deaths by race and age, i960 Infant deaths by race and sex; rates, i960 Infant mortality by age and cause, i960 Fetal deaths by health district and race, i960 Fetal deaths by place of delivery and race,1960 Cases and deaths from communicable diseases, 1956-1960 Summary venereal disease epidemiology, i960 Venereal diseases reported by private physicians, 1956-1960 Venereal disease by disease and stage, 1955-1960 Venereal disease by source of report, i960 Venereal disease by health district, i960 Venereal disease by race and stage, i960 Venereal disease by age group and stage, i960 Venereal disease in civilian minors, 1956-1960 X-ray mini film programs, i960 Chest Clinic, San Frrncicco General Hospital, 1950-1960 Tuberculosis cases and deaths, 1920-1960 Tuberculosis: New cases by race and type, i960 Tuberculosis cases, deaths, and rates, i960 Tuberculosis cases by he 1th district, i960 i960 Tuberculosis cases by age and race, Tuberculosis, pulmonary, percent of cases by stage, 1956-1960 i960 Tuberculosis, interval between reporting disease and death, Tuberculosis cases whose deaths were coded to other diseases, i960

PAGE 11

12 2?

28 29 36 37

FAGE 5 6 6 6 7 8

10 13 15 l6 16 16 17 17 18 19 19

20 21 21 22 2k 2k 25 2^>

25 26 26 26 32 33 J>k

35 35 35 37 37

37

GENERAL INFORMATION San Francisco, one of the original 27 counties in the State, was also incorporated as a city in 1850. Located on the tip of a hilly peninsula, its total area is 129.25 square miles of which less than one-half or 45.451 square miles is land. Excluding islands, its land area is 29,089 acres. The population density in i960 was 16,288 people per square mile, the highest in the state. It has an equable climate with an average daily temperature range of 12.2 degrees, from a daily mean maximum temperature of 62.6 to a daily mean minimum temperature of 50.4 degrees; rainfall averages about 22 inches yearly. The city enjoys about 66$ of all possible sunshine. The total population on April 1, i960 according to the United States Bureau of the Census was 740,316, a decrease of 35,04l or 4.5% from the 1950 figure of 775,357. AGE GROUP BY COLOR AND SEX, SAN FRANCISCO

I960

Number in Each Group

Age Group

Nonwhite

White

All Classes

Female

Male

Female

740,316

363,424

376,892

293,042

311,361

70,382

65,531

Under 5 years 58,851 5 to 14 98,189 15 to 24 91,155 25 to 44 199,362 45 to 64 199,151 65 and over 93,608

29,765 49,712 45,867 98,598 97,365 42,117

29,086 48,477 45,288 100,764 101,786 51,491

20,799 35,347 38,094 77,875 82,230 38,697

20,138 34,550 36,647 78,715 91,905 49,406

8,966 14,365 7,773 20,723 15,135 3,420

8,948 13,927 8,641 22,049 9,881 2,085

100.0

100.0

8.0 13.3 12.3 26.9 26.9 12.6

8.2 13.7 12.6 27.1 26.8 11.6

All ages

Total

Male

Male

Female

Percent in Eact Group 1

All ages

Under 5 years 5 to 14 15 to 24 25 to 44 45 to 64 65 and over

100.0

100.0

100.0

100.0

100.0

7.7 12.9 12.0 26.7 27.0 13.7

7.1 12.1 13.0 26.6 28.0 13.2

6.4 11.1 11.8 25.3 29.5 15.9

12.7 20.4 11.1 29.4 21.5 4.9

13.7 21.2 13-2 33.6 15.1 3.2

The white population, which in 1950 represented 89.5$ of the total, declined by 89,485 (12.9%) and the nonwhite population increased by 54,^4 or 66.8%. Between 1950 and i960 the percentage of whites declined to 8l.6% and the percentage of nonwhites increased from 10.5% to 18.4%. In 1950, the proportion of white births to the total was 8l.2% and of nonwhite births 18.8%. By 1955 these had shifted to 76.1and2 3.9% and by i960 to 71.0 and 29.0%.

1950

I960

740,316

100.0

604"7f03 White Negro 74,383 Chinese 36,4^5 Filipino 12,327 Japanese 9,464 Other Nonwhite 3,294

10.1 4.9 1.7 1.3 0.4

775,357 100.0 89.5 693,888 5.6 43,502 3.2 24,813 Included in other 0.7 5,579 1.0 7,575 -1-

There were marked changes in age composition between the 2 census years:

1950-196 3 Change

1950

19 50

Number

Percent

Number

Percent

Number

Percent

All ages

7^0,316

100.0

775,357

100.0

-35, 04l

- 4.5

Under 5 years 5 to Ik 15 to 2-4 25 to kk 45 to 64 65 and over

58,851 98,189 91,155 199,362 199,151 93,608

8.0 13.3 12.3 26.9 26.9 12.6

62,921 75,944 99,358 262,705 200,379 74,050

8.1 9.8 12.8 33.9

- 4,070

- 6.5

+22,245 - 8,203 -63,343 - 1,228 +19,558

25.8 9.6

+29.3 - 8.3

-24.1 - 0.6 +26. if

For the first time, the number of women was greater than the number of men:

I960 Number Total

Males Females

1950 Number

Percent

Percent

7^0,316

100.0

775,357

100.0

363,424 376,892

^9.1 50.9

389,866 385,^91

50.3 49.7

Some highlights from the i960 Census for the United States, California and some nearby counties are as follows:

% Total Population

Increase 1950-1960

%

%

Percent Population per 65 l8-b4 & Over Household

%

'fonwhite

Under 18 Yrs.

United States California

179,323,175 15,717,204

18.5 48.5

11.4 8.0

35.8 34.7

55.0 56.6

9.2 8.8

3.29 3.05

County Alameda Contra Costa Marin San Francisco San Mateo

908,209 409,030 146,820 740,316 444,387

22.7 36.8 71.5 - 4.5 88.6

15.3 7.4 3.8 18.4 4.3

33.1 40.1 34.7 24.5 36.3

57.4 54.4 58.4 62.9 56.9

9.5 5.5 6.9 12.6 6.7

2.96 3.44 3.12 2.44 3.24

Crude birth and death rates for these areas for the 2 census years: BIRTH RATES DEATH RATES PER 1,000 POPULATION

I960

1950

I960

1950

United States California

23.6 23.7

23.6 23.0

9.5 8.6

9.6 9.3

COUNTY Alameda Contra Costa Marin San Francisco San Mateo

22.9 22.8 22.9 19.9 22.5

22.6 27.1 22.7 20.0 25.6

9.3 6.3 7.2 13.3 6.5

9.3 5.7 8.1 11.9 6.9

Health district populations are included in Table 8 on Page 12.

-2-

:

The number of marriage licenses issued during the calendar year i960 Marriages was 6636, a slight decrease of 87 or 1,3% from 1959. The rate was 9.0 per 1,000 population in i960 and 9.1 in 1959* Divorces; Again in i960 as in 1959 there was a slight decrease in the number of divorce actions filed. In i960 the figure was 3,284 as against 3,319 in 1959 and 3,487 in 1958. One divorce action was filed for every 2 marriage licenses issued.

MARRIAGE LICENSES ISSUED

DIVORCE ACTIONS FILED

1950-51 1951-52 1952-53 1953-54 1954-55 1955-56 1956-57 1957-58 1958-59

8328 7306 7395 6860 6631 6645 6965 6526 6665

4543 4391 4327 if 096 3867 3676 3500 3508 3434

2842 29^0 2917 3088 2598 2604 2432 2442 2257

468 478 552 517 499 483 463 477 499

1959-60

6703

3350

2357

41?

FISCAL YEARS

FINAL DECREES OF DIVORCE

ANNULMENTS GRANTED

Crude Birth and Death Rates in San Francisco since 1950 in the following table are based on jreliminary, tentative population estimates by the California State Department of Finance which are in process of revision. Both series of rates have been revised upward since previous reports because of the decrease in population. Tentative conclusions that may be drawn from the table now are that the death rate is increasing slowly as more people in San Francisco reach the older age groups. The birth rate is a balance between the low, fairly constant rate for whites and the higher rate for the nonwhite group. SAN FRANCISCO ESTIMATED POPULATION.

IEAR 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 I960

775,357** 773,600 763,100 756,600 750,500 734,100 727,100 726,100 736,800 738,800

740,316** *

**

RESIDENT BIRTHS

BIRTH RATE*

RESIDENT DEATHS

RATE*

15,477 15,505 15,710 15,364 15,171 14, 540 14,565 15,240 15,104 14,634 14,728

20.0 20.0 20.6 20.3 20.2 19.8 20.0 21.0 20.5 19.8 19.9

9,204 9,527 9,693 9,435 9,160 9,161 9,548 9,600 9,375 9,559 9,825

11.9 12.3 12.7 12.5 12.2 12.5 13.1 13.2 12.7 12.9 13.3

DEATHi

Rate per 1,000 Population Census figures

Deaths Crude death rates in the United States, California and San Francisco increased from 1959 to I960 but as always the San Francisco rate was higher and showed more of an increase. Both the United States and California had decreases in their rates compared to 1950, the United States from 9.6 to 9.5 per 1,000 population and California from 9.3 in 1950 to 8.6 in i960. The San Frcncisco rate, on the other hand, increased from 11.9 per 1,000 population in 1950 to 13.3 in i960. Differences in the age and racial composition of the 3 jurisdictions as well as mortality conditions peculiar to San Francisco account for the differences in death ;

-3-

»

rates. Strictly speaking, the 3 jurisdictions should not be compared. However, for all 3 areas, heart diseases, cancer, cerebral hemorrhages and accidents in that or"Certain diseases of early infancy" rank 5th der are the 4 leading causes of death. in the United States and California and 7th in San Francisco. Cirrhosis of the liver, 5th cause in San Frencisco, is 7th statewide and 10 cause in the nation. Suicides, 8th on the San Francisco list, are 9th in California and 11th in the United States. Diabetes, 8th cause nationally, is the 10th cause in San Frtncisco. Tuberculosis continues to decline as a cause of death in all 3 jurisdictions but in San Francisco it is 12th in rank and is almost twice rate in the other two. Ranks, rates and percents of the important causes of death are included on page 5 of this report.

During I960, there were 9j825 resident deaths, an increase of 266 or 2.8% over 1959* The previous high number of deaths was 9»693 in 1952, 132 fewer or 1.3$ less than in I960. The low for the 11 year period was 9»l60 in 1954. The average age at death for men in I960 was 63 years, the same as in 1959 but the average for women increased from 6? in 1959 to 68 years in i960. The ageadjusted rate for San Francisco residents was 8.3 per 1,000 population, nearly 8% higher than the rate of 7.7 for the United States in i960.

Table 2 on page 6 shows San Francisco resident deaths from important causes at all ages for the past 5 years. As in the other historical tables, rates are

based on preliminary estimates of population for intercensal years and will be revised when final estimates are available. Heart disease, the leading cause of death in each year, accounted for 38% of the deaths at all ages in I960. Arteriosclerotic heart disease, including coronary arteriosclerosis, was the single most important cause with a death rate of 409 per 100,000 population, nearly 31% of the total in i960. Cancer was the second cause with a rate of 230 or 17% of the total. The rate for accidents, the 4 th cause increased slightly in i960 from 1959 but was half the rate for vascular lesions of the central nervous system. Cirrhosis of the liver, the 5th cause of death throughout the 5 years increased in rate from 46.8 per 100,000 in 1956 to 62.4 in i960. The male death rate in i960 was 15.6 per 1,000 population compared to 11.1 for the femrles and rates for men for each cause were higher except for vascular lesions of the central nervous system and congenital malformations. Although the first six ranking causes for men and women ore the same, there consistent and important differences in the mortality rates. Heart disease as a percent of all deaths was nearly the same for the sexes but the rate for males is nearly half again as high as that for females. For cirrhosis of the liver and ulcers of the stomach and duodenum, male rates were more than twice as high and for tuberculosis more than 3 times as high as the rate for women.

Table 5 on page 7 shows the leading causes of death for the 3 major ethnic groups and some figures for the remainder. The death rate for whites increased from 14.5 per 1,000 in 1959 (revised figure) to 14.8; for Negroes from 6.3 to 6.7 and for Chinese from 6.0 to 6.9. Rates for specific diseases varied as in other years. Heart disease and cancer were the 2 leading causes in all groups but among the Negroes, "certain diseases of early infancy" decreased to 3rd place instead of 2nd as in 1959. Tuberculosis among the Chinese is still a cause for concern; their death rate of 25 per 100,000 is more than twice the 10 for whites and 3 times the 8 for Negroes.

under death cause older to 20

Causes of deaths by age groups follow on pages 10 and 11 except for deaths 1 year of age on page 18. Again in I960, accidents are the leading cause of in age groups 1-4 and 15-24, the 2nd cause in the 5-l4 group and 4th or 5th thereafter. This is not meant to imply th t accidents are unimportant in the age groups; about 300 deaths per 100,000 occur in those 65 and over compared and 37 in age groups where accidents lead the list of causes. -4-

Table 1 DEATHS FROM IMPORTANT CAUSES SAN FRANCISCO, CALIFORNIA & UNITED STATES,

RATE PER 100,000 POPULATION

RANK CAUSE OF DEATH

S.F.

Cal.

I960

u.s»

ALL CAUSES

PERCENT OF TOTAL DEATHS

S.F.

Cal.

U.S.

1327.1

861.1

S.F.

Cal.

U.S.

9U7.0

100.0

100.0

100.0

Heart Diseases

1

1

1

509.1*

321.0

365.2

38.U

37.3

38.6

Malignant Neoplasms

2

2

2

229.9

UU0.3

1U8.U

17.3

16.3

15.7

Vascular Lesions C.N.S.

3

3

3

129.8

92.7

107.1

9.8

10.8

11.3

Accidents

h

h

it

66.5

52.9

51.8

5.0

6.1

5.5

Cirrhosis of Liver

5

7

10

M

18.6

11.2

U.7

2.2

1.2

Influenza & Pneumonia

6

6

6

Uo.o

33.3

36.6

3.0

3.9

3.9

Certain Diseases of Early Infancy-

7

5

5

30.5

3U.2

36.9

2.3

U.o

3.9

Suicides

8

9

11

29.7

15.9

10.U

2.2

1.8

1.1

General Arteriosclerosis

9

8

7

26.6

17.8

20.3

2.0

2.1

2.1

Diabetes

10

11

8

15.7

9.7

17.1

1.2

1.1

1.8

Ulcers of Stomach & Duodenum

11

12

13

12.2

6.5

6.0

0.9

0.8

0.6

Tuberculosis

12

13

Hi

10.3

5.1

5.9

0.8

0.6

0.6

Congenital Malformations 13

10

o /

9.7

12.2

11.7

0.7

ljl

1.2

Nephritis, Chronic & Unspecified

LU

Uj

12

5.U

U.2

6.9

O.ii

0.5

0.7

_

_

_

M

_

-

11.3

11.1

11.8

All Other Causes

Sources:

62

City and County of San Francisco Department Public Health records.

California:

Communication from State Department of Public HealthAugust, 1961. Deaths by residence. Percents rounded independently.

United States: Monthly Vital Statistics Report, Vol. 10, No. 1, March 20, 1961

1

Table

2

DEATHS FROM IMPORTANT CAUSES, ALL AGES San Francisco Residents, 1956-I96p

NUMBER

ALL CAUSES

Heart Diseases Malignant Neoplasms Vascular Lesions of C.N.S.

Accidents Cirrhosis of the Liver Influenza and Pneumonia Certain Diseases of Early Infancy Suicides Arteriosclerosis

Diabetes Ulcers of Stomach and Duodenum Tuberculosis Congenital Malformations All Others

RATE

1960

1959

135g

1957

1956

12&L

1959

1958

1957

9025

a552

23LZ5

2fiQQ

9_5Ag

H27.1

129^. 9

1g7p.11.

n??.i

nn.?

3771 1702 961

3727 1658 949

3635

3^84

1612 963

1743 971

3W 1644

509.4 229.9 129.8

504.5 224.4 128.5

493.3 218.8 130.7

507.4 240.0 133.7

515.3 226,1

If92

"-71

537

41

231

66.5 62.4 40.0

63.8

462 296

W

226 220

21 8

221

30.5

235 182

29. 26,

29.5 26.3 27.5

296

194 203

197

116

11

96 7?

w

1079

367 303

264 198 170

246 194 189

53* 340

m

J

55 40.1

130.5

74.0 46.3 31.8

38.8

35.8 26.9

30.4 32.3

23.1

26I7 26.0

14.3

12.8

12.1

11.8 10.7

11.7 12.7

25.0

105

93

'??

86 78

.72

90

S

12.2 10.3 9.7

13.0 9.7 11.9

1».5 10.5 9.8

12.4

9.4

1031

1019

1132

15^.5

1^.0

139.9

140,3

155,7

97

90 76 72

36? 286

949

1956

15.7

13.1

Table 3 IMPORTANT CAUSES OF DEATH BY SEX, WITH RATES PER 100,000 POPULATION San Francisco Residents, 12£o_ FEMALE

male CAUSE OF DEATH

NUMBER

ALL CAUSES

Heart Disease Malignant Neoplasms Vascular Lesions of C.N.S.

RATE

PERCENT

NUMBER

RATE

PERCENT

- 565 9

1557.1

10 Q.O

4166

1105.4

10Q.0

2182 922 460

6oo.4

38.6 16.3

126.6

8.1

501

421.6 207.0 132.9

38,2

253.7.

1589 780

18.7 12,0

W

Accidents Cirrhosis of the Liver Influenza and Pneumonia

315 309

86.7

5.6

•177

177

8:?

H

IS 8

47.0 40.6 31.6

Suicides Diseases of Early Infancy Arteriosclerosis

141

38.8 38.0 26.7

1:1

3? 100

21.0 23.3 25.5

1.9 2.1

6.9

0.6

Ulcers of Stomach & Duodenum Diabetes Tuberculosis Congenital Malformations All Other

138 97 6*4

1.7

17.6

1.1 1.1

60

w

59

16.2 9.1

'd

i

10.3

0.4 0.9

702

193.2

12.4

442

117.3

10.6

Table 4

195* 1955 1956 1957 1958 1959 i960

2.4

33

JME rnal YEAR

M

14.9

1:1

deaths

NUMBER OF MATERNAL DEATHS

RATIO PER 1n,nnn LIVE BIRTHS

4 n u 2.0

Table 5

LEADING CAUSES OF DEATH FOR SAN FRANCISCO WHITES NEGROES AND CHINESE WITH RANK ORDER AND RATE PER 100,000 POPULATION, i960 J_

WHITE RANK

ALL CAUSES

NO.

8956

CHINESE

NEGROES

RATE

RANK

11*81.8

NO.

RATE

^99

670.9 149.2 106.2 55.1 ^9.7

NO.

RATE

251

688.7

3 6

75 43 26 10

205.8 118.0 71.3 27.4

RANK

Heart Diseases Malignant Neoplasms Vascular Lesions Accidents

1 2 3 4

3551 1567 879 438

587.5 145.4 72.5

5

111 79 4l 37

Cirrhosis of Liver Influenza and Pneumonia Diseases of Early Infancy Suicides

5

409

67.7

6

36

48.4

4

13

35.7

6

268

44.3

8

15

20.2

7

9

24.7

9 7

153 205

25.3 33.9

3 -

5^

72.6 2.7

8 5

7

2

12

19.2 32.9

187 102

30.9 16.9

10

6 4

8.1

-

2

5.4

10

5

83 61

13.7 10.1

3 6

4.0 8.1

-

1

7

9

10

13.4

11

10

5 6

6.7 8.1

16.5

7

18

10

6

24.2 8.1

2.7 5.5

60

80.7

General Arteriosclerosis 8 Diabetes 10 Ulcers of Stomach and Duodenum 11 Tuberculosis 12

Congenital Malformations 13 Intestinal Obstruction & Hernia 14 Nephritis 16

56

9.3

51 26

8.4 4.3

Homicides Pyelonephritis

24 48

4.0 8.0

848

140.3

All Other Causes

17 15

1 2 4

259.3

12

13

10

11

1 2

5.5 13.7

2.8 24.7

11.0

26

71.3

There were 52 deaths of Filipinos with a rate of 4.2 per 1,000 population; among them 16 deaths from heart disease, 6 from cerebral vascular lesions of central nervous system, 5 each from cancer and certain diseases of early infancy, 3 each from cirrhosis and accidents. There were 51 deaths among Japanese with a rate of 5.4 per 1,000 population. 13 heart disease, 9 vascular lesions of central nervous system, 6 cancer, 4 each from diabetes and certain diseases of early infancy.

In the other non-white group there were 16 deaths of which 5 were coded to heart disease, 3 to certain diseases of early infancy, 2 each to cancer and accidents. The rate was 4.9 per 1,000 population. -7-

Table 6

DEATHS FROM SELECTED OUSES,

CITY 4 COUNTY OF SAN FRANCISCO

BY PLACE OF RESIDENCE AND

CCURRENCE

i960

L2-5-3

j_2_jLq_ DEATHS BY RESIDENCE

SEVENTH REVISION INTERNATIONAL LISTS TOTAL,

ALL CAUSES

RESIDENT

BY

3ATE

PERCENT

OCCURRENCE

-322$

1327.1

lflflJL

10,2 67

n

10.3 9.3 1.0

0.8 0.7

3.2 0.3 0.4

0.3

1.1

0.1

NUMBER .

DEATHS

NUMBER

RATE

9SS9

129^9

4

9.7 9.2 0.5

26

3.5

SELECTED COMMUNICABLE DISEASES Tuberculosis, All Forms Respiratory Other Forms

001-019 001-008 010-019

Syphilis Poliomyelitis Encephalitis Hepatitis

020-029 080-081 082-083

Other

7

24 2

092

I

Infective 4 Parasitic Diseases Residual: 001-133

Influenza 4 Pneumonia Influenza Pneumonia , except of Newborn

SELECTED DISEASES, MALIGNANT NEOPLASMS:

0.1

9

5

0.7

3.1

0.2

27

18

2.4

3.0

219

296

40.1

6

40.0 0.8

0.1

1

6

0.8

490-493

290

39.2

2.9

218

290

39.3

IN

140-205

NATURE

1702

229.9

17.3

61

8.2 20.1

0.6 1.5

69 183

57.0

*.3

i»93

34.6 3.3

2.6 0.3

333

149

422 256

21.2

1.6

'11

1

0.4

50

4.1

59

8.0

177-179 180-181

85 72

9.7

0.9 0.7

201

23

3.1

0.2

69

9.3

0.7

61

8.2

192

170 1)1

Leukemia and '^leukemia 204 Other Lymphatic 4 Hematopoietic Tissues 200,202. ?oj, 205 Other 4 Unspecified Sites (156b 165) (190 -199) 3enign 4 Unspecified Neoplasms Diabetes Mellitus Cirrhosis of the Liver Without mention of Alcohol With mention of Alcohol Ulcers of Stomach 4 Duodenum Hernia 4 Intestinal Obstruction

1

23

Trachea, Sronchus 4 Lung 162-163 Other Respiratory System 160,161,16* not specified as secondary

Male Genital Urinary Hodgkins Disease

4

296

Buccal Cavity 4 Pharynx 1>0-148 Stomach 151 Other Digestive Organs 150,152-156A 4 Peritoneum not specified as secondary 157-159

Breast Cervix Uteri Other Uterus Other Female Genital Organs

21 4

480-493 480-483

USUALLY CHRONIC TOTAL

0.1

210-239 260 581

581.0 581,1 540-541

560,561,570

'F 462 319

I"

i

224.4

II 146

10.0 19.8

56.8 249 31

137

I

a u

90

U 14

10.4 12.7 1.9

70

9.5

0.6

90

64

8.7

26.0

2.0

235

151

20.4

3.6

0.3 1.2

*2

26

118

97 411

5:1

489 340 149



19)4 13.0

62

8.4

*3.i

H3 90

12.2

1:1

92

56

7.6

0.6

69

-8-

1658

268

$

4

Table 6,

Continued

DEATHS FROM SELECTED CAUSES

1

SEVENTH REVISION INTERNATIONAL LIST NUMBER

CARDIOVASCULAR RENAL DISEASES.

TOTAL

Vascular Lesions, Central Nervous System 330-334 Rheumatic Fever ^00-^02 410-443 Diseases of the Heart Chronic Rheumatic Heart Dis. 410-H& Arteriosclerotic Heart Disease including Coronary Disease 420 Chronic Endocarditis and Myocarditis 42fl-$22 Other Diseases of the Heart 430-434 Hypertension with Heart Dis. 440-443

Hypertension mention of Heart without General Arteriosclerosis Other Diseases of Circulatory System Nephritis, Chronic and Unspecified

ACCIDENTS

T

NUMBER

5238

RATE

707.5

19

9 6

DEATHS BY RESIDENCE PERCENT

53.3

DEATHS

5

9

RESIDENT

BY

OCCURRENCE

NUMBER

5189

5121

693.2

949

RATE

3t

1.2

i

3

i

128.5 0.5 504.5 13.0

409.3

30.8

3017

2949

399.2

31 .£

2.4

236

199

9.6 43.6

26.9 11.2

323

3.3

3ii

400

5*.l

450

56 197

1.6 26.6

0.6 2.0

50 153

42 203

27.5

451-468

210

28.4

2.1

228

158

21.4

592-59^

40

5.4

0.4

53

38

5.1

492

66.5

5.0

450

471

63.8

17.9

1.3

101

195 154

136 174 161

18.4 23.6 21.8

440-447

961

129.8

9.8

3

0.1-

3771 115

509.4

33.4

15.5

3030 232

P

895

0.7

5.7

POISONINGS AND VIOLENCE

ACCIDENTS Motor Vehicle Accidents Home Accidents Other Accidents

800-962 810-835,960 870-936 WITH.O. Residual

186 174

25.1

23.5

•I 1.8

SUICIDES

963,970-979

220

29.7

2.2

230

194

26.3

HOMICIDES

964,980-985

44

5.9

0.5

40

40

5.*

ALL OTHER CAUSES

Complications op Pregnancy Childbirth, i the Puerperium

640-689

Certain Diseases of Early Infancy

760-776

0.4

0.4

226

30.5

2.3

294

218

29.5 11.9

3.8

Congenital Malformations

750-759

72

9.7

0.7

153

se

Gastritis, Duodenitis, Enteritis, Colitis

5*3,571-572

29

3.9

0.3

36

28

All Other Specified Causes

Residual

80.0

6.0

619

Symptoms, Senility, Ill-Defined 4 Unknown Causes

780-795

3.2

0.3

592

24

-9-

61

83.1

'.

9

*

6 2

Table

7

DEATHS FROM IMPORTANT CAUSES BY AGE GROUP San Francisco Residents,

1

4 YEARS

_

CAUSE OF DEATH

<;

i

RATE

tf

100.0

1M

9 i

25.0 22.2

5

1

NO.

ALL CAUSES

Accidents Congenital Malformations Malignant Neoplasms Influenia 4 Pneumonia

3

All Other Causes

-.

ALL CAUSES

Malignant Neoplasms Accidents Congenital Malformations Influenza 4 pneumonia

2' 9

8.3

RATE

77

100.0

Sf.5

Accidents Suicides Malignant Neoplasms Homicides Nephritis Heart Diseases Diabetes Influenza 4 Pneumonia

3*

W.I

10

13.0

2 2 2

3«? 2.6 2.6 2.6

All Other Causes

15

19.5

CAUSE OF DEATH ALL CAUSES

l6.f

Heart Diseases Cirrhosis of Liver Malignant Neoplasms Accioents Suicides Homicioes Vascular Lesions C.M.S, Influenza 4 Pneumonia Tuberculosis All Other Causes

4

RATE

CAUSE OF DEATH

27M

10Q.Q

1330.4

Heart Diseases Malignant Neoplasms Cirrhosis of Liver Vascular Lesions C.n.S. Accidents Suicides Influenza 4 Pneumonia Ulcers of Stomach 4 Duodenum Tuberculosis

939

34,2 23.2

319.8

10.

H3.1

35

1,3 1.3

All Other Causes

365

13,2

I 3

1:1 3.3 2.2 2.2 2.2

45 - 64 YEARS

CAUSE OF DEATH

ALL CAUSES

NOTE:

^2 10 7 5 2 3



i

RATE

100.0

32.6

31, 21.9

10.2

15.

6.3

25,0

7.1 5.1

2,0 8.2

2C - IH YEARS

i

NO.

ALL CAUSES

.NO.

All Other Causes

24 YEARS

CAUSE OF DEATH

- 14 YEARS

CAUSE OF DEATH

30.6

11

i960

NO.

<

RATE

"tfq

100.0

293. ^

101

17.2 16,2

50.7

H.9

: 42.1

?5

8

14.4 10.3

M

15

3.6 2.6

10 35

iti

21

31.6 12.0 10.5 7.5

6q YEARS AND OVER

NO.

637 285 177 120 93 62

36

6.4 4.4 3,4 2.2

ALL CAUSES

Heart Diseases Malignant Neoplasms Vascular Lesions C.n.S. Accidents Influenza 4 Pneumonia Arteriosclerosis Cirrhosis of Liver Diabetes Mellitus Suicides

88.9 sq:| 31.1 18. 8.1 1

7.*

All Other Causes

183,3

Rates per 100,000 enumerated population in each age group.

Percents and rates adjusted to add to totals

-10-

NO.

i

600S

100.0

2726 956 762 215 200

*5A

RATE

64m.

7b 54

1.2 0.9

2912.1 1021.3 814.0 229.7 213.7 192.3 86.5 81.2 57.7

755

12.6

806.5

180 81

15.9

1.1 3.3 3.0

M

PERCENTAGE OF DEATHS FROM IMPORTANT CAUSES BY AGE GROUP SAN FRANCISCO RESIDENTS,

1

i960

- H YEARS

5 -

1l»

YEARS

MALIGNANT NEOPLASMS

ACCIDENTS

CONGENITAL MALFORMATIONS

H*

1

"22T

ACCIDENTS

22$

MALIGNANT NEOPLASMS

31*

CONGENITAL MALFORMATIONS

INFLUENZA 4 PNEUMONIA

INFLUENZA 4 PNEUMONIA

iq -

YEARS

2l»

2
ACCIDENTS

Ufa



W

YEARS

HEART DISEASES

17* 1

-T5T"]

SUICIDES

MALIGNANT NEOPLASMS

Zi

HOMICIDES

11

NEPHRITIS

CIRRHOSIS OF LIVER

10

/*

MAL'GNANT NEOPLASMS

15*

*

ACCIDENTS

H$S 1

3 * a

-

fit

1

SUICIDES

y ear ?

11*

|

6q YEARS AND OVER

~W

HEART DISEASES

'

"\

HEART DISEASES

*5* |

MALIGNANT NEOPLASMS

.

23*

CIRRHOSIS OF LIVER

I

I

1

1?*1

ACCIDENTS

"]

**

4*

INFLUENZA 4 PNEUMONIA

II

3*

3^

ARTERIOSCLEROSIS

J

3*

Z] *

ACCIDENTS

~\

I]

10

VASCULAR C.N.S. LESIONS

10*

VASCULAR C.N.S. LESIONS

SUICIDES

MALIGNANT NEOPLASMS

-//-

S

.

DEATH RATES FOR CERTAIN IMPORTANT CAUSES BY AGE GROUP SAN FRANCISCO RESIDENTS,

i960

10,000 'HEART

1000

20

Co

IK)

100

$0

AGE

AGE (

GROUP Years ) 1

- 9

10 - 19 20 - 29

ENUMERATED POPULATION

HEART JlQ*

109,225

97J9W

CANCER

0o9

16

1

1.1 5.1

1.

101, ^on

36

102,092 102,87?

171

167-5

50 - 59

*55

W2.3

60 - 69 2° s 79 80 Plus

79,2*3 44,390 13,2*9

7° " ? 9 -

W

%

hoa

1

5

Bail

ACCIDENTS Nn.

H.6

M

Rate

SUICIDES "a.

Bail

2

17

2.2 17.4

p 57

37.2 55.*

33.0 14.5 37.8

3.1

7

7.1

.15 338

328.6

155

588.1

102 33

3*.5

1120.6

>t66

38: I

til

107^.6

12
973

CIRRHOSIS

BAIL

175L1

Rates per 100,000 population

Hl,

121.5 150.7 128.7 7*.3 45.3

%7

^2

18

90

679.

to

50.

28

63.1 37.7

5



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o

There were 20,644 live births recorded in San Francisco during i960, 168 Births; more than in 1959 and 132 more than the previous high year of 1957. The number of non-resident births, 6,205, exeeded the peak of 6,133 reached in 1959» although the percent of the total, 30%, was the same in each year. Resident births occurring elsewhere were about the same number in i960 as in 1959; 289 and 291 respectively. The number of resident births was therefore 14,728 with a crude birth rate of 19.9 per 1,000 population compared to the revised birth rate of 19.8 in 1959. The ratio of males to females decreased slightly from 105 to 100 in 1959 to 102 to 100 in i960. »

The birth rate for whites was 17.3 per 1,000 population in both 1959 and I960, and the number of births remained about the same, 10,442 in 1959 and 10,460 in i960. Negro births were also similar in number and rates for the 2 years; 2,4?4 live births in i960 and 2,462 in 1959; the birth rate in I960, 33.3 per 1,000 population, was almost double the white. The number of Chinese births decreased slightly from 889 in 1959 to 862 in i960 with a consequent drop in the birth rate from 24.5 to 23.7 per 1,000 population. Filipino births increased by 10.7% to 444 in i960 from 401 in 1959 with a birth rate of 36 per 1,000 population in i960. The changing pattern of births by ethnic groups throughout the past 11 years is as follows:

Resident Live Births by Ethnic Groups as a terc ent of all Births,

1950-1960

Other Nonwhite Other Filipi no

Total Nonwhite

Negro

Chinese

81.2 80.3 80.2 78.6 77.3

18.8 19.7 19.8 21.4 22.7

9.5 11.1 11.0 12.4 13.1

7.0 6.4 6.1 5.9 6.0

0.8 0.9 1.0 1.3 1.4

1.5 1.3 1.7 1.8 2.2

1955 1956 1957 1958 1959

76.1 74.5 73.7 72.9 71.4

23.9 25.5 26.3 27.1 28.6

14.0 14.9 15.3 16.3 16.8

6.0 6.2 5.9 5.7 6.1

1.4 1.6 1.6 1.5 1.6

2.5 2.8 1.8 2.3 2.7

1.7 1.3 1.4

i960

71.0

29.0

16.8

5.9

1.1

3.0

1.5

YEAR

White

1950 1951 1952 1953 1954

Japanese

During i960, 1,310 or 8.9% of the resident live births were to unmarried parents, an increase of 150 or nerrly 13% from 1959; 5*9% of the total white births and 25.9% of the total Negro births were out of wedlock. The increase in the total was chiefly in the white group where the number incre sed by 112 or 22% over 1959; the Negro increase was 38 or 6%. Of the 1,310 unmarried mothers, 47.1% were white, 49.0% Negro and 3.9% were other races. Almost % of the deliveries (49.7%) took plrce at San Francisco General Hospital; 23% of these were white and 73% Negro; 11% were delivered at t^e University of California Hospitals; 71% of these were white fnd ne. rly 27% Negro. Not quite half (46.5%) of unmarried mothers had their first child in i960 and nearly 26% of all the mothers were 19 years or younger.

Reporting of medical items on the birth certificate varied from 100% reporting on weight of Japanese live births to 55.9% on completed weeks of gestation for Chinese births. By the criterion of birth weight - 2500 grams or under - 8.1% of all resident live births were premature; using length of gestation period, 8.7% were premature and by length of birth, probably the least satisfactory criterion, 11.0% were under 18.5 inches. Using 2 criteria, birth weight and completed weeks of gestation, 4.1% were premature -14-

Hunters Point He. lth District had the highest birth rate in i960, 29.2 per 1,000 population; 44% of the births were white, 47% Negro and 9% other races. Mission Health District was next highest with a rate of 27*6; in this health disNorth trict, 8l% of the births were white, about 11% Negro, and 8% other races. East Health District had the lowest rate, 13.0 per 1,000 population with 45% white and 49% Chinese. Again in i960 the proportion of Chinese births to residents of the North East District continued to decrease; 68.9% of the Chinese births were to residents in this district compared to 73% in 1958 and 8l% in 1953.

In i960, 34.3% of the children born were first births compared to 34.1% in Thus 1959. Second births decreased slightly from 25.8%, in 1959 to 25.5% in i960. the number of families having 3 or more children increased by 2% over 1959* Additional informction from the medical items on birth certificates is available on request from the Bureau of Records and Statistics. Table 9 RECORDED, RESIDENT /ND NON-RESIDENT BIRTHS BY PLACE OF BIRTH, SAN FR. NCISCO, 1959 & I960

ALL BIRTHS

NON-RES] DENT

RESIDENT

RECORDED I960

1959

I960

1959

I960

20,644

20,^76

14,728

14,634

6205

6133

1959

Kaiser Foundation Hospital U. C. Hospitals Children's Hospital San Francisco General Hosp. St. Mary's Hospital

2899 2044 1929 1811 1744

2687 1833 1863 1757 1778

1526 1410 1290 1790 1181

1439 1213 1257 1740 1219

1373 634 639 21 563

1248 620 606 17 559

Mary's Help Hospital St. Luke's Hospital Letterman General Hospital Mt. Zion Hosp. & Med. Ctr. St. Francis Memorial Hosp.

1690 1471 1421 1198 1136

1618 1392 1336 1233 1164

1298 1012 869 906 830

1229 976 832 914 879

392 459 552 292 306

389 4l6 504 319 285

1057 867 French Hospital 529 Chinese Hospital ^75 St. Elizabeth's Infant Hosj . 290

1124 1294 605 457 255

780 581 349 451 90

815 851 407

211 286 180 24 200

309 443 198

52 11

63 10

1

7

63 9 4

-

20

7

3

-

-

52 11 13 245 44

250

-

41

-

-

St. Joseph's Hospital Presbyterian Medic el Ctr.*

Home Emergency Hospitals Elsewhere Other California Out of State

-

San Francisco Stanford Hospital through April I960; Presbyterian Medical Center from Hay 1, i960.

-15-

440 56

-

17 199 -

2

Table 10 SAN FRANCISCO RESIDENT LIVE BIRTHS BY PLACE AND RACE

L2& WHITE

NEGRO

11,728

10,1-60

2171

San Francisco General Hospital Kaiser Foundation Hospital U. C. Hospitals Mary's Help Hospital Children's Hospital

1790 1526 i4io 1298 1290

666 1029 1069

1032 286 235

1157

2 9 11-6

St. Mary's Hospital

1181

51

21

St. Luke's Hospital Ht. Zion Hospital A Medical Center Letterman General Hospital St. Francis Memorial Hospital

1012 906 869 830

1061 897 6l4

60 229 156

20

13

11

TOTAL

St. Joseph's Hospital

780

Presbyterian (-iedical Center* Chinese Hospital French Hospital Other California

581

973

8

5 2

619 735 261

319 215

FILIPINO

862

227

9

31

6

81

72

3?

3^

3^

26

16 19 12

13

82

2

2*

90

1-0

36

5

8

10 15

116

27 15 22 50 23

9

11

"I

1

1

1

3

1

3

2

2

M

16

6

I

5

-

1

5

2

7

-

13

n

Emergency Hospitals

11

i

&

11

13

16 25 18

5

49 11

8

3 59 6

200

52

OTHER

265

79 26

90

JAPANESE

iUrt

12

w

St. Elizabeth Infant Hospital Home Out of State Elsewhere

*

CHINESE

2

5

5 1

1

1

. -

-

1

-

-

San Francisco Stanford Hospital through April 1960; Presbyterian Medical Center from May 1, i960.

Table 11 RESIDENT LIVE BIRTHS A BIRTH RATES BY RACE 4 SEX San Francisco 1959 ano i960

19

TOTAL

White

Negro

6

9

1

s

9

RATE

MALE

FEMALE

BIRTHS

RATE

11,723

19.9

7.439

7, 289

11,671

19.8

0,160

17.3

5,316

5,111

10,112

17.3

2,171

33.3

1,207

1,267

2,162

33.2

1

Chinese

862

23.7

116

116

889

21.5

Filipino

111

36.0

223

221

101

32.6

Japanese

265

28.0

135

130

237

25.2

Other

223

67.7

112

111

203

63.I

Table 12

RESIDENT BIRTHS BY HEALTH DISTRICT A RACE San er ancisc q, ia£fl ^

OTHER

BIRTH TOTAL

TOTAL

11,728

NEGRO CHINESE

RATE*

'-IHITE

19.9

10,l60 2,171

Alemany Central eureka-noe

1513 1816 1768

20.2 22.8 21.1

1190 1023 1635

253

Hunters Point Marina-Richmond Mission

1371 1335 1962

29.2 15.0 27.6

60I 1516

Si

North East Sunset

1212

15.0

'Iestside

1086

519 1878 311

15.1

DISTRICT NOT REPORTED *

Rates per

1

23.5

126

-16-

JLtiL J* 121

38

2

100

,000 population.

862

FILIPINO

i 1

JAPANESE -2£5_

NCN-'-'HITE

_223_

15 it 22

51

It

]

70

H

591

22

16 11

621

7

Table 13 LIVE BIRTHS

BY TRIMESTER PRENATAL CARE AND BY PLACE OF BIRTH

San Francisco Rfsidents,

I960

1ST

PLACE OF BIRTH

TRIMESTER

TOTAL

TOTAL

BEGAN

11,72!!

771?

San Francisco General Hospital Kaiser Foundation Hospital U. C, Hospitals Mary's Help Hospital

1790 1526 i4io 129s

221

Children's Hospital St. Gary's Hospital St, Luke's Hospital Mt. Zion Hospital 4 Medical Center

1290

CARE BEGAN 2nd 3rd TRIMESTER TRIMESTER

MM

1

m

NO CARE OR NOT REPORTED 811

272

:M9

18

8!!

z

St

119 7*9

Ill

u

1131

936 905

292 203

1012 906

627 642

III

s 9

Letterman General Hospital St. Francis Memorial Hospital St. Joseph's Hospital Presbyterian Meoical Center*

869 830 780

522 510

291

H

207

£

161

581

383

128

p

,2

Chinese Hospital French Hospital Other California St. Elizabeth Infant Hospital

151

333 252

101

14

V

8

29

I]

?!

1

10

1<

8

18 28

I 4

5

3<9 245 90

Home Out of State Elsewhere

11 13

I

Emergency Hospitals

11

-

55

49 15 47 7 1

4

3 1

2

16

8

2

3

I

Table 14

PLACE OF BIRTH OF PREMATURE San Franci sco Residents,

INFANTS BY RACE 12£jl

RACE WHITE

NEGRO

FILIPINO

1199

7f7

5flS

JtL

224

TOTAL

PLACE OF BIRTH

San Francisco General Hospital Kaiser Foundation Hospital U. C. Hospitals Children's Hospital

62

145

120

56

101

70

S

93

67

15

92 90

77

78

83 72

39

St. Luke's Hospital St. Joseph's Hospital St. Francis Memorial Hospital

u

8

S8

2

Presbyterian Hospital 4 Medical Center'

38

46 30 18

6

St. Mary's Hospital

Mary's Help Hospital Mt. Zion Hospital 4 Medical Center Letterman General Hospital

Frahch Hospital Chinese Hospital Othcr California Home

51

_

11 'I

2

4

4

I

7

Emergency Hospitals Elsewhere

1

11

Out of State St. Elizabeth's

4

Infant Hospital

I

1

2 2

-

5

1

San Francisco Stanford Hospital through April 1960; Presbyterian Medical Center from May 1, 1960.

17-

2

CHINESE _S7_

JAPANESE

OTHER

K"S

•-

— oz

•-

•-

to l<>

OJ

t-

<—

»-

«^c •-

CJ

i—

•-

— u>

o>

C\J

r^\

J-

VO

«-

n-\

a »-

CvJ

Ov

*-

CSJ

UJ>-

-'



MN

N"\

T-

T-

«-

NO

»-

1/5

>—

DC >-

*-

d"

ON



.18-

•-



Infant Deaths; During i960 there were 338 resident deaths under one year of age or a rate 22.9 per 1,000 live births, i960 is the third year showing a decrease since 1956 when the rate, 22.6, was the lowest experienced; the rate for 1959 was 23o8, for 1958, 25.8, and for 1957, 25.3 per 1,000 live births. Nearly 1%% of the deaths were under 4 weeks of age compared to 76% in 1959. There was an encouraging decrease in the number and percent of Negro infant deaths from 93 and a rate of 37«£ in 1959 to 77 and a rate of 31.1 in i960. The Chinese rate also dropped from 21 in 1959 to 15 in 1950.

Frematurity was cited as a causal factor in 5k% of all infant deaths The most frequent cause was atelectasis, and, in this group, prematurity -•as mentioned in Bk% of the deaths. Thirteen percent of the infant deaths were coded to congenital malformations and 12% to birth injuries. There were fewer deaths from pneumonia but increases in other respiratory infections, accidents, diarrhea and sepsis of the newborn. •

Westside Health District again had the highest rate of infant deaths, 34 per 1,000 live births, higher than the Negro rate of 31; nearly 84% of these deaths were of those under 4 weeks of age. Central Health District was egain next highest in both categories and also had the highest number and rate of premature births. North East, with the lowest live birth rate, had the lowest infant death rate, 17.3 per 1,000 live births but its unfortunately high fetal death ratio marred its record.

Table 16 INFANT DEATHS BY RACE AND AGE San Francisco Residents, i960

ALL RACES

White Negro Chinese

Japanese Filipino Other Non- •White

1-6

28 DAYS 11 MONTHS

TOTAL

UNDER 24 HRS.

D/*YS

1-21 DAYS

338

164

75

2k

75

234 77

111 37

57 14

16

50 20

13

7

-

5 6 3

3

1 2 1

k 2

6 2

k

-

1 -

-

Table 17 INFANT DEATHS BY RACE AND SEX San Francisco Residents i960 ,

ALL RACES

White Negro Chinese

Japanese Filipino Other Non- White

RATE 1ER 1,000 LIVE BIRTHS

TOTAL

MALE

FEMALE

338

202

136

22.9

234

146

77 13

41

88 36 6

22.4 31.1 15.1

5 6 3

3 4

2 2 2

18.9 13.5 13.5

7

1

-19-

Table 18 INfANT DEATHS FROM SELECTED CAUSES BY AGE San Francisco Residents i960

INTERNATIONAL CAUSE OF DEATH

CODE NO.

TOTAL

NEO.MATAL SUB-TOTAL

ALL CAUSES TOTAL WITH MENTION OF PREMATURITY

UNDER 2* HRS.

1- 6 DAYS

DAYS

28

2ft

75

2*

1«1

131

1?5

11

5

251.

JSL

ASL

15-

11

DAYS _ MONTHS 7"5

CONGENITAL MALFORMATION AND CERTAIN DISEASES OF EARLY INFANCY EXCLUDING INFECTIONS

Congenital Malformations Injury at birth Asphyxia and Atelectasis

Disorders attributed to disease of mother during pregnancy Erythroblastosis

Hemorrhagic Disease Ill-Defined Diseases Immaturity Unqualified

750-759 760-761 762

Diarrhea of Newborn Bacillary Dysentery Gastro-Enteritis 4 Colitis

Sepsis of Newborn "Viral" Infection

76

5

\5 11

30

10

1

55

21

-

769 770 771 20 33

INFECTIONS

Pneumonia of Newborn Other Pneumonia Other Respiratory

12

Jl

-S2_

763 490-^93 500-527

_

764 0*5

:

» 1

3

_

-

12 17

1



1

571

767-768 096.9

ACCIDENTS

22-

Motor Vehicle Collision 816,* Obstruction or Suffocation: Food 921 Suffocation in Bed or Cradle 92M-

M.

OTHER

Hernia & Intestinal Obstruction Cerebral Spastic Infantile Paralysis

560-570

Malignant Neoplasms Endocrine Disorder

HO-205

Disease of Pancreas Homicide

587.2 983

351

277

-20-

Jl

Table 19 FETAL DEATHS BY HEALTH DISTRICTS AND RACE San Francisco Residents, I960

HEALTH DISTRICT TOTAL

FETAL DEATHS /l, OOP LIVE BIRTHS

ALL RACES

WHITE

203

1*»3

k6

13.8

NEGRO

CHINESE

13.7

18.6

it.6

17 25 19

15 15 17

2

Central Eureka-Noe

11.0 13.5 10.7

-

Hunters Point Marina-Richmond Mission

15.3 12.5 16.3

21 23 32

8

11

21 2k

1 5

North East Sunset Westside

18.2 12.1 17.5

22 2k 19

16 23

l -

3

15

Al era any

9 2

FILIPINO

15.8.

JAPANESE

7.5

OTHER

k.3

_ 3 1 -

District Not Reported Table 20 FETAL DEATHS BY PLACE OF DELIVERY AND RACE I960 San Francisco Residents,

ALL RACES

WHITE

203

lk3

k6

San Francisco General Hospital Kaiser Foundation Hospital Mary's Help Hospital

38

Ik

2k

19 17

10 Ik

8

St. Mary's Hospital

Ik 13 13

10 10

13 12 11

13 12 8

11 8 8

9 k 6

5

k

-

_ -

1

l

5

it

1

-

6

5 5 2

PLACE OF DELIVERY TOTAL

Hospitals St. Francis Memorial Hospital U. C.

St. Luke's Hospital

Presbyterian Medical Center**' Children's Hospital St. Joseph' £ Hospital Mt. Zion Hosp. & Medical Ctr.

Letterman General Hospital French Hospital Chinese Hospital Home Elsewhere* Other California Out of State *

7 2

CHINESE

-

1 1 2 -

13

FILIPINO

JAPANESE

1 1

1 1

_ -

-

1

-

1

_

-

1 -

3 1

-

1

2 -

Emergency Hospital, 2 Enroute Emergency, 1 Florence Crittenton, 1 Coroner's Office. San Frencisco Stanford Hospital through April, I960; Presbyterian Medical Center from May 1, i960.

Includes

1

1 Unknown,

***

NEGRO

-21-

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•^

Communicable Diseases: Reported cases of common childhood diseases like chickenpox, German measles, measles and mumps decreased during I960, bringing the total communicable diseases to a new cyclical low of 8,272 cases. For the second time in San Francisco history, there were no reported cases of diphtheria and only 1 case of typhoid fever. Infectious hepatitis cases increased to lMf in i960 from the 100 cases reported in 1959 and were more than twice the 70 cases reported in 1958. Diseases of major importance such as tuberculosis, gonorrhea and syphilis showed increases ranging from 1 to lk%. Only 7 cases of poliomyelitis were reported in i960 compared to 13 in 1959 but 2 deaths were coded to the disease in i960 after none in 1959 and 1958. Of the 7 cases, k were spinal-paralytic, 2 bulbo-spinal and 1 nonparalytic; k of the 7 had not received any polio vaccine, nd 2 of the school age childred had not had a shot since 1957* i

Venereal Diseases; The ye r i960 was one in which the rising trend in the incidence of venereal diseases continued, as it has each year since the all-time low point of 195^-1955 » Table 2h and the charts clearly point this out. In gonorrhea the rate has increased 75.7 percent since 1955 and ?,6 % since 1959» In syphilis, the disease with greater implications to the individual involved as well as to the community, the increase has been more dramatic. Since 1955 there has been a rise of 188.6% in all stages of the disease and a rise of 1^.1% since 1959. Of far greater significance, though, has been the increase in the rate of those stages that are known to be infectious to others. This has risen 3^6.3% since 1955 and 16.5% since 1959 • It must be remembered that the figures presented in this report represent only those cases about which we have been notified. At the same time, there can only be speculation concerning the numbers of cases that have not yet been discovered or about those cases that have been discovered but which, for one reason or another, have not been reported. There is reason to believe that some of the apparent increase in venereal diseases has been the result of the increasing awareness on the part of private physicians as to the desirability and need for interviewing all diagnosed cases, both for the sources of their infections as well as for those to whom they, in turn may have transmitted the disease. There is also reason to believe that a substantial proportion of the apparent increase actually represents a true increase. In any event, whatever the causes, there is represented here a large number of people with serious problems that must be handled properly by the various community resources in the interest of all concerned. Table 25 indicates the reporting sources and, as in the past, the great majority of cases was reported by the ^an Francisco City Clinic. Table 23 reveals the private physician's role in the reporting of venereal diseases. Percentagewise, there was a drop since 1959* This has been so despite continuing efforts on our part' to facilitate the reporting of syphilis. The significance, if As for any, of this seeming decline in interest, can only be speculated upon now. gonorrhea, the poor reporting is more readily understandable; it has never been wellreported nor is the health department in a position to make a serious effort toward having the situation improved. Table 22 points out and emphasizes the importance of interviewing all diagnosed patients for contacts. In i960, almost half of all the early infectious syphilis that was reported came to light as a result of our epidemiological efforts. Table 28 is a breakdown in age distribution of venereal diseases and emphasizes the already known fact that infectious venereal diseases are found essentially among those under ^5 years of age. Table 29 is a further breakdown in age distribution. If any conclusion can be drawn from such a small number of cases, it would have to be that at the present time venereal di n**.i«oo rtr> nr^ *»r>n«H tuta a eeri our yaohl cm omoii/y tho yrmt.h nf S^n F-rnnri poo. -23-

Table 22 SUMMARY OF VENEREAL DISEASE EPIDEMIOLOGY 1959

I960

-

1939

1260

Primary, Secondary, and Early Latent cases reported

521

607

Number of cases interviewed

472

606

Total number of contacts obtained

988

2752

195

273

Genito-Urinary Reported

2050

2142

Number of cases interviewed

1311

1423

Total number of contacts obtained

1500

1705

Number of contacts diagnosed and brought to treatment 593 Most have been diagnosed as Early Infectious.

655

SYPHILIS

Number of contacts diagnosed and brought to treatment

GONORRHEA

*

Table 23 VENEREAL DISEASE • REFORTED TO THE HEALTH DEPARTMENT WITH PERCENTAGES REPORTED BY PRIVATE FHYSICIANS 1956 - I960 1956

1227

i25§

1952

i960

267 48 18.0

221 50 22.6

357 87 24.4

528 171 32.4

616 152 24.7

495 72 14.5

571 143 25-0

687 204 29.7

892 282 31.6

1023 295 28.8

2074 146 7.0

2353 143 6.1

2520

3078 169 5.5

3316 172 5.2

SYPHILIS (Primary, Secondary, Early Latent) Reported from All Sources Reported by Private Physicians Percentage

SYPHILIS

(

All Stages )

Reported from All Sources Reported by Private Fhysicians Percentage

GONORRHEA

(

All Classifications )

Reported from All Sources Reported by Private Fhysicians Percentage *

151 6.0

Includes a small number reported by Military Facilities, -24-

Table 24

REPORTED CIVILIAN CASES OF VENEREAL DISEASE SAN FRANCISCO, 19SS-1960 GONORRHEA

1355.

ias£

1QS7

\35l

mi

12£n

1797

1889

2255

2M&

2235

3157

1343

1590 484

2050

21

31

1773 392 263

349

588 427

1351

1958

1959

1960

120

211

403

Geni to-Urinary

Epidemiological Other

'til

SYPHILIS

1355

391 155

135h.

1

-ML.

TOTAL

26 130 227

214

!*?

1010

570

M

Primary Secondary Ea«ly Latent <'*ll Others

536

52 111

113 121

17S 156 190

3^9

329

364

155 24l

Table 25 REPORTED CASES OF VENEREAL DISEASE BY SOURCE OF REPORT AMD STAGE O F DISEASE, SAN FRANCISCO, i960

TOTAL

HUNT

OTHER CITY

gfl

3333

175

J?A5_

1.0 S£

TOTAL

Percent of Total

j

mo.o

SYPHILIS TOTAL Primary Secondary Early Latent Late Latent Late Congenital All Stages - Report only

M21

GONORRHEA TOTAL Genito- Urinary Other epidemiologically treated

JLHi

U£5-

JJ2_

2299 427 590

1790

120

FEDERAL OTH. JURIS. DICTIONS CIVILIANS

^71

JX

_Lt3-

10.8

JUL

_l£

29";

1*0

ijr

158 242

V 182

8

322

108

118

33

24 14

3

3

17

4.1

JJL

5

_LZ2_

JJL

55^

14

19

NUMBER

ALL SAM FRANCISCO

"LEMANY Central EuREKA-NoE Hunters Point Marina-Richmond Mission North East Sunset '.Jests

OF CASES

OF COSES

100.0

3,533

477.9

76,205 80,999 72,473

154 833 195

202.1

4.4

1034.6

23.7 5.5

47,123 121,979 71,052

1ST

269.1

281

230.4 395.5

7

7

55

ide

San Francisco District Not Reported

PERCENT

RATE PER 100,000 POP.

71+0,316

93,410

ft

-25-

-15SL 157

1-21

Table 2d REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY HEALTH DISTRICT City and County of San Francisco, i960 Excluded are 588 Epidemiologically Treated, 51 Non-Residents, and 3 whose residence ha s not reported

POPULATION

IT;,RY

JL7i_

JL2_

HEALTH DISTRICT

i'-'IL

To

21<

21 31

OTHER TYPES TOTAL

J&i.

PRIVATE M.D.

LOCAL HOSP,

fc

H38.9

s 20.2 2.4 18.8

1.9

5

Table 27 CASE RATES FOR REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY RACE AND STAGE OF DISEASE PER 100,000 POPULATION SAN FRANCISCO, 1960

NUMBER AIL VENEREAL DISEASE

SYPHILIS,

211

22.

155

20.9

TOTAL *

Other OTHER VENEREAL DISEASE,

TOTAL

ENUMERATED POPULATION

NUMBER

RATE

52

34. ;

155*1

1390

711

117.6

273

367.O

42.3

1*3

27

1.6 1.6

166

36.3 20.2 87." 223.2

1497.7

1868.

^03

5W

216

30.3 2 2«9 23.6 35.7

2569

3^7.0

14-29

236.4

1114

26

42.3

2142

1037 "92 392

171.6 .6 64.5 .9

1021

24

39.0

427

289.3 57.7

33

2

3.3

1?

1.2

10

1.7

3

241

Geni to-Urinary

oth: R

RATE

NUMBER

RATE

105*2

1010

Primary Secondary Early Latent Other

SOHORRHEA,

NUMBER

RATE

3592

TOTAL

NEGRO

WHITE

ALL RACES

604,403 740,316 Excludes Epidemiologically treated Gonorrhea

3^.1

4.0

61,530

7^,323

Table 28

REPORTED CIVILIAN CASES OF VENEREAL DISEASE IN i960 SAN FRANCISCO, BY AGE GROUP S, STAGE OF DISEASE TOTAL ALL AG SS

14

-


_2JL

SYPHILIS, TOTAL 1010 Primary 211 Secondary 155 Early Latent 241 Late Latent 319 Late 33 Congenital 21 All Stages - For Report Only 30

JL

.

GONORRHEA

TOTAL Geni to- Ur NARY Other Epidemiologically Treated

^157 2142 427 528

1

OTHER TYPES,

TOTAL

15 - 19

20 - 2t

1130

l67f

2

44

.1!



13

_4JL8_

35 -

_2i_=-3i.

jtUL

_

9

7

i

• 1

-

19

22.

I2L5.

13

303 10 72

7

7#

«7

100 180

249 227

Table 29 IN CIVILIAN MINORS 1956 - I960

IS50 4 21

,

19S3

1959

I960

245

221

35"

521

607

'3

15

13

12

23

5.3

6.3

5.1

2.3

4.6

2142

Early Latent )

Total Reported - All Ages

Total Reported -

-

19

Percentage

jOMORRHEA

(

UNDER AGE 20

19^7

19S6

Primary, Secondary

Genito-Urinary )

Total Reported - All Ages Total Reported -

-

311.

3

1

REPORTED VEHEREAL DISEASES

(

OVER

31

-LI

SYPHILIS

H

19

Percentage

-26-

1343

'590

1773

2050

158

222

220

274

316

11.8

14.0

12.4

13.4

14.3

REPORTED CIVILIAN CASES OF SYPHILIS SAN FRANCISCO,

1956 - I960

NUMBER

1000

800

600



Ugo

m

1

200

7/A

W/ _i±Li. 1956

H Primary X///\ Secondary

tic I

I

1

i

1957

1956 " I

I

_

959

j

i

Early Latent Other

I

I960

REPORTED CIVILIAN CASES OF GONORRHEA SAN FRANCISCO,

19$6 - I960

NUMBER

3000

V/9/A 2500

w

2000

'/,

////

1500

I

1000

500

_J_J._ 1956

Mil

!

1957

Geni to-urinary

1958

1959

Y///A Epidemiological

i960

~|

Othei

REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY HEALTH DISTRICTS

EXCLUDING EPIDEHIOLOGICALLY TREATED RATES PER 100,000 POPULATION

SAN FRANCISCO

ID

i960

Under 250

500 -

250—

750 & Over

<*99

-29-

71*9

Tuberculosis; Tuberculosis control in San Francisco continues to be major public he lth problem. During I960, there were 536 newly diagnosed cases of active tuberculosis discovered in contrast to *+95 in 195 9 • The increased number of newly diagnosed cases was due to intensified casefinding in known high prevalence areas and in high risk groups. The high prevalence areas are confined to the eastern half of the city: three of the five highest areas are in the northeastern quarter. These are the older districts characterized by poorer housing, multiple family dwellings, and over-crowding with people from the lower socio-economic, non-white and LatinAmerican groups. c

The Central Health District, which includes skid row, had 2^.8% of the new cases with a case rate of l6*f.2. The North East Herlth District which includes Chinatown and North Beach, had 18.6% of the new cases with a case rate of 107.1. Westside Health District which is heavily populated with the lower economic Negro group, has been one of the highest incidence areas for many years. Recently much of the housing has been razed as part of the Slum Clearance and Urban Renewal program, resulting in the migration of many of the residents to other districts. In spite of the marked decrease in population the case rate was 99«7 in I960, The Mission Health District, with a high Latin-American, Puerto Rican and non-white population had 12.7$ of all the newly diagnosed cases with a case rate of 95.7'

Of the 536 newly diagnosed cases, 85% reside in the eastern half of the city. However, ?2% of the newly diagnosed cases will be found in five health districts which form the eastern border of Sen Francisco. These districts are represented by the shaded areas on the accompanying health district map. Fifty-four percent of the newly diagnosed cases will be found in the North East section of the city. *t08 of the 536 cases were above the age of 30 years, and 102 were above the age of 65 years, However, 71 cases, or 13*3%, were 19 years of age or younger.

Although the greatest number of cases were found amongst the white population, the non-white group, representing 18.*$ of the population, accounts for 178, or onethird, of the newly diagnosed cases. The incidence of tuberculosis continues to remain high amongst the Filipino group with 22 cases. During i960, 26*t people died with tuberculosis but in only 76, or 29%, was tuberculosis the primrry cause of death. However, in 66 individuals, or 25%, clinically active and significant tuberculosis was reported for the first time at or after death. This indicates two important facts: One, patients under modern chemotherapy two, are not dying from tuberculosis, but live longer to die of other diseases; that a large number of people with clinically active and significant disease are apparently relatively asymptomatic and remain undiagnosed and infectious until the end of their lives. The latter group usually have unsuspected advanced tuberculosis, which can be diagnosed in the living only with a chest x-ray. The findings of *+9 unknown and unsuspected cases of tuberculosis among the admissions to the General Medical and Surgical Wards at oan Francisco Generrl Hospital by the /dmission Chest X-ray Program confirms the magnitude of the problem of discovering the hidden reservoirs of the disease in the community.

TUBERCULOSIS CASEFINDING BY X-RAY: The Health Department Unit took 29,098 minifilms, finding kj> previously unknown active cases. This group includes only those who admit no contact with disease, and who have no symptoms. There were *+26 conIn addition, tact examinations which revealed 13 previously unknown active cases. 10*44 individuals with symptoms requested a chest film. Since the incidence of

-30-

suspicion is very high in such a group, large chest films were taken, revealing 57 with active tuberculosis, of whom ^0 were previously unknown. Furthermore, 217 of Therefore, of the total 30,602 the 104^ were found to have inactive tuberculosis. chest films taken by this unit, 113 active cases were found of which 92 were previously unknown. THE AMISSION CHEST X-RAY PROGRAM AT S/N FRANCISCO GENERAL HOSPITAL took 9,568 films finding ^9 unsuspected cases of active tuberculosis in the General Medical and Surgical Wards. Excluded from this program are all patients with a pulmonary disease problem, known or suspected tuberculosis, children in the Pediatric Ward, acute medical and surgical problems requiring lifesaving procedures, women in labor, and disturbed psychiatric patients.

^95

THE SAN FRANCIoCO JAIL CHEST MINIFILM PROGRAM; films were taken which revealed 22 cases of active tuberculosis; 17 of which were previously unknown. THE MEDICAL SOCIETY CHEST X-RAY UNIT took 18,095 minifilms, finding ten new cases. This unit is used primarily by the medical profession for the referral of private patients who do not have symptoms of pulmonary diseases or tuberculosis. Symptomatic patients are referred to a radiologist for a large chest film. Hence, the low yield in this particular program is expected.

THE MOBILE UNIT OF THE S.N FR/NCISCO TUBERCULOSIS ASSOCIATION does community and in* dustrial survey. There has been very close cooperation between the Tuberculosis Association and the Health Department in program planning for surveys in high prevalence areas, which have been very productive. However, the productivity is diluted by giving survey services upon request to two colleges and several industries. Neither of these latter groups have had any active tuberculosis for years. During the past year, the Mobile Unit took 5^+>847 minifilms which were responsible for finding *t6 active cases of tuberculosis, of which ^5 were previously unknown. The results of I960 chest x-ray casefinding have been good. Through the cooperative efforts of private physicians, the Medical Society, Tuberculosis Association and Health Department, x-ray casefinding is confined to individuals, groups and areas of expected high incidence. This type of programming will increase the case yield, while decreasing repeated surveying of known low incidence groups and areas.

TUBERCULIN SKIN TESTING: The tuberculin skin testing program in our schools has been most productive. During the past four years 259 new cases of tuberculosis In were found through the program: 17^ in stulents and 85 in familial contacts. reviewing the entire group of 17*+ children found to have tuberculosis, it was noted that there were 102 males and 72 females. The racial distribution was surprising in that there were 79 whites, of whom kk were Latin- American, 53 Negroes, 23 Chinese, All of the Samoans, Filipinos and Japanese 9 Samoan, 9 Filipino, and one Japanese. were new to San Francisco schools. Many of the Negroes and a few of the Chinese and Latin- Americans had recently moved into the area. The program will not only detect all active cases among the group tested, but will give an accurate index of the rate of infection in our school children. Furthermore, children no longer r eceive chest films unless they are found to be positive reactors. In addition, it has awakened an interest in tuberculin teoting among private physicians of the community. A very large number of students are now receiving their tests privately from the medical profession. Therefore, the program has also served to educate the child, the parent and the physician.

-31-

Table JO X.RAY MINI FILM PROGRAMS

CALENDAR YEAR UNIT LOCATION

X.RAYS

ism

pfa

i^

iig»233

ate

aji£

?!»jg


3.L

*El

I

ffiuWr"'" North East Health Center

PRCVIOUS RATES PER i,nnn X-B..VS

.

ACTIVE CASES F0UN0

PER J.OOO * - r*ys

tag

ua

1^7

iaa£

1255

3.oo

1.57

,.26

1.*

,,,

5 2*

;

;

\\f5

SAN FRANCISCO SCHOOT TUBERCULIN SKIN TESTING PROGRAM.

1959

,

^

10

?

-

I960

6ntire Srade l6Vel ° nCe P«* aH 3tuSfneftTs \ "V*' S Ch °° 1S AU Previously k »°™ Positive Reactors who Z or Z^f-T induratlon were eluded from testing, but those who had 6 °J o - y IrT'JiZZ mm. of induration were retested. '

'

-

had 10

.

RESULTS:

Of 3^,028 students tested, 6.7% or 2,26? had a positive tuberculin. grade level (high school), 8.8% at the 7th grade r SC 0l) Md 2 ' T/° 3t the l5t S-de level elemen ary school^! ^° ThTfolir° P° SltlVe * uberculin "actors and their family contacts revealed Xftv 6S dren and ^irtynine (39) cases in the *? S ^° 01 homes Ttnfi homes, a total of ninety-three (93) newly diagnosed active cases. 13.5/o were positive at the 12th

Slf^f

'

?H



Elementar y School P^n,,'L Primary Minimal Pul. Tbc. Tbc. Cervical Adenitis Tbc. Meningitis Pleural Effusion

'

?n

~-

_

20

-

3 2 1 1

-

t. n^ Junior High School Primary Minimal Pul. Tbc. Pleural Effusion High School 3» imar y Minimal Pul. Tbc. Mod. Advanced Tbc. •

^2

,.

,

-,

14 -

9 I

-

1

-

1

-

7 Contacts: 39_ 1 Primary _ 2.1 Minimal Pul. Tbc. Adult Day} High Sc School* " r- hool* Mod. Advanced Tbc. „_. The ^ S _ ft Min. Ful. Tbc k Far Advanced Tbc. 1*+ Uderits new t0 San Francisco who go to Mult Day High School are ekin ?es?el^ The Tuberculin Skin Testing Program in San Francisco Schools has proven to be an excellent case-finding procedure.

-6



<

School Year V Pa . Sc.ool

1956 1957 1958 1959

-

1957 1958 1959 i960

^

S

t ! In School

44 32 Mt 3k

,

(^rlTOOoT Case Rate 1>8 1.8 1.5 i/e

-32-

Family Contrct Cases Pi ua fiehnn1 9ases 62 k2 62 93

C^~7t7 per

1

Aloa

2.H 2.1 2.7^

SAN FRANCISCO SCHOOLS TUBERCULIN SKIN TESTING PROGRAM SCHOOL YEARS 1956-1957 THROUGH 1959 -60

SCHOOL YEAR TOTAL

Students tested Positive Reactors found Percent positive reactors ;

105,759 6,649 6.3°/

1957-58

1956-57

1958-59

16,904 1,125 6.7%

25,286 1,492 5.9%

29,541 1,765 6.0%

1959-60

34,028 2,267 6.7%

CASES OF TUBERCULOSIS FOUND THROUGH PROGRAM

SCHOOL PLACEMENT

TOTAL

TOTAL

1956-57

SCHOOL YEAR 1957-58

1958-59

259

62

42

62

93

46

10 11

9 2

23 18

21 10

14 3 27 18

13 14 27 39

High School Junior High School Elementary School Contacts

30 98 85

SCHOOL PLACEMENT AND RACE FOR THE PERIOD 1956-1960 Junior High School TOTAL Elementary RACE

TOTAL

98

30

46

79 53 23

42 32

12

25 9

15

12 3

9

5

1

5 3

9 1

3

2

4

Filipino Japanese

1

Table 31 CHEST CLINIC S/>N FRANCISCO HOSPITAL Pt. Visits for Treatment Pneumoperitoneum

NO.

26,139 23,401 24,577 27,598 31,409

1955 1956 1957 1958 1959 I960

33,262 36,742 32,374 31,685 33,786 29,039

Pt. Visits for Follow-up,

Without Treatment Observation and Contacts

and Chemotherapy

YEAR

1950 1951 1952 1953 1954

High School

174

White Negro Chinese Samoan

TOTAL FT. VISITS

1959-60

*

29. ,8 43. .7

85.3 82.4 76.5 70.2 56.3

60.1 66.7 78.8 83.4 84.6 89.5

13,287 12,250 6,856 5,244 5,207 3,343

39.9 33.3 21.2 16.6 15.4 11.5

17. ,6 23. .5

19,975 24,492 25,518 26,441 28,579 25,966 -33-

*

22,306 19,279 18,806 19,364 17,678

14, .7

3,833 4,122 5,771 8,234 13,731

NO.

7

NEWLY REPORTED CASES 4 TUBERCULOSIS DEATHS OCCURRING IN S*N FRANCISCO 1920-1960

Table 32

YEAR

NEWLY REPORTED CASES

POPULATION

DEATHS

NUMBER

NUMBER

RATE

1*11

278,. 5

670

13*7 1409 1230 1223

zkl.i 261.6 223.1 216.9

08

1925 1926 1927 1923 1929

1179 1032

204.4

644

1101

182.8 185.9 232.0

1930

1309 1317 119$ 1026

1920 1921

1922 1?23 192$

,777 ,512 ,2*7 ^982

1143 145?

1931 1932

1933 193$

1935 1936 1937 193S 1939

mo 1941 m2 1943 1944

19^$

19% 1947 1948

19M

206.3 207.6 189.0 161.7 136.3 1*7.5 140.7 184.6 159.5 130.3

,46?

,m

893

498

1171

,512 ,525

1C12 827

148.9 129.1

,536*

682

869 959

,328

337 1033

111.6 131.0

851

102.9 111.0 134.4 122.6 127.5

,400* ,400 .600 ,200 ,800

13M

907 1084 976 1002

1950

637 666 661

611 593

RATE

111.7 103.7

98.5 101.1

621

93.9

561

88.4

5§3 533

38.

*53

454 461

460

Hi 420 439 3?1

34.0 74.2 71.4 71.6 72.7

M 66.3 66.2 65.1

8:? 5*.5

470 397

56.8

350 333

43.4 41.8 38.3

301 2 1

5

27.7

180

1951

1952 1953 1954

,100 ,600 ,500

214 144

1955 195&

,100 ,100

116 92

195* 1959

100 800 ,300

15.3 12-7 10.7 10.5 9.7

76

10.3

i960

PER DEATH

132.2 121.3 118.3 120.8 117.2

63*

471

NIHLY REPORTED CASES

131

740,316*

72.*

28.0 19.0 17.5

U.S. Census

Population estimates as of July

Rates per 100,000 Population.

-}4-

1,

89S1-1959

Table 33 NEW CASES OF TUBERCULOSIS REPORTED BY RACE, TYPE OF DISEASE AND SEX SAN FRANCIS CO. i960

ALL TYPES RACIAL GROUP

TOTAL

ALL RACES

^6

White Negro Chinese

MALE

PULMONARY FEMALE

101

35g

6

Filipino Japanese American Indian

22 12

47

31 15

15

7

5

7

1

Other

T

H

F

129

M

24

17

34

80

11

11

1

23

22 16

11

5

1*

2

1

1

1

H

F

1^1

W2

317 237 54 31 43 57 19 10

OTHER

PRIMARY

T

13

6

5

5

1

M

T

F

13

16

!

9 3

3

3

10 3 -

2

1

2

1

2

1

1

1

5

Mesican included with White,

Table 34 REPORTED TUBERCULOSIS CASES AND DEATHS, CASE RATES AND DEATH RATES BY TYPE OF DISEASE AND RACE San Francisco Residents, 196q

ALL RACES CASES

Pulmonary Primary Other DEATHS

358

62

12

OTHER

ZL

'11

41

34

19

_6j_ 69

6

55

7

POPULATION

740,316

604,403

74,333

CASE RATE*

72.4

59.2

102.2

DEATH RATE*

10.3

10.1

Rates:

JAPANESE

CHINESE

76

161

TOTAL

pulmonary Other

NEGRO

WHITE

TOTAL

-41*530.

165.3 14.6

8.1

Number of Cases or Deaths per year per 100,000 population (Enumerated as of April 1, i960).

Table 35 NEW CASES OF TUBERCULOSIS REPORTED BY HEALTH DISTRICT OF RESIDENCE San Francisco Residents, 196o

HEALTH DISTRICT IN 'IHICH RESIDING

_53i-^

Alemany Central Eureka-Noe Hunters Point Marina-Richmond Mission North East Sunset i-'estside

POPULATION

CASES

29 133

32 44 68 100 46 46

__

140*11-6

76,205 20,999 72,473 47,123 121,979 71,052 93,410 130,928 46! 147

-35-

CASE RATE PER 100,000 POPULATION

PERCENT OF ALL CASES

72.4

100.0

-

38.1 •

16U.2 44.2 80.6

8 |:5

6,0

U

36.1 95.7 107.1

\i:l

35.1 99.7

1:1

REPORTED CASES OF TUBERCULOSIS BY HEALTH DISTRICTS RATES PER 100,000 POPULATION

SAN FRANCISCO,

1960

Golden Gate

Under 50

50 to 99

-J6-

100 A Over

Table 36 NEW CASES OF TUBERCULOSIS REPORTED BY AGE AND RACE San Francisco, 196o (Re: 3I0ENTS)

AGE GROUP (Years)

ALL COLORS

ALL AGES

Year - 4 1 5 " 9 10 - 14 15 - 1? 20 - 24 25 - 29 30 - 3»

Under

" 55 -

1

49 5*

62

9

i

2

2

6

2

10

2

9

4 4

S

5

2

8

16 25

^3

21

to *3

30

1

44

76

2 $ 16 18 1

??

CHINESE

NEGRO

TE

2 1

5

7

5

7

»0

7 1

5

i

9

15

%\

OTHER

2

10 9 4

27

l\

5?

65 - 69 70 4 Over 2

1

«*

1

,

?5 4o 45 50

'•'H

<*6

ij

32

27 27

3 3

70

<>3

1

7 1

4

Mexicans included with "Whitb" 12 Japanese, and 1 American Indian included with "Other"'

22 Filipinos,

Table 37 PERCENT OF CASES BY STAGE OF DISEASE FOR NEW CASES OF PULMONARY TUBERCULOSIS FOR WHOM STAGE OF DISEASE '-'AS REPORTED

STAGE OF DISEASE ALL STAGES

Minimal Moderate Far Advancec

1

19^0

1959

19S8

loo.o

100,0

100.0

1256

-L25Z

100.0

44

11

8

30 38

24

31

27

32

100.0 23 42

35

Table 38 INTERVAL BETWEEN REPORTING OF DISEASE AND DEATH !

INTERVAL

NUMBER DEATHS

TOTAL

PERCENT OF DEATH

264

100.0

Less than 6 MONTHS 6 - 11 MONTHS 12 - 17 MONTHS 13 - 23 MONTHS

20 12

7.6

YEARS YEARS YEARS YEARS 5 - 9 10 - 14 YEARS 15 YEARS 4 Over

16

6.1

10

3.3 2.6 25.0

9

14

d

,

a 5.3

3*

Reported only on certificate or after death

10

3.3

66

25.0

Table 39 PERSONS HAVING HAD TUBERCULOSIS WHOSE DEATHS WERE CiDED V, OTHER CAUSES CODED CAUSE OF DEATH

INTERNATIONAL LIST NUMBER

1M

TOTAL

Heart Diseases Malignant Neoplasms Cirrhosis of the Liver

410-443 140-205 581

Diseases of Respiratory System 470-527 Vascular Lesions of C.N.S, 530-334 800-965 Accidents

Suicides Ulcers of Stomach A Duodenum Diabetes Mellitus

NUMBER OF DEATHS

970-979 54o-5fL 260

All Others

-37-

NEW TUBERCULOSIS CASES REPORTED BY CENSUS TRACT

SAN FRANCISCO,

-

5-9

rfM

Cases

NUMBER OF CASES A: K: J: L:

91

i960

Cases

72 Cases 67 Cases 63 Cases

N: H:

0:

IN

SHAPED AREAS,

29 Cases 19 Cases 15 Cases

14 Cases 13 Cases 11

Cases

6 Cases

10 or Mo«e Cases

SAN FRANCISCO DEPARTMEN TOF PUBLIC HEALTH STATISTICAL REPORT 1961 PQC(/A|£

NOV GOLDEN GATE

I

CITY AND COUNTY OF SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH

Central Office lOI

GROVE STREET Zone 2

October 25, 1962

The chief sources of data for the Statistical Report of the San Francisco Department of Public „ eaI th are

^

^^^

certificates registered in San Pranciaco or reallocated to oa h y the State Department of Public Heaith, and morbidity reporta received from practicing physicians.

Constant effort

M

is de to improve the quaUtv of reporting that vaiid conclusions ma y he drawn from these statistics; however, the Hmitations of the data and the need for further study shoold be always kept in mind.

-

By 1963 we expect to have more data on socio-economic characteristics of the popuUtion from the 1,60 Census. Further information ahout Census data and hirth and death statistics not i-iuded in this report is available from the Bureau of Records and Statistics, Miss Mildred Holota, Chicf .

c ELLIS D. SOX, M. d) Director of Public "ileal th

CONTENTS

Births Communicable Diseases Deaths Fetal Deaths Infant Deaths Marriages & Divorces Maternal Deaths

SUBJECTS, CHARTS AND MAPS PAGE PAGI Population 1 13 Tuberculosis 19 29 Venereal Disease 19 3 18 Gonorrhea Chart, 1956-1961 23 22 Syphilis Chart, 1956-1961 17 2 Map Venereal Disease by Health District ,1961 2h Map Tuberculosis by Health District, 196l 5 33

TABLES

Deaths from important causes, San Francisco and U.S., 1961, California, i960 Causes of death, all ages, 1956-1960 Causes of death by sex, rates and percent, 196l Maternal deaths, 195^-1961 Death Rates for Whites, Chinese and Negroes, 1961 Death rates, all causes, 3 Year Average, Age Group, Race and Sex Heart disease death rates, 3 year average, age group, race & sex Cancer death rates, 3 year average, age group, race & sex Accident det.th rates, 3 year average, age group, race & sex Suicide death rates, 3 year average, age group, race & sex Deaths from important causes by age group, 196l Causes of death, residence, and occurrence, 1960-1961 Selected morbidity and mortality data for health districts, 196l Birth rates by race and sex, 1961 196O-6I Recorded, resident and non-resident births by place, Resident live births by place and race, 1961 Resident births by race and he? lth district, 196l Live births by trimester prenatal care began by place of birth, 196l Flace of birth of premature infants by race, 1961 Infant deaths by race and sex; rates, 196l Infant deaths by race and age, 196l Infant mortality by age and cause, 196l Fetal deaths by place of delivery and race, 196l Cases and deaths from communicable diseases, 1957-1961 Venereal disease by disease and stage, 1956-1961 Venereal disease by health district, I96I Civilian cases of Venereal disease, 1961, and 5 year median Venereal disease by age group and stage, 1961 196l Venereal disease in civilian minors, Venereal disease by source of report, 196l 1956-I96I fenereal diseases reported by private physicians, Summary venereal disease epidemiology, 1959-1961 1950-61 Chest Clinic, San Frsncisxo General Hospital, Tuberculosis Case Finding by X-Ray Tuberculosis cases and deaths, 1920-1961 Tuberculosis: New cases by race and type, 196l Tuberculosis cases, deaths, and rates, 196l Tuberculosis cases by health district, 196l 1961 Tuberculosis cases by age and race, Tuberculosis, pulmonary, percent of cases by stage, 1956-1961 Tuberculosis, interval between reporting disease and death, 196l Tuberculosis cases whose deaths were coded to other diseases, 196l

k 5 5 5 6

7 8 8

9 9

10 12 1^ 15 15 16 16 16 17

17 18 18 20 21 21 ^5 2 £ 2o

27 2°

33

GENERAL INFORMATION

San Francisco, one of the original 27 counties in the State, was also incorporated as a city in 1850. Located on the tip of a hilly peninsula, its total area is 129.25 square miles of which less than one-half or 45*451 square miles is land. Excluding islands, its land area i6 29,089 acres The population density in I960 was 16,288 people per square mile, the highest in the It has an equable climate with an average daily temperature range of state. 12.2 degrees, from a dsily mean maximum temperature of 62,6 to a daily mean minimum temperature of 50.4 degrees; rainfall averages about 22 inches yearly. The city enjoys about 66% of all possible sunshine* c

The total population on April 1, I960 according to the United States Bureau of the Census was 740,316, a decrease of 35,04l or 4.5% from the 1950 figure of 775,357* The provisional estimate of population made by the California State Department of Finance for July 1, 196l was 744,000, an increase of 3,684 persons or about one-half of 1% over the Census figure. Revised estimates of population by the Department of Finance from 1951 through 1959 will be found on Page 3 « Estimates for race and for broad age groups used in some of the tables are as follows:

I960 Census

1961

TOTAL White Negro Chinese Filipino Japanese Other Nonwhite

744,000

100.0

7^0,316

100.0

603,600 77,100 37 200 12,800 9,70^ 3,600

81.1 10.4 5.0 1.7 1.3 0.5

604,403 74,383 36,445 12,327 9,464 3,294

81.6 10.1 4.9 1.7 1.3 0.4

s

1961 Estim ates

744,000 Under 5 Years 5 - 14 15 - 2k 25 - 44 ^5 - 64 65 & Over

59,100 98,700 91,700 200,300 200,100 94,100

I960 Census 740,316

100,0

58,851 98,189 91,155 199,362 199,151 93,608

8.0 13.3 12.3 26.9 26,9 12.6

However, in 4 of the tables where 3 year average (1959-61) age-sex-and racespecific rates for causes of death are presented, i960 Census figures are used as the population base. Since at this time (October 1962) age breakdowns by sex are available for only white and non-white groups, it is not yet possible to calculate age-rsce-and sex-specific rates for Negroes and Chinese. Lack of this information hinders detailed interpretation of differences in death rates for racial groups as well as fertility ratios. The i960 Census figures for the 4 groups are:

-1-

:

WHITE AGE GROl

TOTAL

\ir

TOTAL ALL aGES Under 1 5 15 25 35 ^5 55 65 75 85

-

1 if

14 24 34 44 54 64 74 84 & Over

Median Age in Years

Male

NONWHli'ja

Female

Male

Feraele

740,316

293,042

311,361

70,382

65,531

13,165 45,686 98,189 91,155 98,226 101,136 105,875 93,276 63,044 26,115 4,449

4,797 16,002 35,347 38,094 39,690 38,185 42,183 40,047 26,806 10,446 1,445

4,591 15,547 34,550 36,64? 36,595 42,120 48,240 43,665 32,153 14,426 2,827

1,916 7,050 14,365 7,773 10 325 10,398 9,006 6,129 2,526 799 95

1,861 7,087 13,927 8,641 11,616 10,433 6,446 3,435 1,559 444

29.1

26.2

38,2

37*3

4l,7

,

82

Estimates for sex for 196l are 364,000 or 48„9% of the total for males and 380,000 or 51. 1# for females.

Health district population estimates are included in Table 13 on Page

12. •

MARRIAGES; The number of marriage licenses issued during the calendar year 196l was 6,569, a decrease of 67 or 1$ from the I960 figure of 6,636. The rate was 8.8 per 1,000 estimated population in 196l compared to 9.0 per 1,000 enumerated population in i960.

DIVORCES In the calendar year 1961 there was an increase of 2.3% in the number of divorce actions filed, 3 360 in 196l as against 3,284 in i960 and 3,319 in 1959. One divorce action was filed for every 2 marriage licenses issued. MARRIAGE FISCAL ANNULMENTS LICENSES DIVORCE EINAL DECREES YEARS GRANTED ISSUED ACTIONS FILED OF DIVORCE 3

1950-51 1951-52 1952-53 1953-54 1954-55 1955-56 1956-57 1957-58 1958-59

8328 7306 7395 6860 6631 6645 6965 6526 6665

4543 4391 4327 4096 3867 3676 3500 3508 3434

2842 2940 2917 3088 2598 2604 2432 2442 2257

468 478 552 517 499

1959-60 1960-61 1961-62

6703 6670 6704

3350 3322 3198

2357 2275 2161

417 394 421

483 463 477 499

BIRTH & DE/TH RATES FOR OTHER JURISDICTIONS:

Tentative and provisional rates for the United States, California and 4 Bay Area counties for the calendar years i960 and 196l, based on enumerated population for I960 and estimated population for 1961 are:

-2-

:

BIRTH 1961 Estimated Population

United States California

1961

RATE DEATH PER 1,000 POPULATION I 960 1961

183,043,000 16, Vf 5 ,000

COUNTY Alameda Contra Costa Marin San Francisco San Mateo

939,700 if 2 8, 900 156,200 744,000 476,700

22.9 22.3 21.8 19.8 21.8

22.9 22.8 22c9 19.9 22.5

RATE i960

9o3 8.3

9.5 8.6

9.0 6.1 6.5 13.1

9.3 6.3 7.2 13.3 6.5

t:t

Crude Birth and Death Rates in San Francisco since 1950 in the following table are based on revised population estimates by the California State Department of Financej Tentative conclusions that may be drawn from the table now are that the death rate is increasing slowly since the early 50* s as more people in San Francisco reach the older age groups. The birth rate is a balance between the low, fairly constant rate for whites and the higher rate for the nonwhite group

YEAR 1950 1951 1952 1953 1954 1955

SAN FRANCISCO ESTIMATED POPULATION

RESIDENT BIRTHS

1956 1957 1958 1959 I960

775,357 (Census) 778,200 772,200 764,700 757,100 740,100 734,800 734,600 744,300 742 , 700 740,316 (Census)

15,477 15,505 15,710 15,364 15,171 14, 540 14,565 15,240 15,104 14,634 14,728

1961

744,000

14,703

BIRTH RESIDENT RATE DEATHS PER 1 ,000 POPULATION

20.0 19.9

DEATH RATE

20.1 20.0 19.6 19.8 20.7 20.3 19.7 19.9

9,204 9,527 9,693 9,435 9,160 9,161 9,548 9,600 9,375 9,559 9,825

11.9 12.2 12.6 12.3 12ol 12.4 13.0 13.1 12.6 12.9 13.3

19.8

9,736

13.1

20.3.

DEATHS During the calendar year I96I there were 9,736 resident deaths, a decrease of 89 or about 1% from the 9,825 deaths in I960; the crude death rate per \,WT population decreased to 13.1 in I96I from 13.3 in i960. The average age at death for males was 63 years, as in i960 and 1959; the average age for females was 67. The age adjusted death rate for San Francisco in 196l was 8.5 per 1,000 population compared to 7.6 for the United States, nearly 12% higher. Using the indirect method of calculating an age-adjusted death rate, the rate for San Francisco is even higher, 808 per 1,000 population.

Crude death rates in the United States, California and San Francisco decreased in 196l from i960. Although we have a provisional figure for California's crude death rate in 196l, rates for causes of death are not yet available. Table 1, therefore, lists I960 provisional rates, and the overall death rate for i960, 8.6 per 1,000 population differs from the crude death rate of 8.3 above. Traditionally the United States, California and San Francisco have had the same four leading causes of death - heart disease, cancer, vascular lesions of the central nervous system, and accidents - but in I96I in San Francisco cirrhosis of the liver outranked accidents; fourth place in San Francisco, it remained tenth cause of death nationally. Rates in San Francisco for most causes of death have been generally higher than the United States, but most marked are the rates for suicide, nearly 3 times as high in San Francisco as in the United States. -3-

c

.

TABLE I DEATHS FROM IMPORTANT CAUSES SAN FRANCISCO, CALIFORNIA & UNITED STATES .

*

Cal.

S i,.F.

PERCENT OF TOTAL DEATHS

RATE PER 100 9 000 POPULATION

RANK

CAUSE OF DEATH

1961

*

*

UeS.

ALL CAUSES

U.S.

SoF,

86 o l l

930 e 9

100,0

100.0

100.0

Cal.

SftP.

1308.6

Cal.

Uj ,S.

Heart Diseases

1

1

1

495.0

321.0

363.5

37.8

37.3

39.3

Malignant Neoplasms

2

2

2

229 . 6

140 o 3

148.3

17.5

16.3

16.0

3

3

3

134.7

92.7

105.1

10.3

10.8

11.4

Cirrhosis of Liver

4

7

10

65.7

18.6

11.2

5.0

2.2

1.2

Accidents

5

4

4

62.9

52„9

50 o 7

4.8

6.1

5.5

Influenza & Pneumonia6

6

6

37.8

33.3

29.7

2.9

3.9

3.2

Suicides

7

9

11

28.8

15 .9

10.1

2.2

1.8

1.1

Certain Diseases of Early Infancy

8

5

5

27.7

34 2

36.7

2.1

4.0

4.0

Arteriosclerosis

9

8

7

22.2

17.8

19.0

1.7

2.1

2.1

Ulcers of Stomach & Duodenum

10

12

12

14,5

6.5

6,1

1.1

0.8

0.6

Congenital Malformations

11

10

9

14

4

12.2

11.3

1.1

1.4

1.2

Diabetes

12

11

8

11,8

9.7

15.8

0.9

1.1

1.7

Tuberculosis

13

13

13

8.9

5.1

5,7

0.7

0.6

0.6

-

154.7

100.9

117.7

12.0

11.6

12.1

Vascular Lesions CNS

All Other Causes

Sources:

!

-

City and Cour ity of S an Fr< incisco Departme nt Publ ic Heal th Reco edc 1

California:



Communication from State Department of Public Health; ^provisional 1960 figures. Deaths by residence. Percents rounded independently.

United States:

Monthly Vital Statistics Report, Vol. 11, No. March 22, 1962

-k-

1,

TABLE 2

DEATHS FROM IMPORTANT CAUSES, ALL AGES San Francisco Residents, 1957-1961 RATE PER 100,000 POPULATION

n u a e e r -L2S2.

1961

lafifl

19R?

9^7S

9600

nog.,6

H27„1

1286.7

3635 1612 963

3684

495.0 229.6 134.7

509c4 229,9 129.8

501.7 223.2 127o7

65o7 62,9 37.8

62 c 4 66,5 40.0

63.4 39.8

19(^1

tafia

_2I3i

9825

3683 1708 1002

3771 1702 961

Cirrhosis of the Liver Accioents Influenza and Pneumonia

%&

46"2

to8

492 296

Suicides Certain Disease of Early Infancy Arteriosclerosis

214 206 165

220 226 197

194 218 203

264 170

Ulcers of Stomach and Duodenum Congenital Malformations Diabetes Tuberculosis

108

90

96

107 88 66

72

88

116 76

97 72

105 77

93 78

11,8 8.9

1151

1144

1079

1031

1019

15V7

ALL CAUSES

Heart Disease Malignant Neoplasms Vascular Lesions of

C t.N.S„

All Other

281

JL152

3559

m 9*9 tii 471

1743 971

367 492 236

296

537

303

1251

1957

1259.6 1~06.3

55.3

488.) 216.6 129.4

501.5 237.3 132.2

48.8 66.1

50.0 73.1

38.4

41.2 26 4

<3.5 25*7

29.7

189

28 8 27.7 22 c 2

26.1 29.3

III

27o3

26.6 35.5 22.8

107

86

14,5

12.2

12.9

14.4

11.7

72

90

14,4

9.7

11.8

9.7

15o7

13.1

10,3

9.7

14,1 10.3

12.3 12.7 10.6

154.5

145.2

138,5

138.7

III

TABLE 3

IMPORTANT CAUSES OF DEATH BY SEX W?TH RATES PER 100,000 POPULATION San Francisco Residents, 19,61

CAUSE OF DEATH

NUMBER

ALL CAUSES

MALE

.

RATE

PERCENT

NUMBER

RATE

PERCENT

15 57. 7

100.0

4066

1070.0

100.Q

2206 956

606,0 262,6 121.4

38.9 16,9 7,8

1477 752 560

38Sc7 197.9 147.4

36.3 18.5 13.8

Cirrhosis of Liver Accidents Pneumonia and Influenza

305

83.8 88,2 45,6

5,4

184 147 115

38o7 30.3

Suicides Diseases of Early Infancy Arteriosclerosis

iVf 128 80

Heart Disease Malignant Neoplasms Vascular Lesions of C.N.S,

Ulcers of Stomach and Duodenum Congenital Malformations Tuberculosis Diabetes All Other

5670

w

321 166

if0.4

35,2 22,0

41

4 17,3 15,1 11,3

682

187.4

78 63 55

21

5,7 2,9

2,6 2.3 1.4 1.4

48 c 4

1

a

1961

1.6 1.9

22 c 4

2.1

1U6

o

11

47

2.9 12,4

?:I 0.3 1.2

11.9

469

123.3

11.6

1„1

TABLE 4

1957 1958 1959 I960

2.8

17,6 20,5

0,7

1

MATERNAL DEATHS

YEAR

3.6

NUMBER OF MATERNAL DEATHS

RATIO PER 10,000 LIVE 8IRTHS 4.6 3.3 2.0 2.0 5,4



Table 5 LEADING CAUSES OF DEATHS FOR SAN FRANCISCO WHITES NEGROES AND CHINESE WITH RANK ORDER AND RATE PER 100,000 POPULATION, 196l

WHITE

NEGROES

RANK

N0„

RATE

ALL CAUSES

_

8810

1459 ->6

Heart Disease Malignant Neoplasms Vascular Lesions Cirrhosis of Liver

1 2

3 4

3445 1561 90k 443

5 6

Accidents Influenza and Pneumonia Suicides General Arteriosclerosis Diseases of EarlyInfancy

Ulcers of Stomach & Duodenum Diabetes Congenital Malformations Pyelonephritis

Tuberculosis Intestinal Obstruction Nephritis Homicides All Other Causes

There were among them of central infancy, 2

RANK

CHINESE NO.

RATE

286

768.8

81

7

217.7 153.2 102.2 18.8

5

10

26.9

25.9 5.2

9 6

7

8

18,8 21.5

5

6.5

13

3

8,1

3

48

62.3

4

12

32.3

17 11

2 6

2.6 7.8

7

12,8

14

7 3

18.8 8.1

12.8 11.1

7

67

10

22 8

28o5 10.4

10

4 6

10,8 16.1

Ik

53

808

12

6

7,8

11

5

13.4

15 16 17

49 23 27

8,1

3.8

16 15 9

2 4

2„6 5.2

845

140.0

NO,

RATE

_

508

658,9

_

370.7 258,6 149,8 73.4

1 2 4 6

119 77 42 35

154,3 99c9 54.5 45.4

1 2

3 8

409

67o8

5

4l

53 .2

250 194

4i.4 32,1

8

20

7

14

4

8

156

25o8

13

9

134

22 2

10

96 77

15 = 9

11

12 13

77

4.5

Ik

18,.

53

68,6

2

RANK

12

57 38

-

-

-

15 16

2 3

5.4 8.1

33

5.6

63 deaths of Filipinos with a rate of 4.9 per 1,000 populaticd.", 20 deaths from heart disease, 8 from cerebral vascular lesions nervous system, 6 from cancer, 4 from certain diseases of early from cirrhosis of the liver and 7 from accidents

There were 55 deaths among Japanese with a rate of 5.7 per 1,000 population; 16 heart disease, 9 vascular lesions of the central nervous system, 7 cancer, 3 from suicides and 6 from certain diseases of early infancy. In the other non-white groups there were 14 deaths of which 3 were suicides, 2 each were heart disease, certain diseases of early infancy and congenital

mal formations

The rate was 3.9 per 1,000 population.

-6-

3

Table 2 shows resident deaths from important causes and rates for a five-year period. Rates for 1957-1959 have been revised since the I960 Report, and the final intercensal estimates quoted on Page 3 have been used as the population base. Heart disease accounted for nearly 38$ of the deaths in 196l, by far the most frequent cause; coronary artery disease accounted for nearly 21$ of the deaths. Including arteriosclerotic heart disease, the death rate in 196l was 402 per 100,000 population* Cancer, the second cause, had a rate of 229*6 per 100,000 population and was 17.5$ of all deaths. Vascular lesions of the Central Nervous System (cerebral hemorrhages, strokes and the like) were the third cause with a rate of 134.7. Accidents for the first time ranked lower than Cirrhosis of the liver but the rate for each of these was half the rate for vascular lesions.

Sex-specific rates in I96I were 15.6 per 1,000 males and 10.7 per 1,000 females. Vascular lesions and diabetes were the only causes for which women had higher rates than men. Interestingly enough, although the male rate for cirrhosis of the liver was nearly 8** per 100,000 compared to the i960 figure of 66 and was nearly 58$ higher than the I96I rate for females, cirrhosis ranked as the fourth cause of death for women and the fifth cause for men. Reasons for this include not only the 20$ increase in female deaths in I96I coded to cirrhosis over i960 but also the fact that more than twice as many men experienced accidental deaths* Table 6, the leading causes of deaths for ethnic groups needs to have rates adjusted for age but as was noted earlier, the census data is not yet available. For this reason, among others, we have calculated rates for various causes by race (white and nonwhite), sex and age which appear on pages 1&3. On all tables in this series, death rates by age group, sex and race are derived from a three-year average of deaths for 1959, I960 and 1961 so that we could use as a base the i960 Census population figures. Differences and similarities in mortality experience are clearly shown in the tables. The first table in the series for all causes of death, is base on numbers sufficiently large to calculate rates per 1,000 population, a concept somewhat easier to realize than the base of 100,000 we used in other tables so that rates could be expressed as whole numbers. Rates for vascular lesions of the central nervous system and for cirrhosis of the liver not included in this report are available from the Bureau of Records and Statistics.

TABLE 6 DEATH RATES FOR ALL CAUSES BY AGE GROUP, RACE & SEX San Francisco Residents, 3 Year Average, 1959-1961 Rates per 1,000 Population TOTAL,

AGE GROUP TOTAL* SCL AGES

UNDER 1

-

1 4

5

- 1*

15

- 2*+

25 35 k5

- 34 - 44 - 54

55 65 75

- 64 - 74 - 84

85

Plus

NON-WHITE

WHITE

ALL RACES

Male

12.3

6,3

8.2

1.1

19,0 1.0 o.k o.k

30.5 0.9 0.4 1.1

33,8 1.0 0.6 1.2

27.2 0c8 0.2 1.0

1.7 5.1 13.0

1.0 3.0 6.4

1.9 k.o

2.5 5.0 9.8

l.k 3.1 7.4

18.0 38.6 69.4

20.3 46.2 79.2

13.9 26.3 51.8

178.9

114.6

Male

Female

TOTAL

Male

Female

13°1

15. *f

10.9

14,6

17.2

26.5 1.0 0.4 0.8

31. k

21.3 0.9 0.3 0.5

2*1.9

30.5 1.1 0.4

1.1

l.k 4,0 9.5

1.5 4,o 9.4

1.0 o.k l.l

1.0 0.4 0.7

1.9 5.1 12.4

3.0 6.5

18.8 25.8 40.9 54.4 91c2 106.2

12.0 29.1 79.9

18.9 26.6 41.0 55.1 92.3 108,3

11.9 29.3 80.8

205.5

213.2 223.0

208,3

210.7

220.3

-7-

Female

TOTAL

TOTAL

148,6

it.

J

4

TABLE 7

HEART DISEASE DEATH RATES BY AGE, COLOR 4 SEX: San Francisco Residents, '959-1961 ( RATES PER 100,000 POPULATION IN SPECIFIED GROUP )

TOTAL ALL RACES TOTAL

HALE

WHITE

6oq.4

5

-

1*

15

-

a

-

24 3* ** 5*

55 f5

-

0.7 0.7

2o2 11.5

286.2 711.1 1795.6 *2?1.3 9642.6

TOTAL

FEMALE

SISLl.

MALE

NON WHITE FEMALE

6?6 r,7

l£fim5

oil

0.6

1o0

0,8

0.9

2.2 15.* 119»* *6*.9

2.2

,H *U9

0,9 10.5 80.1

•34,0

118.9

287.2

0,8 1*.* 130.9 490.0

1058,3 2420.6 4817,3 10,019/5

373.0 1251.8 3788 Q 2 9**3.1

1109.4

720.3 1825,0 24??{,4 *9*9.3 4299o2 9801,0 10,173.0

TOTAL

0,8 6.3

109,9

363,4 1262.7 3828.5 961*.

FEMALE

225*5-

-102*3-

2.1

*.3

7.9 15.0 75.* 280.2

9.0 19.* 76.9

3*7.5

186.2

630.5 1370,9 2872,1 5875-7

722.8 1583,5 3091=* 7789.5

^65,8 1026.3

8.1

11.2

lb*

2

Wo

5

3658.5

TABLE 8

(

CANCER DEATH RATES BY AGE, COLOR 4 SEX: San Francisco Residents, 1959-1961 RATES PER 100,000 POPULATION IN SPECIFIED GROUP )

TOTAL ALL RACES TOTAL

UNDER 1

5

-

'15

1

85

UHITE FEMALE

228.2

255.7

201. 6

12.9

19c*

*

i6

ti

24

TOTAL.

MALE

257c,9

288.9

4.6

27

8.9

14,4 7,6

M

,2:1 64 o 209.0

209.0

68,5 209.0

64 74 - 84 Plus

454,6 821.2 1324.9 1742.0

5*0.8 1039c8 l627o4 2266.2

370„ 1 630c9 1096 e 2 1*67o9

19.4 59.1

*65,0 825.5 13*5*7.

176206

NON HHITE FEMALE

TOTAL

228 ,7

96.2

MALE

FEMALE

7^-2

= 1

9.2

9 «! 11.8

9.9 2.2

81,6 17*.7

1W

12.6 83.7 1*7.7

11.6 1*.6 79.6 212.5

362.8 758-9 909 o 1 1355.9

391.6 882.8 1162.* 1789,5

11.6

7.1

20-9 52:* 222,1

8.2 13.7 65.8 208„7

563o6 1054.6 1665.7 2304.5

37**9 634.5 1114,0 1482o1

7,1

bl

44 5*

25

7.5

MALE

6.1

311.5 558.1

518,0 731.7

TABLE S

ACCIDENT DEATH RATES BY AGE, COLOR 4 SEX: San Francisco Resioents,1959-196i IN SPECIFIED GROUP ) ( RATES PER 100,000 POPULATION TOTAL ALL RACES

TOTAL

MALE

6*.* UNDER -

1

-

4 14

15 25

-

2*

-

34

35

-

45

.'.

44 54

55

-

1

5

65 75 85

64 74 - 84 Plus

167.1 29.1

11.2

4,3 .,4

178.8

»

3*.0

59,

,S:1 283.4 735.0

155.0 25 2 5,6 6.6 14.5

TOTAL

MJL

61.2

33»g 35.8 48.6

39.7

60,1

ioii.9

41,0

W'}

759,7

zlt.l 721.9

9K9 181,4 31-2 13o3

27J

358.4

FEMALE

MALE

156.6 29,5 10.4

67.3 80.7

8:2

8:1

NON

'HITE

FEMALE

53- 7

68.1

85.3 114,1

122,6 292.3 7*9.1

-8-

17|<

81

1

JL

TOTAL * 3,*

'-.'HITS

MALE

tl^.

V*

172,2 38o| 25.8

ifci 30.9 37.9

60.5 67.S .64.4 58.8

130.7

40„5 75.6 230.8 746,4

76.7 170.2

FEMALE

11*1 214.9 18.3

11,6 8„6 12c 5

51.2

ft? 90.1

liM

6

TABLE 10 SUICIDE DEATH KATES BY AGE, COLOrl 4 SEX: San Francisco Residents, 1959-1961 (RATES PER 100 000 POPULATION IN SPECIFIED GROUP ) f

WHITE

TOTAL ALL RACES AGE GROUPS

NON WHITE

FEMALE

MALE

TOTAL

TOTAL ALL AGES

UNDER

10,3

1

-

H

-

24

*-1

*

0.6

0.3

31.4 4?.9

3.8 15,1 28.0

48.8

32,9

66,5 85,2 106,7 64.9

31.7 38.3 20,6

13.7 23 .4

11

S5

FEMALE

16,1

1

5

i

MALE

TOTAL

36.6 4o.6

-

^

-

to

46 c 1

-

7*

56.6 67,8

Plus

36.0

9-.4

26.2 43.6 44.6

55.0 54.5

48.6 58.9 64.3 37.5

26.1

70.7

69.2

3.5 17.2 33,2 35.9 28.2 33.3 39,5 24.3

1.1

2.1

6.1

13.1 9.6 17.5

9.0 19.4 12.5 22.2

24.0 24.5 136.7

37.5 39.6 212.8

6,7

^0.9

TABLE 11 DEATHS FROM IMPORTANT CAUSES 3Y AGE GROUP 4 RATES PER 100,000 ESTIMATED POPULATION San Francisco Residents, 1961 - 4 YEARS 1 TOTAL NUMBER TOTAL F M

CAUSE OF DEATH ALL CAUSES

59

Accidents Congenital Malformations Pneumonia 4 Influenza Malignant Neoplasms Bronchitis All Others

CAUSE OF DEATH ALL CAUSES

All Others

TOTAL RATE

30

100.0

128-0

CAUSE OF DEATH

ALL CAUSES

17

TOTAL RATE

38„5 11.1

13.0 10.8 8.7

Congenital Malformations Malignant Neoplasms

18,4 10.5

fcl

25.4

32.6

All Others

42.2

16.2

15-24 YEARS TOTAL NUMBER TOTAL M F

TOTAL

TOTAL RATE

TOTAL

i

TOTAL RATE

22

100„0

86,2

100.0

270.1

36.7

31.6

10„1 10o1

8.,7

18.6 10,2 8=5 15

57

29

8

8

Total

W

CAUSE OF DEATH

20.3

17.5

2753

1841

981

748 372

648 282 166 135 84 4b

161

98 100 53 36

39

30

28

25 218

344

912

16

25 - 44 YEARS TOTAL NUMBER F TOTAL M

ALL CAUSES

541

328 213

46,4 41.9 40.9 37.9 32.0 9>§ 9,5 4.5 4.0 4.0 5-5 36.0

Cirrhosis of Liver Heart Diseases Accidents Malignant Neoplasms Suicides Vasc, Lesions of C.n.s. Homicides Congenital Malformations Diabetes Influenza 4 Pneumonia Maternal Deaths All Others

M

7.6 4.4 3.3 2.2 2.2

65 AND OVER

4

TOTAL RATE

100.0

1375.S

35,6 23o5 1Q,2 6,0

490,3 323.S 140.9 83.0

4.9 3.1 1.1

42,0 23,0

TOTAL

t

21

23 o9

1:1 2,5 2.5

8,9

TOTAL NUMBER

ALL CAUSES

i

28,9

16

Heart Diseases Malignant Neoplasms Cirrhosis of Liver Vasc. Lesions of C.N.S. Accidents Suicides Influenza 4 Pneumonia Ulcers of Stomach and Duooinum Tuberculosis All Others

78

TOTAL

100«0

45 - 64 YEARS

CAUSE OF DEATH

5 - 14 YEARS TOTAL NUMBER TOTAL M F

Accidents

39.0

79

Accidents Suicides Homicides Malignant Neoplasms Pneumonia 4 Influenza Heart Diseases Vasc. Lesions of C N.s Congenital Malformations

29

i

TOTAL

1,4 1,Q 12.6

1?.5 14 C

171.8

-9-

CAUSE OF DEATH

ALL CAUSES

TOTAL

TOTAL NUMBER TOTAL M F

I

TOTAL RATE

5906

Vl64

2742

100.0

6276„3

Heart Diseases 2615 Malignant Neoplasms 967 Vasc. Lesions of C.N.S, 8i4 Influenza 4 Pneumonia 178 Accidents 168 Arteriosclerosis 154 Cirrhosis of Liver 114 Ulcers of Stomach and Duodenum 66 Suicides 58 Diabetes 56 All Others 71

1401 543 335

1214 424

k4 c * 1b,4 13.3

2779.0 1027.6 865,0 18§„2

92

T6

100

I?

68 82 27

a

45

21

U1

23 423

15 33 293

1.0 0.9 12.2

1.9

1J8„5 163-7 121

761

1

1

TABLE 12

DEATHS FROM SELECTED CAUSES,

CITY & COUNTY OP SAN FRANCISCO

BY PLACE OF RESIDENCE AND OCCURRENCE.

19 SEVENTH REVISION INTERNATIONAL LISTS TOTAL.

ALL CAUSES

^q( ^ t

6

19 6q

1

DEATHS BY RESIDENCE

NUMB ER

-9J3i



RATE *

13fl&i

PERCENT** 100-0

DEATHS

BY

OCCURRENCE LfltJZ52

RESIDENT...

NUMBER

RATE

9825

H27,1

SELECTED COMMUNICABLE DISEASES T UBERCUinsts,

Am Forms

Totai

Respiratory Other Forms

Syphilis Septicemia 4 pyemia Poliomyelitis Encephalitis Hepatitis

MLUQ15 8.7

020-029 053 080-081 082-083 092

0»1

2

0.3 0,7

9.3 1.0

0.1

2.4 1.6

Other Infective and Parasitic Diseases Residual 001-138 Influenza & Pneumoni a, Totai Influenza Pneumonia, except of Newborn

_ULd

001-003 010-019

12

1.6

0.2

2t-

3.2

7

3

1.0 O.3 0.4

8

1,1

16

2.0

0.1

0.1

15

_£8j_

J2JL 0.9

0.1

274.

36„8

2.8

229.6

17,-5

9»1

0,7

51

3.2

129

17*3

U3

149

20.1

490-493

T

_£23_

-226

199

290

JfcMJ 0,1 39.2

1792

??q-q

T

SELECTED DISEASES, USUALLY CHRONIC NATURE

MALIGNANT NEOPLASMS: TOTAL Buccal Cavity ak Pharynx

Stomach

14-0-20';

146-148

-LIS

151

210 3

Other Digestive Organs Peritoneum not specified as Secondary

150,1 52-1 56A

157-159

483

65.0

5o

422

57.0

Trachea, Bronchus and Lung

162-163

257

3M

2 ,6

256

34.0

28

V

Other Respiratory System not

specified as Secondary

160,161,161.

25

3.*

0o3

139

U4

50

i8o7 6.7

30

4.0

3c8

Breast Cervix Uteri Other Uterus Other Female Genital Organs

171

172-174 175-176

53

7.1

0.5

59

8o

Male Genital Organs

177-179

86

11.6

0.9

85

'1.5

73 12 53

9.8

72

170

Urinary Organs 180-181 Hodgkins Disease 201 Leukemia and Aleukemia 204Other Lymphatic & Hematopoietic 200,202, Tissues 2Q3'205' Other and Unspecified Sites 1 56B, 165* 190«1?9

1



is of the Liufr without mention of alcohol With mention of Alcohol

Benign and Unspecified Neoplasms

Diabetes Mellitus

& 87

0o5

oJ

21

'P 30

1.6

0.7 0.1

7.1

0.5

8o5

0.6 1,9

192

25o1

2

l:\

n 3.2 26.0

4s*

53l70

^371

581.1

122

16 U 4

1.3 3

319 1*3

210-239

30

4„0

o<3

27

3.6

11*8

0,9

116

15,7

260

Ulcer of Stomach 4 Duodenum

540-541

Hernja 4 Intestinal Obstruction

560,561,570

19.3

108

14,5

1.1

90

12.2

51

6„9

0.5

56

7.6

-10-

Table 12,

Continued

DEATHS FROM SELECTED CAUSES

19 SEVENTH REVISION INTERNATIONAL LISTS CARDIOVASCULAR RENAL DISEASES:

6

NUMBER

TOTAL

RATE

glU

637-Q

Vascular Lesions of Central Nervous System

330-334

1002

134.7

Rheumatic Fever

400-402

3

0*4

Diseases of the Heart 41 0-443 Chronic Rheumatic Heart Disease 4Tcu4Tl Arteriosclerotic Heart Disease 420„0 Heart Disease specified as involving Coronary Arteries U-20.1 Angina Pectoris without mention 4-20^2 of Coronary disease Chronic Endocarditis and 421-422 Myocarditis Other Diseases of the Heart 430-434 Hypertension with Heart Disease 440-443

^68?

49S„0

DEATHS

52*5

5H7J

5238

707^5

10.3

934

961

129.8

129.7

2026

272,3

20.8

1

RESIDENT

NUMBER

965

14TT

BY

OCCURRENCE

PERCENT

37*8 1o2 9.9

106

9 6 Q

1

1

DEATHS BY RESIDENCE

RATE

3

0.4

509.4

;S686

3771 ill

142 855

1073

145.6

2087

1952

263.7

31.4 9.6 43.6

0.1

200 63 322

26.9 8.5 43.3

2o

212

232

0.6 3.3

78 311

323

0=5 1.7

43 152

56

7.6,

197

26.6

71

Hypertension without mention of Heart General Arteriosclerosis Other Diseases of Circulatory System

450

165

6.5 22,2

451 -458

184

24.7

1.9

216

210

28.4

Nephritis, Chronic & Unspecified

592-594

26

3c5

0.3

42

40

5.4

JL-J_ 1.1 I08

J&L

2,0

173

25.1 23c 5

444-4-47

ACCIDENTS, POISONINGS AND VIOLENCE ACCIDENTS TOTAL. Motor Vehicle Accidents Home Accidents Other Accidents

£16-835,966 870-936 WITH Residual

SUICIDES

HOMICIDES

r

Late Effect of Injury due to War

300-962

468

62.9

103

^F9

17T9

30

190

23.5 25.5

B

186 174

963,970-979

214

28.8

2.2

233

220

29.7

964,980-985

47

6.3

0.5

49

44

5.9

.C

179

965

ALL OTHER CAUSES

Complications of Pregnancy, Childbirt and the Pucrperium 640-689

8

1.1

0.1

8

3

0.4

Certain Diseases of Early Infancy

760-776

206

27o7

2.1

284

226

30.5

107

14.4

1.1

213

72

9.7

Congenital Malformations

750-759

Gastr;tis, Duodenitis, Enteritis, Colitis

543,571, 572

All Other Specified Causes

Residual

Symptoms, Senility, Ill-Defined and Unknown Causes

780-795

**

32

4.3

0.3

36

29

3.9

653

87.8

6.7

664

592

60.0

2.6

0.2

24

3.2

19

Rate per 100,000 population. Rates and Percents as calculated.

-11-



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BIRTHS

During the calendar year 1961 there were 14,703 resident births with a birth rate of 19° 8 per 1,000 population, compared to 14,728 resident births in i960 and a rate of 19<>9» The decrease in the birth rate was chiefly because of the slightly larger population estimate for July 1, 196l ( 744 , 000 as against the census figure of 740,316 for I960). The ratio of males to females was nearly 105 to 100, reverting to the 1959 ratio after being 102 to 100 in i960. There were 20,804 live births recorded in San Francisco during 196l of whom 6,348 or 30«5% were non-residents. Although the number of recorded births increased only 0.8$ over i960, the number of non-resident births increased 2.3%. Resident births occurring elsewhere decreased from 289 in i960 to 247 in 1961.

Again in I96I as in i960 and 1959, the birth rate for whites was 17.3 per 1,000 population; there were 10,469 resident white births in 196l and 10,460 in i960. The total non-white birth rate was 30.2, a decrease from 31.4 in i960, caused by small decreases in the number of Chinese, Filipino, and Japanese births and the perhaps high estimates for non-white population. Changes in the fertility ratio (number of children under 5 years of age per 1,000 women in the child-bearing ages, 15 through 49 years) since 1950 reflect the out-migration of white families to the suburbs and the increase in non-white population. Again since age breakdowns for ethnic groups are not yet available, only the broad categories of white and nonwhite can be presented.

CHANGS FROM 1950 to i960

FERTILITY RATES White Non-White No. Children Under 5 Years

White Non-White

I960

NUMBER

PERCENT

301

339

38

12.6

286 419

294

8

520

101

2.8 24.1

62,921

58,851

•4,070

-6.5

53,263 9,658

40,937 17,914

-12,326 8,256

-23.1 85.5

209.160

173,696

-35,464

-17.0

186,093 23,067

139,272 34,424

-46,821 11,357

-25.2 49.2

White Non-White No. Women 15 - 49 Years

1950

Birth rates for i960 and 196l for the groups are shown in Table l4 on Page 14 . White births as a percent of all births showed a slight reversal in trend for the first time since 1950 as did the non-white births ;the percent of negro births showed a slight increase over the 1959 and i960 figures.

Resident Live Births by Ethnic Groups as a Percent of All Births, Total Non-White

YEAR

White

1950 1951 1952 1953 1954

80.3 80.2 78.6 77.3

18.8 19.7 19.8 21.4 22.7

9-5 11.1 11.0 12.4 13.1

7.0 6.4 6.1 5.9 6.0

0.8 0.9 1.0 1.3

1955 1956 1957 1958 1959 I960 1961

76.1 74.5 73.7 72.9 71.4 71.0 71.2

23.9 25.5 26.3 27.1 28.6 29.0 28.8

14.0 14.9 15.3 16.3 16.8 16.8 17.1

6.0 6.2 5.9 5.7 6.1 5.9 5-6

1.4 1.6 1.6 1.5 1.6 1.8 1.7

81 o2

Negro

-13-

Chinese

Japanese

1950-1961

Other NonWhite Other Filipi no 1.5 1.3 1.7 1.8 2.2

1.4

2.5 2.8 1 .8 C .3 2 .7 3 .0 2 .8

1.7 1.3 1.4 1.5 1.6

During 196l, 1251 or 8.5% of the resident live births were to unmarried mothers, a decrease of 59 or 3/2 percent, probably because of more accurate reporting of residence on the birth certificates. It should be emphasized that a statement as to "legitimacy" does not appear on the California birth certificate and that our figures are not based on one specific item but are judgmental decisions reached from the way other items are or are not reported. However similar patterns have been evident throughout the years; 5.5% of all white births were out-of-wedlock in 1961 as against 5.9% in i960 and 4.8% in 1959. The percents for Negro birtb.6 were 25.2 in 1961, 25.9 in i960 and 24.5 in 1959. Of the unmarried mothers, 46.4% were white, 50.5% Negro and 3% other races. Nearly 51% of the deliveries took place at San Francisco General Hospital and of these deliveries, almost 23% were white and 76% Negro. Almost half (48.4%) of the mothers had their first child in 196l 30% of all unmarried mothers were 19 years of age or younger and 36% were between 20 and 24 years old. ;

Using birth weight - 2500 grams or under - as a criterion, 8.2% of all live births were premature. Percent of prematurity by racial groups ranged from 5.7 of the residual non-white group, 7°0% for Chinese, 7.4% for whites, 8.7% for Filipinos to 10.3% for Japanese end 11„8% for Negroes. Forty-eight percent of the mothers of premature infants received prenatal care in the first trimester of pregnancy and another 33% in the second trimester but there was great variation in prenatal care by place of birth. Although only 10% of all mothers began prenatal care in the third trimester and only 9% received no care or care was not reported, 26% of the mothers delivered at San Francisco General Hospital began care in the third trimester and 27% were in the last category.

In 1961, 34.9% of the children born were first births compared to 34.3% in i960 and 34.1% 1959. Second births again decreased slightly over the previous year; the 1961 figure was 24.8%, 196l, 25.5% and 1959, 25.8%. Just over 40% of the mothers had three or more children. Hunters Point Health District again had the highest birth rate, 29.6 per 1,000 estimated population; 43% of the births were white, 51% Negro and 6% other races. Mission Health District was second highest as in i960 with a birth rate of 28. 4 ;8l% of the births were white, and 10.6% were NegrOc North East District was lowest with a birth rate of 12.9 per 1,000 estimated population; white births increased to 48.4% and Chinese decreased to 46, reversing the i960 figures. The trend toward the decreasing proportion of Chinese births to residents of North East is still continuing; in 1961,67.2% of all Chinese births were to North East parents as against 68.9% in 1960, 73% in 1958 and 8l% in 1953. Additional information from the raedi.cal it eras on birth from the Bureau of Records and Statistics.

c

TABLE 14 RESIDENT LIVE BIRTHS AND BIRTH RATES BY RACE,

ertificates is available

I960 & 1961

I960

1 9 6 1

TOTAL White Negro Chinese Filipino Japanese Other

NUMBER BIRTHS

RATE PER EST . 1,000 FOP.

MALE

14,703

19.8

7516

7187

14,728

19.9

5367 1286 423 201 132 107

5102 1223 404 214 121 123

10,460 2,474

17.3 33.3 23.7 36.O 28.0 67.7

10,469 2,509 827 4l5 253 230

17.3 32.5 22.2 32.4 26.1 63.9 -14-

FEMALE

1

BIRTHS

862 444 265 223

RATE

TA8LE 15 RECORDED, RESIDENT AND NON-RESIDENT BIRTHS SAN FRANCISCO 19&0 i. 196"l

BY PLACE OF BIRTH

RECORDED PLACE OF BIRTH

1961

2o,m

TOTAL ,

20 ,

1961

6h

Kaiser Foundation Hosp. U. C, Hospitals San Francisco General Hosp. Children's Hospital St. Mary's Hospital

2956 2203 1930 1897 1688

289? 2044

Mary's Help Hospital St. Luke's Hospital Letterman General Hospital Mt. Zion Hosp. & Med. Ctr. St, Francis Memorial Hosp.

16"24

1690

1428 1243 1135

St. Joseph's Hospital

986"

Presbyterian Medical Ctr,* French Hospital Chinese Hospital St„ Elizabeth's Infant Hosp.

945 452 397 274

Home Emergency Hospitals Elsewhere

NON RESIDENT

RESIDENT

1960

1811

1929 17«W

tefVg

1961

1960

g.ug

6,2,05

1193 79

1373

ii£fl

tajza

1763 1406 1909 1267 1 1 o4

2?

1197 1083

1-27

392 $59

1.72

119$ 1136

913 822

325 313

1057 867 529 475 290

697 613 297 382

5&3

552 292

306

289

332

III

? 204

180 24 200

%

11

20

Other California Out of State

534

70

52

21

639

m

1471 1421

,

630 584

13

208 39

San Francisco Stanford Hospital through April i960; Presbyterian Medical Center from Hay 1, 1960,

TABLE 16 SAN FRANCISCO RESIDENT LIVE BIRTHS BY PLACE AND RACE

J96J

TOTAL

TOTAL

WHITE

NEGRO

CHINESE

F

I

L

I

P

us

I

NO

JAPANESE

14,703

10,469

2S09

32.7

San Francisco General Hosp, Kaiser Foundation Hospital U. C. Hospitals Children's Hospital

1909 1763 1406

744

4

'3 362

10

2

111

12

1068

213

126"7

944

131

Mary's Help Hospital St. Mary's Hospital St, Luke's Hospital Mt. Zion Hosp. 4 Med. Ctr.

1197 1104 1083 913

10S9 1020 975 630

13

894 822

s

Letterman General

Hospital

St. Francis Memorial Hospital St. Joseph's Hospital

Presbyterian Medical Center Chinese Hospital French Hospital St. Elizabeth's Infant Hospital Home

Emergency Hospital Elsewhere Other California Out of State

697 6I3

646"

62 235 12

2

1

7

406"

14 100

I?

H

382 297 70 58 13 13

208

39

b1

29

1?

184 35

-15-

'1

m 4? 14

13 5

.R

n

15 15

7

18

17

10 4

6 103 16 29

11

56

328

H

11

4 1

20

253

OTHER NON-HHITE

4

11

3 1

TABLE 17

RESIDENT BIRTHS BY HEALTH DISTRICT AND RACE,

TOTAL

TOTAL

i

BIRTH RATE

11,7(B

WHITE

NEGRO

CHINESE

19.8 uJtfia

ImSE

g?7

1169

267

9%

m

28 28 28

Alemany Central Eureia-Noe

1521 1726 1769

Hunters Point Marina Richmond Mission

1395

mi

29.6 15.1

605 1564

2038

28.4

1651

Northeast Sunset Wests ide

1206 1926 1103

12.9

584 1893

District Not Reporteo

19.9 21.3 24.3

1640

15.1 23. ^

711 70 217

117

OTHER NON-WHITE

JAPANESE

FILIPINO Jil5-

230

_2S3_

39 123

57

35

20

11

26

39

81

V 80

45

32

14 12 , 643

318

1961

17

16 15 40

556 30 29

21

9

13

99

TABLE 18 LIVE BIRTHS BY TRIMESTER PRENATAL CARE BEGAN 4 PLACE OF BIRTH San Francisco Residen ts, ,1961 .

PLACE OF BIRTH

CARE BEGAN 2nd TRIMESTER

1ST

TRIMESTER

TOTAL TOTAL

4707

1»,7Q3

San Francisco General Hospital Kaiser Foundation H-.spital U. C, Hospitals Children's Hospital Mary's Help Hospital St, Mary's Hospital St. Luke's Hospital Mt. Zion Hosp. 4 Medical Ctr. Letterhan General Hospital St. Francis Memorial Hospital St. Joseph's Hospital

3rd TRIMESTER

NO CARE OR NOT REPORTED 610

1505

1909 1763 1406 1267 1197 1104 1083 918

320

844

8

822

7

61

27

4 2

6

697 613 382 297 208 70 58

Presbyterian Medical Center* Chinese Hospital French Hospital Out of Town (California) St. Elizabeth's Infant Hosp. Home Out of State Emergency Hospitals Elsewhere

10

,1 11

20 32

39 13 13

Presbyterian Meoical Center from May

San Francisco Stanford Hospital through April 1960;

TABLE 19 RESIDENT PREMATURE LIVE BIRTHS BY PLACE OF BIRTH AND COLOR,

1,

i960.

1961

PREMATURES

PLACE OF BIRTH

TOTAL TOTAL

San Francisco General Hosp. U. C. Hospital Kaiser Foundation Hospital Children's Hospital Mary's Help Hospital St. Mary's Hospital Mt. Zion Hospital 4 Med. Ctr. St. Luke's Hospital

1?03 221

115 110

Letterman General Hospital

So 64 58

Home St. Elizabeth Infant Hosp. Emergency Hospital Out of State Elsewhere

7""*

JJEGRQ

FILIPINO

JL

296

'8

%

St. Francis Memorial Hosp.

Presbyterian Medical Ctr. St. Joseph's Hospital Chinese Hospital Other California French Hospital

HHITE

a $ 20 16 g 2

2 1

-16-

CHINESE

St.

JAPANESE

3L

OTHER NON-b'HUE

AS A PERCENT OF TOTAL

BIRTHS 8.2

k

INFANT DEATHS; During 196l there were resident deaths under one year of age or a rate of 2h-,5 per 1,000 live births; nationally the provisional rate of 25»3 was a record low. Twice during the last six years San Frencisco has had an infant death rate of less than 23; in 1956, the rete was 22,6 and in i960 when, it The increase in 1961 was because of an increase of 2k deaths in the inwas 22.9. fants more than 28 days of age; there were two fewer deaths of infants under 28 days. Infections played a primary role in the higher number of infant deaths; there were 53 of these compered to 32 in i960. Pneumonia and other respiratory diseases were most frequently cited. There were also increases in deaths from congenital malformations in both the neonatal group and those 28 days and over. Coding limitations make it difficult to asaess the part played by prematurity in deaths due to congenital malformations, and pneumonia other than that of the newborn However, prematuirity was mentioned as a causal factor in 16^ deaths, or nearly k6%; £>2% of the deaths coded to atelectasis included this condition. All ethnic groups had increases in the infant mortality rate; for whites the increase was in the age group over 28 days but both Chinese and Japanese increases were in the one to six day old infants.

TABLE 20 INFANT DEATHS BY RACE AND SEX San Francisco Residents, 196l TOTAL

ALL RACES White Negro Chinese

Japanese Filipino Other Non- •White

MALE

FEMALE

360

230

130

2kl 82 17

161 kS 10

80 3k

9 6

7 1

5

3

RATE PER 1,000 LIVE BIRTHS I960 1961 22.9 2k~3

7

23o0 32.7 20=6

22. 31.1 15.1

2

35.6

5 2

1^5

18.9 13.5 13.5

21.7

TABLE 21 INFANT DLAIEHS BY RACE AND AGE San Francisco Residents, 196l

ALL RACES White Negro Chinese

Japanese Filipino Other

1-6

7-27 Days

28 Days11 Months

TOTAL

UNDER 2k Hrs.

360

163

72

26

?9

2^+1

111 38

k9 11 5

15 7 2

66 26 3

1 1

1 2

82 17

7 3 2 2

9 6

5

-17-

Days

5 2

1

TABLE 22 INFANT DEATHS FROM SELECTED CAUSES BY AGE San Franc sco Residents, 1961 i

CAUSES OF DEATH

INTERNATIONAL CODE NUMBER

NEO-MATnL TOTAL

^0

ALL CAUSES TOTAL WITH MENTION OF PREMATURITY

UNDER 24 HRS.

SUB-TOT. .L

2iL_

1

-6

l63_

JXL

JB.

266

ML R

162

66 13

Congenital Malformations Injury at Birth Asphyxia 4 Atelectasis Disorders attributed to disease of Mother during pregnancy Erythroblastosis Hemorrhagic disease Ill-defined diseases Immaturity with subsidiary condition Immaturity Unqualified

MOUTHS

^2_

6o

3 9

m

16

3

1

.

1

«.

4

_ -

26

26

11

2

2

1

54

53

44

-15_ 12

9

1

INFECTIONS

11

72

JiJL

Congenital Malformations A Certain Diseases of Early Infancy except Infections

28 DAYS -

DAYS

9

22

m -

-£2_

Meningococcemia Pneumonia of Newborn Other Pneumonia Other Respiratory Gastro-Enteritis 4 Colitis Sepsis of Newsorn Viral Infection Non-Meningococcal Meningitis Encephalitis

057.1 763

2

4

490-493 500-527

5 2

571

767-768 096«9 340 343

ACCIDENTS Food causing obstruction Other obstruction Mechanical Suffocation Bed 4 Cradle Other OTHER Hernia and Obstruction Muscle Defect homicioe Neoplasm Brain Mongol sh Asthma Other Artery Disease

58

38

5 1

4 1

2S 12

921

922

1

921-

10

925

2

56O-570 744 983 193

325.*

i

241

456

TABLE 23

RESIDENT FETAL DEATHS BY RACE AND PLACE OF DELIVERY San Francisco, 196l HOSPITAL TOTAL

ALL RACES

WITE

NEGRO

-193

J2Z

San Francisco General Hospital Kaiser Foundation Hospital St, Joseph's Hospital Mary's Help Hospital St. Mary's Hospital Letterman General Hospital Children's Hospital St. Francis Memorial Hospital

40 20 15

16

19

11

6

15

13 13

U. C. Hospitals

11

Mt. Zion Hospital 4 Medical Ctr.

11

Presbyterian Medical Center St. Luke's Hospital Chinese Hospital French Hospi tal St. Elizabeth's Infant Hospital Emergency Hospitals Enroute Emergency Elsewhere Other California

13 12

12 12

9

9 3 1 1

1

3 1

4

4JL

14 1

10 I

I

FILIPINO 10

CHINESE

J.MVNESS

OTHER

»

COMMUNICABLE DISEASES; Reported cases of communicable diseases increased to 10,931 during 196l, or 32% over the 8,272 cases reported in i960. The most frequently reported diseases were gonorrhea and syphilis-, (excluding epidemic-logically treated conditions) accounting for k2% of the total. Although I96I was a "measles' yrU &the number of reported cases increased from 35^ in i960 to 2,551 in 196l, the disease accounted for only 26% of the total number of cases. For the third time in San Francisco history there were no reported cases of diphtheria and only one case of typhoid fever,, Infectious hepatitis cases in 196l increased 16% to 167 cases from the Ikk in I960; deaths coded to this diseases decreased to 5 from the 8 in i960. Meningococcal meningitis increased to 16 cases and five deaths in 1961 as against 8 cases and 2 deaths in I960. Five cases of poliomyelitis were reported for the calendar year; 3 were bulbo-spinal , 1 spinal-paralytic and 1 was non-paraly tic Three of the 5 had not received any polio vaccine; there was one death, that of a 33 year old man.

VENEREAL DISEASE; The constant rise in venereal diseases that has become the pattern in San Francisco, as well as through the rest of the Nation, continued during 1961 with certain modi fie ations Of the first five reportable communicable diseases, in numbers of cases, gonorrhea ranked first with about 600 more than second- ranking measles, and syphilis was third, well above both chickenpox and mumps. In evaluating this comparison, while it is true that childhood illnesses are poorly reported, it must be remembered thrt venereal diseases are also exceedingly poorly reported and that these tabulated data are, too, but sketchy representations of the true picture. This is especially so in the case of gonorrhea. With syphilis, though there is still much room for improvement, the figures are thought to be more representative. For years, the Division,, in the interest of better syphilis reporting among other considerations, has lost little opportunity to improve working relationships with practicing physicians of the Bay Area and recently, with the help of additional U.S.P.H.S,, personnel, the physician visitation program has been appreciably expanded. It is felt that the increase in cases reported by doctors previously unknown to the Division has been largely the result of these combined efforts. It will be noted that during 196l, while there was a decline in primary and secondary syphilis, the increase in early latent (also infectious) and other types, kept pace. The net result was that for the first time since 1955 » there was a flattening of the ever-ascending curve of diagnosed cases of syphilis. Hopefully, this represents the first obvious dividends of a program developed through early recognition of the problem in San Francisco. Any conclusions drawn at this time, however, would be premature and possibly over-optimistic. It will also be noted that another category, "Epidemiologically Treated" has been added to the syphilis tables. In previous years, since relatively few were sotreated, they were added to the "Other" category. This refers to treatment with antisyphilitic drugs of those known to have been exposed to infectious diseases, and who, while they have not yet contracted syphilis, may be in the incubation stage. What effect this type of therapy has upon early disease rates can only be estimated, but it is believed to be substantial,

In gonorrhea, the picture is nothing but discouraging. The increase during 1961 was more than twice as great as that recorded during i960. Intensified syphilis control activities with some lessening of personnel time available for gonorrhea With continued and even more epidemiology may have been a contributing factor. intensified emphasis upon syphilis during 1962, no improvement in this trend can be expected. Another and perhaps more serious factor responsible for this deterioration in control is the development of increasing resistance to penicillin among strains of the causative organism. No longer can we be reasonably certain that one injection of penicillin will be adequate, but, more and more, this must be repeated in various schedules or in combination with other drugs.. The consequent delay in rendering people non-infectious has the net effect of increasing the reservoir of infection.

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TABLE 25 REPORTED CIVILIAN CASES OF VENERE/L DISE/SE SAN Sill? CISCO - 1956 - 1961

1956

1957

1958

1959

i960

1961

GONORRHEA TOTAL

I889

2255

2U28

2935

3157

38U5

Diagnosed cases

11490

1771

2036

2399

2569

3132

391

m

392

536

588

713

1956

1957

1958

1959

i960

1961

h72

570

683

885

1010

13L6

58

120 113 121 329 -

175 156 190 36U

211 155 2Ul U03

166 105

-

-

Epidemlologically treated

SYPHILIS TOTAL

Rrimary Secondary Early Latent Other Epidemiologically treated

51 6U 130 227 -

52 111 3U9 -

TABLE 26 REPORTED CIVILIAN CASES OF "ENERE.'L DISEASE BY HE/LTH DISTRICT City and County of San Francisco, 1961

HE/LTH DISTRICT ALL

SM

FRriCISCO

ESTIi ATEli

NO. OF

POPULATION

CASES

R/TE PER 100,000 D JP„

PERCENT OF CASES

7UU,000

1,113

552.8

100.0

76,600

180

235*0

U.JU

Central

81,100

1,02b

1262,6

2U.9

Eureka-Noe

72,800

300

U12.1

7.3

1|7,200

322

682.2

7.8

122,300

20U

232.2

6.9

71,700

356

1*96.5

8.6

93,U00

719

769.8

17.5

131,800

119

90.3

2.9

h7,100

761

1615.7

18.5

Alemany

Hunter's Point

Marina-Richmond Mission

North East

Sunset v/estside

San Francisco District Not Reported

U8

-21-

1.2

277

165 333

REPORTED CIVILIAN CASES OF SYPHILIS SAN FRANCISCO,

-

|l

1956 - 196l

'

i

1958

1959

v///

m

: :

&

& L..

1

J

LUi

Lit 1957

1956

Mil

\////\

Early Latent

Primary J

Secondary

I

I

Other -22-

»

1

in

i960

HE

1961

Epidemiologic ally Treated (1961 Only)

REPORTED CIVILIAN CASES OF GONORRHEA

SAN FRANCISCO,

NUMBER k 000

1956 - 196l

3500

3000

2500

2000

1

1500

1000

500

1956

J-957 I

1958

Diagnosed Cases -23-

1959

I960 1961 Epidemiologically Treated

REPORTED CIVILIAN! CASES OF VENEREAL DISEASE BY HEALTH DISTRICTS

EXCLUDING EPIDEMI0L0C-ICALLY TREATED RATES PER 100,000 POPULATION

SAN FRANCISCO, 1961

\

HUNTERS POINT

r-

LAKE

HERCED

ALEMANY

I

Under 250

SOO - 7*9

J5 °-

7',o

i*99

TTTffl -2k-

4

Over

°

REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY STAGE AND SEX 5-YEAR MEDIAN City and County of San Francisco 1961

TOTAL

MALE

FE.i&LE

5-YEAR ED IAN

5202

3808

139U

3118

SYPHILIS TOTAL

13U6

1023

323

683

Primary Secondary Early Latent Late Latent

166 105

7

277 386 U5 16 18 333

159 96 230 232 30 h 11 261

hi 15a IS 12

120 113 130 250 ho 13

GONORRHEA TOTAL

38U5

2776

1069

2U28_

Diagnosed Cases Epidemiologically Treated

3132 713

2h56 320

676 393

2036 koh

U.

9

g

TOTAL

Late

Congenital All Stages, Report Only Epidemiologicsally Treated

OTHER TYPES TOTAL

NOTE:

9

7

72

Totals for medians were made independently and do not add to the total of the subgroups in syphilis and gonorrhea.

-25-

1

-

TABLE 28 REPORTED CIVILIAN CASES OF VENEREAL DISEASE IN 1961 SAN FRANCISCO BI AGE GROUP AND STAGE OF DISE/.SE -

ALL AGES SYPHILIS TOTAL

TOTAL

O-llj

15-19

20-2U

25-31

35-Uh

U5 & Over

5202

22

Sbb

13J2

1973

787

U8U

13U6

2

^

197

I1U1

280

368

2U 18 U5 10 1

90 bl 129 U2

35 3h 59 86

13 11

11 1

Primary-

166 105

Secondary Early Latent Late Latent

277

386 \6 16 18 333

Late

Congenital All Stages, Report Only Epid. Treated GONORRHEA TOTAL

Diagnosed Cases Epid. Treated

it

-

1 22 2

2

2 2

1 5 5

3

8

2lt

9$

131

51

32

2

-

-

22

2U6 32 b

38U5

20

U89

1191

1526

50U

115

3132

lit

6

381 108

1015 176

12ltli

713

282

391 113

87 28

3

3

1

OTHER TYPES TOTAL

11

-

-

It

TABLE 29 REPORTED VENEREAL DISEASE IN CIVILIAN MINORS - UNDER AGE 20 1956 - 1961 1956

1957

1958

1959

I960

1961

2\6

221

35b

521

607

5U8

13

15

18

12

28

27

5.3

6.8

5.1

2.3

b.6

lug

13U3

1590

1773

2050

2llt2

2672

158

222

220

27U

316

37h

11.8

lb.O

12. It

13oh

lh.8

lli.O

SYPHILIS (Primary, Secondary, Early Latent)

TOT^L REPORTED TOTAL REPORTED -

j\LL

AGES

- 19

PERCENTAGE

GONuRRHEA (Genito-Urinary) TOTAL REPORTED - ALL AGES TOTAL REPORTED PERCENTAGE

- 1?

-2«-

.

TABLE 30 REPORTED CASES OF VENEREAL DISEASE BY SOURCE OF REPORT Ai'D STAGE 0- TYPE OF DISEASE San Francisco 196I

-----

TOTAL

Hunt

Other City

Local Hosp

Priv. li. D.

Fed. Civ.

Other Juris.

Military

5275

U05U

262

181

639

23

1*3

73

100.0

76.9

5.0

3.1*

12,1

o.l-

0.8

1.1*

1356

725

79

98

396

7

m

10

168 105 280 387

105 U6

5

53

2

2

7

1*8

2

33

TOTAL PERCENT OF TOTAL

SYPHILIS TOTAL Priiriary

Secondary Early Latent Late Latent Late Congenital Report only/All Stag es Epid. Treated

GONORRHEA TOTAL

Diagnosed Cases Epid. Treated OTHER TYPES TOTAL

1*5

209

3

7

127 16

51

1*7

9

6

1

10 k

56 12U 10 k

3

8

5

16 18 337

216

10

10

96

3905

3322

183

83

3192

2681

137

713

61*1

1*6

77 6

-

1

2

-

1

1 _

3

1

37 _

_ -

1 1

1 1

-

-

2U0

15

2

60

221 19

lU l

1*

60

1 3 TABLE 31 VElffiREAL DISEASE * REPORTED TO T £ HEALTH DEPARTMENT KITH PERCENTAGES REPORTED EY PRIVATE PHYSICIANS 1956 - 1961

SYPHILIS (Primary

11*

,

3

7

1956

1957

1958

1959

I960

1961

267 U8 18.0

221 50 22.6

357 87

528 171

553 157

21- .1*

32.1*

616 152 2U.7

U95

571 LU3 25.0

687

892 282 31.6

1023 295 28.8

1356 396

3078

3316

3905 2U0 6.1

Secondary, Early Latent)

Reported from All Sources Reported by Private Physicians Percentage

28.lt

SYPHILIS (All Stages)

Reported from All Sources Reported by Private Physicians Percentage

72 Hi. 5

20U 29.7

29.2

GONORRHEA (All Classifications)

Reported from All Sources Reported by Private Physicians Percentage Includes a small number reporhed iw

11*6

2353 Uj3

7.0

6.1

207h

Jlifcary

-27-

Facilities.

2520 151 6.0

1 ?

1'

5.5

5.2

2

TABLE 32 SUILJRY OF VENEREAL DISEASE EPIDEalGLOGY -

1959

1961 1959

I960

1961

Primary, Secondary, and Early Latent reported

521

607

5U8

Cases interviewed

U72

606

5^8

Contacts obtained

1988

2752

2631

195

273

252

-

-

337

SYPHILIS

Contacts diagnosed Syphilis and treated Contacts treated epidemiologically

GONORRHEA Geni to-Urinary Reported (males only)

LU99

1577

1996

Cases interviewed (males only)

1311

1U23

1707

Contacts obtained

1500

1705

1921

Contacts diagnosed Gonorrhea and treated

593

655

683

Contacts treated epidemiologiccJLly

536

588

713

-28-

:

Tuberculosis control in San Francisco continues to be a major pubDuring 196l, there were kkj> newly diagnosed cases of active tuberculosis discovered in contrast to 536 in i960.

TUBERCULOSIS

lic health problem.

Of the kkj> newly diagnosed cases, 80$ reside in the Incidence by Residence; eastern half of the city: with 60% of the cases being found in Northeastern quarter. Listed below are the four health centers involved:

%

of the new

1.

Central Health District, which includes Skid Row, had 21c cases with a case rate of 117.1

2.

North East Health District, which includes Chinatown and North Beach, had 16.0% of the new cases with a case rate of 760O.



Westside Health District, which is heavily populated with the lower economic Negro group, has been one of the highest incidence areas for many years. Recently much of the housing has been razed as part of the Slum Clearance and Urban Renewal program, resulting in the removal of many of the residents to other districts. In spite of the marked decrease in population the case rate was 55°2 in 196l«

k

Mission Health District, with a high Latin- American, Puerto Rican and non-white population had 11»3% of all the newly diagnosed cases with a case rate of 69.7.

Incidence by Age: Of the newly diagnosed cases 2^8, or 56%, were k5 years of age of older; 99 or 20% being 65 years of age or older; and 63 cases or lh»T% were under 20 years of age. Incidence by Race: The greatest number of cases (306) were found in the white population, representing 8l»l% of the population, There were 137 cases found The incidence of tubercuin the non-white, who represent l8.9% of the population losis continues to remain highest in Filipinos with a case rate of 171»9° This stands out in sharp contrast to whites who have a case rate of 50<>7» but is comparable to the Chinese who have a case rate of 126. 3°

During 196l, 237 persons died with tuberculosis but in only 66, or 28%, was tuberculosis the primary cause of death. However, in 48 individuals, or 20%, clinically active and significant tuberculosis was reported for the first time at or after death. This indicates that patients under chemotherapy are not dying from tuberculosis; and that a large number of people with active disease are apparently asymptomatic and remain undiagnosed and infectious until the end of their lives. The latter group usually have unsuspected advanced tuberculosis, which can be diagnosed in the living only with a chest x-ray.

TABLE 33 CHEST CLINIC SAN FRANCISCO HOSPITkL Pt. Visits for Treatment

TOTAL PT. VISITS YEAR

139

1951

1952 1953 195* 1955 195' 1957 1958 1959 1960 1961

577 593 409 262 7^2

m 039

Without Treatment Observation and Contacts NO.

N0< 1950

Pt. Visits for Follow-up

Pneumoperitoneum and Chemotherapy

1M 17.6

833 \ 122 5

8

25 -§ 29,8

771

2H

13

i

^3.7 60.1 66,7 78.8 83. I*

i

518 11 28 25 25 ofy

W.6

ni

89*5 89.4

-29-

3

TABLE in TUBERCULOSIS CASEFINDING BY

UNIT LOCATION

x 17

San Francisco General Hospital Admission Program S.f. Jail

PREVIOUSLY UNKNOWN

TBC.

25,920

70 MM.

U

ACTIVE FOUND

NO. FILMS

101 Grqve Total

RAY

X

C'AMCER OF LUNG

37

62

30

2^,712 1,208

11

30 32

H

9,^13

*2

6

<*,086

17

12

1

16

(70mm.)*

*?1

S.f. Medical Society

16

16

11

^05

3*

32

10

1,799

5

5

1

109,0*7

201

133

6o

S.F. Tuberculosis Association

North East Health Center TOTAL

7



S Wl KN0WN CHEST PA THOLOGY ARE EXCLUDED FROM THE ADMISSION PROGRAM N N LUDE0 ,N THESE FILMS AL >- OF THESE CASES WERE ADMITTED TO « ?I n ! ? THE OPEN MEDICAL AND SURGICAL WARDS.

^I'?SI *«

SAN FRANCISCO SCHOOL TUBERCULIN SKIN TESTING PROGRAM GRADES TESTED: 1, 7, 10 and 12; entire grade level once per year; and all students new to San Francisco schools. All previously known Positive Reactors who had 10mm. or more of induration were excluded from testing, but those who had 6 - 9mm. of induration were retested. SCHOOL YEAR

TOTAL

1956-57

Students Tested 134,458 Positive Reactors Found 8,300 Percent Positive Reactors 6.2%

School Year 1956-1957 1957-1958 1958-1959 1959-1960 1960-1961

Cases In School

25,286 1,492 5.9%

(Per 1,000) Case Rate 1.8 1.8

44 32 44 54

1957-58

1958-59

1959-60

1960-61

16,904 1,125 6.7%

29,541 1,765 6.0%

3h-,028

28,699

2,267 6.7%

1,651

Family Contact Cases plus School Cases 62 42 62 93

1.5 1.6 1.3

38

58

SUMMARY OF TYPES OF TUBERCULOSIS FOUND

TYPE OF TUBERCULOSIS

GRAND TOTAL I. II.

TOTAL

SR.

,

HIGH

212

59

PRIMARY 114 PULMONARY 75 Minimal 60 Moderately "dvancedl2 Far Advanced 3

1 51

III. EXTRA PULMONARY

Meningitis Miliary Lymphadenitis Pleural Effusion Genito Urinary

23 2 2 11 7 1

40 8 3

5.7% Case Rate per 1,000 2.4 2.4 2.1 2.74 2.0

SCHOOL LEVEL 1956-1961

.ND

JI 1. HIGH

ELEMENT; '.RY

TOTAL

35

118

212

19 13 9

94

ilk

11 11

60

4

75 12 3

7 1

3

13

23 2 2

4 1

1 2

1 2 6 4

l

-30-

11 7 1

TABLE 35

NEWLY REPORTED CASES 4 TUBERCULOSIS DEATHS OCCURRING IN SAN FRANCISCO 1920-1961 -

YEAR

POPULATION

NEWLY REPORTED CASES NUMBER

1920 1921

RATE

506:676* 525,777 533,512

256,2 261,6

BUMBER

670 638

1.8

621

111.7 103.7 93.5 101.1 98.9

561

88.4

563 533 471 ^53

88.7 34.0 74.2 71.4

454

71.6 72,7

223.1

W 661

1925 1926 1927 1923 1929

576,717 589,452 602,137 614,911 627,657

204.4

644

1930 1931

04,39** 0***11

1932 1933 1934

634,426

206.3 207.6 189.0 161.7 136.3

1935 193& 1937 1932 1939

WO 1941

19*2 1943 1944 19*5 1946 1947 19*8 19*4-9

1950 1951

1952 1953 195*

1

*

2

^

1

i 5 *i

182.8 185.9 232.0

63***55 634,469 634,484 634,493 634,512

1*7.5 140.7 184.6 159.5 130.3

634; 525

611

634

461

2.2

Ut

1.8

M

1.8 1.8 2.3

2.3 2.3 2.2 2.2 1.9 2.1

m

1.9 2.5 2.6 2.0

66.2

129.1

420 439

13M

381

Hi

2.2 2.0 2.5

46

396 424

634,536* 673,109 711,632 750,255 733J823

148.9

111,6 131.0

363 430

827,400* 817,400 806,600 796,200 785,800

102.9 111.0 134.4 122,6 127.5

470 397 350 333

775,357* 778,300 772,200 764,700 757,100

112.1

104.4

1:5 1.8 2.3

301 Z

27*7

V> 180

92,4

131

91.2

116

79.1

a

^44,300 '42,900

74.2 66,4 66.6

1960

740,316* 744,000

72.4 59.5

65.1

56e8 48.6 43.4 41.8 38.3

103.7

740,100 734,800 734,600

66.8

5*. 5

214 144

111,1

1955 1956 1957 1958 1959

1961

PER DEATH

2.1 2.1

216.9

If

RATE

132 2 121.2 118.3 120 o 8 117.2

563,932

1922 1923 192^

NEWLY REPORTED CASES

DEATHS

7

6

23.1

m

3.3

4.0 4.5 4.0

17.3 15«7 12.5 10.6 10.3 9o7

10„3 8.9

If,

hi 1.9

2:1

Population estimates os of July 1, 1951-1959 and 1961 by California State Department of Finance.

U.S. Census Rates per 100,000 Population.

-31-

TABLE 56 NEW CASES OF TUBERCULOSIS REPORTED BY RACE, TYPE OF DISEASE AND SEX San Francisco, 196l

PULMONARY

ALL TYPES

RACIAL GROUP

TOTAL

MALE

ALL RACES

kkl

300

306 55 hi

210 37

22

13 3

White* Negro Chinese

Filipino Japanese American-Indian

7 3

FEMALE

33

T

M

F

T

M

F

262

98

ko

21

1?

«t3

17

26

255 39 37

188 31 27

67

20 12 5

23 k

8 8 1

31 k

20

8

2

21 2

5

2

3

20

12

8

2 2

k 1

1 -

1 -

1 -

_

6 3

M

l*f3

360

96

9 k 1

2

F

T

18 Ik

OTHER

PRIMARY

10

k

_

1 1 -

1 -

Other White includes Mexicans.

*

TABLE 37 REPORTED TUBERCULOSIS CASES AND DEATHS, CASE RATES AND DEATH RATES BY TYPE OF DISEASE AND RACE San Francisco Residents, 196l ALL RACES CASES

-

TOTAL

Pulmonary Primary Other DEATHS -

TOTAL

Pulmonary Other POPULATION

CASE RATE* DEATH RATE *

**

*

NEGRO

WHITE*

CHINESE

FILIPINO

JAPANESE

OTHER

kk3

306

55

k7

22

7

6

360

39 12 k

37 5

20

5

1 1

6 1

k3

255 20 31

3 1 2

66

53

6

5

1

1

-

65

52

6

5

1

1

-

l

1

12,800

9,700

3,600

171.9

72.2

166.7

7.8

10.3

7kk, 000

603,600

77,100

59.5

50. 7

71 .3

8.9

8. 6

7 .8

37,200 126.5

White includes Mexicans Rates: Number of Cases or Oeaths per year per 100,000 estimated population.

-32-

13.
-

-

TABLE 38 NEW CASES OF TUBERCULOSIS REPORTED BY HEALTH DISTRICT OF RESIDENCE

San Francisco.

HEALTH DISTRICT ALL HEALTH DISTRICTS

CASES

1961

PERCENT OF ALL CASES

CASE RATE PER 100,000 POPULATION

POPULATION

443

744,000

59=5

100.0

Alemany Central Eureka-Noe

36 95 4o

76,600 81,100 72,800

^7.0 117.1 54.9

21c 5

Hunters Point Mar i na-Ri chmo nd Mission

22

48 50

47,200 122,300 71,700

46,6 39.2 69.7

5.0 10.8 11.3

North East Sunset Westside

4o 26

93,400 131,800 47,100

76,0 30.3 55.2

16.0 9.0 5.9

District, Not Reported

15

-

71

8.1

9.0

-

3.4

TABLE 39 NEW CASES OF TUBERCULOSIS REPORTED BY AGE AND RACE. AGE GROUP TOTAL

(Years)

ALL AGES

FILIPINO

OTHER** 13

22 -

-

1

2

7

5 5 1

2 1

10

3

5 1

13 10 13 25

3 4 5 2

4 4 3 4

3

3

1 -

1 2 1

8

1

5 3 5

5 1 2

2 2

38

15 25 27 30

64 69

37 44

27 36

4 1

5 4

Ov.

55

46

4

5 10 15

-

9

-

14 19

35

_ -

24 29 34 39

40 45 50 55

_ -

44 49 54 59

26 40 34

60 65

_ -

70

&

30

CHINESE 47

-

25

NEGRO 55

443

1

20

WHITE*

306

16 22 13 14

9 13

26

20 23 35

Mexicans included with white 7 Japanese, 3 American-Indian, included with "Other".

-33-

3

3 1 l 2

-

3 1

REPORTED CASES OF TUBERCULOSIS BY HEALTH DISTRICTS RATES PER 100,000 POPULATION

nz

UNDER 50

50 to 39

100 AND OVER

TABLE 40 PERCENT OF CASES BY STAGE OF DISEASE FOR NEW CASES OF PULMONARY TUBERCULOSIS FOR WHOM STAGE OF DISEASE WAS REPORTED San Francisco, 196l STAGE OF DISEASE

1961

I960

1959

1938

1957

1956

100

100

100

100

100

100

33 47 20

32 44 24

27 kz 31

32 4l 27

30 38

23 42 35

ALL STAGES

Minimal Moderate Far Advanced

32

TABLE kl INTERVAL BETWEEN REPORTING OF DISEASE AND DEATH,

INTERVAL

PERCENT OF DEATHS

237

100.0

16 8 15

6.8 3.4

TOTAL Less than 6 months 6-11 months 12 - 17 months 18 - 23 months 2 years 3 years 4 years

5-9

years 10 - 14 years 15 years & Over

Reported only on certificate or after death

10

6.3 4.2

11 11 15 56 28 19

4.6 4.6 6.3 23.6 11.8 8.0

48

20.4

TABLE 42 PERSONS HAVING HAD TUBERCULOSIS WHOSE DEATHS WERE CODED TO OTHER CAUSES, CODED CAUSE OF DEATH

196I

NUMBER DEATHS

INTERNATIONAL LIST NUMBER

TOTAL

1961

NUMBER OF DEATHS 171

Heart Diseases Malignant Neoplasms Cirrhosis of the Liver

410-443 140-205 58l

48 35 20

Diseases of Respiratory System Vascular Lesions of C.N.S. Accidents Suicides

470-527 330-334 8OO-965 970-979

17 11 11

-

25

All Others

-34-

4

SAN FRANCISCO DEPARTMENT

PUBLIC HEALTH

OF

STATISTICAL REPORT u-wOA/iENTS

1962

AUG 2^

1963

Golden Gate

SAN FRANCISCO PU»'!5LIE'

o l\

PRESIDIO

NORTH EAST

o

MARINA. RICHMOND

C WESTS IDE

OCENTRAL

GOLDEN GATE PARK

o EUREKA NOE

Omission

O SUNSET

HUNTERS POINT

LAKE

MERCED

\

O

CITY AND COUNTY OF SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH

Central Office lOI

GROVE STREET Zone 2

August 15, 1963

°eP«t-nVof1^

;*<>« of the San Francisco y the birth and death certificates sent to us by pJLtJcS P y those reallocated to us by * 2° San Franc ^co, or from the st«£ n De P«fent of Public Health of births and deaths of in the case San Franc?! 10 " Francisco. Another major outsid * of San Lurcra^the'^bidif eases which we receive 7 rGP ° rtS of "portable disfrom DrLtrn § P h y^ians. Included in the Statistical Report are data and information secured from the United States Census Bureau,

nhJ^

.

?

1L

"^



«^%rs ss^Ls^^rj?^ v £?«?£'

^

o

thes ata «• **>«*«* the included in ° rd reader may have some insist that the & 8 ° Cittl *"* cult "ral City and County of San FrfnL? structure of the u ^ancisco, which is the patient of the Public Health Department of

"

^^^^S.jg""*^ P" "

eases San Francisco in the field dicated enabeus itllt here they have not aalsf S Population toward°:hic n :;

bi

hS and '««.. and reportable disblems th *t face the community of COXmunit y health and the trends > that are in1 haVe been successful, and §

1

V""^ " EtfSLSJZ ^^l~^* S!"

°"

T" ^

°*



Md Mrth and death statistica which were n" nclu de rrthis ' 3Vailable fr '" the Bureau of Records and Statistics of de P artraent through Miss Mildred Holota, Chief > of that Bureau

th^H^r ^



ELLIS D. SOX, M. D. Director of Public Health

CONTENTS SUBJECTS, CHAM'S AND MAPS

Births Communicable Diseases Deaths Fetal Deaths Infant Deaths Marriages & Divorces Maternal Deaths

PAGE 15 19 3 18 16 1 6

PAGE

Population Tuberculosis Venereal Disease Gonorrhea Chart, 1958-1962 Syphilis Chart, 1958-1962 Map Venereal Disease by Health District, 1962 1962 Map Tuberculosis by Health District,

1

27 19 25 26 23 31

TABLES 1. 2. 3. k. 5. 6. 7. 8.

9.

10. 11. 12. 13. Ik. 15. 16. 17. 18. 19« 21. 22. 23. 2k. 25. 26. 27. 28. 29. 30. 31. 32. 33. 3k. 35. 36. 37.

Deaths from important causes, San Francisco & U.S., 1962, Cal., 196l & i960 5 6 Causes of death, all ages, 1958-1962 6 Causes of death by sex, rates and percent, 1962 6 Maternal deaths, 1957-1962 Death rates for Whites, Chinese and Negroes, 1962 7 8 Deaths from important causes by age group, 1962 (Chart on Page 9) 10 & 11 Causes of death, residence, and occurrence, I96I-I962 12 Selected morbidity and mortality data for health districts, 1962 13 Birth rates by race and sex, 1962 13 Recorded, resident and non-resident births by place, 1961-1962 13 Resident live births by place and race, 1962 1^ Resident births by race and health district, 1962 Ik Live births by trimester prenatal care began by place of birth, 1962 16 Place of birth of premature infants by race, 1962 17 Infant deaths by race and sex; rates, 1962 17 Infant deaths by race and age, 1962 17 Infant mortality by age and cause, 1962 18 Fetal deaths by place of delivery and race, 1962 20 Cases end deaths from communicable diseases, 1958-1962 21 Venereal diseases reported by private physicians, 1956-1962 21 Civilian cases of venereal disease, 1962, and 5-year median 21 Venereal disease by disease and stage, 1962 Venereal disease by health district, 1962 22 Venereal disease by age group and stage, 1962 22 Venereal disease in civilian minors, 1958-1962 2H Venereal disease by source of report, 1962 29 Chest Clinic, San Francisco General Hospital, 1950-1962 Tuberculosis: New cases by race and type, 1962 Tuberculosis cases by sex, age and race, 1962 Tuberculosis, pulmonary, percent of cases by stage, 1958-1962 Tuberculosis cases, deaths, and rates, 1962 32 Tuberculosis crses by health district, 1962 32 1962 New cases of Tuberculosis by age and race, Tuberculosis cases and deaths, 1920-1962 Tuberculosis, interval between reporting disease and death, 1962 Tuberculosis cases whose deaths were coded to other diseases, 1962

^

:

GENERAL INFORMATION San Francisco, one of the original 27 counties in the State, was also incorporated as a city in 1850. Located on the tip of a hilly peninsula, its total area is 129»25 square miles of which less than one-half or ^5«^51 square miles is land* Excluding islands, its land area is 29,089 acres. The estimated population density in 1962 was 16,391 people per square mile, the highest in the state. It has an equable climate with an average daily temperature range of 11.9 degrees, from a daily mean maximum temperature of 62*8 to a daily mean minimum temperature of 50.9 degrees; rainfall averages about 21 inches yearly. The city enjoys about 66% of all possible sunshine. The provisional estimate of population for July 1, 1962, made by the California State Department of Finance was 7^5,000, an increase of 1,000 over the 1961 estimate of 7^,000 and 4,68*+ or 0.6% over the April 1, i960 census figure of 7^0,316.

Estimates and census figures for race and broad age groups are: 1962

TOTAL White Negro Chinese Filipino Japanese Other Nonwhite

5 15 25 k5

-

l*f

2k kk 6k 65 Years and Over

I960

CENSUS

7^5,000

100,0

7^0,316

100.0

602,700 78,300 37,500 13,100 9,700 3,700

80.9 10.5 5.0 1.8 1.3 0.5

60if,4l3

81.6 10.1 ^.9 1.7 1.3 O.k

1962

Under 5 Years of

ESTIMATE

ESTIMATE

7^,383

36,^5 12,327 9,^6*+

3,29^ i960

CENSUS

7^5,000

7^0,316

100.0

59,260 98,800 91,800 200,500

58,851 98,189 91,155 199,362 199,151 93,608

8.0 13.3 12.3 26.9 26.9 12.6

200,1+00

9^,2^0

The number of males was estimated at 36^,^00 or ^8.9% of the total population and females at 380,600 or 51.1%.

MARRIAGES The number of marriage licenses issued during the calendar year 1962 was 6,871, an increase of 302 or k.6% from the I96I figure of 6,569 which was a decrease of 1% from the i960 figure of 6,636. The rates were 9.2 per 1,000 estimated population in 1962, 8.8 in 196l and 9-0 per 1,000 enumerated population in I960. DIVORCES: During the calendar year 1962 the number of divorce actions filed decreased by 269 or nearly 8%, from 3,360 in 196l to 3,091 but there was still one divorce action filed for each 2.,2 marriage licenses issued. -1-

MARRIAGE LICENSES ISSUED

DIVORCE ACTIONS FILED

FINAL DECREES OF DIVORCE

/ANNULMENTS

4543 4391 4327 4096 3867

2842 2940 2917 3088 2598

468 478

^2

195^-55

8328 73C6 7395 6860 6631

1955-56 1956-57 1957-58 1958-59 1959-60

6645 6965 6526 6665 6703

3676 3500 3508 3434 3350

2604 2432 2442 2257 2357

483 463 477 499 417

1960-61 1961-62 1962-63

6670 6704 6921

3322 3198 3108

2275 2161 2243

394

YEARS

1950-51 1951-52 1952-53 1953-5**

GRANTED

517 499

421 454

BIRTH AND DEATH RATES FOR OTHER JURISDICTIONS:

Tentative and provisional rates for the United States, California and 4 Bay Area counties for the calendar years i960, 196l, and 1962, based on enumerated population for i960 and estimated populations for 1961 and 1962 are:

1962 Estimated Population

United States

California COUNTY Alameda Contra Costa Marin San Francisco San Mateo

188,050,000

BIRTH RATE per I960 1962 1961 :

22.4

23.4

DEATH RATE POPULATION 1961 1962

I960

23.6

9.5

9.3

9.5

8.3

8.6

9-0 6.1 :6.5 13.1 6.5

9.3 6.3 7.2 13.3 6.5

17,094,000

22.1

23.2

23.7

8.2

946,700 448,200 166,700 745,000 492,800

21.7

22.9 22,3 21.8 19.8 21.8

22.9 22.8 22.9 19.9 22.5

8.9 N.A. n.a. 13.1 6.5

N.A. N.A.

19.0 20.6

After years of high birth rates, the crude birth rates for both the United States and California are back at the 1945 levels. Counties for which rates are available show a similar decrease, partly because of the decreasing proportion of women of childbearing age in the total population. Fluctuations in death rates are probably due to greater mortality risks for older persons during outbreaks of respiratory diseases, resulting in more deaths ascribed to cardiovascular renal diseases as well as pneumonia and influenza.

Crude birth and death rates for San Francisco since 1950 in the following table are based on revised population estimates by the California State Department of Finance. Since the early 5Cs, the death rate has shown an upward trend while the crude birth rate has been decreasing, though not ats markedly as the rates in other jurisdictions. '

-2-

YEAR 1950

SAN FRhNCI SCO ESTIMATED FOFULATICN

RESIDENT BIx
RESIDENT DEi.TH DEATHS rate PER 1,000 POPULATION 11.9 9,204 12.2 9,527 12.6 9,693 12.3 9,435 12.1 9,160

1951 1952 1953 1954

775,357 (Census) 778,200 772,200 764,700 757,100

1955 1956 1957 1958 1959

740,100 734,800 734,600 744,300 742,700

l4,54o 1^,565 15,240 15,104 14,634

19.6 19.8 20.7 20.3 19.7

9,161 9,548 9,600 9,375 9,559

12.4 13.0 13.1 12.6 12.9

i960 1961 1962

740, 316 (Census) 744,000 7^5,000

14,728 14,703 14,177

19.9 19.8 19.0

9,825 9,736 9,777

13.3 13.1 13.1

DEATHS:

During the calendar year 1962 there were 9,777 resident deaths, an increase of 4l from 1961 ; the crude death rate was 13.1 per 1,000 estimated population for each year. As in the previous three years, the average age at death for males was 63 years and for females was 67. The age adjusted rate for San Francisco in 1962 was 8.3 per 1,000 population, nearly 11% higher than the United States estimated rate of 7.5

Table 1, Deaths from Important Causes for San Francisco, California and the United States, contains final 1962 figures for San Francisco, provisional 1962 rates for the United States and provisional 1961 figures for the state. The first six leading causes of death were the same for the United States and California and have been so for several years. In San Francisco, however, cirrhosis of the the liver was the fifth cause in 1962, while certain diseases of early infancy, fifth cause in the other two jurisdictions was seventh here. Accidents reverted to fourth place in San Francisco in 1962 after their fifth place showing in 1961. Heart diseases and cancer caused over one-half the deaths in each jurisdiction. Respiratory diseases other than tuberculosis are increasing in seriousness as causes of death. Tuberculosis, once the leading cause, was sixteenth on the San Francisco and California list while emphysema, formerly infrequently indicated as an underlying cause of death was in eleventh place in San Francisco, twelfth in the state, and thirteenth in the United States. Table 2 shows resident deaths from important causes for the past five years. Each year diseases of the heart accounted for 38 or 39% of all deaths, cancers for 17 or 18%, vascular lesions of the central nervous system 9 or 10%, accidents 5% and cirrhosis of the liver between 4 and 5%- Thus about three-fourths of all deaths are included in the first five causes. Compared to 1958, increases in rates from 8 to 16 per 100,000 were shown by heart disease, cancer, cirrhosis and emphysema.

-3-

Sex-specific causes of death, shown in Table 3, present the familiar picture of higher rates for males, except for vascular lesions of the central nervous system, arteriosclerosis, diabetes and congenital malformations The first seven leading causes are the same for men and women but the rates for men are generally half again or more as high except for vascular lesions. The sex difference is particularly marked in emphysema where the rate for males is nearly 30 per 100,000 population and for females is not even three* Census data for age groups by sex for minority racial groups is not yet available. For tables showing death rates specific for age groups and sex by white and nonwhite classifications, and rates for leading causes such as heart disease, cancer, accidents and suicides, reference should be made to the 196l Statistical Report of the .ban Francisco Department of Public Health. In 1962 and 196l the death rate for whites was l*f.6 per 1,000 deaths, considerably higher than the Negro rate of 6.8 and the Chinese rate of 7.8. Heart disease and cancer ranked first and second in the three ethnic groups although the rates were quite different. Heart disease accounted for 5.8 white deaths in each 1,000 estimated population, almost **0% of the total number of deaths of whites, while among the Chinese they \ere 32% of the deaths and in Negroes, 2k%, Cancer caused almost 21% of the Chinese deaths, 18% of the whites and 16% of the Negro deaths. Again in 1962 as in 1961 and i960, certain diseases of early infancy ranked as third cause among the Negroes with a rate of 7^ per 100,000; it was the fourth cause of death for Chinese and ninth among the whites. Information about numbers and rates for various causes by the ethnic groups is the subject of Table 5»

Causes of death by age groups appear in Table 6 Again in 1962 accidents were the leading cause of death from age one through twenty-four and rank with heart disease in the age group 25-^. Although they were the fifth cause in age groups over *+5, the rates were considerably higher in the older age groups than at younger ages; it is nevertheless shocking that ^0% of the deaths from 5-1h years of age and 55% of the young adult group, 15-2*t years, were accidental. Nearly 31% of the accidents were caused by motor vehicles and one-third of these were deaths of pedestrians. Accidents in the home caused another 31% of the deaths with falls causing 71 or 47% of them. Hates for heart disease increased sharply with age; ^5% of the deaths of those 65 years and over were coded to this cause. One-third of all accidents happened to those in this age group. Cirrhosis of the liver was the fourth cause of death in the age-groups 25-**^ and k^-Gk but the rate increased sharply from hO per 100,000 estimated population in the younger age group to 137 in t'lose ^5 to Sk a In those 65 and over, the rate was still high, 102 per 100,000 population.

Suicide was the second cause of death in the 15-2^ year age group. Seventeen persons in the age group, 73 in those 25-^ years, 85 in the prime of life, ^5-6*+, and 38 of those 65 and over took their own lives. Of those v/hose length of stay in the county was reported, 8l% had lived in San Francisco five years or more.

-h-

TABLE 1 DEATHS FROM IMPORTANT CAUSES

CAUSE OF DEATH

RATE PER 100,000 POPULATION

RANK S.F.

Cal.*

U.S.

ALL CAUSES

PERCENT OF TOTAT, niTATHS

S.F.

Calc*

U.S.

S.F.

1312.3

833.7

9^5.9

100.0

Cal.*

U.S.

100.0 100.0

Heart Diseases

1

1

1

50^.8

316.2

368.8

38.5

37.9 39=0

Malignant Neoplasms

2

2

2

232.6

138.0

1^9.2

17.7

16.6 15.8

Vascular Lesions C.N.S.

3

3

3

125.5

90.3

106.3

9.6

10.8 11.2

Accidents

k

k

k

66„0

50.6

52.3

5.0

6.1

5.5

Cirrhosis of Liver

5

7

9

60.8

18.9

11.5

k.6

2.3

1.2

Influenza & Pneumonia

6

6

6

^2.3

25.9

32.8

3.2

3.1

3.5

Certain Diseases of Early Infancy

7

5

3

31. <*

33.^

35.3

2.k

k.o

3.7

Suicides

8

9

11

28.6

15.k

10.9

2.2

1.8

1.2

9

8

7

22.8

16.0

19.8

1.7

1.9

2.1

10

11

8

17.2

9.6

17.0

1.3

1.2

1.8

Emphysema

11

12

13

16.0

7.6**

6.1

1.2

0.9

0.6

Aortic Aneurysms

12

Ik

16

12.5

6.6**

k.e

0.9

0.8

0.5

Ulcers of Stomach and Duodenum

13

13

12

12.1

7.0

S.k

0.9

0.8

0.7

Malformations

Ik

10

10

9.9

12.1

11.3

0.8

l.k

1.2

Hernia, Intestinal Obstruction

15

15

Ik

8.0

k.k**

S.k

0.6

0.5

0.6

Tuberculosis

16

16

15

7.8

3-7

5.1

0.6

o.k

0.5

-

-

-

UA.O

78.0

L03.1

8.8

9.5 10.9

Art eriosclerosis

Diabetes

Congenital

All Others

SOURCES

:

:

San Frnnri Rrn p^ P>artmer it of Pi Jblic Herl th Recoj rds California: Communications from State Department of Public Health Provisional 196l figures i960 figures. United States: Monthly Vital Statistics Report, Vol. 12, No. 1, March 20, 1963 provisional figures for 1962. :



-5-

TABLE 2

DEATHS FROM IMPORTANT CAUSES San FfjAm rtscn i1fs|oents, '

NUMB 13£l all causes

Heart Disease Malignant Neoplasms Vascular Lesions of C.N.S. Accidents Cirrhosis of the Liver Influenza and Pneumonia Certain Diseases of Early Infancy

c

.

Suicides arteriosclerosis diabetes Emphysema aortic Aneurysm

-9777

3683 1708 1002

492 ^53

489

315

281

234

206 214 165

213 170

all Other

90

B



90

S

851

915

9375-

3635 1658 949

1612

9£j

471 411

492

296

286

226

218 194 203

264

116 87 110

108 107

JL251

492 462 296

220 197

95

58

iag

9825, 3771 17Q2

90

97

£ 76 891

198 170 105

101

83

II

96

72 5

RATE PER

m o.QQQ

12£g

JL9ll

_L9i£

.1312.3

13HU5

504.6 232.6 125.5

495.0 229.6 134.7

66„o 60.8 42.3

31.4 28,6

E R

i2£o

9J3&.

3759 1733 935

128 119 93

Ulcers of Stomach 4 Duodenum Congenital Malformations Hernia 4 Intestinal Obstruction tuberculosis

1961

ALL AGES mg_i

11

22.8 17, „2

16,0 12.5

72

77

833

834

114.2

54

JL2S2

JL9_5J_

im*-7

V^ 9/

509.4 229.9 129.8

501,7 223.2 127.7

488.4 216.6 129.4

62.9 65.7 37.8

66,5 62 e 4 40.0

63.4 55.3 39,8

66.1 48.8

38.4

27.7 28.8 22.2

30.5 26.1

2 nil

11.8 12.8

15.7 11.7 14.8

12.1

12.1

9.9 8,0 7.8

62

POPULATION

1322

1

26 *:l

27.3

22.8

13.1

13.6 11.2

14.1 7.9 11.3

14.4 9.7 7.2 10.3

14.5 14.4 6.9 8.9

u

10.3

12.9 11.8 8.3 9.7

122.8

120o 3

112o3

12.2

112c1

TABLE 3

MP0RTANT CAUSES OF DEATH BY SEX WITH RATES PER 100,000 POPULATION bAN Franci sco RFsinriuT-g, l9 g$ MALE

FEMALE

CAUSE OF nFATH

NUMBER

Heart Disease Malignant Neoplasms Vascular Lesions of C,n,S.

Accidents Cirrhosis of Liver Influenza and Pneumonia Diseases of Early Infancy Suicides Emphysema

Arteriosclerosis Aortic Aneurysm Ulcers of Stomach 4 Duodenum Diabetes Tuberculosis Congenital Malformations Hernia 4 Intestinal Obstruction All Other

RATE

PERCENT

1080.4

lon.n

Ill

403.8" 200.7 200,

37.4

501

1.6 13K

12 u 2

164

43.1

175

46.0 31.8

4.0 4.3

4112...

2222

III

328 278 194 140 138 109

60 59

90,0 76.3 53.3

4.9 3.4

38.4 37.9

I:?

29.9

1.9

22.2 16.5 16.2

1.4 1.1 1.1

15.9 12.3

1.0 o8

30

8.2

0.6 0.5

486

133.4

i.6

34

121

94

n

24.7 19." '?:2 2.

2..9

Z

'l

1.8

0.2

8?

23.4

I?

8.2

2.2 0.8 0.7

I" 40 30

18.4 3.4 10.5 '7.9

1.0 0.7

365

95.9

8.9

TABLE H .MATERNAL DEATHS.

YEAR

18.6

NUMBER OF MATERNAL DEATHS 4.6

1:1 2.0

w

7

4

Table 5 LEADING CAUSES OF DEATHS FOR SAN FRANCISCO WHITES, NEGROES AND CHINESE WITH RANK ORDER /ND RATE PER 100,000 POPULATION, 1962

WHITE RANK

.

ALL CAUSES

CHINESE

NEGROES

NO,

RATE

8808

1461 o

NO.

RATE

_

291

776 .0

162.2 108.6 70.2

1 2 3

93 36

248.0 160.0 96.0

48.5 30.6 23.0

4

9 6 8

24.0 16.0 21.3

NO.

RATE

_

532

679.4

1 2 4

127 85 55

38

RANK

RANK

Heart Disease Malignant Neoplasms Vascular Lesions

1 2 3

3495 1567 833

579^9 260.0 138,2

Accidents Cirrhosis of Liver Influenza & Pneumonia

4 5 6

435 421 285

72.2 69-9 47.3

5 6

7

24 18

7 8

202 165

33 o5 27.4

_ -

2 2

2.6 2,6

8 -

5 1

13.3 2.7

9

152

25.2

3

58

74,1

4

9

24.0

10 11

112 108

10 -

8 3

82

11

7

10.2 3.8 8.9

7 7 -

6 6

12

18„6 17o9 13.6

l6c0 16„0 8,0

79 5^

13.1 9.0

-

2 4

2.6 5.1

6 -

7 2

50

8.3

7

18

23.0

-

2

5-3

47

_

2 11 6 16

2.6 14.0

_ -

30 26

7.8 7.0 5.0 4.3

7.7 20.4

6 -

1 2 7 1

2-7 5.3 18.7 2.7

623

103.2

46

58.7

27

72.0

Suicides Arteriosclerosis Diseases of Early Infancy Diabetes Emphysema Aortic Aneurysms

Ulcers of Stomach and Duodenum 13 Intestinal Obstruction^ Congenital Malformations 15

Pyelonephritis Tuberculosis Nephritis Homicides All Others

16 17 18 19

42

9

12 8

7

5

60

3

18.

5.3

There were 6l deaths of Filipinos with a rate of 4.7 per 1,000 estimated population; among them 26 from heart disease; 7 from certain diseases of early infancy, 5 fatal accidents and 4 from cancer. There were 56 deaths of Japanese with a rate of 5.8 per 1,000 population; among them 14 from cancer, 13 from heart disease, 8 from cerebral vascular lesions, 3 accidents and 2 each from certain diseases of early infancy, tuberculosis and suicides. In the other non-white group there were 29 deaths with a rate of 7.8 per 1,000 popueach from lation; among them, 6 from diseases of early infancy, 5 heart disease, 3 cancer and cerebral vascular lesions and 2 each from accidents, homicides and congenital malformations. -7-

TA3LE 6 DEATHS FRCH IMPORTANT CAUSES BY AGE GROUP WITH RATES PER 100,000 POPULATION San Francisco, 1 962

1 B 4 YEARS TOTAL NUMBER TOTAL M

AGES

AGES

CAUSE OF DEATH

ALL CAUSES

32

Accidents 9 Congenital Malformations 5 Malignant Neoplasms 5 Influenza 4 Pneumonia 3 Heart Diseases 2 All Others

CAUSE OF DEATH

8

RATE

100.0.

69„6

7

28.1

2

15.6 15.6

19.6 I0o9 10.9 6.5

19

13

.

2 1

!•*

1

6.3

6

AGES 15 _ 24 YEARS TOTAL" NUMBER TOTAL F M

ALL CAUSES

97

Accidents Suicides Malignant Neoplasms Heart Diseases Homicide

$

RATE

CAUSE OF DEATH

54.6 17.5 9,3

2 2

2.1 2.1

57.7 18.5 9.8 2.2 2.2

1M

14

4"; - 64 YEARS TOTAL NUMBER TOTAL H

Accidents 13 6 Malignant Neoplasms Congenital Malformations 3 2 Influenza & Pneumonia 2 Homicide All Others

7

10

15.3

n

ALL CAUSES

17. 4-

105„7

25

CAUSE OF DEATH

25.0

100.0

72 46

All Others

5-14 YEARS TOTAL NUMBER TOTAL M "

£

F

£

F

S

5

39.4

4

2

18.2

1

2

1

1

.

AGES 25 - 44 YEARS TOTAL NUMBER TOTAL M 346

Heart Diseases AcCIDfeNTS

Malignant Neoplasms Cirrhosis of Liver Suicides Homicides Vasc. Lesions, C.N.S. Influenza 4 Pneumonia Congenital Malformations Nephritis All Others

89 89 86 80 73 24 18 12

1.00..

6.1 2.,0

6.1

2„0

21.1

7,1

F

$

RATE

215

100.0

279,8

22 26

15.9 15.9

|

ftj

1

*S 3.2

44.4 44.4 42,9 39.9 36.4 12.0 9.0 6.0 4.5 *'5 35.8

10

2.1 1.6

2

9

2

9 72

3 37

13,2

3o0

2-

S61

33,4

1?

7

ALL CAUSES

RATE

20

35

1.6 12.8

AGES

CAUSE OF DEATH ALL CAUSES

Heart Diseases Malignant Neoplasms Cirrhosis of Liver Accidents Vasc. Lesions, C.N.S. Suicides Pneumonia & Influenza Aortic Aneurysm Diabetes Ulcers Stomach 4 Duodenum Emphysema Tuberculosis All Others

2776

1830

992 662 27J

383 173

146 128 85 66 33 32

741

103 61

48 51

23 17

.

£

F

946 251

8 37 15 10 15

mnji. _1385.g 35.7 23.8 9.9

495.0 330.3 137.2

11

63.9 42„4 32.9 16.5 16.0

7<-»8

3.1

2.4 1.2 1.2

3

23

25 25 18

5

1.2 1.0 o.g

274

162

112

9.9

32 28

7

RATE

16.0 14.0 11.5 136.7

WUSE

OF DEATH

ALL CAUSES Heart Diseases Malignant Neoplasms Vasc c Lesions, C.N.S. Influenza 4 Pneumonia Accidents Arteriosclerosis Cirrhosis of Liver Diabetes Emphysema Aortic Aneurysm Ulcers Stomach 4 duodenum All Others

TOTAL NUMBER TOTAL M

5926

2674

167

RATE

2J50 _JM.fi___?iL._

1411

1263 427 423

8 $ 200

£

F

3176.

107 93

160 97 93 89

1

ft 2 t.}

P 5

2.8

2837.4 1021.9 834.0 212.2 177.2 169.8 102.9 98.7 94.4 60.5

22

5:2 1.6 1.5 1.0 0.9

59.4

9.9

619.8

53 7

57

4

56

33

23

584

340

244

PERCENTAGE OF DEATHS FROM IMPORTANT CAUSES 3Y AGE GROUP SAN FRANCISCO RESIDENTS,

J-*

1962

f YEARS

J

ACCIDENTS

a 14 YEAfjg

ACCIDENTS

li$

CONGENITAL MALFORMATIONS

10

MALIGNANT NEOPLASMS

MALIGNANT NEOPLASMS

10

CONGENITAL MALFORMATIONS

IT

INFLUENZA & PNEUMONIA

3

INFLUENZA ft PNEUMONIA

tf

HEART DISEASES

HOMICtWS

1S - 34

V

EA as

2-i

~~j

Vf

ACCIDENTS

ACCIDENTS

MALIGNANT NEOPLASMS

MALIGNANT NEOPLASMS

2$

SUICIDES

45 - 64 YEARS

HEART DISEASES

VASCULAR C.N.S. LESIONS

SUTCWS

w

zvjt

1<$

u 3 3

~w 6S YEARS ANO OVER

%i

HALIGNANT NEOPLASMS

ACCfDENTS

YEARS

CIRRHOSIS OF LIVER

]

HOMICIDES

CIRRHOSIS OF LIVER

ftt

HEART DISEASES

SUICIDES

HEART DISEASES

-

HEART DISEASES

«J<

|

HALIGNANT NEOPLASMS

10

1

VASCULAR

3

t

C.N.S. LESIONS

3*

#

INFLUENZA 4 PNEUMONIA

9f

ACCIDENTS

1 %

ARTERIOSCLEROSIS

1 *

it

1

yp

1

TABLE 7

DEATHS FROM SELECTED CAUSES,

CITY 4 CCUNTY OF SAN FRANCISCO

BY PLACE OF RESIDENCE AND OCCURRENCE

1

SEVENTH REVISION INTERNATIONAL LISTS

CAUSE OF DEATH

TOTAL T

ALL PAIISFS

nm-Eqqg

196?

9 6 2

19

DEATHS OY RESIOENCE

NUMBER

-2112

RATE*

PERCENT**

DEATHS

BY

£

OCCURRENCE

6

1

RESIDENT NUMBER

RATE

ino.n

10,^00

9736

13Qg T 6

JUL

Jk6

41+

66

7.0 0.8

-1*2 8.7

0,1

M

0.1 0.1

14

IS 12

2.4

H12^

SELECTED COMMUNICABLE DISEASES TubercuiosIS, Respiratory Other Forms

Aii

Fns MS.

TnxAi

-QQ1-.Q19

001-008 010-019

Syphilis Septicemia and Pyemia Poliomyeli TIS Infectious Encephalitis Infectious Hepatitis

JL

020-029

0,8

080-081 082-083

0.1

0.1

INFIDFN7 A AND PNFIIwnNIA Tp T ftl Influenza pneumonia, except of Newborn

480-483 490-493

SELECTED DISEASES, USUALLY CHROMIC MALIGNANT NEOPLASMS, TOTAL Buccal Cavity and Pharynx

Stomach

IN

0.1

2 5

0.3 o.7

Bronchus and Lung

Other Respiratory System not specified as Secondary

12

1.6

Emphysema OF THE LIVER mthout mention of alcoholism Iith mention of Alcoholism

Ulcer of Stomach 4 Duodenum

Hernia 4 Intestinal Obstruction

0,1

2

7

0.9

3.2

230

274

36.8

1133

232.6 9-0

..1JM0.7

?178

1708 T8"

229.6

149

20.0

1.5

175

129

17.3

9.1

473

63=5

4.8

544

483

65.0

296

39.7

3.0

389

257

3*.5

30

160,161,164

177-179

CI RRH OSIS

-281

157-159

Male Genital Organs

Diabetes Hellitus

23Z.

162-163

172-174 175-176

Benign and Unspecified Neoplasms

0.1

150,1 52-1 56A

Breast Cervix Uteri Other Uterus Other Female Genital Organs

Urinary Organs Hodgkjn's Disease Leukemia and Aleukemia Other Lymphatic « Hematopoietic Tissues Other and Unspecified Sites

309

42 ,.3 0.8 41,5

NATURE

14o-?qc 140-148 151

Other Digestive Organs and Peritoneum not specified as Secondary

1.1

480-1193

,

1.6

1

092

Other Infective and Parasitic Diseases(Residual) 030-138

Trachea,

0.5

23

3.1

0.2 1.8

i

23.5 5.0 3.6 7.2

0.4 0.3 0.6

53

7.1

72

9.7

0.7

92

86

11.6

9.5

9.8 1.6

170 171

180-181

'1?

71

25

3.4

139 50

18,7 6.7 4.0

30

201

11

204 200,202, 203,205 1568,165, 190-199

1.5

0.7 0.1

9.9

0.8

93 23 123

73 12

74

53

7.1

63

8.5

0.6

96

63

8.5

141

18.9

1.4

201

187

25.1

23

3.1

0.2

zi

30

4.0

128

17.2

1.3

128

is

11. ,8

210-239 260

502.0,527.1

119

16.0

1.2

128

95

12.8

4.6

308 145

-6JLJ

3.1 1.5

48S 330

_489_

521.1

60.8 *t.3 19o5

540-541

90

12.1

560,561,570

60

8.0

5!L 581.0

155

367 122

1* 16.

0.9

101

108

H.5

0.6



51

6.9

9

1

Table 7,

Continued

DEATHS FROM SELECTED CAUSES

19 SEVENTH REVISION INTERNATIONAL LISTS

CAUSE OF DEATH

CARDIOVASCULAR DISEASES.

6 2

1

DEATHS BY RESIDENCE NUMBER

TOTAL

RATE*

5120

687.?

DEATHS

PERCENT

BY

OCCURRENCE

9 6

1

RESIDENT RATE

NUMBER

52jt

106 J5A1

5111

637.0

9.6

882

1002

13M

Vascular Lesions of C.N.S.

330-334

935

125.5

Rheumatic Fever

400-402

2

0.3

DISEASES OF THE HEART. SUBTOTAL Chronic Rheumatic Heart Disease Arteriosclerotic Heart Disease Heart Disease specified as involving Coronary Arteries Angina Pectoris without mention of Coronary Disease Chronic Endocarditis and Myocarditis Other Diseases of the Heart Hypertension with Heart Disease

In 0-443

375?

.5Q4.fi

410-411 420.0

11.3 140.4

0.9 10.7

137

106

104-6

932

4-20.

2030

272.5

20.8

2133

1

0.1

1

l&JL

3782

3

0.4

3683

965

495." 14.2 129.7

2026

272.3

420.2

421-422 430-434

19S

84 316

440-44-3

Hypertension without mention of Heart Diseases

1

26.6 11.3

2,0 0,9

42,,4

3.2

94 299

0.1

1

200 63 322

26.9 8.5 43.3

444-447

40

5.*

0.4

33

48

6.5

General Arteriosclerosis

4J0

170

22.8

1.7

144

165

22.2

Aortic Aneurysm, non-Syphilitic and Dissecting

90

451

93

12.5

0.9

Other Diseases of Circulatory. System

452-468

77

10,3

0.8

92

94

12.6

Nephritis, Chronic 4 Unspecified

592-594

44

5.9

0.5

60

26

3.5

ACCIDENTS, POISONINGS AND VIOLENCE tqt A L ACCIDENTS, Motor Vehicle Accidents Home Accidents Other Accidents

SUICIDES

810^35,960 871-

* WITH .0 Rccidual j

1

963,970-979

HOMICIDES

964.930-985

6?. 13.9

1-

20.;

189

25^

U9

161

468 103 175 190

213

28.6

2.2

220

214

28.8

47

6.3

o.5

49

47

6.3

4

0..5

-

.492

_fi6,Q

152

20.4

5.0 1.6

4?4 101

1o2

2

5

2>-5

ALL OTHER CAUSES

Complications of Pregnancy, Childbirth 640-689 and the Puerperium

5

8

1.1

206

27«7

107

14.4

Certain Diseases of Early Infancy

760..776

234

3L4

2o4

298

Congenital Malformations

750-759

74

9.9

0„8

172

Gastritic, Duodenitis Enteritis, Colitis

571-572

All Other Specified Causes

Residual

Symptoms, Slnility, Ill-Defined and Unknown Causes

780-795

*

**

543.

Rates per 100,000 population. Rates and Percents as calculated.

-11-

42

5.6

0,4

47

32

4.3

524

70.3

5.4

551

558

75.0

17

2.3

0.2

3

19



2„6



J-

UCO K

UI

UN

kn

CJ

d-


K> .=h no

cxi

UN UN

On KN

KN

DO

O

O UN NX>

NO On CJ

DO

KN NO

O

lr\

If

J-

r*N

NO

CJ jr

DO


jj UJ

Z

UJ =CO



o

^C

UJ CO

a

o 2:

.=»

On

UN

CJ

O

UN DO CJ

d-

,_

DO CJ

ij-

UN

t^,

DO

VO

iT

d-

NO

ON

«"

d-

a

*

UJ

Cj
^i-

NO

CO

<_>

-*


Z o r> -J

a:

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KN d-

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ON

* KN

d-

c—

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CJ

rc,

ea

UN

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CJ

CJ

NO

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t-

«

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ro <_> cc:

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o

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KN KN

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O

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NO

UN t—

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CC ta.

3,

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u 00

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Do


a-

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KN

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CJ

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d-~

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NO

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UJ cc Dn

CJ i=

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Wm CJ *"

t—

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UN

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a-

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<

uj

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rr

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Hcc

"" °i_i

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ON

<*

CJ

CJ

O CJ

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c— t—

ft _J

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c—

r—

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0N DO

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d-

to

UN

KN

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C—

ON

t

NO

t—

d-

ON NO

kn NO

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to

ON

UN UN

DO

c—

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ON

ON ON

.*

uj en

K* **

>-


-J «x

en

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no KN

NO UN

ch

ON

NO

NN

DO

DO

NO

DO

ON

r*N

-d-

UN

ON

p^

VO KN

HN

NO KN

cc:

KN

.=»•

ON

CN)

UJ

DO

^j.

.=*•

UN NO

CC

f\)

U_

kn

CJ

CJ


Z oru> >-



c

u tr

CO

s
:r

CM

kn DO

CJ

c~~

CJ

KN

KN

CJ

CJ

NO J*-

CJ J*

°> *

C—

UN

CJ

^

*

^r

O

ON KN

DO

*

KN

^

NO

UN

O

KN

O

r~

kn

KN

NN CJ

KN

C-N

J-

NO

CJ

NO

KN KN

KN

O

t— NO

O O

O O

KN

d-

C\j

CO DC <£

GC

UJ

O -j -X

UJ

.

c—

j

c

'*!

UN

NO

DO

J*

O O DO

O O

NO t—

DO

*

O

CJ

UN

NO KN

KN UN

DO

O O O

O

3

O O J±

O O

KN c—

*

On

KN UN

rc\

ON

—»—o2 •-X •

•-

"i

O O UN J>

1 UO O.

t—

c—

CJ CJ

On

KN

On

KN r-

ON

0:

<

X J o. o 5 ui o •- Q. > O. I- o — < a. o __i

_i

o

O CD O» COO 0000 « «o 13

O

,_

a z

ca.

O ui a cc a •tana.

— -12-

10

to

-

TABLE 9 RESIDENT LIVE BIRTHS AND BIRTH RATES BY RACE, 1961 and 196?

TOTAL

14,177

19.0

9836 2572 789

16.3 32.8 21.0

White Negro Chinese

Filipino Japanese Other

19

9 6 2 rati pnr EST. i T ono POP.

NUMBER BIRTHS

RACE

438 260 282

3

6

RATE

14,70T

19.8

32.5 22.2

1272 426

1300 363

10,469 2509 827

288

210 112 143

415 253 230

M

26.8 76.2

1

4-8

139

1

BIRTHS

17.3

32.4 26.1

63.9

TABLE 10 RECORDED, RESIDENT AND NON-RESIDENT BIRTHS

1?6g

& 1961

RECORDED PLACE OF BIRTH TOTAL

NON-RESIDENT

RESIDENT

1962

1961

1962

1961

1962

1961

20,112

20,801;

14,177

U-70*

6,190

6,^48

2956 2203 1897 1930 1688 1624

1702 1425 1299 1947 1116 1156

1763 1406 1267 1909 1104 1197

102S 856 701

1193 797 630

?5 563 389

584 427

966 803

1083 844 918 822 697 613

Kaiser Foundation Hospital

2727

U. C. Hospitals

2281

Children's Hospital San Francisco General Hospital St. Mary's Hospital Mary's Help Hospital

2000 1972 1679 1545

St. Luke's H spital

1410 1314 1097 1069 935 870

Letterman General Hospital Mt. Zion Hospital & Medical Ctr. St. Francis Memorial Hospital St. Joseph's Hospital

Presbyterian Medical Center French Hospital Chinese H spital St. Elizabeth Infant Hospital Home Emergency Hospital Elsewhere

1 ?55 1428 1243 1135 986

600

444

472 584 325

511

317

33* 335

313 289

277

332

945

593

452 397 27f

293

297

174

155

368 75

382 70

204

41

58

41

58

19 209 -

12

15 18

11

13 13

1

2

22

10

5

_

_

207

m

_

467

at

Other California Out of State

780

21

12



208 39

48

_

TABLE 11

SAN FRANCISCO

AND RACE.

F

WHITE

TOTAL

TOTAL

JJULZ1

San Francisco General Hospital Kaiser Foundation Hospital U. C. Hospitals Children's Hospital Mary's Help Hospital St, Mary's Hospital

1947 1702 1425 1299 115§ 1116

_

NEGRO

9,8^6

.

774 1109 1060 97? 976 1015

2^512 1055 376 227 123 27 52

CHINESE .

1962

FILIPINO

3

92 44

71

33

104 17 12

11

4J

88 25

6 7

5

19

%

12

21

52 3 10 9 10

41

861

63

803 780 735 600 593

538 514 559

142 220

I 18

23

99

17

11

8

364

120

32

7

Chinese Hospital French Hospital

368 293 75

19

,3

65

*?

12

220 66

7

2

14 t

5

12

18 6

_ _

11

3

7

207 48

174

22

37

5

Elsewhere Emergency Hospital Out or Town (Other California) Out of State

41

-13-

28?

32

7

966

St. Elizabeth's Infant Hospital Home

OTHER

?6o

St. Luke's Hospital Letterman General Hospital Mt. Zion Hospital 4 Medical Cent ER St. Francis Memorial Hospital St. Joseph's Hospital Presbyterian Medical Center

5W

JAPANESE

___Jflfl

789.

44 14

2

11

20 3

60 1 1

If 15 8

42

8 1

_ 1

1

1

3

2

3

1

1

1

3 -

1

7

RESIDENT BIRTHS

TOTAL

TABLE 12

W

HEALTH DISTRICT AND RACE.

TOTAL BIRTHS

BIRTH RATE

WHITE

NEGRO

CHINESE

19i2

JAPANESE

FILIPINO

OTHER NON-WHITE

14,177

19.0

9,8^6

?,S72

789

4}8

?6o

282

Alemany

IW

19.2

1117

252

27

47

13

18

Central

697

20.9

892

592

24

95

40

5*

EUREKA-NOE

1708

23.^

1567

3^

29

*3

8

27

Hunters Point

1408

29.7

560

714

13

39

8

74

Marina-Richmond

1809

14.8

1474

68

114

49

89

15

Mission

1898

26.4

1474

240

33

97

6

48

Northeast

1155

12.4

579

19

498

14

17

28

Sunset

1907

H.5

1793

25

32

20

32

5

990

21.0

269

616

16

3*

*3

12

111

12

3

Westside

District Not Reported

131

4

1

TABLE 13 LIVE BIRTHS BY TRIMESTER PRENATAL CARE BEGAN WITH PERCENT BY PLACE OF BIRTH - SAN FRANCISCO RESIDENTS. 1962

2ND TRIMESTER

1ST

TOTAL PLACE OF BIRTH

i

NO.

JOTAL

14,177

TRIMESTER

1

NO.

San Francisco General Hospital Kaiser Foundation Hospital U. C. Hospitals

1947 1702 1425

100.0 100.0 100.0

175 482 250

Children's Hospi tal Mary's Help Hospital St. Mary's Hospital

1299

100.0 100.0 100.0

982 670

100.0 100.0 100.0

621

in!

St. Luke's Hospital

966

Letterhan General Hospital

803 780

Mt. Zion Hospital 4 Medical Center

St„ Francis Memorial Hospital St. Joseph's Hospital Presbyterian Medical Center

735

Chinese Hospital French Hospital Other California

368

600 593

293 207

$

0CUL _£29.8__49^l

NO.

_

i

48.4X. .-14..2

44.7 5^.7 52.5

.

3RD TRIMESTER

NO CARE OR NOT REPORTED

NO.

NO.

697

4.9

560 218

28.8 12.8 24.9

341 71

17.5 4.2

355

72

5.1

55

4.2

79 32

11

2.6 4.0

2.8

9.0

871

PI 7<*8

75.6 58.0 78.7

229 361

205

17.6 31.2 18.4

428 528

64.3 53.3 67.7

282 325 194

29.2 40.5 24.9

100.0 100.0 100.0

590 473

80.3 78.8

12

49.1

109 112 195

18.

291

32.9

95

100.0 100.0 100.0

276 189

W

I5

56.5

60

20.4 30.4 29.4

117

89

14.8

i

...11.5

23.3 17.5

878

$

1.635.

1

0.1

1:1

10

0.8 0.6 1.3

2.3 2.0 16.0

19 3 12

1:1

11 21

3.7 10.2

4 9

8

11 48 17

5

16

2.6

1

!:? *.3

St. Elizabeth Infant Hospital Out of State Home

75 48

100.0 100.0 100.0

30

40.0

38

50.7

6

8.0

4 10

8.3

41

24.4

2 16

4.2 39.0

3

7I3

Elsewhere

12

100.0

3

25.0

3

25.0

3

25.0

3

25.0

Emergency

11

100.0

1

9.1

2

18.1

4

36.4

4

36.4

-Ik-

1

42 12

1.3

87.5 29.3

:

BIRTHS

During 1962, the total number of births occurring and recorded in San Francisco was 21,122, of which 6,190 or 29.3% were non-residents. There was a decrease of 158 births or 2.3% from the 1961 figure of 6,3^8, the highest ever recorded. The number of resident births was 1^,177 in 1962, a decrease of 526 or 3.6% from the 1961 figure of 1^,703; numbers and rates for each year since 1950 are included on Page 3» The crude birth rate in I962 was 19.0 per 1,000 estimated population compared to 19.8 in 1961, a decrease of k% Since 1950, the previous low was 19.6 in 1955 while the highest rate was 20.7 in 1957. A slightly higher proportion, 35.8% of 1962 mothers had first births in 1962, compared to 3^.9 in 1961 and also second births 25.8% for I962 compared to 2*u8% for I96I. The percents associated with additional birth orders decreased slightly for ell those except for the fifth and seventh which remained the same. There were 103 male births to every 100 female births in 1962, compared to nearly 105 in 1961, 102 in i960 and 105 in 1959. The birth rate for whites was 16.3 per estimated 1,000 population, lower than the rate of 17.3 for 196l. There was a decrease of 633 in the number of white live births or 6%. The Negro birth rate was 32.8; the number of births increased by 63, from 2,509 to 2,572 or2/$. Chinese births decreased from 827 to 789 or 4.6%; the rate in I962 was 21.0 per 1,000 estimated population compared to 22.2 in 196l. Other non-white groups increased; the Filipino from 32.4 to 33.4, the Japanese from 26.1 to 26.8 and the "other" group from 63.9 to 76.2 The distribution of births by ethnic groups in 1962 continued the pattern set during the years since 1950 but which had shifted slightly in 196l. The decline in white births as a percent of all births and the increase in total non-white births was again in evidence.

Resident Live Births by Ethnic Groups as a Percent of all Births,

YEAR

WHITE

TOTAL NON-WHITE

NEGRO

CHINESE

JAPANESE

81.2 80.3 80.2 78.6 77.3

18.8 19.7 19.8 21.4 22.7

9.5 11.1 11.0 12.4 13.1

7.0 6.4 6.1 5.9 6.0

0.8 0.9 1.0 1.3

76.1 74.5 73.6 72.9 71.4 71.0 71.2 69-4

23.9 25.5 26.3 27.1 28.6 29.0 28.8 30.6

14.0 14.9 15.3 16.3 16.8 16.8 17.1 18.1

6.0 6.2 5.9 5.7 6.1 5.9 5.6 5.6

1.4 1.6 1.6 1.5 1.6 1.8 1.7 1.8

1950-62

OTHER NON- WHITE OTHER FILIPINO 1.5 1.3 1.7 1.8 2.2

1.4

2.5 2.8 1, ,8

2.

3

2, .7

3. .0 2, ,8 5. .1

1.7 1.3 1.4 1.5 1.6 2.0

During 1962, 1,235 or 8.7% of the resident live births were to unmarried mothers, a decrease in number of 16 but an increase over the percent of 8.5 for 196l. There is no statement on the birth certificate as to "legitimacy" and the decision whether to call a birth "illegitimate" is based on the way other items are or are not completed. The percent of out-of-wedlock white births of the total number of white births increased to 6.4% in 1962 compared to 5.5 in 1961; the Negro percent was a -15-

sizeable decrease from 25*2% in 1961 to 21.9% of all Negro births, the lowest yet recorded; the other non-white groups were 2.k%. Of the unmarried mothers, 50.8% were white, compared to kS.k% in 1961, ^5»7% were Negro and 3«5%» other races. Half the deliveries took piece at San Francisco General Hospital and of these 30% were white and 67% were Negro. Thirty percent of the mothers were 19 years of age or younger and 37% were between 20 to 2k years old. Of the total live births, 1,202 or 8.5% were premature by weight (2500 grams or under), as expected there was considerable variation by race, ranging from 13«8% of the Negro babies, to 5*3% of the other non-white group. Although Hunters Point Health District had the highest birth rate, 29«7 per 1,000 estimated population compared to the city-wide rate of 19; its rate of prematurity was lower than Westside and Central. Mission District, as usual, had the second highest birth rate and the rate of prematurity was only slightly higher than the city-wide rate. The birth rate in North East Health District continued to decline as did the proportion of Chinese births born to residents of the area. In 1953? 8l% of all Chinese births were to residents of North East Health District and by 1962, only 63% of the Chinese babies had parents living in North East; the proportion of white births increased in 1962 to just over 50%.

Additional information from the medical items on the birth certificates is available from the Bureau of Records and Statistics.

INFANT DEATHS: There were 9 fewer resident infant deaths in 1962 than in 1961 but the rate increased to 2^.8 per 1,000 live births compared to 2^.5 in 196l because of the decrease in the number of births. The rate for white remained the same, 23 per 1,000 live births; rates for the other races except Japanese and Chinese showed increases over the previous year. Three-quarters of the infant deaths occurred in the first month and ^5% of the total died before they had lived 2k hours. Prematurity was mentioned as a causal factor in one-half the infant deaths and in 67% of those who died within 28 days of birth. Both infections and accidents decreased in number as a cause of infant deaths. Table Ik PLACE OF BIRTH OF PREMATURE INFANTS BY RACE,

PLACE OF BIRTH

1962

JAPANESE

OTHER NON-WHITE

TOTAL

WHITE

NEGRO

1202

70 **

355

57

kj>

28

15

San Francisco General 2^7 Kaiser Hospital 129 U. C. Hospitals 106 Mary's Help Hospital 101 Children's Hospital 92 St. Mary's Hospital 92 St. Luke's Hospital 77 Mt. Zion Hosp. & Med. Ctr. 73 Letterman General Hosp. 69 Presbyterian Medical Ctr. 50 St. Francis Hospital 50 St. Joseph's Hospital 35 French Hospital 2k Chinese Hospital 22 Other California 16 Home 8 Out of State 5 St. Elizabeth Infant Hosp. 3 Elsewhere 2 Emergency Hospital 1

71 73 65 87 66 76 66 39

16*+

k k 1

1 3 2 1 2 2

6

k5

5 k 3 6 5

TOTAL

.

39 22 3k 29 16 1

13 2

30 3 9 8 9

CHINEbE

10 2 -

1 -

*f

2 3 5 1 -

27 21 15

2 -

3 2 8 -

10

18

3

2 5 3

-

-

1 -

-

-

1

1

-

3 3

3-1

FILIPINO

1 2

2 3

1

2

10 2 1

-

1

1

TABLE 15 INFANT DEATHS BY RACE AND SEX San FRftNcisco Residents, 1962

ALL RACES

White Negro Chinese Filipino

3S1

201

ISO

24.8

24.5

226

8

90

23.0

41

}K6

5

3

17.7 20.5

3 8

11*5 35.5

23.0 32.7 20.6 14.5 35.? 21.7

So

JfcPANESC

9 6

m

3

Other Non-"hite

10

tarPe 16 INFANT DEATHS BY RACE AMD AGE San Francisco Residents, 1962

ALL RACES

RATE PER 1.000 LIVE BIRTHS 1962 1961

FEMALE

HALE

TOTAL

1-6

TOTAL

UNDER 24 HR<

DAYS

7-27 DAYS



160

79

24

88

107 40 4

54

13

19 3

52 25

2

4

2

1

2

_

1

2

_

-

1

4

White 226 Negro a? Chinese 11 Filipino 9 Japanese 3 Other Non-White lb

5

28 DAYS -

11

5

MONTHS

5

TABLE 17 INFANT DEATHS FROM SELECTED CAUSES BY AGE San Francisco Residents, 1962

INTERNATIONAL

NEO-NATAL SUB-TOTAL

CODE

CAUSES OF DEATH

NUMBER

ALL CAUSES

-15L

26^

TOTAL aiTH MENTION OF PREMATURITY

178

JJl

CONGENITAL MALFORMATIONS g CERTAIN DISEASES OF EARLY INFANCY EXCEPT INFECTIONS

275

246

50

25

Congenital Malformations 75,0-759 Injury at Birth 760-761 Asphyxia & Atelectasis 762 Disorders attributed to disease of Mother during pregnancy 769 Erythroblastosis 770 Hemorrhagic Disease 771 Ill-Defined Diseases 773 Immaturity with Subsidiary condition774 Immaturity, Unqualified 776 INFECTIONS Pneumonia of Newborn Other Pneumonia Other Respiratory Gastro-Enteritis 4 Colitis Sepsis of Newborn Non-Meningococcal Meningitis

ACCIDENTS Motor Vehicle Food causing Obstruction Other Obstruction Extreme Heat & Insulation Complications of Anesthesia Mechanical Suffocation niHFR Assault Mongol sm Cerebral Infantile Paralysis Hernia and Obstruction Cholecystitis Inborn Defect Muscle Other Lymphoma Other Leukemia Cerebral Hemorrhage i

763

l6o

1 ,

-6

_LQ_

157

74

15

11

8

41

31

9

39

23

13

2

2

2

6

6

5

4 43

4

22

2

41 2

62

61

45

_y

12

I

3

571

1

767-768 340

4

1

1

16 14 3_

2

l«L

921

923 931

,

945-946 924-925 v

"983 325.4

J5i 560-570 585 744.1 202.1

204.4 331

-17-

MONTHS

79

64

500-527

11

Ji^

65

7 31

28 DAYS -

DAYS

41

490..493

800-96S 822.4-823.0

UNDER HRS

24

—2...

1

2?

Table 18 RESIDENT FETAL DEATHS BY RACE aND PLaCE OF DELIVERY, San Francisco Residents, 1962

R A C E

PLACE OF DELIVERY

ALL RACES

WHITE

193

126

TOTAL

NEGRO .

FILIPINO

CHINESE

JAPANESE

OTHER

51

3

7

1

5

*t0

16

22

-

-

-

2

Kaiser Foundation Hospital 21

12

8

1

-

-

-

16

11

4

-

1

-

-

16

Ik

l

-

1

-

-

St. Francis Memorial Hosp. 15

15

-

-

-

-

-

St. Luke's Hospital

15

12

3

-

-

-

-

Children's Hospital

12

8

5

-

1

-

-

9

3

k

-

1

-

1

8

1

k

_

1

1

1

St. Mary's Hospital

8

8

St. Joseph's Hospital

7

7

-

-

San Francisco General Hosp.

U. C.

Hospitals

Mary's Help Hospital

Home Mt.

Zion Hosp. & Med. Ctr.

Letterman General Hosp. Presbyterian Medical Ctr.

6^17

6

Chinese Hospital

3

Other California

3

Enroute Emergency

3

French Hospital

2

Out of State

1

1

Elsewhere

1

1

-

-

3311 -18-

2

1 1

COMMUNICABLE DISEASES: In 1962 reported cases of communicable diseases remained almost at the level of 1961 reporting, though some diseases shifted considerably. The increase in the venereal diseases will be discussed in succeeding pages. Measles receded from the 2,551 cases reported in 196l to 1,M*9 cases in 1962 while chickenpox and mumps showed increases. For the fourth time in San Francisco history there were no reported cases of diphtheria. After two successive years with only one case of typhoid, there were three cases in 1962. For the first time since 1957 the number of cases of infectious hepatitis was lower than the preceding year; the number of deaths also declined. Three cases of poliomyelitis, all paralytic, and one death were reported. j

VEN EREAL DISEASES;

_

.

, The increasing spiral of important venereal diseases, syphilis and gonorrhea together, continued during 1962, as it has each yetr since low point of 195^. For the second time in the past three years, these illnesses in numbers of cases reported exceeded all other infectious diseases combined. In 196l, venereal diseases ranked second. .

.

Closer scrutiny of the data developed so far, however, must lead one, hopefully, to a conclusion that the picture is not entirely black. It appears that some progress is being made in the case of syphilis, even if not yet substantial enough to be too exciting. While, aside from those epidemiological^ treated, the total of diagnosed cases in all categories continued to rise after a pause in 196l, there was a further slight decline in the curve of early infectious syphilis. During 1962, for the second successive year since the high point in i960, there was an improvement in this category (primary, secondary, and early latent combined). 607 cases were reported in I960; 5^8 cases were reported in 1961; and, 5^0 cases were reported in 1962. During this same period all other stages of syphilis (late latent, central nervous system, etc., combined) rose from **03 cases in i960 to ^65 cases in 196l to 5?8 cases in 1962, The regulation requiring compulsory reporting of reactive serologies, which became effective in San Francisco July 1, 1962, has undoubtedly been a contributing factor in this increase in the reporting of later stages. By the same token, though, it would seem that this same regulation, along with more intensive efforts by an augmented field staff, should have been just as productive of early infectious syphilis. Since this hasn't been the case, it may perhaps not be illogical to assume that the reservoir of early syphilis, the index of what is occurring in the City, is simply becoming smaller. The situation in gonorrhea is, if anything, more discouraging than that of 1961. Reported cases have more than doubled in the past five years and almost a half of this increase has occurred in the past two years. While it is acknowledged that reporting of gonococcal infections is exceedingly poor, it is still felt that data presented in this report do serve as a sufficiently reliable indication of trends. The combination of short incubation periods, high degree of infectiousness, poor contact tracing (virtually non ex-istent except in City Clinic patients), increasing resistance to therapy, difficulty of diagnosis in women, etc., seems to be just too overwhelming. It is difficult to imagine how there can be any improvement without some dramatic new break-through in knowledge or technique.

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>-

TABLE 21

VENEREAL DISEASE * REPORTED TO THE HEALTH DEPARTMENT WITH PERCENTAGES REPORTED BY PRIVATE PHYSICIANS

1956

1258

1959

I960

221

357

528

616

553

87

171

22.6

24.4

32.4

152 24.7

28.4

27.6

571

687 204 29.7

31.6

1023 295 28.8

1356 396 29.2

1543 432 28.0

3078

3316

3905

4473

169 5.5

172 5.2

6.1

1957

1962

1961

SYPHILIS (Primary, Secondary, Early Latent) Reported from all Sources Reported by Private Physicians Percentage

267 48 18.0

55*

5

J 7

SYPHILIS (All Stages) Reported from all Sources Reported by Private Physicians Percentage

GONORRHEA (All

Ci

1-95

72

143

H.5

25.0

892 282

assifi cations)

Reported from all Sources 2074 2520 2353 Reported by Pricate Physicians 51 1*5 J Percentage 6.1 6.0 7.0 Includes a small number reported by Military Facilities.

m

240

0.0

TA8LE 22

REPORTED CIVILIAN CASES OF VENEREAL DISEASE 5-YEAR MEDIAN BY STAGE AND SEX San Francisco, 1962

TOTAL

SYPHILIS TOTAL Primary Secondary Early Latent Late Latent Late Congenital All Stages, Report Only Epidemiologically Treateo

GONORRHEA TOTAL

Diagnosed cases Epidemiologically

T SEATED

OTHER TYPES TOTAL

1957-1961 5-YEAR MEDIAN

TOTAL

MALE

FEMALE

5951

4^88

156^

^827

1526

1189

337

885

164 97 279 465

166 113 190

1

11

11

23?

40

8

26

2

191

l! 12

9

11

15

358

20 50

30

408



4419

^194

1225

29^5

'gi

2872 322

855 370

2399 536

6

5

1

8

TABLE 23 REPORTED CIVILIAN CASES OF VENEREAL DISEASE San Francisco, 1956-1962 1956

GONORRHEA TOTAL

Diagnosed cases Epidemiologically Treated SYPHILIS TOTAL

Primary Secondary Early Latent Other Epidemiologically Treated

1957

1958

1959

1961

H19 3727

1889

??55

?4?*

? 935

3157

S845

1498 391

1771

2036 392

2399 536

2569 588

3132

122

484

^510_. _68l__ 58

20

713

W

885__1010__1.2J6

I52i

166 105 277

164 97 279 578 408

64

52

113

130 227

111

121

175 156 190

349

329

364

-

-

-

-

51

-21-

1962

196o

211

241 241 403

165 203

TABLE 24

REPORTED CIVILIAN CASES OF VENEREAL DISEASE 3Y HEALTH DISTRICT San Francisco, 1962 (Excluded are 110(1 Epi. Treated and 57 Non-Res dents) 1

ESTIMATED POPULATION

HEALTH DISTRICT SAN FRANCISCO TOTAL

RATE PER 100,000 POP.

NO. OF CASES

PERCENT OF CASES

100.0

745, QOA

Alemany Central eureka-noe

76,800 81,100 75,000

2 1,258 285

Hunters Point Marina-Richmond Mission

122,1-00

281

71,900

364

Northeast Sunset Westside

93,300 131,900 Vf, 200

114 964

4.4 26.2 5.9

865.0 229.6 506.3

?:!

%:l

17.0 2.4

2042.4

20.1

155U2

410

815

San Francisco District Not Reported

390.4

277.3

21

8.6

90

1.9

TABLE 25 REPORTED CIVILIAN CASES OF VENEREAL DISEASE IN 1962 - SAN FRANCISCO BY AGE GROUP AND STAGE OF DISEASE

YEARS OF AGE 45 &

TOTAL

0-1H.

15-19

20-24

25-34

35-44

OVER

5951

29

590

l635

2243

928

_S26

^L

J21

ALL AGES SYPHILIS TOTAL

1526

Primary Secondary Early Latent Late Latent Late Congenital All Stages, Report Only epioemiologically treated

164 97 279

465 3?

36o

_ -

75 52 134

8

-

-

10

'Z

48

1

2

2

6

14 8

32

,3

57 2

254 22

1

17

il

10 10 201

4419

28

551

1437

1700

_5i8_

3727 692

27

450

1

101

1232 205

1444 256

466 102

A

Diagnosed Cases epidemiologically treated

541

35

_ _

26

GONORRHEA TOTAL

-125_

4 4 10

1

2

8

29

30 JL35.

108 27

CHANCROID TABLE 26

REPORTED VENEREAL DISEASE

IN

1^53

CIVILIAN MINORS 1962 1959

1960

1961

1962

354

3?1

607

548

540

m

1?

zi

27

18

5.1

2.3

4.6

4.9

3.3

1773

2050

2142

2672

3312

220

274

316

374

45°

12,4

13.4

14.8

14.0

13,8

1958

SYPHILIS

(

Primary, Secondary

,

TOTAL REPORTED

_

ALL AGES

TOTAL REPORTED

_

0-19

PERCENTAGE GONORRHEA

(

UNDER AGE 20

Early Latent )

Geni to-Urinary )

TOTAL REPORTED TOTAL REPORTED

PERCENTAGE

-

ALL AGES

0-19

REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY HEALTH DISTRICTS

EXCLUDING EPIDEMIOLOGICALLY TREATED RATES PER 100,000 POPULATION

SAN FRANCISCO,

1962

Golden Gate

600 - 899

Under JOO

'

500 - 599

I

~ 900 4 Over

Table 27 REPORTED CASES OF VENEREAL DISEASE BY SOURCE OF REPORT AND TYPE OR STAGE OF DISEASE San Francisco 1962 }

Other

Mili-

Juris,

tary

TOTAL

33 Hunt

Other City

6023

^708

196

226

727

56

38

72

PERCENT OF TOTAL

100.0 78.2

3.3

3.7

12.1

0.9

0.6

1.2

SYPHILIS

15^3

86**

51

129

^32

30

20

17

Primary

172

102

3

51

8

-

8

Secondary

101

55

7

3k

1

-

k

Early Latent

281

188

if

10

68

3

6

2

Late

^66

112

ko

81

208

12

12

1

Late

33

8

5

9

8

-

2

1

Congenital

27

9

-

5

11

1

-

1

Report Only All Stages

55

1

1

11

37

5

-

-

Epidemiologically Treated ^08

389

1

3

15

.



^73

384l

ljjg

96

295

Zk

18

2l

Diagnosed Cases 3781

3216

11*+

9*+

26*+

2k

15

5^

Epidemiologically Treated 692

625

31

2

31

TOTAL

TOTAL

Latent

GONORRHEA

TOTAL

Local Hosp.

-

-2k-

Priv. M. D.

Fed. Civil.

3

REPORTED CIVILIAN CASES OF GONORRHEA SAN FRANCISCO,

1958 - 1962

1000

1958

1959

Diagnosed Cases

I960

1961

epidemiologic ally Treated

1962

REPORTED CIVILIAN CASES OF SYPHILIS

SAN FRANCISCO,

1958 - 1962

Number 1600

l^OO



1200

-

1000

-

800

-

600 -

*+00

-

200 -

1959 Primary

Secondary

I960 I

\

1962

1961 Early Latent

Other

I

1-4

11

Epi Rx 1961)

from +FH (fro

:

TUBERCULOSIS San Francisco experienced an upsurge in new tuberculosis during 1962. There were 48l newly di gnosed cases as compared to kkj> during 196l. This represents an increase of 8.6%, and a rise in the case rate from 59.5 to 6^.6 per 100,000. Conversely, the death rate continued to decline from a rtte of 8.9 in 196l to 7.8 in 1962.

INCIDENCE BY RESIDENCE: The Eastern half of the city continued to contribute most of the newly reported cases representing Sk% of the total; hZ.2% came from the Northeastern section of the city, and if the adjacent Skid Row area were included this would increase to 50.8%. As in the previous ye?r, four health districts predominated:

Central Health District - which includes the Tenderloin and Skid Row, contribubuted 109 cases, raising its case rate from 117.1 in 1961 to 13^.^ in 1962. 1.

2. North East Health District - comprising the Chinatown and North Beach areas, had 75 cases, raising its rate from 76 in the previous year to 80.^ in 1962.

Mission Health District - which is highly populated by Latin Americans, Puerto Ricans and non-whites, had 67 cases, increasing its rate from 69-7 to 93.2.

3.

Westside Health District - with its high distribution of the lower economic ^. Negro population, contributed 52 cases, raising its case rate from 52.2 to 110.2. It is to be noted that the incidence of tuberculosis in 1962 over that of I96I increased in the Central, Mission, Westside, Hunters Point and North East Health Districts. A decrease in the order of greatest extent was seen in the Eureka Noe, Marina, Richmond, Sunset and /.lemany Health Districts.

INCIDENCE BY AGE: 50.5% or 2*f3 of the 48l newly diagnosed cases were ^5 years older. 17.5% or 8^ were older than 65. 17% or 82 were under 20. 32.5% or 156 between the ages of 20 to kk. By comparison with the previous year the *+5 and er group dropped k.5 percent; the under 20 group increased by 2.3%; and the 20 kk group increased by 3.2%.

or were oldto

INCIDENCE BY RACE: White: Represents 80.1% of population and accounts for 299 cases, or 62.1% of new cases for a case rate of ^9.6/100,000.

Negro Represents 10.5% of population and accounts for 96 cases, or 20% of new cases for a case rate of 122.6. :

Represents 5% of population and accounts for 39 cases, or 8% of new cases for a case rate of 10^f. 0/100,000.

C hinese:

Filipino; Represents 1.7% of population and accounts for 19 cases and k% new cases for a case rate of 1^5.0/100,000.

Japanese: Represents 1.3% of population and accounts for 15 cases or 3.1% of new cases for a case rate of 175.3/100,000.

Other Non- White: Represents 0.5% of population and accounts for 13 cases or 2.7% of new cases for a case rate of 351. Vl00,000. Racial Case Rates: Thus during 1962 the case rate for whites continued to decline from 50.7 to *+9.6» The negro rate rose from 71.3 to 122.6. The Chinese dropped from 126.3 to 10U. The Fil-ipi" dropped from 171.9 to 1^+5. The Japanese increased significantly from 7?. 2 to 175-3* OthT non- whi to.- tore sharply from a case rate of 166.7 to 351. ^. -?7-

.

STAGE OF DISEASE; Of the newly diagnosed cases of tuberculosis in 1962, 31% were minimal hk% wore moderately advanced and 25% were far advancedo This distribution of stage of disease has not changed significantly since 1958. s

DEATHS; While 232 persons died with clinically active tuberculosis in 1962, in only 58 of this number was the cause of death directly attributed to tuberculosis. By comparison, in 196l, 237 persons died with active tuberculosis and in 66 was tuberculosis the cause of death. Tuberculosis as a cause of death was reduced by 12% during 1962. It is significant that 45 persons were reported to have tuberculosis only after death. While this number is only slightly reduced from 48 the year before, it again is illustrative of a large group of people who apparently had asymptomatic, but infectious tuberculosis until death without benefit of diagnosis or chemotherapy and to whom must be accredited an indefinite number of cases.

SCHOOL TUBERCULIN TESTING PROGRAM; In this sixth year of tuberculin testing in the schools there was a drop in positive reactors from 5.7% to 2.3% in spite of 3,306 more children tested than in the previous year. This significant drop in positive reactors has been predicted and is indicative of a tightening in the tuberculosis control program through which there is less chance for the active case to be at large in the community and hence less opportunity for children to be in contact with the open active case. while there was a reduction in positive reactors, the school tuberculin testing program continued to be an excellent case finding tool since it led to the detection of 10 active cases in the schools and an additional 11 cases in the family follow-up.

CASE FINDING BY X-RAY; With the cooperation of the San Francisco Tuberculosis Association, the San Francisco Medical Society and the San Francisco Health Department, a total of 142,805 X-rays were taken to detect 186 cases of active tuberculosis of which 160 were previously unknown, the U.S. Public Health Service considers a detection rate of one case per thousand films to be a good case finding program. Our rate for 1962 is slightly above 1 3 cases per 1,000 films, of coincidental interest, 51 cases of lung cancer were also detected. TUBERCULOSIS CASE FINDING BY X-RAY ACTIVE TEC FOUND NO. FILMS

UNIT LOCATION 101 Grove Total *

70 mm 14 x 17

San Francisco Hospital Program S.F. Jail

1

PREVIOUSLY UNKNOWN

CANCER OF LUNG 15

24,175

81

63

23,007 1,168

29 52

28 35

11,517

45

42

3,742

10

8

dmission

/rl

8

S.F. Medical Society

19,927

12

12

15

S.F. Tuberculosis association

57,093

32

30

10

2,176

6

5

3

142 805

186

160

51

North East Health Center TOTALS

,

SAN FRANCISCO SCHOOL TUBERCULIN SKIN TESTING FROGRAM GRADES TEST ED; 1 7, 10 and 12; entire grade level once per year; and all students new to ^an Francisco schools. All previously known Positive Reactors who had 10mm or more of induration were excluded from testing, but those who had 6 - 9 mm. of induration were retestedo -28-

Students Tested Positive Reactors Found Fercent Positive Reactors

TOTAL 1956-57 166,463 25,286 9,049

1957-58 16,904

1,492

4.2%

SCHOOL YEAR 1958-59 1959-60 29,54l 34,028

1960-61 28,699

1961^62 32,005

2,267

1,651

749

1,125

6.7%

5.9%

1,765

6.0%

6.7%

5-7%

CASEFINDING RATE PER 1,000 TESTS GIVEN 1956-1962 C ases (Per 1,000) Family Contact Cases In School Case Rate Plus School Cases 44 1, .8 62 1, .8 42 32 44 1, -5 62 1, ,6 54 93 38 1, .3 58 10 21 0.3

1956-1957 1957-1958 1958-1959 1959-1960 1960-1961 1961-1962

2.3% Case Rate per 1,000 2.4 2.4 2.1 2.74 2.0 0.7

SUMMARY OF TYPi^ OF TUBERCULOSIS FOUND AND SCHOOL LEVEI 1956-1962 ,

TYPE OF TUBERCULOSIS

III.

JR. HIGH

222

60

37

118

222

PRIMARY 122 PULMONARY 77 Minimal 62 Moderately dvanced 12 Far Advanced 3 EXTRA PULMONARY 23 Meningitis 2 Miliary 2 Lymphadenitis 11 Pleural E f fusion 7 Genito-Urinary 1

2

20 14 10

100 12 12

122 77 62 12 3 23

TABLE 28 YEAR

51 40

1951 1952 1953 1954 1955 1956 1957 1958 1959 I960 1961 1962

4

8 3 7 1

3

13

1 2

1 2 6 4

4 1 1

2 2

11 7 1

CHEST CLINIC SAN FRANCISCO HOSPITAL Pt. Visits for Follow-up Pt. Visi ts for Treatment Without Tre; itment Pneuraoperit oneum Observation and and Cont ;acts Ch emotherapy 1

TOTAL PT . VISITS

%

NO,

1950

TOTAL

SR . HIGH.

GRAND TOTAL I. II.

ELEMENTARY

TOTAL

26,139 23,^01 24,577 27,598 31,409 33,262 36,742 32,374 31,685 33,786 29,039 28,499 31,337

14.7 71.6 23.5 29.8 43.7 60.1

3,833 *+,122

5,771 8,234 13,731 19,975 24,492 25,518 26,441 28,579 25,966 25,049 28,645

66.7 78.8 83.4 84.6 89-5 89.4 91.4

-29-

NO.

22,306 19,279 18,806 19,364 17,678 13,287 12,250 6,856 5,244 5,207 3,343 3,450 2,692

% 85.3 82.4 76.5 70.2 56.3 39.9 33.3 21.2 16.6 15.4 11.5 10.6 8.6

TABLE 29 NEW CASES OF TUBERCULOSIS REPORTED BY RACE TYPE OF DISEASE AND SEX San Francisco, 1962

ALL TYPES

PULMONARY

PRIMARY

OTHER

RACIAL GROUP

TOTAL

HALE

FEMALE

TOTAL

ALL RACES

ML

-128

LS3_

3&L

m

299

214

253 62

192 38

29 15 13 9

21

S

13

2

2

1

1

5

1

1

-

1

White* Negro Chinese

96 39

no Japanese Other * White includes Mexican. f l i

p

i

3

28 15 9

19 15 13

i

5

MALE

FEMALE

T

M

F

™fc

58

^0

28

4?

?1

61

24

11

13

22

11

2^

25 3

14

11

3

-

?

5

2

1

-

3

?1

3

TABLE 30 NEW CASES OF TUBERCULOSIS REPORTED BY RACE, AGE AND SEX San Francisco, 196?

AGE GROUP (YEARS)

TOTAL TOTAL 481

Under _ 1 5

10 15

20 25

19



24 29

26

34 39

33 39

50

ib

~

40 45

m

m -

44 49 54

1

FILIPINO M

H4__£ _51_J2_?1

JAPANESE

OTHER

F

JL

Ji_ _2_

._!! _LS

_5_

14

4

16 27

_

46

30

JL

1

12 14 O 7

P

59

White

I2i_LSI

CHINESE

F

6

6

8

6

4

10

7

4

4

i

9

3

4

1

11

16

7

8

17 15

9 18 16

6 9 16

10

23

2 1

5

5

3 3

3

6

1

1

1 1

2

1

1

1

2

2

1

22

64 69 Over

_

M

4

1

30

~

fin

65 70

4 9

14

m -

JO bb

2

1

26 22 16

-

WHITE*

TOTAL

1

1

33

33 28

27

23

57

43

14

35

12

includes Mexican.

TABLE 31

PERCENT OF CASES BY STAGE OF DISEASE FOR NEW CASES OF PULMONARY TUBERCULOSIS FOR WHOM STAGE OF DISEASE WAS REPORTED San Francisco, 1958 - 1962 STAGE OF DISEASE

I2£?

1961

A2£o

100

100

100

25

* 20

44 24

ALL STAGES

Minimal Moderate Far Advanced

1253.

1958

9 27

TABLE 32 REPORTED TUBERCULOSIS CASES AND DEATHS, CASE RATES AMD DEATH RATES* BY TYPE OF DISEASE AND RACE 1962

ALL RACES CASES

_

TOTAL

Pulmonary Primary Other

4!*1

?8

62 25

1

g

DEATHS TOTAL Pulmonary Other

ESTIMATED POPULATION CASE RAfE* DEATH RATE*

NEGRO 96

WHITE 299

CHINESE

29 3

22

9

7

42

11

2

FILIPINO

JAPANESE 15

n

15 2 2

13

9

602,700 49.6 7.0

78.300 122.6 14.0

Rates per 100,000 Estimated Population. -30-

37,500 1&4.0

1

2

5.3

13,100

H5.

3

1

2

745 000 64.6 7.8

OTHER

19

9.700 175.5 20.6

1

..

* 1

3,700 351.4 27.0

REPORTED CASES OF TUBERCULOSIS BY HEALTH DISTRICTS RATES PER 100,000 ESTIMATED POPULATION

SAN FRANCISCO,

1962

Golden Gate

Under 50

50 - 99

TOO i Over

Table 33 NEW CASES OF TUBERCULOSIS REPORTED BY HEALTH DISTRICT OF RESIDENCE San Francisco, 1962

HEALTH DISTRICT TOTAL

CASES

POPULATION

CASE RATE FOR 100,000 POPULATION

PERCENT OF ALL CASES

481

745,000

64.6

100.0

33 109 35

76,800 81,100 73,000

43.0 134.4 47.9

6.9 22.7 7.3

Hunters Point Marina-Richmond Mission

29 40 67

47,400 122,400 71,900

61.2 32.7 93.2

6.0 8.3 13.9

North East Sunset Westside

75

33 52

93,300 131,900 47,200

80.4 25.0 110.2

15.6 6.9 10.8

Alemany Central Eureka-Noe

District Not Reported

1.6

8

Table 34. NEW CASES OF TUBERCULOSIS REFORTED BY AGE AND RACE. AGE GROUP (YEARS)

TOTAL

WHITE

NEGRO

CHINESE

FILIPINO

JAPANESE

ALL AGES

481

299

96

39

19

15

10 10

12 11

8 7

3 3 4 8

Und er

1

_ -

4

14 19

26 22 16 16

_ -

24 29 34 39

27 26 33 39

15 11 19 21

_ -

44 49 54 59

31 38 45 46

23 20 33 36

_ -

64 69

30 27

20

5

65

19

5

70

& Over

57

47

1

5

10 15 20 25

30 35 4o 45

50 55

60

9

3 9 6 15 4

5

-32-

OTHER 13

— TABLE 55

NEWLY REPORTED CASES & TUBERCULOSIS DEATHS OCCURRING IN SAN FRANCISCO 19?0-19fc

YEAR

POPULATION

NEWLY REPORTED CASES

NUMBER

RATE

,

1920 1921

1922 1923 192^

1925 1926 1927 1922 1929 1930 1931

1932 1933 193*

1935 1936 1937 1938 1939

506 b76* 52 § 777 538 512 2*7 563 982 576"

666 661

120,8 117.2

20*.*

NEWLY REPORTED CASES

PER DEATH

63* 39*'

0* 0*

*11 *26 63* **1 63* *55

63* *6"9 63* *8* 0* *98 63* 512 63* 525 536* 109 6*82

IV

19*5 19*6 19*7 19*8 19*9

827 *00* 817 *00 806 600 796" 200 785 800

1955 1956 1957 1958 1959

223.1

175.1 182.8 185.9 232.0

19*2 1943 19**

1952 1953 195*

132.2 121.2

717

19*1

1951

RATE

670 638

602 187 61* 911 627 657

19*0

1950

NUMBER

273,5 256.2 261.6 216.9

589

DEATHS

750 828

357* 300 200 '6* 700 757 100

IP "72

*o 100 800

600

in 300 900

1960

7*0

1961

7**: 000

1962

7*5 000

U.S. Census Rates per 100,000 Population.

Population estimates as of July Department of Finance.

1,

-33-

1951-1959, and 1961-1962 by California State

Table 36 INTERVAL BETWEEN REPORTING OF DISEASE AND DEATH,

1962

DYING FROM TUBERCULOSIS

OTHERS

TOTAL

58

l?k

232

Less than 6 months

3

9

12

6 - 11 Months

2

7

•9

17 months

1

10

11

18 - 23 months

3

2

5

19

INTERVAL TOTAL

12 -

5 -

10 -

2 years

1

18

3 years

2

8

10

4 years

k

13

17

9 years

7

43

50

years

4

32

36

1*+

15 years

and Over

1

17

18

Reported after death

27

6

33

Reported only on certificate

3

9

12

Table 37 PERSONS HAVING HAD TUBERCULOSIS WHOSE DEATHS WERE CODED TO OTHER CAUSES 1962

CODED CAUSE OF DEATH

INTERNATIONAL LIST NUMBER

TOTAL

NUMBER OF DEATHS 174

Heart Diseases Malignant Neoplasms

410-443 140-205

67 23

Cirrhosis of Liver Vascular Lesions of C.N.S.

581 330-33^

19

Accidents Pneumonia

800-965 490-493

11

Diseases of Respiratory System Diabetes

470-527 260

9 3

All Others

13

10

19

-34-

SAN FRANCISCO DEPARTMENT

OF

PUBLIC HEALTH

STATISTICAL REPORT

DOCUMENTS AUG

4 1964

1963 Got den Gate

O

NORTH EAST

o

MARINARICHMOND

G WESTS IDE

OCENTRAl

GOLDEN GATE PARK

o EUREKA NOE

Omission

O

SUNSET

HUNTERS POINT

O ALEMANY

C

City and County of San Francisco DEPARTMENT OF PUBLIC HEALTH Central Office lOI

GROVE STREET Zone 2

June 25, 1964

The information contained in the Statistical Report of the San Francisc< Department of Public Health is obtained primarily through the birth and death certificates sent to us by practicing physicians in San Francisco, or from U by the State De P artm ^t of Public Health in the case t° l of births and deaths of San Francisco residents which occur-outside of San 1S An ° ther ma J° r source a the morbidity reports of reportable dis "I!!! J°\ " e r eive from Practicing physicians. : Included in the Statistrf?% 150 . are Mld information ^cured from the United States Census Bureau?

ir

7!

"

f

,

The conclusions that He can draw from these data are dependent upon the accuracy of the original information, and are included in order that the reader may have some insight into the social and cultural structure of the n ty ° f FranCiSC °' Which is the P atient of the Department of Public Lalth

^

The information with reference to births and deaths and reportable diseases gives us an understanding of the problems that face the community of San ^ancisco in the field of community health, and the trends that are indicated enable us to judge where our activities have been successful, and where they have not; also, they point out the diseases or segments of the population toward which we should concentrate our attention.

Additional information about census data and birth and death statistics in this report are available from the Bureau of Statlstlcs of thts department, through Miss Mildred Holota, Chief

Aich were „ot included

oHSt

B

ELLIS D. SI Director of Public Health

CONTENTS SUBJECTS, CHARTS AND MAPS

Births Communicable Diseases Deaths Fetal Deaths Infant Deaths Marriages and Divorces Maternal Deaths

PAGE 15 22 3

20 15 1 7

Population Tuberculosis Venereal Disease Gonorrhea Chart, 1959-1963 1959-1963 Syphilis Chart, Map Venereal Disease by Health District, 19b 3 29 Map Tuberculosis by Health District, 1963

TABLES Deaths from important causes, San Francisco & U.S., 1963t Cal., 1962 Causes of death, all ages, 1959-1963 ? Causes of death by sex, rates and percent, 1963 7 Maternal deaths, 1957-1963 8 Death rates for Whites, Chinese and Negroes, 1963 Deaths from important causes by age group, 1963 (Chart on Page 10) Causes of death, residence, and occurrence, 1962-1963 11 & 12 13 Selected morbidity, natality & mortality data for health districts, 1963 16 Birth rates by race and sex, I963 16 I962-I963 Recorded, resident and non-resident births by place, Resident live births by place and race, 1963 !? Resident births by race and health district, 1963 17 Live births by trimester prenatal care began by place of birth, 1963 !° Place of birth of premature infants by race, 1963 18 Premature live births by race, weight, length and gestation, 1963 ^9 Infant deaths by race and sex; rates, 1963 -^ Infant deaths by race and age, 1963 -*-9 Infant mortality by age and cause, 1963 20 Fetal Deaths by place of delivery and race, 1963 21 Cases and deaths from communicable diseases, 1959-1963 23 Venereal disease cases by age groups, 1963 2k Civilian cases of venereal disease, 1963 and 5-year median 2i+ Venereal disease cases, 1958-1963 24Venereal disease by source of report, 1963 25 Venereal disease in civilian minors, 1958-1963 Venereal disease by health district, 1963 26 Venereal diseases reported by private physicians, 1956-1963 2b Venereal disease by age group and stage, 1963 Chest Clinic, San Francisco General Hospital, 1950-1963 33 Tuberculosis cases, deaths, and rates, 1963 Tuberculosis: New cases by race and type, 1963 Tuberculosis, pulmonary, percent of cases by stage, 1958-1963 53 Tuberculosis cases by sex, age and race, 1963 3^ Tuberculosis cases by health district, 1963 3^ Tuberculosis, interval between reporting disease and death, 1963 3^ Tuberculosis cases whose deaths were coded to other diseases, 1963 35 Tuberculosis cases and deaths, 1920-1963

^

^

;

:

GENERAL INFORMATION

San Francisco, one of the original 27 counties in the State, was also incorporated as a city in l850« Located on the tip of a hilly peninsula, its total area is 129»25 square miles of which less than one-half or 45.451 square miles is land. Excluding islands, its land area is 29,089 acres. The estimated population density in 1963 was 16,499 people per square mile, the highest in the state. It has an equable climate with an average daily temperature range of 12.1 degrees, from a daily mean maximum temperature of 62,.6 to a daily mean minimum temperature of 50.5 degrees; rainfall averages about 21,6 inches yearly. The city enjoys about 66?o of sunshine during the daylight hours. The provisional estimate of population for July 1, 19o3, made by the California State Department of Finance was 749,900, an increase of 4,400 over the 1962 estimate of 745,000 and 9,584 or 1.3% over the April 1, i960 census figure of 740,316.

Population estimates and census figures for race and broad age groups

I960 CENSUS

1963 ESTIMATE

TOTAL V/hite

Negro Chinese Filipino Japanese Other Non White

749,900

100.0

7^0,316

594,600 85,300 40, 800 14,500 10,800 3,900

79,3 11.4 5.4 1.9 1.5 0.5

604,403 7^,383 36,445 12,327 9,464 3,294

Under 5 Years of Age 5 15 25

-

14 24 44

64 45 65 Years and Over

61, ,5

10, ,1 4, .9 1, .7 1, .3

0,

A

i960 CENSUS

1963 ESTIMATE

TOTAL

100, .0

749,900

100.0

740,316

59,240 107,260 91,200 186,300 204,100 101,800

7.9 l4„3 12.2 24.8 27.2 13.6

58,851 98,189 91,155 199,362 199,151 93,608

The number of males was estimated at 365,400 or 48.7 of ulation and females at 384,500 or 51.3$.

100, ,0 8- .0

13, .3 12.

26, 26, 12. .6

the total pop-

MARRI AGES The number of marriage licenses issued during the calendar year 1963 was 7,022, an increase of 151 or 2,2% over the 1962 figure of 6,871 and 386 or 5.8% over the i960 figure of 6,636. The rate per 1,000 estimated population was 9.4 in 1963, 9.2 in 1962 and 9.0 in i960.

DIVORCES During the calendar year 1963, 3,l4l divorce actions were filed, an increase of 50 or 1.6% over the 1962 figure of 3,091 wh.ich had been nearly 8% lower than the 196l figure of 3,360. During I960, 3,284 divorce actions were filed; thus the number for 1963 was 4.4% lower than i960.

-1-

»

YEARS

MARRIAGE LICENSES ISSUED

FINAL DECREES OF DIVORCE

DIVORCE ACTIONS FILED

ANNULMENTS GRANTED

1950-51 1951-52 1952-53 1953-54 1954-55

8328 7306 7395 6860 6631

4543 4391 4327 4096 3867

2842 2940 2917 3088 2598

468 478 552 51? 499

1955-56 1956-57 1957-58 1958-59 1959-60

6645 6965 6526 6665 6703

3676 3500 3508 3434 3350

2604 2432 2442 2257 2357

483 463 477 499 417

1960-61 1961-62 1962-63 1963-64

6670 6704 6921 7201

3322 3198 3108 3160

2275 2161 2243 2178

394 421 454 418

BIRTH AND DS^TH RATES FOR OTHER JURISDICTIONS:

Tentative and provisional rates for the United States, California and 4 Bay Area counties for the calendar years I96O-63 and final figures for San Francisco based en enumerated population for i960 and estimated populations for 1961-1963 are: BIRTH RATES PER 1,000 POPULATION YEAR

U.S.

CALIF.

ALAMEDA

CONTRA COSTA

I960 1961 1962 1963

23,6 23.4 22.4 21.6

23.7 23.2 22.1 21.5

22.9 22,9 21.7 21.5

22.8 22.3 20.7 19.5

9.5 9.3 9.5 9.6

8.6 8.3 8.2 8.4

MARIN 22.9 21.8 20.7 19.3

SAN FRANCISCO

SAN MATEO

19.9 19.8 19.0 18.5

22.5 21.8 20.6 19.7

13.3 13.1 13.1 13.3

6.5 6.5 6.5 6.6

DEATH RATES PER 1,000 POPULATION :

I960 1961 1962 1963

6.3 6.1 5.9 6.1

9.3 9.0 8.9 9.3

7.2 6.5 6.8 6.5

1963 saw a continuation of the downward trend in crude birth rates begun in 1957 when the post war baby boom reached its peak* The U.S. birth rate decreased 8.5/° from i960 to 1963; California's decrease was 9»3% and five Bay Area counties showed decreases varying from 6% in Alameda County, 7% in San Francisco to nearly 16% in Marin County, Despite the increasing number of women in the child-bearing ages (15-44 years of age) and the increase in marriage rates, the number of babies born has been decreasing. Reasons for this are not readily apparent. Aside from the longtime downward trend in crude death rates (the U.S. rate has been below 10 since 1947; the provisional figure of 8.2 for California in 1962 was the lowest ever recorded) year-by-year fluctuations in death rates reflect chiefly the presence or absence of acute respiratory disease outbreaks. The West coast did not experience major outbreaks in 1962 while other parts of the country did, so while the U.S. showed an increase in the death rate, Celifornia and most counties had either small decreases or the same rate as in 196l. However, all jurisdictions except Marin County had increases in 1963» -2-

:

The age-adjusted death rate for San Francisco, direct method, was 8.0 per 1,000 population compared to 7*5 for the U.S. or 7% higher, San Francisco's rate decreased from 8o3 in 1962 and 8„5 in 196l. The U.S. rate was 7=5 in 1962 and 7.3 in 3-961, the most recent year without a major influenza epidemic. Using the indirect method, the San Francisco rate was 8.4 per 1,000 population.

Crude birth and death rates for San Francisco since 1950 are shown in the following table based on population estimates prepared by the State Department of Finance, The crude death rate is significantly higher than in 1950 and the birth rate is significantly lower. If these trends continue, San Francisco may again have more deaths than births as it did from 1928 through 1938c

YEAR

SAN FRANCIbCO ESTIMATED POPULATION

RESIDENT BIRTHS

BIRTH RATE*

1950 1951 1952 1953 1954

775,357 (Census) 778,200 772,200 764,700 757,100

15,477 15,505 15,710 15,364 15,171

19.9 20.3 20.1

1955 1956 1957 1958 1959

740,100 734,800 734,600 744,300 742,900

l4,54o 14,565 15,240 15,104 14,634

I960 1961 1962 1963

7^0,316 (Census) 744,000 745,000 749,900

14,728 14,703 14,177 13,839

*

20

RESIDENT DEATHS

DEATH RATE*

20.0

9,204 9,527 9,693 9,435 9,160

11.9 12.2 12.6 12,3 1H.1

19.6 19^8 20.7 20.3 19.7

9,161 9,548 9,600 9,375 9,559

12.4 13,0 13.1 12.6 12,9

19-9 19.8 19.0 18.5

9,825 9,736 9,777 10,004

13.3 13.1 13-1 13.3

Rate per 1,000 population.

DEATHS

During the calendar year 1963, there were 10,004 resident deaths, an increase of 227 or 2,3% from 1962; the crude death rate was 13.3 per 1,000 estimated population, the same rate as in i960, after two years with a rate of 13.1 The average age at death for males was 63.9 years after having been 63.4 in 1962 and 62,8 in 196l The average age at death for females was 68.0 years in 1963 and 67.4 in 1962 and I96I. The median ages at death also increased for both men and women. In 1963, the median age for males was 67.8 years as against 66.3 in 1962 and for females 73.7 years compared to 72.5 in 1962.

TABLE 1, Deaths from Important Causes for San Francisco, California aud the United States ldsts 1963 final figures for San Francisco residents, provisional 1963 figures for the U.S. and provisional 1962 figures for California. The first four causes of death are the same in each of the jurisdictions, heart disease, cancer, vascular lesions of the central nervous system and accidents in that order; percents of all deaths, the figures are about the same but the rates are, as usual, considerably higher in San Francisco, next highest in the U.S. and lowest for California because of the higher proportion of older people in San Francisco. Again in I963 as in 1962 in San Francisco, cirrhosis of the liver was the fifth cause, the seventh in California and the ninth in the U.S.; the rate in San Francisco was three times that for California and five times that of the U.S.. Other parts of the U.S. had a serious outbreak of respiratory diseases in 1963 so that pneumonia and influenza advanced from the sixth cause to fifth on the list. The two diseases remained in sixth place in both California and San Francisco. -3-

Though influenza and pneumonia caused a larger percent of deaths in the United States, the rate for San Francisco was higher as in 1962. In California "certain diseases of early infancy" remained in fifth place but decreased to sixth in the U.S. and eighth in San Francisco, chiefly because of the fewer number of births. Emphysema advanced to tenth cause in San Francisco but remained in twelfth and thirteenth place in California and the U.S. respectively. Tuberculosis rates remained the same in California and the U.S. but increased from 7.8 per 100,000 population in San Francisco in 1962 to 9.9 in 1963.

TABLE 2 shows resident deaths from important causes for the past five years. About three-quarters of the deaths are included in the first five causes; heart disease accounted for about 33%, cancer 17%» vascular lesions of the central nervous system 10%, accidents and cirrhosis of the liver about 5% each. Rates in, 1963 for every cause except arteriosclerosis, ulcers and congenital malformations increased over 1959. Accidents increased by 11% from a rate of 63.^ in 1959 to 70.3 in 1963. Cirrhosis of the liver with a rate of 65.7, the same as in 196l, when it was the fourth leading cause, increased almost 20% over 1959 » The number of deaths from emphysema compared to heart disease is small but the percentage increase from 1959 to I963 for emphysema was ^3%; the increase for pneumonia and influenza was almost 7%.

Race-specific death rates with minor changes repeated the pattern of the past five years. Year by year there are slight increases or decreases in the overell rate and in the rate for various diseases. In San Francisco, differing from the usual pattern of higher nonwhite mortality found in the U.S. as a whole, the death rate for whites is about two and one-third times that for Negroes and about, twice that for Chinese. In 1963, the death rate for whites was 15. 1 per 1,000 estimated population, 6.5 for Negroes and 7.6 for Chinese. Heart disease and cancer are the first and second leading causes in the largest ethnic groups with vascular lesions third for whites and Negroes but fourth among the Chinese where accidental deaths took third place. Cirrhosis, the fifth cause of deaths for whites, was sixth in the other two groups who had far lower rates. "Certain diseases of early infancy" was again the fourth cause of death among Negroes, seventh for Chinese and ninth for whites. Suicides ranked fifth for the Chinese with a rate of 41.7 per 100,000 estimated population compared to 13.3 in 1962; the rate for whites was 35.0, seventh cause of death in the ranking. Death rates specific for age and sex for whites and nonwhites and such rates for certain leading causes based on three year averages, are included in the 1961 Statistical Report of the San Francisco Department of Fublic Health. The following table summarizes for 1963 resident deaths by age and sex, with rates and percents of the total. The first year of life is still the year of greatest risk; in no other single year are there so many deaths.

.

RESIDENT DEATHS BY SEX AND AGE San Francisco, 1963

RATE PER 100,000 ESTIMATED FOP.

NUI4BER

AGE

TOTAL

ALL AGES

Under 1 Year 1 5 Ik 25 k5 65 85

- 4

MALE

FEMALE

TOTAL

MALE

10,004 5,775

4,229

1,334

1,580

l4l 22 18 36 202 912 2214 684

2566 92 39 101 268 13^8 5291 22,090

3^6 k2

- Ik

k2

-

92

2k - kk - Gk - 8k & Over

Not Reported

500 2752 5119 1110

205 20 2k 56 298 l84o 2905 426

11

FEMALE

TOTAL

MALE

1,100

100.0

100»0

100.0

3.5 0,4 0.4 0.9 5.0 27.5 51,2 11.1

3.5 0,3 0.4 1.0 5*2 31.9 50.3 7.k

3.3 0.5 o.k C.8

2143 97 44 3k 124 78 216 322 861 1875 4172 6650 24,825 20,671

2970 87

PERCENT :

FEMALE

4.8

21.6 52.4 16.2

___-.-_

-

Causes of death by age groups appear in Table 6. Accidents again were the leading cause from age one through 24, the second cause in age group 25-44, and fifth in age groups over 45, although rates were considerably higher in the older age groups. Nearly one-third of the accidental deaths were caused by motor vehicles and 67 or almost 40% were to pedestrians. Home accidents accounted for 32.% of the deaths with falls causing about 50% of them

Cirrhosis of the liver was the leading cause of death in the age group 25-44, causing 18% of the deaths. Though it was the third cause of death in age group 45-64, the rate tripled from 48 per 100,000 estimated population for age group 25-44 to 146 for the older age group. Among those 65 and over, the rate was 104,, The rate for males was greater than that for females, ranging from almost half as great in the under 45 group to two and three times as great in the 45-64 and over 65 groups. Of those whose length of residence in San Francisco was reported, 8' had lived here 10 or more years. Rates for heart disease, along with other chronic conditions, increased sharply with age, and at all ages over 45 it was the leading cause of deathc Here, too. rates for males were considerably higher than tnose for females. Suicide was again the second cause of death in age group 15-24 where it caused 13% of the deaths. Ten percent of the deaths in age group 25-44 were suicides; the number of suicides in age group 45-64 was nearly double that of the preceding age group with consequent increases in rates. Of t'\ose whose length of stay was reported, 83% had lived in San Francisco five or more years and 7k% had lived in San Francisco ten or more years.

-5-

:

TABLE 1 DEATHS FROM IMPORTANT CAUSES SAN FRANCISCO, CALIFORNIA AND UNITED STATES,

RATE PER 100,000 POPULATION

RANK

CAUSE OF DEATH

S.F. Cal-* U.S.

1963

PERCENT OF TOTAL DEATH s

S.F,

Cal.*

U.S.

S.F.

Cal,*

U.S.

100.0

100.0

-

-

-

133^.0

828. k

961.6

100.0

Heart Diseases

1

1

1

503.0

31k.5

37^.0

37.7

38.0

38,9

Malignant Neoplasms

2

2

2

228,8

136.5

152.2

17.2

16.5

15.8

Vascular Lesions C.N.S„

3

3

3

133.8

87.2

106,5

10.0

10.5

11.1

Accidents

k

k

k

70.5

50.6

53A

5.3

6.1

5.6

Cirrhosis of Liver

5

7

9

65.7

19.1

12 c 3

k.9

2.3

1.3

Influenza and Pneumonia

6

6

5

te.l

25,6

36.9

3.2

3.1

3.8

Suicides

7

8

11

30.3

16.5

10.7

2.3

2.0

1.1

Certain Diseases of Early Infancy

8

5

6

29-9

31.^

33.0

2.2

3.8

3.4

Arteriosclerosis

9

9

7

21.3

15.7

19.6

1.6

1.9

2.0

Empnysema

10

12

13

19.2

10.0

6.1

l.*»

1.2

0.6

Aortic Aneurysms

11

Ik

15

lk.&

k.G

1.1

0.8**

OA

Diabetes

12

11

8

13.5

10.2

17.5

1.0

1.2

]

Ulcers of Stomach and Duodenum 13

13

12

11.7

7.1

6.2

0.9

0.9

0.6

Congenital Malformationsl4

10

10

10.8

11.6

11.0

0.8

l.k

1.1

Tuberculosis

15

17

Ik

9-9

3.7

5.1

0.7

OA

0.5

Hernia and Intestinal Obstruction 16

15

l*t

9.1

k.?

5.1

0.7

0.6

0.'

Chronic and Unspecified Nephritis 17

16

12

6.8

k.3

6.2

P.'.

0.5

0.6

112.8

73.1

101.2

8.5

5.8

10,9

ALL CAUSES

All Others

SOURCES

San Francisco: California: United States:

6.6*

:

*

° .

Department of Public Health Records Communications from State Department of Public Health ** i960 figurcr Provisional 1962 figures Monthly Vital Statistics Report, Vol. 13, No, 1, March 23, 196A provisional figures for 1963. -6-

J Table 2 DEATHS FROM IMPORTANT CAUSES 1 ALL AGES S AN Francisco Residfnts, 19W- •19^3 RATE PER 100.000 POPULATION

N U M B E R

ALL CAUSES

Heart Disease Malignant Neoplasms Vascular Lesions of C.M.S.

1352_

li£i

1962

1961

19^0

1251

12£l

196?

1961

1960

10,004

9777

97^6

98?<;


M*M

m?.3

KflftJi

1'?7,1

)?86 a 7

3769 1716 1003

3759

36g3 1703 1002

3771 1702 961

3727 1653

502..6

228„S 133»g

504,6 232.6 125.5

455.0 229.6

935

13M

509.4 229.9 129.8

501.7 223.2 127.7

66.5 62.4 40.0

63.4

Accidents Cirrhosis of the Liver Influenza ano Pneumonia

Suicides Certain Diseases of Early Infancy

Arteriosclerosis Emphysema Aortic Aneurysms Diabetes

529 493

492 ^53

463 489 231

492 462 296

471 411

315

296

70 c 5 &5«7 42.1

66.0 6o,3 42,3

62.9 65.7 37.8

227

213

214

220

194

30.3

23,6

28o8

29,7

26.1

224 160

234

206 165

226 197

213 203

29.9

3M 22.3

30.5

21

27,7 22,2

25.3 27.3

1W

119 93 12g

95 90

37 110 116

101 33

19.2 14.8 13.5

16.0 12.5 17.2

12.8 11.8

11.7 14.3 15.7

13.6 11.2

gg

10S

90

96

f

74

53

B

1% 76

gg 72

11.7 10.3 9.9

12.1

81

90 74

14.5 14.4 8.9

12.2 9.7 10.3

12=9 11.8 9,7

6g

60

51

56

62

9.1

8.0

6.9

7.6

3.3

900

851

g91

833

120,0

114.2

122.8

120.3

112.3

88

All Other

9%

316

111 101

Ulcers of Stomach and Duodenum Congenital Malformations Tuberculosis Hernia and Intestinal Obstruction

1733

170

915

97

9.9 7.8

12.1

26.6

55-3 39.8

13.1

Table 3 IMPORTANT CAUSES OF DEATH BY SEX WITH RATES PER 100,000 POPULATION, San Francisco Residents, 1963

MALE CAUSE OF DEATH

NUMBER

ALL CAU!

Heart Disease Malignant Neoplasms Vascular Lesions of C.N.S.

FEMALE

RATE

PERCENT

NUMBER

RATE

PERCENT

.153.0.5

-lfltUP-

..4.229

1099.9.

100.0

400,5 195,8 140.4

36,4

2229

6io„o

38.6

971 463

265c7 126o7

i6 c 8

8,0

15^0 745 540

Accidents Cirrhosis of the Liver Influenza and Pneumonia

340

^

93..0

181

89.2 49,5

5o9 5.6 3.1

189 167 135

49.2 4^ 4 35*1

3.2

Suicides Diseases of Early Infancy Emphysema

145 132 124

39.7

2*5

82

36.1

2a3

33c9

2.2

92 20

21.3 23.9 5.2

2.2 0.5

B

21.6

32 94

24.4

Aortic Aneurysms Arteriosclerosis Ulcers, Stomach and Duodenum Tuberculosis Diabetes Congenital Malformations Hernia and Intestinal Obstruction a ll

Other

62

M

18.1

17.0

1.1 1.1

26

30 428

111.3

10.1

16

0,8 0.7 0,7

8

38

11.2 10.4

472

129.2

8.2

Table 4

NUMBER OF MATERNAL DEATHS

RATIO PER 10,000 LIVE BIRTHS 4.6 3.3 2.0 2.0 5.* 2.8 5.1

-7-

0.8 2.2 0.6

1.2 0.9 o.7

',1.0

13.1

41

HATEPNH DEATHS YEAR

1.9

4.2 13.8 10,4 7.8

15.9

48

58

17.6

0.1

6

Table 5 LEADING CAUSES OF DEATHS FOR SAN FRANCISCO WHITES, NEGROES AND CHINESE WITH RANK ORDER AND RATE PER 100,000 POPULATION, 1963

WHITE NO.

RATE

8983

1510.8

1 2 3

3510 1540 914

590.3 259.0 153.7

Accidents 4 Cirrhosis of Liver 5 Influenza and Pneumonia 6

444 436 289

74.7 73.3 48.6

Suicide 7 Arteriosclerosis 8 Diseases of Early Infancy 9

208 155

35.0 26.1

142

23.9

Emphysema Aortic Aneurysms Diabetes

136 100 91

22.9 16.8 15.3

RANK ALL CAUSES

Heart Disease Malignant Neoplasms Vascular Lesions

10 11 12

RANK

1 2 3 5 6 7

10

NO.

RATE

557

653.0

124 93 53

145.4 109.0 62.1

V? 37 17

55.1 43.4 19.9

RATE

311

762.3

1 2 4

80 66 18

196,1 161.8 44.1

3 6 -

25 14

61.3 34.3

8

19.

17 1

41.7 2.5

53

62.1

13

31.9

3 5 8

3.5 5.9 9.4

2 k 2

k*9 9.8 4.9

77

12.9

62 59

10.*+

10

9.9

3

Tuberculosis Homicide Nephritis

53 25 35

8.9 4.2 5.9

707

118.9

All Other

NO.

RANK

1.2 3.5

Ulcers of Stomach and Duodenum 13 Congenital Malformations 14 Intestinal Obstruction 15 16

CHINESE

NEGRO

12.3

5.9

10

9 2

22.1 4.9

10

24.5

5

9
10

2k . 5

69

80.9

25

61.3

11 13

11.7 3.5

There were 71 deaths of Filipinos with a rate of 4.9 per 1,000 estimated population; among them 31 from heart disease, 8 cerebral vascular lesions, 6 fatal accidents, 6 cancer, and 2 each from certain diseases of early infancy, tuberculosis and emphysema. There were 57 deaths of Japanese with a rate of 5«3 per 1,000 population; among them 17 from heart disease, 9 cancer, 9 cerebral vascular lesions, 8 certain diseases of early infancy and 5 accidents.

In the other nonwhite group there were 25 deaths with a rate of 6.4 per 1,000 population; among them 7 from heart disease, 6 certain diseases of early infancy, k cirrhosis of liver, 2 cancer and 2 accidents. -8-

b

Table 6 DEATHS FROM IMPORTANT CAUSES BY AGE GROUP WITH RATES PER 100,000 POPULATION SAN FRANCISCO, 1963

AGES

1

AGES

- 4 YEARS

TOTAL NUMBER TOTAL K

CAUSE OF DEATH

ALL CAUSES

*?

20

F


22

15

7

6

31.0 23.*

7

2

1&\>7

All Other

H

h

5

5 2

3

1

2

7

7

CAUSE OF DEATH

AGES 15 7 2* YEARS IUIAL NUHBtH TOTAL M

ALL CAUSES

92

56

Accidents 44 Suicide 12 Homicide 6 Malignant Neoplasms 5 vascular Lesions, C.N.S. 3 Influenza and Pneumonia 3 Congenital Malformations 3 Heart Disease 2

34

All Other

'USE OF DEATH

ML

CAUSES

30.6

£ 100.0

36

*7.8 13.0

g

a

1

RATE

10M 12.2 5.6

1

3.3

5.5 3.3 3.3

2

ii3

3.3

1

2.2

2.2

i**n

5.

i

15.2

f

i

15c3

17

4-0.8

16

3

0.7

All Ot

\ti

ion

%.*

n*.6

242

*7 *3 21

15 19

9.5

16.8 8.* 3.7

All Other

7

26 c 2

10,3

F

%

^7.9

22.1

297,9 1*5.5

5

10.8 5.7 5.6 3.7 2.4 1.7

9

1.1

1*

1.0 0.9

40 18

6

76.* 75.5

It*

("UTAL

ALL CAUSES

500

Cirrhosis of Liver Accidents Malignant Neoplasms Heart Disease Suicide Vascular Lesions, C.N.S, Homicide Influenza and Pneumonia Pancreatitis Tuberculosis All Other

YEARS

TOTAL NUMBER M

CAUSE OF DEATH

H*8n*

3*.7

W,2

21
kit CAUSES

50.5 31.8 23.5 l*.7 14 a 2 12.3 10 o 3 9.3

235 256 97 72 *9

RATE

100.0

5

CAUSE OF DEATH

720 352 200 8* 105 63

i

&

3 3

RATE

Heart Disease 955 Malignant Neoplasms Cirrhosis of Liver 297 Vascular Lesions, C.N.S. 156 Accidents 154 Suicide 103 Influenza and Pneumonia 65 Emphysema 48 Tuberculosis 30 "lABETES 29 Ulcers, Stomach, Duodenum25 Aortic Aneurysms 21 Nephpitis 19

1

Accidents Malignant Neoplasms Congenital Malformations

"

912 100.0

2*

*2„9

'

3

AGES 45 - 64 YEARS TOTAL NUMBER" TOTAL M

It?

AGES 25 F

U

27<;?

15.3 11.9 10.9 6.6 7.1

33.3

YEARS TOTAL NUMBER TOTAL F H

ALL CAUSES

100-0 91 .a

Accidents Congenital Malformations Malignant Neoplasms Influenza and Pneumonia

5-1*

CAUSE OF DEATH

RATE

29g

202 100.0

29 g* 7*

35

s 1M it.g 39

71

55

it>

1*.2

53 13 12 10

n

2

10.

g

17„g

58

?

*7.« *5-.1

39.7 2S„4

12

» rt fc

3

2rt

2:1

7

3

3

5

2„0 1.6 1.2 15.0

3.2 40,3

6

5

1

75

38

37

AGES 65 AND OVER TOTAL NUMBER TOTAL M

F

),

Vttt

2893

Heart DistAse 2741 Malignant Neoplasms 1014 Vascular Lesions, C.N.S. 825 Influenza and Pneumonia 21* Accidents 196 Arteriosclerosis 150 Cirrhosis of Liver 106 Emphysema 93 Aortic Aneurysms 89 Diabetes Ulcers, Stomach, Duodenum 61 Suicide 59 Tuberculosis 38

1*53 573 372 112

1288

576

20.4

9

6229

A(l Other

RATE

a

RATE

IM.A '6118.9 4t c

2692.5

**1

16.-,

996„1

*53 102 85 95 32

13.2 5.*

8i0.it

11 37

\:i

8.7.*

1,1

11

19

** 32

15 b

1.0 1.0 0.6

65.8 59.9 58.0 37.3

?9>

284

9.3

565.8

111

57 74

5J 2.4 1.7

210.2 192.6 147.* 104.1

91.4 i?

?a

1

Table

DEATHS FROM SELECTED CAUSES,

7

CITY AND COUNTY OF SAN FRANCISCO

BY PLACE OF OCCURRENCE AND RESIDENCE

1

SEVENTH REVISION INTERNATIONAL LISTS

CAUSE OF DEATH TOTAL,

ALL CAUSES

9 6

196^

NUMBER

RATE*

PERCENT**

10,001-

1334,0

100.0

001-008 010-019

9.9 9.3 0.5

Q.7 0.7

020-029

1.5

0.1 0.1 0.1

001-E999

9 6

1

,3

DEATHS BY RESIDENCE

DEATHS

BY

O CCURRENCE

10,373

.

RESIDEN T

NUMBER

9,777

RATE" 1312.3

SELECTED COMMUNICABLE DISEASES Tuberculosis, All Forms, Respiratory Other Forms

JL

00UO19

Total

Syphilis Septicemia and Pyemia Meningococcemia Diphtheria Poliomyelitis Infectious Encephalitis Infectious Hepatitis

1.1

053 057 055 080-081

0.7 0.1

0,1

L

1

4

0.1*

6

1*80-1*83

OcS

S

0.4

nfluenza Pneumonia, exccpt of Newborn

0.3

13 6

6

092

480-49^

7 '2

I 1?

082-083

Total

JLL

5

T

Other Infective and Parasitic Diseases Residual 030-138 Jj!BL lienza and Pneumonia

_5I_

To

0.8

3Ui 1

490-493

315

0.1

&&J o

3.1

229

0.9

7

-115-

1

1

42.0

9

_2i0_

oil*

3

309

JiZsl 0.8 A

L5

SELECTED DISEASES, USUALLY CHRONIC IN NATURE MALIGNANT NE OPLASMS, JCQ.Tftk Buccal Cavity and ru ARYNX Stomach

171-6-

.

Other Digestive Organs and Peritoneum

59

¥

232.6_ 9.0 20.0

559

469

63.0

162-163

339

296

39.7

16

2.1

0.2

135

18.0

1.3

166

H 5^

5.1

7.2

0.3 0.4 0.5

41

172-174 175-176

Male Genital Organs

177-179

87

11.6

Urinary Organs

180-181

77

10.3

11 71

83

163

Breast Cervix Uteri Other Uterus Other Female Genital Organs

XL

50,152-1 55 157-159

Trachea, Bronchus and Lung

Other Respiratory System not specified as Secondary

2110.

149

151 1

22S.8 7.9 18.8

161

141

160,161,164 170 171

Hodgkjns Disease 201 Leukemia and a LE ukemia 20<* Other Lymphatic 4 Hematopoietic 200,202 Tissues 205.205 Other and Unspecified Sites 156-165, 190-199 Benign and Unspecified Neoplasms

Diabetes Mellitus

210-239 260

SFiFrTFD Respiratory Disfasfs _ Emphysema 502.0,527.1 Other Selected Respiratory Diseases

23

3*1

71

27 5^

23.5 5.Q 3,6 7.2

0.9

102

72

9.7

0.8

91

71

9.5

1.5

0.1

0.7

19 113

1

9.5 11.1

0.8

108

63

8.5

21.7

1.6

230

145

19.5

M

42

74

;:5

23

3.1

0.2

3C

23

3.1

101

13.5

1.0

100

128

17.2

iU

25.1.

_U3_

144

19.2

1.4

JL9J_ 149

119

TSTo

ZS7

21*1,501,502.1 5.9

0.4

44

Jai

6.1.L

4-9

355 138

^7.3 18.4

H

m

540-541

88

11.7

570

68

9.1

44

525,526

CIRRHOSIS OF THi LIVER w| ihout mention of alcoholism H;th mention of Alcoholism

"581.0 581.1

Ulcer of Stomach 4 Duodenum Hernia and Intestinal Obstruction

.

560,561

^15

65 •

'l_

3or

_.6juS_

140

i<*5

41.3 19.5

0.9

93

90

12.«

0.7

72

60

8„0

Table 7,

Continued

DEATHS FROM SELECTED CAUSES

1

CAUSE OF DEATH

CARDIOVASCULAR. RENAL DISEASES,

SEVENTH REVISION INTERNATIONAL LISTS

9 6

DEATHS BY RESIDENCE

NUMBER

RATE*

PERCENT**

TOTAL

Vascular Lesions of C.N,S. Rheumatic Fever

9 6

1

330-334 400-402

DEATHS

BY

OCCURRENCE

NUMBER

RATE*

5155

5120

687.2

952

935

125.5

*75
K04 T 6 11.3 140.4

0,3

3

DISEASES OF THE HEART, SUB TOTAL In 0,443 ~ Chronic Rheumatic Heart'^isease 410-41 6 Arteriosclerotic Heart Disease 420.0 Heart Disease specified as involving Coronary Arteries it20J Angina Pectoris without mention of Coronary 4-20.2 Chronic Endocarditis and Myocarditis 1-2 1-4.2 2 Other Diseases of Heart 4-30-434 Hypertension with Heart 44CL.443

?

RESIDENT

3704

,

119

997 2055 1

84 1046 2030 1

272.5 0.1

26,6

193

25.7

1.9

180

193

70 292

2» 3

38.9

0.7 2.9

275

316

444-447

46

6.1

0.5

41

40

5.*

General Arteriosclerosis

450

160

21.3

1.6

13*

170

22,8

Aortic Aneurysm, Non-Syphilitic and Dissecting

4-51

111

14.9

u

126

93

452-468

123

16,4

1.2

125

77

10.3

592-594

51

(>.t

0.5

70

44

5.9

Hypertension without Heart

84

42;4

Other Diseases of Circulatory

System Nephritis, Chronic and Unspecified

ACCIDENTS, POISONINGS AND VIOLENCE ACCIDENTS. TOTAL Motor Vehicle Other Transport Home Other Non-Transport

_

SUICIDES

HOMICIDES

S23.

tsls.

sa.

0-83 57960 800-802,840-866 870-936 with .0 Residual

173

23.1

23 171

3.1

1.7 0.2

963,970-979 964,980-985

j}00-q 62

81

.

162

22,8 21.6

227

30.3



5.1

7

476 123

Ji2Z_ 152 9

20.4 1.2

20^

1.6

180 156

180

24.2

2.3

234

213

28.6

0.4

42

47

6.3

1.7

ALL OTHER CAUSES

Complications of Pregnancy, Childbirth 640-689 and the puerperium Certain Diseases of Early Infancy Congenital Malformations

0.9

0.1

8

4

0.5

760-776

224

29.9

2.2

282

234

31.4

750-759

81

10,8

0.8

166

74

9.9

Gastritis, Duodenitis, Enteritis, Colitis 543,571-572 All Other Specified Causes

Symptoms, Senility, Ill-Defined and Unknown Causes *

**

Residual

780-795

Rates per 100,000 Population Rates and Plrcents as calculated.

42

5.6

0.4

47

42

5.6

459

61.2

4.6

483

459

61.6

27

3.6

o.3

17

2.3

«—

fN

«-

«o

*-

ON

•-

<

- X 5 IO K z MJ

— ON m-

»vx>



K\ f\i

•-

O

»0

ts>

a

N\ v-

*-

u. <\J

acirt ax S2

CE

X

c

°-

K\

1

UN

1

•-

o

OS


+-

Z 3 UIO a ltn < 0J hi K «0

<

OU 2

.=*

a

T a Ten

•<

«-


or


< or ">

01 -*

< s

U. CL LT\

2q

o

5J

«-

OJ

g

n< T

•)

|H

a

0.

H 3

r-

»-

*-

O

w-

v~

(M

cu

•-

CM

v-

<\J

MO

M>

t*X

V3

«-

«—

cv

*-

*-

to

©

v*

*-

to

a O Sues uj

2

<

ON

*-

.18?! Z

-J

O 3 — a.

I

:

3 OO a. 00 o oo< <

8 a

5

5QC

•—

UJ

3

Z B

5

i£ UJ



£ 9 •13-

.i

a a

o

QC»-

•-O

UJ C

a a.

9

BIRTHS:

During 1963? the total number of births occurring and recorded in San Francisco ^as 19,978, of which 6,394 or 32% were non-resident. The latter increased from b,19C in 1962 by 3.3%; the previous high for non-resident births was 6,348 in 196l. The number of resident births continued to decrease from 14,177 in 1962, 14,703 in 1961 and 14,728 in i960 to 13,839 in 1963; the decrease from 1962 was 338 or 2.4$ and from i960, 6<,0% o Number of births and crude birth rates since 1950 are included on Page 3 C The crude birth rate in 1963 was 18.5 per 1,000 estimated population, the lowest rate since 1950 compared to 19.0 in 1962, 19. 8 in I96I and 19.9 in i960. Nearly 37% of the mothers had their first child in 1963 compared to just over 34% in i960. The proportion having second births was just about the same, 25.4% and 25.5%, and in succeeding birth orders, the percents for 1963 decreased slightly from i960. During 1963, there were 106 male births for every 100 female births compared to 103 in I962, 105 in 1961 and 102 in i960. All birth rates for the socalled ethnic groups except that for "other nonwhite" decreased in 1963 partly because of the decrease in number of births and partly because of the increase in estimated population in all groups except white. The birth rate for whites was 16.1 per 1,000 estimated population, lower than the 1962 rate of 16. 3; there was a decrease of 275 or 2.8% in the number of white births, less than one-half the decrease from 1961 to 1962. The Negro births decreased by 105 or 4.1% from 2,572 to 2,46?; the rate was 28.9 in 1963 compared to 32.8 in 1962. Chinese births went up from 789 in 1962 to 826 in 1963 but the rate decreased from 21.0 to 20.2 in 1963; for several years in the 1950's, Chinese births exceeded 900. The rate for Japanese was 19.7 compared to 26.8 in 1962; not since 1955 had the number of births been so small. For Filipinos the rate was 32.6 per 1,000 estimated population and for other nonwhites, 76.9; the latter represents 300 births in I963 born to a population estimated at 3,900; there were 282 births in this group in 1962.

Again in I963, white births as a percent of all births continued to decrease and the total nonwhite births increased, although the percents associated with the components of the nonwhite group shifted. Chinese, Filipino and "other nonwhite" percents increased while Negro and Japanese decreased slightly,

RESIDENT LIVE BIRTHS BY ETHNIC GROUPS AS A PERCENT OF ALL BIRTHS

YEAR

WHITE

1950 1951 1952 1953 1954

81,2 80,3 8o„2 78.6 77.3

1955 1956 1957 1958 1959 I960 1961 1962

76.1 74.5 73.7 72.9 71.4 71.0 71.2 69.4

1963

69.1

TOTAL NONWHITE

9

1950-65

OTHER NONWHITE FILIP] :no other

NEGRO

CHINESE

JAPANESE

18.8 19.7 19.8 21.4 22.7

9.5 11.1 11.0 12.4 13.1

7.0 6.4 6.1 5.9 6.0

0.8 0.9 1.0 1.3 1.4

1.5 1.3 1.7 1.8 2.2

23.9 25.5 26.3

14.0 14.

28.6 29.0 28.8 30.6

1.4 1.6 1.6 1.5 1.6 1.8 1.7 1.8

2.5 2.8

15.3 16.3 16.8 16.8 17.1 18.1

6.0 6.2 5.9 5.7 6.1 5.9 5.6 5.6

2.3 2.7 3-0 2.8 3.1

1.7 1.3 1.4 1.5 1.6 2.0

30.9

17.8

6.0

1.5

3.4

2.2

27d

-14-

L.8

During I963, 1,40? or 10.2% of the resident live births were to unmarried mothers, an increase of 172 or 13.9% over 1962. The California birth certificate does not contain any items about "legitimacy" and the decision c-bout a child's "illegitimacy" is based on the manner in which other items are or are not reported. Most ethnic groups showed an increase in number and percent of out-of-wedlock births; whites increased from 6.4 in 1962 to 6.7% in 1963, Negroes from 21.9 to 28.7, other nonwhite groups from 2.4 to 3.4%, Forty-five percent of the unmarried mothers were white, 30% Negro and the remainder, other races. About ^2% of the deliveries took place at San Francisco General Hospital and of these, 28% were white and 69% Negro. Unlike the Negro mothers, 70$ of whom were delivered at San Francisco General Hospital, 68% of the white mothers were delivered at other hospitals than County. Nearly 31% of the mothers were under 20 years of age and 36% were between 20 and 24 years old. Half of the infants were firstborn childrep„ Using a birth weight of 2500 grams or under as a criterian, 8.4% of all live births were premature,, Percents by race ranged from 7.3 for whites to 13 «1 for Negro infants. Twenty percent of the premature births took place at San Francisco General Hospital, 11% at Kaiser Foundation Hospital and 9% at U.C. Hospitals. Using 36 or fewer completed weeks of pregnancy as a standard, 9.3$ of the births were premature; the Negroes had the highest proportion, 16.1%. Lack of reporting of this item by the Chinese results in a very small percent for them; if those whose gestation period could not be calculated (333 of the 826 birth certificates, about 43%, did not include information on the first day of the last normal menses) were excluded, the rate of prematurity for the Chinese would have been 8.9. All the other percents for the Chinese thus seem to be far smaller than they probably are.

Information about the period of gestation appeared on 87.1% of the certificates, weight on 99»9% and length at birth on 99.1%. Congenital malformations were mentioned on 1*1% of the live births, compred to 1„2% in 1962 and 0.9% for each of the preceding 3 years. Additional information from the medical items on birth certificates is available from the Bureau of Records and Statistics. Again in I963, Hunters Point Health District had the highest birth rate, 27.6 per 1,000 estimated population compared to the citywide figure of 18.5; the rate for premature births, 113.5 per 1,000 live births, was considerably higher than the citywide figure of 84.4, but lower than Westside's customary hign rate of 120,7 per l 000 live births. Sunset's rate of prematurity was the lowest in the city as was its infant death rate. The birth rate in North East Health District continued to decrease as did the proportion of C hinese births; from 8l% in 1953 the percent dropped to 6l In 1963. Marina Richmond had the second highest number with 12.5% of all the City's Chinese births. v

INFANT DEATHS: With fewer births, the number of infant deaths decreased also but the decrease was not commensurate with the reduction in the population at risk and therefore the infant death rate per 1,000 live births increased to 25.0 in 1963 from 24.8 in 1962. There were marked changes in rates for ethnic groups., Numbers and rates for whites, Chinese and Japanese increased; the Negroes had an encouraging decrease from 89 deaths and a rate of 34.6 in 1962 to 71 deaths and a rate of 28,8 in 1963 the first year the rate dropped below 30. Rates for the two remaining groups also decreased but sihce the number in each case is so small, improvement could be due to chance. Seventy-six percent of the infant deaths occurred in the first 4 weeks of life and almost ^9% in the first 24 hours. Prematurity was mentioned as a causal factor in nearly 5^% of the deaths and in of those who died within 24 hours of birth. Congenital malformations infections and accidents all increased as causes of infant deaths. ,

1

-15-

Table 9 RESIDENT LIVE BIRTHS AND BIRTH RATES BY RACE PER 1,000 ESTIMATED POPULATION San Francisco, 1962 A 196^

19 6S RACE

TOTAL

BIRTHS

RATE

JZJ33L

JLJLL

White Negro Chinese

19 MALE

Filipino Japanese Other

-26 826

28.9 20.2

1,236 459

1-72

32.6

236

213

12.7 76.9

15s

300

'9,0

1f,177

7,111

16.1

2/67

6 2

BIRTHS

FEMALE

4,627

9,8?6 «2;$72

>6?

789

2?6 125 142

438

16,3 32.3 21,0

2S.2 76.2

2'bO

282

Table 10 RECORDED, RESIDENT AND NON RESIDENT BIRTHS BY PLACE San FpANPtsrn 196? AW 1962 t

RECORDED PLACE OF BIRTH

TOTAL

1

Kaiser Foundation Hospital U, C. Hospitals Children's Hospital San Francisco General Hosp. St s Mary's Hospital

2689 2335 2025 1898 1684

2727

Mary's Help Hospital Letterman General Hospital St. Luke's Hospital Mount ^ion Hosp. 4 Medical Ctr. St. Francs Memorial Hospital

1506 1368 1232 1126 1032

15*5 1314 1*10 1097 1069

870 845

V>*>

St. Joseph's Hospital Presbyterian Medical Center French Hospital Chinese Hospital St Elizabeth Infant Hospital

2281

2000 1972 1679

555 450 282

Home

126^

1963

1962

5,8^9

14,177

6,394

6,190

1637 1392 1284 1873 1054

1702

U25

1052 9*3

1025 856

1299

71-1

1116

630

563

9 838 848

1156 8Q1 966 780 735

411 530

389

Si

»4

5 65

600

305

335

5*8

277

1.963

-_20..J12-.

9 ,978

1

2 5

811

738

701

194-7

511

384 317

870 467

337

at

m

593 293 36S

62

75

295 218 26 220

59

41 11

m -

_

A

12

5

10

212 «3

207 48

_



-

-

59

Emergency Hospital Elsewhere

NON. -RESIDENT

PES IDENT

1962

JL9ii

7

12

17

22

Other California Out of State

Table 11 SAN FRANCISCO RESIDENT LIVE BIRTHS BY PLACE AND RACE,

174 <9 2C9

1

196^

OTHER 'LACE OF BIRTH

TOTAL San Francisco General Hospital Kaiser Foundation Hospital U. C. Hospitals Children's Hospital Mary's Help Hospital St. Mary's Hospital

1

TQIAL

W HITE

NEG RO

CHINESE

3 ,839

_9^6j

?,467

J2L

I873 1637 1392 1284 1095 1054

753

999 378 203

,o1*

1045 99° 9*0 950

St. Luke's Hospital Letterman General Hospital Mount Zion Hospital 4 Medical Ctr, St. Francis Memorial Hospital St. Joseph's Hospital Presbyterian Medical Center

848 838

Chinese Hospital French Hospital St 4 Elizabeth Infant Hospital Home Elsewhere Emergency Hospitals

424 337

ZiG

62 59

54 31

12

4

Other California Out or State

212

811

738 565 548

7

43

732 539 517 573

21

69

58

16

18

7 7

22

6 ?

360

103

19 91 11

28

369

19

5

3

20 1

1

24 4

-21L

87

28

147 239

JAPANESE

31

11 48 84

8

.16-

472

109

516

170 35

14

FILIPINO

50

M

64

19

21

25

5 1/

1

J7

WMWHITE JlDJL

Table 12 RESIDENT BIRTHS BY HEALTH DISTRICT AND RACE, San Francisco. 1 96^

TOTAL BIRTHS

HEALTH DISTRICT TOTAL

BIRTH RATE*

WHITE 9,

13,3 3 9

18.5

Alehany

1405

18.1

OTHER

NEGRO

^7

NONWUIi

FILIPINO

CHINESE

W2-.

213—

1034

25S

32

44

9

^1

2,

311. _

2i

Central

1551

19-0

786

522

37

122

27

57

Eureka Noe

1730

23.3

1530

4l

23

40

10

31

Hunters Point

1357

27.6

550

693

13

31

11

54

ma r na r

1796

1».7

1*71

67

103

51

77

27

1947

26„6

1510

234

31

101

10

61

507

19

15

21

31

26

6

32

27

15

i

i

chmond

Mission North East

1125

12„1

5*1

22

Sunset

1820

13c3

1702

13

Westsioe

978

20,3

277

600

District Not Reported

130

110

12

37 27

Per 1,000 Estimated Population

Table 13 LIVE BIRTHS BY TRIMESTER PRENATAL CARE BEGUN AND PERCENT BY PLACE OF BIRTH, San Francisco Residents, 1963 PLACE OF BIRTH

TOTAL

TRIMESTER

2ND TRIMEST ER

NO.

NO.

1st

TOTAL

_

TRIMESTER

i

_3^2

NO CARE OR NOT REPORTED

-1 -tfiU—JAJ.

100*0

6?7ft

frg-9

4727.

&&L

Jbr.

San Francisco General Hos. 1873 Kaiser Foundation Hospital 1637 U. C. Hospitals 1392

100.0 100.0 100.0

206 463 185

11.0 23.3 13,3

850 884 750

45.4 S4.0 53.9

548 193 410

29.2 11.8

269 97

!Vl

29 o4

47

3.4

Children's Hospital Mary's Help Hospital St. Mary's Hospital

1234 1095 1054

lOOaO 100.0 100.0

595 845

75.4 54*3 30.2

III

18.4 33.4

u

62

133

17.3

47 72 25

St. Luke's Hospital 848 Letterman Gemeral Hospital 838 Mount Z|on Hosp. & Med. Ctr.811

100.0 100.0 100.0

561

65.7 49.2 69.2

245 329 203

28.9 39.2 25.0

I?

5.1

St. Francis Memorial Hosp. 738 St, Joseph's Hospital 565 Presbyterian Medical Center 548

100*0 100.0 100.0

570 459 269

122 86 174

16.5

16

81,2

15 -i 31. a

18 101

2.2 3.2 18.4

Chinese Hospital

100.0 100.0 100.0

293 226 20

|9o1 67.1 32.3

18,9 23.5 56.4

48

100.0 100.0 100.0

15

25.4 25rO

7

22„0 25.0 42.8

212 43

100.0 100„0

122

57.5 11.6

30.7 7.0

13*833...

French Hospi tal St. Elizabeth Infant Hosp. Home

Elsewhere Emergency

Other California Out of State

424 337 62 5? 12

557

3

5

49.1

-17-

.

2.4

40

12 7

2.=;

1

6

a

5.9

5.1 0,1

4? 6

0,7 5.0 0.7

30

4.;

2

4

0.4 0.7

3

3

:?

16.7 28.6

16 4 2

m

:l

34

11,3

25.4

7

27.2

Table 14 PLACE OF 3IRTH OF PREMATURE INFANTS BY RACE, San Francisco Residents

PLACE OF BIRTH

TOTAL

WHITE

NEGRO

11 68

7m

323

San Francisco General Hospital Kaiser Foundation Hospital U„ C. Hospitals

235

74 60 go

11-7

Utterman General Hospital Mary's Help Hospital St„ Mary's Hospital

100

50

S2

73 69

81

W

TOTAL

123 110

U

Mount Zion Hospital and Medical Center Children's Hospital St. Luke's Hospital

ok

St.

51

73

Francis Memorial Hospital Presbyterian Medical Center St. Joseph's Hospital

38 34

Other California Frsnch Hospital Chinese Hospital

25

Home St. Elizabeth Infant Hospital Out of State

11

21

3

1

l

L

I

P

5

8

3

29

-

1? 8

1

1

7

2

2

31

3

9

3 3

5

-

1

3

1

42 19 30

6

1

-

2

5

1

1

5 1

6

4

3 _

3

JAPANESE

21

OTHER NONHMITE -13-

2

9

15 15

NO

6

3

56 56

I

52

19

5^1

4

4i

F

46

15

Emergency

CHINESE

1963

1

12

2

-

Table 15 PREMATURE LIVE BIRTHS BY RACE, BIRTH WEIGHT, LENGTH AND GESTATION PERIOD San F rancisco Res dents, 1963 i

NUMBER PREMATURE BY:

TOTAL PREMATURE

WHITE

NEGRO

CHINESE

FILIPINO

JAPANESE

52

OTHER NOTWHITE

ONE CRITERION;

Weight at Birth Length at Birth Gestation Period

11

68 1501

701

323

1*6

1282

735

396

42

B

27 22 16

583

®

187 247 192

19 27 20

27

11

39

299

17 10

460

250

160

13

19

8.4 10.8 9.3

7.3

9.0

13.1 18.1

5.6 8.4

7.7

16.1

5.1

11.0 15.7 12*7

4.2 6.0 4.0

3.5

7.6 10.0 7.3

5.2

3.0

5.1 3.1

1:1

8.3 4.9

8.0 4.7

3.7

3.3

2.6

6.5

1.6

4.0

4.7

2.7

69

TWO CRITERIA:

Weight and Gestation Weight and Length Length and Gestation ALL THREE CRITERIA:

826 555

23

9 13 11

PERCENT OF PREMATURE LIVE BIRTHS BY: ONI

CRITERION:

Weight at Birth Length at 8irth Gestation Period

12.7 10.3 7.5

6.3 9.7 11.0

TWO CRITERIA;

Weight and Gestation Weight and Length Length and Gestation ALL THREE CRITERIA:

-12-

2.3

S* 7

4.3

Table 16

INFANT DEATHS BY RACE AND SEX San Francisco Reside nts, 1963

RATE PER 1,000 LIVE BLUMS

TOTAL

FEMALE

JLftl

IM

2.5.0

24. 5 2g.g 27,3

12& ALU RACES

White Negro Chinese Filipino Japanese Other Non Whi te

71

^

9S 33

23

13

5

23<*

1

I 7

1

2

5 5

3

1262

M

37.6 23.3

2

Table 17 INFANT DEATHS BY RACE AND AGE s

"iN

Francisco SESIflStLXS, 19J3. UNDER 2ft HRS.

ALL RACES

-5JUL

White Negro Chinese Filipino Japanese Other Non White

231-

1.6

28 DAYS -

DAYS

11

KONTHS 82

74 1?5

SI

<*o

s

9

I

i

! 7

Tabu

18

INFANT DEATHS FROM SELECTED CAUSES BY AGE San Francisco Residents, 196^

CAUSES OF DEATH

INTERNATIONAL CODE NUMBER

ALL CAUSES TOTAL HITH MENTION OF PREMATURITY

CONGENITAL MALFORMATIONS 4 CERTAIN DISEASES OF EARLY INFANCY EXCEPT INFECTIONS Congenital Malformations Injury at Birth Asphyxia and Atelectasis Disorders attributed to disease of Mother during pregnancy Erythroblastosis Ill-Defined Diseases Immaturity with Subsidiary Conditioiv Immaturity, Unqualifies 'NFECTIONS Pneumonia of Newborn Other Pneumonia Other Respiratory Gastro-Enteritis and Colitis Sepsis of Newborn Meningococcal Infections

Non-Meningococcal Meningitis Other Virus Disease ACCIDENTS Object causing Obstruction Mechanical Suffocation Other and Unspecified OTHER Assault Malignant Neoplasm Neoplasm, Unspecified Mental Deficiency Pulmonary Embolism Hernia without Obstruction Other and Unspecified Other Diseases Kidney, Ureter

1

TOTAL

NEO-NATAL SUB-TOTAL

JUL

_2£JL

JiS-

_LfflL

JUL

262

239

55

7SO-759 760-761

37

34 37

762

53

52

769 770 773

2

2

W m

096

159

t'7

13

23

H

11

9

26

9

2

21 .

38

14

_

1

1

-

1

_ _

6

4 26

1

2

19 _

_

2

_

,.

61

61

48

11

2

-

2

20

6

6

3

12 _

5

4

3

21

1

-

-

I

_

-

-

5

5

1

2

2

1

1

-

1

1

-

_

1

-

-

-

-

3 1

19

922-923 924-925, 917 « 936

'3

_

1

_

_

_

3

-

-

_ -

11

4

3

1

2

193

1

239

1

4 2 1

11 1 7 3

7 z 1

_ _

_

1

„ _

3

3

2

1

_ -

_

-

1

•19-

U 21 6

_

1

1

1

-

_ 1

1

1

1

1

8

983

560 725-5 603

J2L

45

800-96";

i

J2.

74

2

474. 500-527 ,571

-6

6

12

767-768

1

DAYS

H6

«l 1+90-1*93

UNDER Zk HRS.

-

_ _

1

-

_

_ -

1

1

1

Table 19 RESIDENT FETAL DEATHS BY RACE AND PLACE OF DELIVERY, 1963 San Francisco Residents,

RACE PLACE OF DELIVERY

ALL RACES

WHITE

NEGRO

Y?h

105

53

San Francisco General Hos.

k2

l*f

28

Sto Luke's Hospital

16

13

3

Mary's Help Hospital

Ik

8

l

Kaiser Foundation Hosp.

12

7

5

St. Mary's Hospital

11

10

Mount Zion Hospital

11

6

St. Joseph's Hospital

10

7

Presbyterian Medical Ctr.

10

6

U. C, Hospitals

10

5

Children's Hospital

10

10

TOTAL

St. Francis Memorial Hos»

8

Letterman General Hospital

7

Chinese

2

French Hospital

2

Home Emergency Elsewhere

Other California Out of State

-20-

CHINES E 3

FILIPINO 7

JAPANES E 3

OTHER 3

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;

COMMUNICABLE DISEASES: In 1963, the number of reported cases of communicable diseases was about 6% higher than in 1962, chiefly because of the increase in venereal diseases. For the first time in San Francisco history, no cases of typhoid fever or poliomyelitis were reported. After three successive years of freedom from diphtheria, there were 3 cases and 1 death in 1963. Both measles and German measles continued to decrease while mumps increased. Infectious hepatitis continued the upward trend interrupted in 1962 but the number of deaths remained the same.

VENEREAL DISEASES In 1963, the total of diagnosed venereal diseases, com.-, bined, continued upward in the manner to which alt have become accustomed in recent years. Gonorrhea was primarily responsible. Syphilis rose, too, but the rise was principally in the category of epidemiologic diagnoses. For the third consecutive year the level of infectious syphilis remained below the 607 cases reported in the high year of i960. It is thought by many that, while reported cases probably are useful in comparing one year with another, they do not come close to representing the true magnitude of the problem. In May, 1963, the American Social Health Association published the results of a survey (April 1, 1962 to June 30, 1962) on the reporting habits of practicing physicians in the United States. It was learned that, in San Francisco, these physicians were informing the Health Department in only \k.S% of the cases of primary and secondary syphilis and 17.1% of the other stages combined. During 1963 » private physicians in San Francisco reported 97 of the total of 277 cases of primary and secondary syphilis. Applying the survey data to these figures, it would seem that they should have reported, not 97, but 664 cases. The total of primary and secondary syphilis should then have been 8*f4 rather than the 277 reported. As a consequence, intensive contact tracing was pursued in only about one third of the cases of syphilis in the stages most infectious to others. One cannot help but wonder what would happen to this disease if there were fairly complete reporting, especially in the light of the modest degree of success that 6eems to have been achieved with such poor reporting.

If the promise of success appears just beyond reach in syphilis, the same cannot be said in gonorrhea. The curve of diagnosed gonorrhea among civilians continued upward, with the reporting of 4,316 cases. This was an increase of 589 over the 1962 total; in 1962, 595 more cases were reported than in 196l. In the above-mentioned survey it was learned that private physicians in San Francisco informed the health department of only about 10% of those they had found to be infected. If this estimate of the degree of reporting is correct, these physicians actually saw 3,^C0 rather than the 3^0 cases reported, and the City-wide total should be conservatively estimated as having been in excess of 7,000 rather than the 4,316 tabulated.

Despite a general feeling that standard epidemiological methods are of limited value in controlling gonorrhea, these were pursued as vigorously as possible with available personnel. Only City Clinic patients were interviewed for contacts. It was felt that, at its very worst, a substantial number of people without symptoms would be found to be infected and brought to treatment, thereby preventing later complications as well as reducing, to a degree the reservoir in the Community. While definite

- 22 -

figures are not available, it is known that the total of reported cases includes many discovered in this manner* It is believed, also that many among those epidemiologically treated were infected but not diagnosed because of limitations inherent in presently used laboratory tests* An additional, though not unexpected benefit, wes the discovery of a number of cases of early syphilis. The problem of venereal diseases among young people has received much attention and publicity in San Francisco as well as the rest of the Country., Table 21 is a compilation of data concerning the relative problem (reported cases only) in different age groups, Table 25 points out that, while venereal diseases represent a growing health menace, it is not a menace that is growing disproportionately in those under 20 years of age c The 1963 "V.D. Fact Sheet" published by the United States Public Health Service has just been released. Data presented confirm our own findings. The major increase has not been among those under 20 but among those between the ages of 20 and 30.

Table

21

NUMBER, RATE AND PERCENT OF VENEREAL DISEASE CASES IN CERTAIN AGE GROUPS, SAN FRANCISCO. 1963

AGE IN YEARS

1963 ESTIMATED POP.

TOTAL

749,900

0-14

NUMBER CASES

PERCENT OF

V. D.

AGE GROUP

100.0

6,891

100.0

918.9

166,500

22.2

39

0.6

23.4

15 - 19

43,900

5-9

720

10.4

1640.1

20 - 24

47,300

6.3

1,944

28.2

4109.9

25 - 29

44,200

5.9

1,570

22.8

3552,0

46 500

6.2

1,011

14.7

2174.2

401,500

53.5

1,607

23.3

400.2

7

30 - )h

35

&

Over

,

PERCENT OF AGE GROUP IN POP.

23 -

V. D. IN

RhTE PER 100,000 ESTIMATED POJ-

table


.

PORTED CUILIAM CASES OF VENEAEnL DISEASE BY STAGE ..NO SEX _ 5-YEAR MEDIAN JAN FRANCISCO, 96^ 1

TOTAL VENErfEAL DISEASE

SYPHILIS TOTAL

Primary Secondary Early Latent Late Latent Late Congeni tal All Stages,

?<>

MALE

FEMALE

6891

S079

1812

1634

1?9$

33b

101(1

1J ! 13$ 233 326

13*

5

166 113

131 221

epioemiologically treated GONORRHEA TnTJj.

Diagnosed cases epioemiologically treated

241

319

'2

30 3 -(sport Only

1958-1962 q_*£AR MEDIAN

TOTAL

"I

3

40 16

95

30

153 557

501

'I 56

52S1

3776

Ut- 75

428

507

25 §1 588

431.6

935

OTHER TYPES TOTAI

1

TABLE

REPORTED CIVILIAN CASES OF VENEREAL DISEASE San Francisco, 1953-1963

GONORRHEA TOTAL

Diagnosed cases epioemiologically treated SYPHILIS TOTAL

1153

1959

196o

1961

1962

21*28

2935

W?f

««K

4419

5251

2036 392

2399 536

256? 588

3132

1-316

713

3727 692

1346,

1526

1634

_JM5L_ _±QiP

683

Primary Secondary Early Latent Other epioemiologically treated

120 113

\9

121

190

241

329

364

403

_

166 105 277 U65

211

935

164 138 283 517 557

97

279

as

333 TABLE

J96i

?l|

REPORTED CASES OF VENEREAL DISEASE BY SOURCE OF REPORT 1963

r

TOTAL PEwCLNT OF TOTAL SYPHILIS

Late Congeni tal All Stages,

Report Only EPIOEMIOLOGICALLY T reated

GONORRHEA TOJAL

Diagnosed Cases EPIOEMIOLOGICALLY

.

Ti

Cha;:croi d

Lymphopathi

«

Venereum

_

.

seated

OTHER JURISDICTICN

U-

LOCAL HOSP,

7003

-5511

236

204

843

6?

35

11?

78.7

1-4

2.9

l?-fl

0.9

n.S

1..'

9SL7

22

39

26

10

1.64.4. ._ -

Primary Secondary Early Latent Late Latent

--vi

FEDERAL CIVILIAN

TOTAL

OTHER CITY

100-0

TOTAL

PRIVATE H.D.

33 HUNT

1*7 '39 284 326

83 75 177 124

30

11

8

3

153 557

2

522

5352.. _ JtSlL.

455.

JJS.

. .

6

2

52

5

i 4 14 _

10

90

21

135 12

2

3

6 -

44

86

_ 12

3

32

-

4

,,, .

IAS..

»3

340

23

*5

-

-

LOS.

4417 935

3668 84?

163 46

108

2

2

-

5

1

-

1

TAHY

»5

13 m _

1

HI

-

.. 1

19

3 3

.

9.

1

1

-

_ _ -

.-10L_ 1.11

-

9 -

-

-

-

-

3

_

-

1

-

TABLE 25

REPORTED VENEREAL DISEASE IN CIVILIAN MINORS -

1958

136 1959

1258 S YPHILIS

(Primary. Secondary,

TOTAL REPORTED

ALL AGES

TOTAL REPORTFT)

-

E

GONORRHEA

1960

1962

12&

m.

510

s6n

n£l

arly Latent )

J2L

r>

PERCENTAGE

UNDER AGE 20

_S2J_

607.

J?_

28

S«L

2*5-

JtaL

Jtx2_

J*}-

ALL ARES

177*

2050

2U2

2672

"12

3782

_L3_

220

27IL

M(,

^74

l«l

560

12«f

«-*

14-8

U-0

«-«

1*,8

(Geni to-Ur.nary )

TOTAL REPORTED

-

TOTAL REPORTED

PERCENTAGE

TABLE 26

REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY HEALTH DISTRICT San Francisco, 1963 (Ex cluded are 11-92 Epi- Treated & ^Non-Residents) HEALTH DISTRICT

ESTIMATED POPULATION SAN FRANCISCO TOTAL

ALEMANY Central EuREKA-NoE

Jig^m

NO. OF CASES

_

5B4_

RATE PER 100,000 POPULATION

Jl\ZJu

77,600 81,500 7^,200

H05

331.2 1723.9

359

W3.8

*9,200 122,500 73,200

^67 309 397

9*9,2

Mission Northeast Sunset

92,700 131,900

939

M-7,100

959

Hunters

Point

."Iarina-Richmond

iIestsioe

San Francisco District Not Reporteo

257

1H

133

- 25-

PUBCENT Of CASES

_10Cu£

26.3 6.7

252,,2

So7 5.8

W*3

7,*

1012.9 86.* 2036.I

V, 18.0

2.6

TABLE

27

VENEREAL DISEASE * REPORTED TO THE HEALTH DEPARTMENT WITH PERCENTAGES REPORTEO 8Y PRIVATE PHYSICIANS lSSfi

SYPH I

L IS

I3&

-

1962

ISfii

553 157

55*

5?o

28.4

27.6

1961

19^6

1957

19S8

lag

1960

267 ki 13.0

221

3|7

523

616

171

152 24.7

1023 295 23.3

396 29.2

432 23,0

3905

W73

(Primary, SrcpMnARy^ Early Latent )

Reported from a ll Sources reported ay Private Physicians Percentage

CHILIS

50

22.6

32.4

(An Stacf.O

Reported froh a ll Sources Reported by Private Physics Percentage GONORRHEA

C

Ali

292 232

m

637 204 29.7

31U6

2353 «43

2520

307.S

«46

^0

6.1

J51

6.,o

169 5*5

495 ,

72

14»5

571

143 25,0

1644

CiA»< ll >ir. T | n f ..1

Reported from a L l Sources Reported by Private Physicians Percentage

20"")-

3316 172 5.2

240 6,1

* Includes a small number reported by Military Facilities.

TABLE 23 REPORTED CIVILIAN CASES OF VENEREAL DISEASE IN 1963 BY AGE GROUP AND STAGE OF DISEASE SAN FRANCISCO -

YEARS OF AGE

~vrx TOTAL

ALL AGES

SYPHILIS TOTAL

Primary Secondary Early Latent Late Latent Late Congenital All Stages, Report Only epidemiologically treated GONORRHEA TOTAL

Diagnosed cases epidemiologically treated OT HER

27.7

TY PES

TOTAL

0-14

15-19

20*24

15=34

35-44

OVER

720

19W

2tf1

1107

SOO

33

228

595

439

351

y

37 59 80

3 12

5

101 H

4 20

60

69

276

117

31

19

6391

16^4

2

139 138 283 326

_

_

^

65 60 117

1

5

48

30

m

-

1

3

1

1

1

11

15

1

52m

^7

4316 935

31

6

6

.

4

_ _

153 557

-

.

.

1

20 _

686

171s

1982

668

1ft

563 123

1423 292

1631 351

537

131

131

32

1

26 -

1

4 117

?6 171

1

t



5352 3*5 7„2

REPORTED CIVILIAN CASES G? GONORRHEA SAN FRaNCISCO, 1959 - 1963

Number 5500

5000 --

4500

4000 --

3500



3000

2500

2000

1500

1000

500

— 1959

I960

Diagnosed Cases

1961

1962

Epid eminlegi rallyTreated

1963

REPORTED CIVILIAN CitSES OF SYPHILIS SAN FRaNCISCO, 1959 - 1963

Number 1800

1600



1400

1200

1000

800

600

400

200 --

r---

1961

1959

1962

Primary-

Early Latent

Secondary

Oth er

.;-

i

-

Epidemiologically treated (from 1961.'

SEPORTEQ CIVILIAN CASES of JENESEAL DISEASE


HEALTH DISTRICTS

EXCLUDING EP1DEWIOLOGICALLY TREATED KATES PER 100,000 POPULATION

SAN FRANCISCO,

19 g5

i]TTT

^

Under 350

350 - 699

III!

700 - 10f9

1050

S

OVER

:

TUBER CULOSIS For the third consecutive year newly reported tuberculosis cases Increased from a low of 443 cases for 196l, and 48l cases for 1962, to 514 cases for I963 a This represents a 7% increase over 1962 and a 16% increase over I96I. Correspondingly, case rates per 100,000 population show the upward trend: 59*5 for 1961; 64.6 for 1962 and 68.5 for 1963. Significantly, 1963 is the first year since 1945 that the death rate from tuberculosis failed to decline. The death race for 1963 is 9.9 compared to 7.8 and 8.9 for 1962 and 1961 respectively.

INCIDENCE BY RESIDENCE: The eastern half of the city continued to contribute the greater number of cases: 430, or 83,6% of the total reported* Greater concentration of cases was again noted in the Skid Row, Chinatown and North Beach areas. Of particular interest was the doubling of cases over last year in Census Tract Q-l or that part of Sunset District from Sunset Boulevard to the Ocean. Much of this area contains cheaper housing (built during the war years) than is currently available on the market today, hence highly susceptible, lower economic groups would tend to move to this area* Five Health Districts contributed a total of rates per 100,000 population).

72/&

of the 5l4 cases reported (case

1*

NORTH EAST HEALTH CENTER : 111 cases with a case rate of 119.7, increasing from 75 cases and a case rate of 80.4 for 1962.

2.

CENTRAL HEALTH CENTER: 97 cases with a case rate of 119, decreasing from 109 cases and a case rate of 134.4 for 1962.



MISSION HEALTH CENTER: 64 cases with a case rate of 87*4; decreasing from 67 cases and case rate of 93.2 for I962.

**•

MARINA RICHMOND HEALTH CENTER: 51 cases with a case rate of 41.6; increasing from 40 cases and a case rate of 32.7 for 1962.

5.

WESTSIDE HEALTH CENTER: 48 cases with a case rate of 101.9 decreasing from 52 cases and case rate of 110.2 for 1962,

With the exception of Aleraany Health District, all remaining Health Centers had fewer cases and decreasing rates comparing 1963 to 1962. IN CIDENCE BY AGE: 46 3% or 238, of the newly diagnosed cases were 45 years or older. 21 A% or 110 were under 20 and 32$, or 166 were between 20 to 44 years t By comparison with the previous year, there is a slight drop of the older than 45 group at the expense of a moderate increase in the below 20 age group; whereas the group between 20 to 44 remained about the same. (EST. POP.) INCIDENCE BY RACE; CASE RATE PERCENT OF CASES PER 100,000 PERCENT OF NO. CASES RACE 1962 l?62 TOTAL POP. 1963 1963 19.62 . White Negro Chinese Filipino Japanese

Other Non White

2-7

62.2 20.0 8.1 3.9 3.1

54.2 90.3 164.2 151-7 129.6

49.6 122.6 104.0 145.0 175 -3

2.3

2.7

507,7

351.4

79.3 11.4 3nk 1.9 1.5

322 77 67 22 14

62.7 15.0 13.0

0.5

12

-30-

M

;

STaGE OF DISEASE; Of the 51^ cases reported for 1963? 35% were minimal, hy/o were moderately advanced, and 22% were far advanced* By comparison, since 1958 there is a significant increase in minimal stage and a decrease in far advanced stage, whereas the moderately advanced stage remains fairly stationary. It is encouraging to note that the disease is being detected at the earlier stage indicating a significant awareness of this disease.

DEATHS During 1963, 295 persons died with tuberculosis, but in only ?4 of this number was death directly attributed to tuberculosis. By comparison, with 1962, these figures are 232 and 58 respectively. Thus, death caused by tuberculosis increased by 27.6% during 1963 and the death rate rose from 7.8 to 9*9 per 10,000, 5*+ were reported after death comparedto *f5 for 1962.

SCHOOL TUBERCULIN TESTING PROGRAM; During the seventh yerr of this program, a more selective testing was limited to schools in higher prevalence areas. Of 35,595 tests given, 1,369 were read as positive (3.9%). This compares with 2.3% for the previous year. By casefinding 23 cases were found in the schools and 6 cases were found through the family contact investigation. Thus tuberculin testing at this level continues to be a good casefinding tool and a good instrument of prevalence in the various areas of the city.

TUBERCULOSIS CASE FINDING BY X-RAY, ACTIVE NO. FILMS TBC FOUND

UNIT LOCATION 101 Grove Total

1963 PREVIOUSLY UNKNOWN

CANCER OF LUNG

23,773

6l

46

6

70 mm 22,3^ 14 x 17 1,429 San Francisco Hospital Admission Program 11,329

21 40

l8 28

2 4

38

33

4

S.F. Jail #1

if,5*f7

23

18

1

20,691

13

13

12

S.F. Tuberculosis Assoc iation46,6?l

13

S.F. Medical Society

33

32

2,742

7

6

109,753

175

-48

North East Health Center TOTALS

36

SAN FRANCISCO SCHOOL TUBERCULIN SKIN TESTING PROGRAM GRADES TESTED; 1, 7, 10 and 12; entire grade level once per year; and all students new to San Francisco schools. All previously known Positive Reactors who had 10mm. or more of induration were excluded from testing, but those who had 6 - 9 mm. of induration were retested. SCHOOL YEAR

TOTAL

1956-57

1957-58

1958-59

1959-60

1960-61

1961-62

1962-63

Students Tested 201,858

25f 286

16,904

29,5m

34,038

28,699

32,005

35,395

1,^92

1,125

1,765

2,267

1,651

749

1,369

Positive Reactors Found Percent Positive Reactors

10,41.8

5,2%

5.9%

6.7%

6,0%

6,7%

5.8%

2.J>%

3.9%

CASEFINDING RATE PER 1,000 TESTS GIVEN 1956-1963 Cases Case Rate Family Contact Cases In School Per 1,000 Plus School Cases

YEAR

44 32 44

1956-1957 1957-1958 1958-1959 1959-1960 1960-1961 1961-1962 1962-1965

1.8 1.8 1.5 1.6 1.3 0.3 0.6

54 38 10 25

Case Rate Per 1,0 00 2.k 2.4 2.1 2.7 2.0 0.7 0.8

62 42 62 93 58 21 29

SUMMARY OF TYPES OF TUBERCULOSIS FOUND AND SCHOOL LEVEL 1956-1965

TYPE OF TUBERCULOSIS

TOTAL

GRAND TOTAL I.

II.

III.

PRIMARY

SR.

66

38

141

138

2

20

116

57 45

15

12 12

EXTRA PULMONARY Meningitis Miliary Lymphadenitis Pleural Effusion Genito-Urinary

TOTAL PT. VISITS

ELEMENTARY

245

PULMONARY 84 Minimal 67 Moderately Advanc edl4 Far Advanced 3

CHEST CLINIC,

JR. HIGH

HIGffi

10 5

9

3

23

3

7 1

2 2 11 7 1

4 1 1

2

Table 29 SAN FRANCISCO HOSPITAL, Pt. Visits for Treatment

Pneumoperitoneum and Chemotherapy

%

NO.

2 6 4

1950-1965 Pt. Visits for Follow-Up Without Treatment Observation and Contacts NO,

26,139 23,401 2^,577 27,598 31,409 33,262 36,742 32,374 31,685 33,786

3,833 4,122 5,771 8,234 13,731 19,975 24,492 25,518 26,441 28,579

14.7 71.6 23.5 29.8 43.7 60.1 66.7 78.8 83.4 8*t.6

17,678 13,287 12,250 6,856 5,244 5,207

29,039 28,499 31,337 40, 318

25,966 25,049 28,645 37,420

89.5 89.4 91.4 92.8

3,3^3 3,450 2,692 2,898

-32-

13 1

22,306 19,279 18,806 19,36**

85.3 82, *l

76,5 70.2 56»3 39<9 33.3 21.2 16.6 15 .A

11.5 10.6 8.6 7.2



5

Table 30 REPORTED TUBERCULOSIS CASES AND DEATHS CASE AND DEATH RATES PER 100.000 BY TYPE OF DISEASE AND RACE San Fr ancisco Residents, 1963

ALL RACES CASES

TOTAL

51A

_I22_

375

260

91

48

31 31

_2i-

_53_

Pulmonary Primary Other DEATHS

TOTAL

Pulmonary Other

S



1

594, 600 5* 2 S.9

S3. 9.9

1

9

7

749*900

CASE RATE

DEATH RATE

2

6

J

14

22.

38

!3 28

7

ESTIMATED POPULATION

_6j

77

CTHER

JAPANESE

CHINESE

NEGRO

WHITE

35.300 90.3 9.4

4-0

1

3,900 307.7

10,800 129.6 9.3

14,500 151.7 13.8

.8 00

164.2 2^.5

Table 31 NEW CASES OF TUBERCULOSIS REPORTED BY RACE, TYPE OF DISEASE AND SEX. SAN FRANCISCO, 196?

ALL TYPES

RACIAL GROUP

FEMALE

HALE

TOTAL

ALL RACES

-51A.

White* Negro Chinese Filipino Japanese Other

322

219

I] 22

12

TOTAL

14JL

375

103 26 24 10

260

267

*l 14 10 10

14.

I

12

MALE

White includes Mexican

OTHER

PRIMARY

PULMONARY FEMALE

T

1M_

91

M

48

??

?

'2

3

3

1

3

25

12 15

6

5

2

1

F

?6

14 12 10

11

1

M

40

12

5

T

SI

11

3

F

6 4

1

18 2

3

1

2 2

1 1

1

1

Table 32 PERCENT OF CASES BY STAGE OF DISEASE FOR NEW CASES OF PULMONARY TUBERCULOSIS FOR WHOM STAGE OF DISEASE WAS REPORTED San Franci sco, 19S3 - 196? STAGE OF DISEASE

A9&

1962

1961

ALL STAGES

Minimal Moderate Far Aovanced

l\

I] 20

25

1960

1252

100

100

19t,R

11

11

8

24

31

27

Table 33 new cases of tuberculosis reported by race, age amd sex San f ran,ciseq, 12& AGE GROUP (YEARS)

TOTAL

TOTAL T TOTAL

Und ER _ 1

_5Ji

4

5<

m

9

24

10 15

m -

14

11

19

14

20 25

— • • -

24 29 34 39

JS 42 39

35

44

40

45

_

50 55

• -

60

64 . 69 4 Over

65 70

CHINESE

WHITE

IT H

F

m m

21a

4 12 18 18

12

i<»

_2£

i

f

13

21

FILIPINO M F

JAPA NESE F

fi

F

JJ2

_5

i

6_

12.

OTHER

1

5

50

Fl

8 59

11

12

24 21

46 28

32 19

14 9

41

11

3*

30 28

42

30

1

-

-

3

1

-

1

23

$ 6 9

6

14 27 1$

12

23

10

5

32

27

S

21

3

bl

46

15

37

12

-33-

NEW CASES OF TUBERCULOSIS REPORTED BY HEALTH DISTRICT OF RESIDENCE San Francisco, 1963

HEALTH DISTRICT

CASjlS

ESTIMATED POPULATION

CASE RATE PER 100.000 POPULATION

PERCENT OF ALL CASES

514

749,900

68.5

100.0

Alemany Central Eureka Noe Hunters Point

38 97 36 25

77,600 81,500 74,200 49,200

49.0 119»0 48,5 50.8

7,4 18.9 7,0 4.9

Marina-Richmond Mission Northeast

51 64 111

122,500 73,200 92,700

41.6 87.4 119^7

9.9 12.5 21.6

Sunset Westside

31 48

131,900 47,100

23.5 101.9

6.0 9.3

District Not Reported

13

TOTAL

2.5

Table 35 INTERVAL BETWEEN REFORTING OF TUBERCULOSIS AND DEATH San Francisco Residents, 1963

DYING FROM TUBERCULOSIS

INTERVAL TOTAL

years years years years 5 10 - 14 years 15 years and over 2 3 4 9

Reported after Death Reported only on certificate

TOTAL

221

295

8 2 1 2

10 10 5

18

4 2 2

18 9 10

22 11 12

10 12

60 39

.51

7V

Less than 6 months 6 - 11 months 12 - 17 months 18 - 23 months

DYING FROM OTHER CAUSES

12 6 6

4

70

4

29

33

24

14

38

3

13

16

Table 36 PERSONS HAVING HAD TUBERCULOSIS WHOSE DEATHS WERE CODED TO OTHER CAUSES San Francisco Resicents, 1963

CODED CAUSE OF DEATH

INTERNATIONAL LIST NUMBER

TOTAL Heart Diseases Malignant Neoplasms Cirrhosis of Liver Vascular Lesions of C.N.S. Accidents Pneumonia Diseases of Respiratory System Arteriosclerosis Diabetes All Others

NUMBER OF DEATHS

221

410-443 140-205 58I 330-334 8OO-965 490-493 470-527 450 260

64 41

32 6

7 14 16 6 3 32

Table 37

NEWLY REPORTED CASES AND TUBERCULOSIS DEATHS OCCURRING IN SAN FRANCISCO

1920 -

YEAR

POPULATION

19frS

NEWLY REPORTED CAS£S RATE

1920

NUMBER

1921

506.676* 52§-777

278.5 256,2

1922 1923 192*

532 512 551 2*7 563 982

261 e 6

223.1 216.9

III

1925 1926 1927 1928 1929

5 6 I

20*.*

6**

589

602 61* 627

717 *52 187 21 657

2.1 2,1

1.8

621

111.7 103.7 98„5 101.1 93.9

561

88.*

563

JR

88.7 8*„0 7*.2

2c 2

*53

7L*

1.9 2,1

*61

71.6 72.7

*6o 396 *2*

b2„* 66.i

tt

661

593

63*

63* 63* 63* 63* 63*

39**

1932 1933 193*

*55

206.3 207.6 189-0 161.7 136.3

1935 1936 1937 1938 1939

63* 63* 63* 63* 63*

*69 *8* *9g 512 525

1*7.5 1*0.7 13*„6 159.5 130.3

*5*

19*0

63* 536*

1*8.9

19*1

129.1

19*2 19*3 19**

673 109 711 682 750 255 828

*20 *39

19*5 19*6 19*7 19*8 19*9

827 817 806 796 785

1950

357* ffl 200 200 700 757 100

1930 1931

1951

1952

111*

m Mil 1958 1959 1960 1961

1962 1963

U. S.

*11 *26 **1

*00* *00 600 200 800

g

RATE,

132.2 121,2 118,3 120,8 117.2

ill

611

182,8 185,9 232,0

NEWLY REPORTED CASES

DEATHS

1.8

M

1.8 1.8 2.3 2.3 2.3 2.2

U9 2.0

66.2

2e 2

65,1

2.0 2»5 2.3 2.*

13*o8 111.6 131.0

381

430

5*0 5

102.9

*70 397 350 333

56,8 *8 U 6

301

38.3

2 15

27.7

*.0

23.1 27*7

s§ *.o

18.8 17.3

6.0

111

8

13*c* 122.6 127.5 112,1

10*.* 111.1

92.* 103.7

7*0 100 73* 800 73* 600

Hi *3,*

m.s

180 21* 1** 131

116

15.7 12,5 10.6 10.3 9.7

92

lU

300 7*2 900 7*0 71* 7*5 7*9

2.2 1.8

316*

1.8 2-3 3.1 2.9 3.3

*.9

li 1:1 5.9

10.3

000 000 900

58

7.8

s

7*

9.9

6.9

Census

Rates per 100,000 population

Population estimates as cf July 1, 1951-1959, and 1961 . by California State Uepartment of Finance.

-35-

^963

REPORTED CASLS OF TUBERCULOSIS BY HEALTH DISTRICTS RATES PER 100,000 ESTIMATED POPULATION

SAN FRANCISCO,

1963

Under 30

60 - 89

30 - 59

90 - 119

-36-

-AN FRANCISCO DEPARTMENT

OF

PUBLIC HEALTH

STATISTICAL REPORT

City and County of San Francisco DEPARTMENT OF PUBLIC HEALTH Central Office lOI

GROVE STREET Zone 2

July 22, 1965

The informauion contained in the Statistical Report of the San Franciscc Department of Public Health is obtained primarily through the birth and death certificates sent to us by practicing physicians in San Francisco, or from those reallocated to us by the State Department of Public Health in the case of births and deaths of San Francisco residents which occur' outside of San Francisco. Another major source are the morbidity reports of reportable dis eases 'jhich we receive from practicing physicians. Included in the Statistical Report are data and information secured from the United States Census Bureau.

The conclusions that we can draw from these data are dependent upon tht accuracy of the original information, and are included in order that the reader may have some insight into the social and cultural structure of the City and County of San Francisco, which is the patient of the Department of Public Health. The information with reference to births and deaths and reportable, diseases gives us an understanding of the problems that face the community of San Francisco in the field of community health, and the trends that are indicated enable us to judge where our activities have been successful, and tfhere they have not; also, they point out the diseases or segments of the population toward which we should concentrate our attention.

Additional information about census data and birth and death statistic? which were not included in this report are available from the Bureau of Reeords and Statistics of this department, through Miss Mildred Holota, Chief of that Bureau.

ELLIS D. Director of Public Health

CONTENTS PAGE Births Communicable Diseases Deaths Infant Deaths Marriages and Divorces Maternal Deaths Population

1.

2. 3. 4. 5.

6-1. 6-2. 7 8. 9.

15

24 4

21 2 8 1

Tuberculosis Map Tuberculosis by Health Districts, 1964 Map Tuberculosis by Census Tract, 1964 Venereal Disease Chart Gonorrhea, 1960-1964 1960-1964 Chart Syphilis, Map Venereal Disease by Health Districts, 1964 TABLES

PAGE 31 37 38 24 28 29 27

Deaths from important causes, San Francisco & U.S., 1964, Cal. , 1963 8 Causes of death, all ages, 1960-64 8 Causes of death by sex, rates and percent, 1964 S Maternal deaths, San Francisco, California and ILS., 1960-1964 Death rates for Whites, Negroes and Chinese, 1964 9 10 Causes of Death by ten-year age group, 1964 11 Causes of Death, rates and percents, by age group, 1964 Detailed causes of death, residence and occurrence, 1963-1964 12 & 13 14 Selected morbidity, natality & mortality data for health districts, 1964 17 Birth rates by Ethnic Group and Sex, 1964 Recorded, resident and non-resident births by place, 1963-64 17 Resident live births by place and ethnic group, 1964 17 18 Resident births by ethnic group and health district, 1964 18 Live births by trimester prenatal care began by place of birth, 1964 Place of birth of low weight infants by ethnic group, 19 1964 Premature births by ethnic group, birth weight, length and gestation, 1964 19 Birth weight, gestation and ethnic group of 11,454 live births, 20 1964 21 Infant deaths by ethnic group and sex; rates, 1963-1964 21 Infant deaths by ethnic group and age, 1964 Infant mortality by age and cause, 22 1964 22 Fetal deaths by place of delivery and ethnic group, 1964 Cases and deaths from communicable diseases, 1960-1964 23 Infectious Venereal Disease cases by age group, 1959-1964 2^ Civilian cases of venereal disease, 1964 and 5-year median 25 26 Venereal disease cases, 1959-1964 26 Venereal disease by source of report, 1964 26 Venereal disease by health district, 1964 Venereal disease reported by private physicians, 1959-1964 30 Venereal disease by age group and stage, 1964 30 Chest Clinic, San Francisco General Hospital, 1950-1964 33 Tuberculosis cases, deaths, and rates, 1964 33 34 Tuberculosis: New cases by ethnic group, type and sex, 1964 fulmonary tuberculosis, percent of cases by stage, 1960-1964 34 Tuberculosis cases by sex, age and ethnic group, 1964 34 34 Tuberculosis cases by health district, 1964 Tuberculosis, interval between reporting disease and death, 1964 35 Tuberculosis cases whose deaths were coded to other diseases, 1964 35 Tuberculosis cases, deaths and rates, 1920-1964 36

.

GENERAL INFORMATION San Francisco, one of the original 27 counties in the State, was also incorporated as a city in 1850. Located on the tip of a hilly peninsula, its total area is 129.25 square miles of which less than one-half or 45.451 square miles is land. Excluding islands, its land area is 29,089 acres. The estimated population density in 1964 was 16,627 people per square mile, the highest in the state. It has an equable climate with an average daily temperature range of 12.1 degrees, from a daily mean maximum temperature of 62.6 to a daily mean minimum temperature of 50.5 degrees; rainfall averages about 21.6 inches yearly. The city enjoys about 66% of sunshine during the daylight hours. The provisional estimate of population for July 1, 1964, made by the California State Department of Finance was 755,700, ar increase of 5,800 over the 1963 estimate of 749,900 and 15,384 or 2.1% over the April 1, i960 census figure of 740,316.

POPULATION OF SAN FRANCISCO BY ETHNIC GROUPS U. S. CENSUS

ESTIMATE ETHNIC GROUP

1964

TOTAL

755,700

740,316

775,357

634,536

White

593,200

604,403

693,888

602,701

Nonwhite

162,500

135,913

81,469

31,835

89,4oo

7^,383

43,502

k,ske

Chinese

^2,^00

36,4^5

24,813

17,782

Japanese

11,30C

9,^64

5,579

5,280

Filipino

15,300

12,327

4,100

3,294

Negro

Other

I960

1940

1950

Included in Other.

7,575

3,927

PERCENT IN EACH ETHNIC GROUP TOTAL

100.0

100.0

100.0

100.0

.Jhite

78.5

81.6

89.5

95.0

Nonwhite

21.5

18.4

10.5

5.0

11.8 5.6 1.5 2.0

10.1 4.9 1.3 1.7

0.6

0.4

Negro Chinese Japanese Filipino

Other

-1-

0.8 5.6 2.8 3.2 0.8 0.7 Included in Other. 1.0

0.6

:

:

POPULATION BY SEX U.S. CENSUS

ESTIMATE I960

196**

1950

1940

TOTAL

755,700

740,316

775,357

634,536

Male

367,400

363, 424

389,866

322,441

Female

388,300

376,892

385,491

312,095

0.95

O.96

1.01

1.03

M/F fiatio

POPULATION BY AGE GROUP

ESTIMATE 1964

AGE GROUP

I960

1950

1940

ALL AGES

755,700

740,316

775,357

63^,536

Under 5 Years 5 - 14 Years 15 - 24 Years

59,600 110,700 91,500

58,851 98,189 91,155

62,921 75,944 99,358

30,333 61,080 90,269

23 - kk Years 45 - 6k Years 65 & Over

182,500 206,500 104,900

199,362 199,151 93,608

262,705 200,379 74,050

229,821 171,326 51,707

PERCENT IN EACH AGE GROUP

ESTIMATE 1964

U.S. CENSUS

Ijgo

1950

1940

100.0

100.0

100.0

100.0

7-9 14.7 12.1

8.0 13.3 12.3

8.1

5 - 14 Years 15 - 24

9.8 12.8

4.8 9.6 14.2

25 - 44 45 - 64 65 & Over

24.1 27.3 13.9

26.9 26.9 12.6

33.9 25.8 9.6

36.2 27.0 8.2

TOTAL Under 5

Years

MARRIAGES The number of marriage licenses issued during the calendar year 1964 was 7,393, an increase of 371 or 5.3% over the 1963 figure of 7,022 and 757 or 11.4% over the i960 figure of 6,636. The rate per 1,000 estimated population was 9.8 in 1964, 9.4 in 1963, 9.2 in 1962 and 9.0 in i960. DIVORCES During the calendar year 1964, 3,089 divorce actions were filed a decrease of 52 or 1.7% over the 1963 figure of 3,l4l. During i960, 3,284 divorce actions were filed; thus the number for 1964 was 5.9% lower than I960.

-2-

MaRkIaGE LICENSES ISSUED

YEARS

DIVORCE nCTIONS FILED

FINaL DECREES OF DIYjORCE

ANNULMENTS GRANTED

1950-51 1951-52 1952-53 1953-54 1954-55

8328 7306 7395 6860 6631

4543 4391 4327 4096 3867

2842 29^0 2917 3088 2598

468 478 552 517 499

1955-56 1956-57 1957-58 1958-59 1959-60

6645 6965 6526 6665 6703

3676 3500 3508 3434 3350

2604 2432 2442 2257 2357

483 463 477 499 417

1960-61 1961-62 1962-63 1963-64 1964-65

6670 6704 6921 7201 7618

3322 3198 3108 3160 2975

2275 2161 2243 2178 213^

394 421 454 418 379

Tentative ?nd provisional rates for the United Stotes, California and 4 Bay Area counties for the calendar years 1960-64 and final figures for San Francisco based on enumerated population for i960 and estimated populations for 1961-64 are:

BIRTH RATES PER 1,000 POPULATION

m&

U.S.

CALIF.

ALAMEDA

I960 1961 1962 1963 1964

23.6 23.4 22.4 21.6 21.2

23.7 23.2 22.1 21.5 20.5

12.9 £2.9 21.7 21.5 20.5

CONTRA COSTA

MARIN

SAN FRANCISCO

SAN MATEO

22.8 22.3 20.7 19.5 18.9

22.9 21.8 20.7 19.3 18.5

19.9 19.8 19.0 18.5 17.5

22.5 21.8 20.6 19.7 18.7

13.3 13.1 13.1 13.3 12.7

6.5 6.5 6.5 6.6 6.6

DEATH RATES PER 1,000 POPULATION

i960 1961 1962 1963 1964

9.5 9.3 9.5 9.6 9.4

8.6 8.3 8.2 8.4 8.3

6.3 6.1 5.9 6.1 6.0

9.3 9.0 8.9 9.3 9.1

7.2 6.5 6.8 6.5 6.7

the downward trend in crude birth rates that began in 1957 continued in all the jurisdictions listed. The U.S. birth rate decreased 10% from i960 to 1964; California's was 13. 5%. Alameda County had the smallest decrease, 10.5%. then San Francisco with 12.1%. San Mateo had a nearly 17% decrease, Contra Costa had just over 17% and Marin was highest with a decrease of 19.2% in the birth rate since i960. Yet marriages continued to increase in the U.S. California and San Francisco in 1964 as in 1963. *.gain in 1964,

,

With the exception of San Mateo County, all jurisdictions showed a decrease in the crude death rate from i960 to 1964 ranging from the 1% decrease in the U.S., 3$ %. in California as a whole to the 6.9% decrease experienced in Marin County.

-3-

.

:

The age-ad justed death rate, direct method, for San Francisco in 1964 was 7.6 per 1,000 population, a record low for the city and county. The San Francisco rate for 1964 was within 3% of the United States estimated age-adjusted death rate of 7.4 for 1964 and was the same as the U.S. rate in 1963 and i960. The San Francisco rate has been decreasing each year; the 196l rate was 8.5; 1962 was 8.3 and 1963 was 8.0. In 1950, the U.S. rate was 8.4. Using the indirect method of age-adjusting, the San Francisco rate was 7.9 in 1964, compared to 8.4 in 1963.

Crude birth and death rates for San Francisco since 1950 are based on population estimates prepared by the State Department of Finance for inter-censal years. The birth rate is continuing its downward trend; mortality declined in 1964 also.

YEAR

SAN FRANCISCO ESTIMATED POPULATION

1950 1951 1952 1953 1954

RESIDENT DEATHS

DEATH.

RESIDENT BIRTHS

BIRTH RATE*

775,357 (Census 778,200 772,200 764,700 757,100

15,477 15,505 15,710 15,364 15,171

20.0 19.9 20.3 20.1 20.0

9,204 9,527 9,693 9,435 9,160

11.9 12.2 12.6 12.3 12.1

1955 1956 1957 1958 1959

740,100 734,800 734,600 744,300 742,900

14,540 14,565 15,240 15,104 14,634

19.6 19.8 20.7 20.3 19.7

9,161 9,548 9,600 9,375 9,559

12.4 13.0 13.1 12.6 12.9

I960 1961 1962 1963 1964

740,316 (Census) 744,000 745,000 749,900 755,700

14,728 14,703 14,177 13,839 13,239

19.9 19.8 19.0 18.5 17.5

9,825 9,736 9,777 10,004 9,598

13.3 13.1 13.1 13.3 12.7

RATE*

DEATHS During the calendar year 1964, there were 9,598 resident deaths, a decreas< of 406 or just over k% from the 10,004 deaths in 1963. The crude death rate was 12.7 per 1,000 estimated population, the lowest rate since 1958. The average age at death for males was 64.0 yerrs after having been 63.9 in 1963, 63.4 in 1962 and 62.8 in 1961. The average at death for females dropped to 67.8 years in 1964 after having been 68.0 in 1963; it had been 67.4 in both 1962 and 1961. The median age at death for males in 1964 was 67.7 compared to 67.8 in 1963 and for females 73.0 in 1964 as against 73.7 in 1963

TABLE 1, Deaths from important Causes for San Francisco, California and the United States lists 1964 final figures for San Francisco residents, provisional 1964 figures for the U.S. and provisional 1963 figures for California. About 70$ of the deaths in each jurisdiction are included in the first four causes though as usual the rates in San Francisco are considerably higher than either in California or the U.S. Cirrhosis, the fifth cause of death in Son Francisco is seventh in California and ninth in the U.S. Influenza and pneumonia was the sixth cause in San Francisco and California, fifth in U.S. Suicides, seventh in San Francisco were eighth in California and eleventh in the U.S.; the rate decreased slightly in San Francisco over 1963, increased slightly in California nnd remained the same nntionwide. *

Rate per 1,000 population. -4-

In California and the U.S., "Certain diseases of early infancy" were in fifth and sixth respectively, but remained in eighth place in San Francisco, probably because of the smaller number of births. Emphysema advanced to the ninth cause of death in San Francisco in 1964 from tenth in I963 and to the tenth cause in California in 196** from twelfth in 1963; nationally it was twelfth in 196** compared to thirteenth in 1963.

General arteriosclerosis was tenth in San Francisco and ninth and seventh in California and the U.S. respectively. Rates for tuberculosis declined in all jurisdictions; in rank it was fifteench in San Francisco and well below that in both California and the United States. Since 1950, the San Francisco death rate has fluctuated from 11.9 per 1,000 to highs of 13.3 in i960 and 1963; seven times during the fifteen year period, 1950 to 1964 the death rate was higher than the 12.7 rate of 1964 and seven times it was lower. TABLE 2 lists important causes and rates for the past five years. Again in 1964, about three-quarters of the deaths were included in the first five causes; rates for these declined from 1963 except for accidents. Heart disease, the leading cause of death in each year, accounted for nearly 37% of the deaths at all ages in 1964; Arteriosclerotic Heart Disease, including coronary artery disease, made up 82% of the heart disease deaths. Eighteen percent of the deaths were coded to cancer. Cirrhosis of the liver was again the fifth cause of death, not having been in fourth place since 1961. Emphysema continued to increase in importance as a cause of death; the rate of 22 per 100,000 in 1964 was almost double the i960 rate and was about 17% higher than the 1963 rate.

Causes of death by sex are shown in TABLE 3. The male death rate in 1964 was 15.2 per 1,000 estimated male population, a decrease from 15.8 in 1963. The death rate for females, as usual about two-thirds of the male rate, decreased to 10.3 per 1,000 estimated female population in 1964 from 11.0 in I963. Generally speaking, male rates were higher for each cause than females with the customary exception of vascular lesions of the Central Nervous System and in 1964, hernia and intestinal obstructions. The most striking differences between the sexes are emphysema, which accounted for 2.6% of the male deaths but only 0.6% of the female deaths and then accidents and cirrhosis where the rates for men are twice as high as the rates for women. Relatively minor causes such as aortic aneurysms, ulcers, tuberculosis and homicides also show marked differences for the sexes.

TABLE 5 lists the leading causes of death for the three major ethnic groups and some figures for the remainder. The overall nonwhite death rate in 1964 was 6.6 per 1,000 estimated population as it was in 1963 but in 196*t, increases in the Filipino and other nonwhite rates offset the decreases in the Chinese and Japanese rates. Again in 1964, the Negro rate was 6.5 per 1,000 estimated population, although the number of deaths incrcnsed '».7%. -5-

Although the white death rate decreased to Ik.k per 1,000 in 196^ as against a rate of 15.1 in 1963, it was still twice as high as the other ethnic groups. Ranking causes of death have a scattered pattern except for heart disease and cancer Occidents were the which are first or second in all groups except other nonwhite. third cause of death among Negroes and fourth among whites and Chinese where it had the same rate as influenza and pneumonia. For whites, cirrhosis was the fifth cause; for Negroes vascular lesions and for Chinese tuberculosis were fifth. Certain diseases of early infancy were the fourth cause for Negroes, though the rate decreased slightly from 1963; it was sixth among the Chinese, along with suicide and cirrhosis, though all three of the diseases showed marked decreases from high 1963 rates. Death rates specific for age and sex for whites and nonwhites and for certain leading causes by these characteristics are included in the 1961 Statistical Report of the San Francisco Department of Public Health.

TABLE 6-1 is a listing of the major causes of death by smaller age groups than are included in TABLE 6-2; accidents are classified by type. In 196** accidents were the leading cause of death from age one through kk; in 1963 cirrhosis outranked accidents in the age group 25-*+*+ but in 196*+, it took second place. Though accidents were the fifth cause of death in age groups ^5-6*+ and 65 and over, death rates for accidents increased steadily with age; the rate for those 65 and over was 172 per 100,000 estimated population as against rates of less than 100 for younger age groups. Nearly one-third of these accidental deaths were caused by motor vehicles and kl% were to pedestrians. Home accidents decreased from 32 to 30% from 1963 with falls causing about one-half of the deaths. Heart disease did not become the first ranking cause of death until age group V? to 6*+; it was also the leading cause for age group 65 and over; by decades shown in TABLE 6-1 it was first cause in every decade from k$-5k on.

Cancer is listed as a leading cause in those 15-2*+ and 25- Vt, it is the first three causes in the 15-2*+ age homicide and suicide in that order; year age group were suicides.

in each of the broad age groups, fourth place second cause in the two older age groups. The group are all external in nature, accidents, again in 196*+, 10% of the deaths in the 25-M+

Of the suicide deaths whose length of stay was reported, 85% had lived in San Francisco five or more years and 73% had lived here 10 or more years. The cirrhosis death rate decreased slightly in 196*+ from 1963 and it was not the first cause of death in any age group though it was second and third in 25-'+'+ and *+5-64 respectively. Of tho&e whose length of stay was reported, nearly 88% had lived in San Francisco five or more years and 79% ten or more years.

-6-

TABLE 1 DEATHS FROM IMFORTANT CAUSES SAN FRANCISCO, CALIFORNIA AND UNITED STATES, RATE PER 100,000 POPULATION

RANK

CAUSE OF DEATH

S.F. Cal.* U.S.

S.F.

Cal.*

lg64

PERCENT OF TOTAL DEATHS

U.S.

S.F.

Cal.

U.S.

-

-

-

1270.1

835.3

941.3

100.0

100.0

100.0

Heart Diseases

1

1

1

468.7

320.2

367.0

36.9

38.3

39.0

Malignant Neoplasms

2

2

2

228.7

138.3

151.6

18.0

16.6

16.1

Vascular Lesions C.N.S.

3

3

3

119.6

88.7

104.9

9.4

10.6

ll.l

Accidents

4

4

4

70.8

50.6

54.1

5.6

6.1

5.7

Cirrhosis of Liver

5

7

9

62.1

19.7

12.3

4.9

2.4

1.3

Influenza and Pneumonia

6

6

5

48.6

26.4

31.2

3.8

3.2

3.3

duicides

7

8

11

27.9

17.3

10.7

2.2

2.1

1.1

Certain Diseases of Early Infancy

8

5

6

24.9

30.2

31.1

2.0

3.6

3.3

Emphysema

9

10

12

22.4

11.1

9.3

1.8

1.3

1.0

Arteriosclerosis

10

9

7

21.6

14.8

19.4

1.7

1.8

2.1

Diabetes

11

12

8

14.2

10.2

16.8

1.1

1.2

1.8

12

13

14

12.4

6.9

5.7

1.0

0.8

0.6

Ulcers of Stomach and Duodenum

13

14

Ik

11.9

6.6

5.7

0.9

0.8

0.6

Hernia and Intestinal Obstruction

1*+

15

16

9.8

4.3

5.1

0.8

0.5

0.5

Congenital Malformations

15

11

10

7.9

10.7

10.8

0.6

1.3

1.1

Tub.rculosis

15

19

18

7.9

3.4

k.2

0.6

O.k

O.k

Infections of Kidney

16

16

15

6.6

4.2

5.3

0.5

0.5

o.<

Homicide

17

17

17

6.5

4.1

5.0

0.5

0.5

0.5

Chronic and Unspecified Nephritis

18

18

13

6.1

3.8

5-8

0.5

0.4

0.6

_

_

-

91.5

63.8

85.3

7.2

7.6

9.3

ALL CAUSES

t

ortic aneurysms

i\ll

"Other Causes

SOURCES:

San Francipoo: r.-ili

fornia:

Department of Public Health Records Ounnmni.cn tion from State Department

of Public Health Provisional 1963 figures Monthly Vital Statistics Report, Vol. 13, No. 13 July 2, 1965. hovisinnal Statistics for 1964 *

United States:

5

Table 2

DEATHS FROM IMPORTANT CAUSES, ALL AGES San Francisco Residents, 1960-1964

NUMBER ALL CAUSES

Heart Disease Malignant Neoplasms Vascular Lesions of C.N.S.

Accidents Cirrhosis of the Liver Influenza and Pneumonia Suicides Certain Diseases of Early Infancy Emphysema

Arteriosclerosis Diabetes Aortic Aneurysms Ulcers of Stomach and Duodenum Hernia and Intestinal Obstruction Congenital Malformations Tuberculosis All Other

RATE PER 100,000 POPULATION 19^1

13£!k

12fi3

JL2&

9S98

10,004

9777

3537 1728 904

17l6 1003

3759 1733 935

3683 1708 1002

s

529

192

4?3 316

468 489

367

196o

i2&t

ia&j

iafia

lafii

9825

i?7iv.i

Htt.n

1312J

una. 6

1*77.1

3771

468.0 228.7 119.6

502.6 228.8 133.8

504.6 232.6 125.5

*95.Q 229.6 13^.7

509.4 229.9 129.8

62.1

IV

48.6

42,

66.0 60.8 42.3

27.9

30.3

24.9 22.4

29.9 19.2

31.*

'}»

70.8

til 296

281

%1

227

213

214

224

1W

206 95

226

169

234 119

163

160

165

'8

101 111

170 128 93

197 116

21.6 14.2 12.4

21.3 13.5 14.8

90

88

90

108

90

11.9

68

60

51

56 72

B

81

7

7*

58

2

'2

842

900

851

915

40.0 29.7

27.7 12.8

30.5

22.8 17.2 12.5

22.2 11.8

26.6

11.7

12.1

14.5

12.2

9.8

9.1

7.9 7.9

10.8 9.9

6.9 14.4

76

8.0 9.9 7.8

8.9

7.6 9.7 10.3

891

111.4

120.0

114.2

122.8

120.3

90

6o

m & 62.9

28.3

87

88

28.6

i?fo,

16.0

1U7

12.1

Table 3

IMPORTANT CAUSES OF DEATH BY SEX WITH RATES PER 100,000 POPULATION San Francisco Residents, 1.964

FEMALE CAUSE OF DEATH At, L

NUMBER

CAUSE S

-5.591

Heart Disease Malignant Neoplasms Vascular Lesions of C.N.S.

PERCENT

NUflBER

RATE

PERCENT

10Q .Q.

4P.Q7

10*1.9

100.1

37 «5 17.8 7.2

1442 503

371.4 188.3 129.5

36.0 18.2 12.6

*5.t

4.4 4.0 3.9

2095 997

570,2 271 i*

401

109.1

Accidents Cirrhosis of the Liver Influenza and Pneumonia

360 308 209

98.0 8}.8

6.4

!H

41."

56.9

1:1

158

3.7

Emphysema Suicide Diseases of Early Infancy

147 132 100

4n.o 35.9 27.2

2.6 2.4 1.8

22

5.7

I?

20.3 22.7

82 65 62

22.3

81

20.9

16.9

ill

ii

53

14.4 14.2 9.5

2.1

9.3

39 15

10.0

34

0.9 0.9 0.6 0.6

8

35

3.9

0.4

29

7.5 94.0

0.7

Arteriosclerosis Aortic Aneurysms Ulcers of Stomach and Duodenum Diabetes Tuberculosis Hernia and Intestinal Obstruction Hbmioioes

Congenital «alfo«ha.tions ^LL Others

52

1

M

31

428

H

116.

M ATERNAL DEATHS, UNITED STATES,

YEAR

RATIO PER U.S.

731

CALIFORNIA AND SAM FRANCISCO,

m,0 00 CAL.

i:!

:i 3.4

!:? N.A.

-3-

1960-1964

LIVE BIRTHS

5JV 2.0

j:j

13.9

365

1:1

2.0 0. 0. !:]

5

?:1

0.6 2.0 2.2

NUMBER IN S.F.

1.3 0.2 1.0

9.1

Table 5 LEADING CAUSES OF DEATHS FOR SAN FR/.NCIbCO WHITES, NEGROES AND CHINESE WITH RANK ORDER AND RATE PER 100,000 POPULATION, 196**

WHITE RANK ALL CAUSES

NO.

RATE

32

67.1 42.5 35.8

198 159 152

33.4 26.8 25.6

2 2 6

2.2 2.2 6.7

18.9 2.4 16.5

109 88 86

18.4 14.8 14.5

52 12 3

58.2 13.4 3.4

18.9 9.4 7.1

2.2

2.4

44o 417 317

1 2 5

12 4 9

Ulcers of Stomach and Duodenum 12 Hernia and Intestinal Obstruction 13 Infections of Kidney 14

86

14.5

62 45

10.5 7.6

10

Congenital Malformations Tuberculosis Nephritis Homicide

43 41 37 28

7.2 6.9 6.2 4.7

11 12

606

102.2

All Other

RATE

60 38

4

5 6

-

NO.

74.2 70.3 53.4

Accidents Cirrhosis of Liver Influenza and Pneumonia

15 16

RANK

652.1

548.4 261.3 136.5

Diseases of Early Infancy 10 Diabetes 11 Aortic Aneurysms 12

RATE

168.9 92.8 54.8

3253 1550 8lO

9

NO.

583

1437.5

1 2 3

7 8

RANK

151 83 49

8527

Heart Disease Malignant Neoplasms Vascular Lesions C.N.S.

Suicide Arteriosclerosis Emphysema

CHINESE

NEGRO

-

8

301

709.9

89

209.9 l4l.5 84.9

1 2

60

3

36 11 11

25.9 18.9 25.9

9 3

10.1 3.4

-

-

2 1

4.7 2.4

7 6 3 15

7.8 6.7 3.4 16.8

7 5 -

7 9 3 3

16.5 21.2 7.1 7.1

48

53.7

29

68.4

There were 89 deaths of Filipinos with a rate of 5.8 per 1,000 estimated population; among them 28 from heart disease, 17 malignant neoplasms, 6 cerebral vascular lesions, 5 each accidents and cirrhosis of the liver, 3 each pneumonia and tuberculosis, and 2 suicide, nephritis, congenital malformations and certain diseases of early infancy. There were 52 deaths of Japanese with a rate of 4.6 per 1,000 estimated population; among them 16 malignant neoplasms, 11 heart disease, 7 certain diseases of early infancy, 3 accidents, and 2 each pneumonia and emphysema.

In the other non-white group there were 46 deaths with a rate of 11 ,2 per 1,000 estimated population; among them 16 accidents, 10 diseases of early infancy, 5 heart disease, 3 cerebral vascular lesions, and 2 each malignant neoplasms, pneumonia and homicides. -9-

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tQ 05 •H U)

sso S-.

•H ij

B

a

p..-j

£3

0>

"

Table 6 DEATHS FROM IMPORTANT CAUSES BY AGE GROUP WITH RATES PER 100.000 POPULATION SAN FRANCISCO r 1964

AGES 1 _ t YEARS TOTAL NUMBER ' TOTAL M F

CAUSE OF DEATH ALL CAUSES

46

21

25

'

RATE

CAUSE OF DEATH

100.0

97*5

ALL CAUSES

tf

Accidents Congenital Malformations Malignant Neoplasms Influenza and Pneumonia

14

30.4

29.7

7 5 4

15.2 10.9 8.7

10.6 8.5

All Other

16

ALL CAUSES

109

Accidents Homicides Suicides Malignant Neoplasms Vascular Lesions C.N.S. Congenital Malformations Asthma Influenza and Pneumonia Heart Disease

All Other

57

10

73

43 6

36 It t 3

8

5

6

1

5

J

2 2

1

i

34.8

i

2

z

1

1

2

2

-

52.3

9.2 7.3 5«5 2.8 2.8 2.8 1.8 1.8

1

13.7

2617

171*9

868

869

646

223

641

370

272

'&

H2

187 8?

141

96

g6 72 46 26

8 39 25

24 22 21

19 15 15

206

8

8 8

12

5 7

9

6

12't

8?

RATE

CAUSE OF DEATH

62.3 10.9

1:2 3.3 3.3 7.3

2.2 2.2

16.4

33.2 24.5 10.4

2.8 1.7 1.0 0.9 0.8 0.8 0.7 0.6 0.6

7.9

°

*M 68.3 41.6 34.9 22.3 12.6 11.6 10.7 10.2 9.2 7.3 7.3

99 J?

-11-

#

RATE

ft

^8

16

100.0

48.8

29

24

5 2

53.7 14,8 14.8

26.2 7.2 7.2

5

16.7

8.1

t 6

25 . 44 YEARS TOTAL

"

5ko

108

AcClOENTS 90 Cirrhosis of Liver 80 Heart Disease 66 Malignant Neoplasms Suicides 56 21 Vascular Lesions C.N.S. 18 Influenza and Pneumonia Homicides '! Diabetes Ulcers, Stomach & Duodenum 7 Nephritis, Chr. and Unspec 'I Tuberculosis A LL

Other

56

CAUSE OF DEATH

ALL CAUSES

mp

V*

RATE

83 49 61

25 35

?17

inii.il

^^-9

25

20.0 16.7 14.8 12.2 10.4 3.9 3.3 3.2

59.2 49.3 43.8

tl

19

H

21

12 9

9 ? 6

11

5

M

3b,

2

30.7 11.5 9.V

53

3 5

2

5

2

1.3 1.3

3

3

1.1

3.« 3.3

27

29

10.4

30.7

M

OVER TOTAL

2727

100.0

5676.8

1785

1199

2463.'

S91

411

304

477 110

47.4 16.8 12.4 3.9 3.0

_sass. ^272

Heart Disease 2584 Malignant Neoplasms 1002 Vascular Lesions, C.N.S. 737 Influenza and Pneumonia 180 Accidents Arteriosclerosis 156 Emphysema 119 Cirrhosis of Liver 107 Aortic Aneurysms 78 Diabetes Ulcers, Stomach, Duodenum Suicides So Hernia, Int. Obstruction 47 Infections of Kidney Hypertension without Heart33 22 Male Genital Organs Dis. Tubercuiosis 27 Nephritis 22

8

All Orwcfl

Nlfl BET

M

ALL CAUSES

ARES 65 RATE

420.8 310.4

tl

11

:i

All Other

1267.3

5.4

1

33.9

100.0

60

20

1M

A GES

<-GES tt - 64 YEARS TOTAL NUMBER •<& TuTAL H t

ALL CAUSES

AcClOENTS Congenital Malformations Malignant Neoplasms

100.0 119.1

1

15

Heart Disease Malignant Neoplasms Cirrhosis of L| V er Vascular Lesions, C.N.S. Accidents Suicides 'nfluenza and Pneumonia Emphysema Tuberculosis Diabetes Ulcers, Stomach, Duodenum Hernia, Int. Obstruction Homicide Aortic Aneurysms Nephritis

All Other

11

AGES 15-24 YEARS TOTAL NUMBER TOTAL H F 4

CAUSE OF DEATH

CAUSE OF DEATH

5

AGES C . It YEARS TOTAL NUMBER F TOTAL H

375

125 105 76 106 76 52

a

8

IS 80 13 71

26 78 18 26

5° 11

y

27 16 _

24

7

95*«

2.0 1.8

702.6 224. C 171,6 148." I1J # * 102.0

\i

•*i. c

Z,(>

1.0 1.0 0.8 0.6

12

10

0.6 0.4 0.4 0.4

194

181

6.3

«8.;

SM

44.8 37.* 31." 21.0 ?5.' 21.0

357.5

f

1

Table

7

CITY AND COUNTY Of SAN FRANCISCO

DEATHS FROM SELECTED CAUSES,

BY PLACE OF OCCURRENCE AND RESIDENCE,

19

TOTAL,

ALL CAUSES

19

4

6

DEATHS BY RESIDENCE

SEVENTH REVISION INTERNATIONAL LISTS

CAUSE OF DEATH

1964

001-E999

NUMBER

RATE*

9,593

12?0.1

PERCENT" 100.0

DEATHS

BY

OCCURRENCE

9,905

6 3

RESIDENT

NUMBER 10,004

RATE* i33^»o

SELECTED COMMUNICABLE DISEASES TugERrinnsis, Respiratory Other Forms

An

Fa rms

1*2

k&

7 «?

0.6

020-029 053 055

1.9 0.7

0.1 0,1

057

oil

0T1

001-019 001-008 010-019

Totai

Syphilis Septicemia and Pyemia Diphtheria Meningococcemia Infectious Encephalitis Infectious Hepatitis

6o

082-08? 092

Other Infective and Parasitic Diseases Residual 030-138 1nflu£N7a and Pnfumonia Total Influenza Pneumonia, except of Newborn

SELECTED DISEASES,

54-

0.4

4«0-493 480-483 fc? 0-493

0Z7

oil

1.2

0.1

Sfr 9 358

48.6 1.2 V7.4

3.8

1778

13*

228.7 9.3 17.7

*53

59.9

JL 70

.sua 9.3

4

0.5

11

8

!:?

1

0.1

5

3

0.7 0.4

3

o.ft

6

0.8

jH

0.1

1

0.1

3-7

262

315

42.0

18 T Q

2095

Ul£

22M

3

1*5

M

537

470

62,7

370

278

37.1

USUALLY CHRONIC IN NATURE

MALIGNANT NEOPLASMS: TOTAL Buccal Cavity ano Pharynx Stomach

140-201;

140-148

70

151

Other Digestive Organs and Peritoneum

150,152-155,157- 159

Trachea, Bronchus and Lung

162-163

Other Respiratory System not specified as Secondary

305

40.4

3.2

28

3.7

0.3

160,161,164

1.) 18.8

31

16

179

135

2.1

Breast Cervix Uteri Other Uterus Other female genital organs

171

41

•H

172-174 175-176

23

3.0

0.4 0.2

22

9

51

6.7

0.5

64

5*

".2

Male genital organs

177-179

89

11.8

0.9

101

87

11.0

Urinary organs

180-181

81

10.7

0.8

98

77

10.-

Hodgkin's Disease 201 Leukemia and Aleukemia 204 Other Lymphatic and Hematopoietic 200,202 Tissues 203,205

12 67

1.6 8.9

0.1

o.7

Other and Unspecified Sites

Benign and Unspecified Neoplasms

Diabetes Hellitus

Ulcers of Stomach and Duodenum

5,1

11

1.-'

104

71

?.'-

0.7

83

83

11,1

21.7

63

8.3

171

22.6

1.8

212

163

210-239

19

2.5

0.2

24

23

3.1

107

14.2

1.1

113

101

13-5

169

30.4 22.4

1.8

170

144

61

8.1

0.6

57

44

ft 123

m 16.3

1.3

131

35 5 138

18.1*

90

11.9

0.9

99

88

11.7

74

9.8

0.8

74

68

9.1

502.0,527.1 241,501,502.1 525,526 .

50

18.

156,165 190-199

260

Selected Respiratory Diseases tMPHYSEMA Other Selected Respiratory Diseases CIRRHOSIS OF THE LIVER Without mention of Alcoholism With mention of Alcoholism

140

170

-S1L. 581.0

-

581.

-

540-541

Hernia and Intestinal Obstruction 560,561,570

-12-

222-

-2S~--

5.5

6<;~

S0.4

373

19.2

J

Table 7,

Continued

DEATHS FROM SELECTED CAUSES

19 CAUSE Of DEATH

SEVENTH REVISION INTERNATIONAL LISTS

CARDIOVASCULAR-RENAL DISEASES,

6

19

1

DEATHS

DEATHS BY RESIDENCE

6 3

RESIDENT

OCCURRENCE

NUMBER

RATE*

50.9

1779

5266

702.2

119.6 0.7

9.1

818

1003

0.1

7

3

133.8 0.1

168.0 9.8 80,6

36.9

3177

^769

6.3

191

1172

301.8 28.8

23.8 2.3

2320 208

1961

218

193

261.9 25.7

105 250

13.9 33.1

1.1

2.6

108 252

70 292

38.9

NUMBER

RATE*

1883

616.2

330-331

901

loo-ii-02

5

TOTAL

BY

PERCENT**

Vascular Lesions of the Central Nervous System

Rheumatic Fever

DISEASES OF THE HEART. SUBTOTAL JHflaAJH Chronic Rheumatic Heart Disease 11 0-11 arteriosclerotic Heart Disease 120.0 Heart Disease specified as involv ING Coronary Arteries 120.1 Chronic Endocarditis and Myocardi TIS121-122 Other Diseases of the Heart Hypertension with Heart Disease

Hypertensicn without mention of Heart Disease

3537

609 2281

I30-I3I 110-113

oX

78

502.6 10.1 156.3

111-117

11

5.1

0.1

37

16

6.1

General Arteriosclerosis

150

163

21.6

1.7

126

160

2U3

Aortic Aneurysm, Non-Syphilitic and Dissecting

151

91

12.1

1.0

122

152-168

93

12.3

1.0

102

123

16.1

592-591

16

6.1

0.5

60

51

6.S

W

Ms

0.1

11

162

70-8 22.9 1.9 21.1

1.7

171

171

• 163

21.6

1.7

156

162

11.8

Other Diseases of the Circulatory

System Nephritis, Chaonic and Unspecified

ACCIDENTS, POISONINGS AND VIOLENCE

-^1

Accidents.. -Total Motor vehicle Other Transport Home Other Non-Transport Residual

810-835,960 800-802,810-866 870-936 with .0 870-936 with .1 910-959,961,962

SUICIDES

963,970-979

211

27.9

2.2

236

227

HOMICIDES

961,980-985

19

6.5

0.5

16

38

-

.9

.1SLS 23.'

121

h 21.6

30.3 5.1

ALL OTHER CAUSES

Complications of Pregnancy, Childbirth and the Puerperium 610-689

-

1

0.5

5

7

0.9

Certain Diseases of Early Infancy

760-776

188

21.9

2.0

213

221

29.9

Congenital Malformations

750-759

60

7.9

0.6

136

81

10-8

Gastritis, Duodenitis, Enteritis, 513,571-572 Colitis

38

5.0

0.1

12

12

5.6

117

55.2

1.3

111

159

61.2

31

1.1

o.3

10

27

3.6

all Other Specified Causes

Residual

Symptoms, Senility, Ill-Defined ano Unknown Causes

780-795

**

Rates per 100,000 population. PfRTFNTS A* CALCINATED.

-13-

lA \8

O

T-

ON

•-

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< Ju 2 1-US3 O II o a: >- z 2<—< — o- 3

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tf:

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KN

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uj

«o

*h- CO

«-

s en tovc

VD

:

*-

IfN

(T\



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«-

K\

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•—

O

*-

£

-J

lO

O

CO c/->

C

ar

CL

CD UJ <-

-J

-H

v

v-

.-

xo

CM

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CV

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VO

«-

O

«•

«-

ro

SO

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w

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— O*— 1

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5 3 Ul «- O —

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:

BIRTHS During 1964 19,229 births were recorded in z^n Francisco, the lowest number since 1953, when there were 19,038 recorded births. In 1956 and for six years after thrt, the number of recorded births exceeded 20,000, reaching a high of 20,804 in 1961. A downward trend began in 1962 which still continues. .Although ncn-resident births decreased to 6,224 in 1964 from 6,394 in 1963, they were 32.4% of the total number of births compared to 32.0% in 1963; the highest percent prior to 1964. Resident births occurring outside the city in 1964 decreased to 234 births from 255 in I963 and 1962. The number of resident births was therefore 13,239 with a crude birth rate of 17.5 per 1,000 estimated population, the lowest number and rate in the fifteen years since 1950. The ratio of male births to female births was 100.5 in 1964, lower than the ratio of 106 in 1963. The percent of primiparas increased to 37.9% in 1964 from 36.9% in 1963; the percent having borne two children was exactly the srme, 25.4% and the percent having borne three or more children was slightly less than in 1963*

The white birth rate continued to decrease; the rate in 1964 was 15.1 per 1,000 estimated population compared to 16.1 in 1963, 16.3 in 1962 and 17.3 in i960. In I960, the number of white births was 10,460 and by 1964, the number had decreased to 8,959 or 14%.

Although Negro births increased by about 1% in 1964 over 1963, the rate decreased to 27.9 per 1,000 estimated population compared to the 1963 rate of 28.9; the rate in i960 was 33.3 per 1,000 enumerated population. The number of Chinese births remained almost the same but the rate decreased to 19.5 in 1964 from 20.2 in 1963, because of the increase in the population estimate; the rate in i960 was 23.7 per 1,000 enumerated population. Filipino and Japanese birth rates declined slightly.

Again in 1964, the number and percent of unmarried mothers continued to increase. There is no item about the "legitimacy" of a birth on the California certificate and therefore the conclusions should be used cautiously. For whatever it is worth, there were 1,531 such births in 1964, 11.6% of the total number, an increase of 8.8% over the 1963 figure of 1,407, when the socalled illegitimate births were 10.2% of the total. Both white and negro out of wedlock births increased, the Chinese decreased by one- third, and the others remained the same as in 1963* Nearly 45% of the unmarried mothers were white, 51% Negro and 4%, other races. Half of the infants were first-born children. About 51% of the deliveries took place at San Francisco General Hospital; nearly 27% of these were white and 69% Negro. Seventy percent of the white mothers were delivered at hospitals other than San Francisco General Hospital while 69% of the Negro mothers used the county facilities.

The percent of mothers under age 20 increased to 33% in 1964 from 31% in 1963; 35% were between 20 and 24 years of age.

TABLE 15-1 :Presents information on live births by three standards of prematurity for the ethnic groups. Using a birth weight of 2500 grams or under as a criterian, 8.2% of all births fell into the low-weight category. Percents by ethnic groups were 12.8% for the Negroes, 10.2% for Filipino, 9.9 for Japanese. 8.0 for Chinese, 7.0% for whites and 6.2 for the other group. Nearly 2ZZ> of the low weight births took place at San Francisco General Hospital; next highest were Kaiser with 11% and U* C. with nearly 9%.

-15-

Using length at birth, of under 18.5 inches all the nonwhite groups had percents considerably higher than the white group which was 9.2%] their percents ranged from 10.5 for Chinese to 19*1 for Negroes. Using under 37 completed weeks of pregnancy as a criterion, 8.8% of all births were premature. Percents for ethnic groups varied from 15.*$ for Negroes to a low of 3.8$ for the Chinese. The percent for Chinese represents only 59% of the 1964 certificates and so no accurate picture can be obtained for any criteria including gestation period as a factor. Excluding the unknown gestation periods and computing a new percent gives 6.4% which is considerably lower than the percent for any ethnic group.

Information about gestation period appeared on 86.3% of the certificates, weight on 99*9% and length at birth on 99.5%. Congenital malformations were mentioned on 1.1% of the live birth certificates as was also the case in 1963. Additional information from the medical items on birth certificates is available from the Bureau of Records and Statistics.

Mission Health District had the highest birth rate, 24.8 per 1,000 estimated population, lower than its 1963 rate of 26.6 but higher than the Hunters Point rate for 196*+ of 23.8. Mission's rate of low weight babies was only a trifle higher than the city wide rate of 82.5 per 1,000 live births but Hunters Point's rate was 110.1 and Westside's nearly 105. Sunset Health District again enjoyed the lowest rate for low birth weight, infant and fetal death rate. The birth rate in North East continued to decrease as did the proportion of Chinese births; from 8l% in 1953, 69% in I960, the percent dropped to 59% in 1964. Mirina-RLchmond's proportion of Chinese births increased to 16% in 1964 from 12.5% in 1963 and 9% in I960.

Births in ethnic groups as percents of total births continued the patterns set in previous years. White births decreased to 6?. 7% of the total in 196*+ compared to 81.2% in 1950 and 71.0% in i960. Nonwhite births increased to 32.3% in 1964 compared to 18.8 in 1950 and 29.0% in i960.

RESIDENT LIV E BIRTHS BY ETHNIC GROUPS AS A PERCENT OF ALL BIRTHS , TOT/iL

YEAR

WHITE

1950 1951 1952 1953 1954

81.2 80.3 80.2 78.6 77.3

1955 1956 1957 1958 1959

i960 1961 1962 1963 1964

NEGRO

CHINESE

18.8 19.7 19.8 21.4 22.7

9.5 11.1 11.0 12.4 13.1

7.0 6.4 6.1 5.9 6.0

0.8 0.9 1.0 1.3

76.1 74.5 73.7 72.9 71.4

23.9 25.5 26.3 27.1 28.6

14.0 14.9 15.3 16.3 16.8

6.0 6.2 5.9 5.7 6.1

1.4 1.6 1.6 1.5 1.6

71.0 71.2 69-4 69.I 67.7

29.0 28.8 30.6 30.9 32.3

16.8 17.1 18.1 17.8 18.8

5.9 5.6 5.6 6.0 6.2

1.8 1.7 1.8 1.5 1.6

NONWHITE

-16-

JAPANESE

1950-64

OTHER NONWHITE FILIPINO OTHER 1.5 1.3 1.7 1.8 2.2

1.4

2.5 2.8 1, .8

2, .3 2, .7

3. .0 2. .8 3. .1 3. ,4

3- ,1

1.7 1.3 1.4

1.5 1.6 2.0 2.2 2.6

6

TABLE 9 RESIDENT LIVE BIRTHS AND BIRTH RATES BY ETHNIC GROUP PER 1 OOO ESTIMATED POPULATION Saw Francisco, 1964 & 196*

L3 ETHNIC GROUP

BIRTHS ,

QTAL

T.

White Negro Chinese

Filipino Japanese Other

19

6.f

MALI

fEjJALE

4,466 1,237 409

13+aa.

17,^

8,95?

15.1

2 491

27.9 19.5

1,25*

325 212 3*0

26.9 18.8 82.9

213 100 159

6 3

BIRTHS

_L2*S

13.83?

41

16.1

28.9 20.2

32.6 19.7 76.9

472 213 300

199 112 181

TABLE 10

RECORDED, RESIDENT San Francisco

AI'D

NON-RESIDENT LIVE BIRTHS 8Y PLACE 1964 and 196s

RECORDED PLACE OF BIRTH

NON.RESIDENT

RESIDENT

125JL

I2£i

19,229

iq t Q7«

Kaiser Foundation Hospital U. C. Hospitals Children's Hospital San Francisco General Hosp. St. Mary's Hospital

2727 2222 1953 1945 1509

2689 2335 2025 1898 1684

iary's Help Hospital Letterman General Hospital St. Luke's Hospital Presbyterian Medical Center St. Francis Memorial Hosp.

1J82 1218 1178 983

15 9£ 1368 1232 843 1032

416 4*2 332

271

419 269

1126 370 555 450 282

53 20 14

3

TOTAL

Ht. Zion Hosp. 4 Medical Ctr. St. Joseph's Hospital French Hospital Chinese Hospital St. Elizabeth Infant Hosp.

Home Emergency Hospital Elsewhere

940 919 762 711

iSffll

6,??4

H.239

6,394

97

262 286

30 203

Other California Out of State TABLE 11 SAN FRANCISCO RESIDENT LIVE Bj RJHS_ BY PLACE ANO ETHNIC GROUP,

1964

OTHER PLACE OF BIRTH

TOTAL

WHITE

13.259

S,9W

1929 1652 1277 1256

742 993 993 928 S30

,

IPTA L .

San Francisco General Hosp. Kaiser Foundation Hospital U. C. Hospitals Children's Hospital Mary's Help Hospital St. Mary's Hospital

966 942

St. Luke's Hospital

846 Letterman General Hospital 736 Mt. Zion Hospital 4 Medical Ctr, 648 Presbyterian Meoical Center 646 St. Francis Memorial Hospital 643 St. Joseph's Hospital 500

728 492 406 402

French Hospital Chinese Hospital St. Eli7abeth Infant Hosp. Home Emergency Hospital Elsewhere

360

Other California Cut of State

m

NEGRO 825 1030 426 144 28 48

95

55

14 4

8

25

21

32 79 22

41

7

6

58 18

'! 5

2o6 28

-17-

9)

I

TE

?12

3fta

6

108 21

II

14 22

6

?!

3

•7

I

13

17

1

66

14

90 41

190 130 28

NOWH

FILIPINO

357

19

10 12 54 11 1

TABLE 12 RESIDENT BIRTHS 3Y HEALTH DISTRICT and ETHNIC GROUPS 4ITH RATES 1.000 ESTIMATED POPULATION,

J3£L TCTAL BIRTHS

BIRTH FILIPINO

JAPANESE

RATE

WHITE

NEGRO

CHINESE

>VI f

17. %

8,?W

2,491

82<;

412

?1?

^40

"LEMANY

1,394

17.7

1,021

273

28

41

9

22

Central

1,585

19.5

744

639

30

88

21

63

eureka-noe

1,539

20.3

1,377

37

29

45

14

37

Hunters Point

1,216

23.8

463

636

15

29

2

71

Marina-Richmond

1,7"^

1

f.2

1,378

78

132

49

78

29

Mission

1,859

24.8

1,424

261

28

81

5

60

TOTAL

n

OTHER

North East

1,069

11.7

510

23

486

13

11

26

Sunset

1,806

13.7

1,666

15

51

33

31

10

Westsioe

897

IM

24

32

39

22

District Not Reported

130

263

517

113

TABLE 13 LIVE BIRTHS BY TRIMESTER PRENATAL CARE BEGUN AND PERCENT BY PLACE OF BIRTH, San Francisco Residents , 1964

PLACE OF BIRTH

1st

TOTAL

TRIMESTER

2nd TRIMESTER

3rd TRIMESTER

NO CmRE OR NOT REPORTED

NO.

_n t 2y?

100.0

6027

«:2^

4^o

San Francisco General Hosp. Kaiser Foundation Hospital U. C. Hospitals

1,929 1,652 1,277

100.0 100.0 100.0

209 885 317

10.8

872 605 665

Children's Hospital Mary's Help Hospital St. Mary's Hospital

1»2S6 966 942

100.0 100.0 100.0

930

74.1 52.6 78.1

245 323

19.5

177

48.8

St.

Luke's Hospital Letterhan General Hospital

846

Mt. Zion Hosp. 4 Med. Ctr.

Hi

100.0 100.0 100.0

6 2-9 47.6 71.2

253 337 155

29.9 45.8 23.9

Presbyterian Medical Center Francis Memorial Hosp.

646 643 500

100.0 100.0 100.0

129 73

20.1

425

TOTAL

St.

St. Joseph Hospital

French Hospital Chinese Hospital

508

736 533

at

24.8

83.6

St. Elizabeth Infant Hosp.

'8

100.0 100.0 100.0

291 27

Home Emergency Hospital Other California

?! 2o6

100.0 100.0 100.0

2

11.1

126

61.2

59

28 8

100.0 100.0

6

21.4 25.0

3

Out-of -State Elsewhere

296

12

2

utafi

u.2

516

JL-2

30.1

268

13.9

5fci

580 134 275

20

a

52.1

74.8 40.9 20.7

-18-

¥1 15

4

8.1

21.5

14

65

i

w \a

5.8 4.0

o.s o.s 0.°

14.6

16.9 2.3 1.2

0.6

24.7 18.5 40.9

4.0 6.4 16.7

i.5

25.9 27.3 28.6

17.2 16.7 7.3

36.2 44.4 2.9

14.3 37.5

3.6

28.8

326 492 418

32.6

6

109 15

-l

1.'

\,i

60.1

'I

5?:5

PLACE OF BIRTH OF LOW SftN FftAN C |<;cP

R

TABLE 14 INFANTS BY ETHNIC GROUP 12i4

'-'EIGHT

ESmNTS,

PLACE OF BIRTH

TOTAL

TOTAL

1092

HHITE

NEGRO

fe3

.^

San Francisco General Hospital Kaiser Founoation Hospital U. C. Hospitals

CHINESE

FILIPINO

JAPANESE

!t2

2J

&

1q

OTHER NONNHITE

1M-9

44 29

w

Children's Hospital Letterman General Hospital Mary's Help Hospital

21

15 ^9

16

Mt. Zion Hospital and Medical Center Presbyterian Medical Center St. Luke's Hospital

30 bo

23

50

I

St. Mary's Hospital St. Francis Memorial Hospital

49

4

French Hospital

32

5

1

St. Joseph's Hospital

1

f

Chinese Hospital Other California Home

Emergency Hospital

It

1

5

2

2

2

St. Elizabeth's Infant Hospital

2

Out-of-State Elsewhere

2 1

TABLE 15-1 PREMATURE LIVE BIRTHS BY ETHNIC GROUP, BIRTH HI IGHT, LENGTH AMD GESTATION PERIOD San FaAwciscQ RESxriENta, _ iq64

NUMBER PREMATURE BY ONE CRITERION:

Weight at Birth (2500 grams A under) Length at Birth (under 18,5 inches ) Gestation Period (under 37 weeks ) Thin

TOTAL PREMATURE

WHITE

NEGRO

1092 1514 1163

623 823 635

319

ft 37

12 60

21 31

58

31*

53

20

484 797

266 44o 252

1 59 251

If 12*

26 15

CHINESE

F

I

L

I

P

I

NO

JAPANESE

OTHER NQNHHITE

rR ITER A: I

Weight and Gestation Weight and Length Length ano Gestation ALL THREE CRITERIA:

491

392

187

12

137

PERCENT OF PREMATURE LIVE BIRTHS BY ONE CRITERIA;

Weight at Birth Length at Birth Gestation Period

8.2 11.4 i.8

7.0

12.8

9.2

19.1

7.1

»5.»

8.0 10.5 3.8*

2.r

6.2 11.2 11.8

10,2 14.6 12.9

9.9 14.6 9.4

g

M

3.5

2.9

5.2

2.4

TWO CRITERIA:

Weight and Gestation Weight and Length Length and Gestation ALL THREE CRITERIA; *

3.0

6.4

6.0 3.7

4.9 2.8

10.1

3.0

2.4

>;.5

hi

5.7

7.5

1.S*

6.1

Only 59$ of the Chinese Mothers reported last day of normal menses from which length of gestation The figures for Chinese should be used cautiously if at all. perioo is calculated.

-19-

2.9 5.0

TABLE 15_2 BIRTH WEIGHT, GESTATION AND ETHNIC GROUP OF San Frami-isco,

UNDER 3 Lb. RACE

TOTAL

Oz.

tt»&5_

ANY GEST. PERIOD

JL23-

78W

90

2273

61

IV MORE THAN

3 Lb, 5 Oz. THRU 5 LB. 8 Oz.

TOTAL

GESTATION IN UEEKS

White Negro Chinese Filipino Japanese

5

RESIDENT LIVE BIRTHS

it 14.54.* 1964.

UNOER 37

t;7

OR MORE

417

JLSiL

M.92

360 193

199 112 16

246 118 2*

16 7

'1

31—

UNDER

Lb.

i

,

oz.

^7 OR MORE

__!__

93 30.

369

693 a 1757

S\

<*33

33 7

289 166

30

2^7

?.7

q.9

«-_ 88.5

OTHER NONWMTE 294

PERCENT

1

5

EACH GROUP

IN

TOTAL

10(1.0

1.5

White

100.0

1.2

2.5

3.1

*;.

Negro

100.0

2.7

1.9

5.2

9.9

77.3

Chinese

100.0

1.0

3.3

*.»

2.8

88.0

fi|L|P|NO

MOO.O

1.1

M

5.0

9.2

80.3

Japanese

100.0

3.6

3.6

3.1

3.6

86.1

OTHER NONHHITE

100.0

2.0

2.0

1.7

10.2

g*% 1

3-1

* SAN FRANCISCO RESIDENT LIVE BIRTHS FOR WHCH GESTATION INFORMA TIO N HAS NOT REPORTED BY ME IGHT GROUP

ME IGHT

* TOTAL

JUBJHJL

GHI3DP"

TTXTll

OF

UNDER

LIVE 3

Lb.

.

Oz

3 Lb. 5 OZ. iLafl- 8 _z_.

u

&

iv

HEIGHT AND GESTATION

v

UVER

-its-

8 nz_

.

._NOT_RE.PQR.TEO_

TOTAL

LS19

1I~7

*6

146

16^1

6 _

White

1132

12.6

16

88

1023

5

Negro

230

9.2

12

28

190

21

312

337

40.8

4

Filipino

52

12.6

1

if

>7

Japanese

20

?.*

1

1

17

OTHER NONWHITE

48

H.I

Chinese

K2

One White infant, gestation over 37 weeks and one Filipino gestation under 37 weeks, WHOSE HEIGHT WAS MOT REPORTED ARE EXCIIIOEO PROM THIS TABLE. 3.6 INFANTS UNDER 3LBS., 5 OZ. WITH NO INFORMATION ON GESTATION ARE INCLUDED IN GflfHIP T.

-20-



INFaNT Dj^THS:

In 1964, the number of infant deaths decreased by 20% from 346 in 1963 to 276 in 1964 with a drop in the death rate from 25.0 per 1,000 live births to 20.8 in 1964. Numbers and rates for the whites, Chinese and Japanese decreased; the Negroes with the same number of deaths in each yeer had a light drop in rate because of the increase in live births but the other nonwhite group number nearly doubled with a jump in the rate from 23 in 1963 to 38 in 1964. Nearly 73% of the infant deaths occurred in the first week of life and 51% during the first day. Prematurity v/as mentioned as a causal factor in at least 53% of the infant deaths (if a congenital malformation is mentioned, it generally takes precedence and the prematurity is not coded) and in 75% of those who died within 24 hours of birth. One encouraging note was the decrease in the number of accidental deaths from 19 in 1963 to 5 in 1964.

TABLE 16 INFANT DEATHS BY ETHNIC GROUP AND SEX San Francisco Residen ts, 1964

TOTAL TOTaL

male

RATE PER 1,000 LIVE BIRTHS 1963 1964 25-0 20.8

FEMALE

276

150

126

white

167

94

73

18.6

24.5

Negro

71

35

36

28.5

28.8

Chinese

13

7

6

15.8

27.8

Japanese

7

3

4

33.0

37.6

r'ilipino

5

3

?

12.1

6.4

13

8

5

38.2

23.3

28 DAYS 11 MONTHS

Other

TABLE 17 INFaNT DEATHS BY ETHNIC GROUP San Fro nc is co Residents,

AM

<.Gt.

1964

UNDER

1-6

TOTAL

24 HRS.

DAYS

7-27 DAYS

276

142

58

14

62

hite

167

82

38

9

38

Negro

71

41

12

3

15

Chinese

13

3

5

l

4

Japanese

7

6

1

_

Filipino

5

3

13

7

TOTAL

Other

-21-

TABLE 13 INFANT DEATHS FROM SELECTED CAUSES BY AGE San Francisco Residents, 196U-

INTERNATIONAL CODE NUMBER

CAUSES OF DEATH

ALL CAUSES TOTAL WITH nEflTIOM Of PREMATURITY

CONGENITAL MALFORMATION & CERTAIN DISEASES OF EARLY INFANCY EXCEPT INFECTIONS Congenital Malformations 750-759 Injury at Birth 760-761 Asphyxia and Atelectasis 762 Disorders attributed to disease of mother during pregnancy 769 Hemorrhage of Newborn 771 Ill-Defined Diseases 773 Immaturity with Subsidiary Condition 774 Immaturity, unqualified 776 NFECTIONS Pneumonia of newborn Other Pneumonia Other Respiratory Diarrhea of Newborn Gastro-Enteritis and Colitis Sepsis of Newborn Non-Meningococcal Meningitis I

ACCIDENTS Motor Vehicle Collision Fall on Same Level, Home Mechanical Suffocation, Home OTHER Cystic Fibrosis Hernia with Obstruction Intussusception Subarachnoid Hemorrhage Assault

NEO-NATAL SUB-TOTAL

TOTA

UNDER HRS.

?it

U2

1-6 DAYS

gift

_112_

ML

203

199

30

23

11

30 35

3

11

3^

?

11

MONTHS

53

23k.

13*

28 DAYS _

Says

56

10 2 1

i

20

1

'I

~753

50

50

-55_

J2.

J«_

5

49 0-^93 *7*, 500-527

35 5 f

7blf

,571

1

767-768 3^0

ft it

M 903.0 92^-925

2«V 560 570 3 2° 9«3

TABLE 19 RESIDENT FETAL DEATHS BY ETHNIC GROUP AND PLACE OF DELIVERY

&6N FjiAHCISCCv-

,

_.196Jt

OTHER PLACE OF OEL VER Y

TOTAL

I

IQIAk

'HITE

NEGRO

CHINESE

76

111

San Francisco General Hosp. Kaiser Foundation Hospital Children's Hospital St. Luke's Hospital

27 25

6

21

20 11

2 2

2

IS

12

1

-

St. Mary's Hospital Mt. Zion Hospital & Med. Ctr.

It

11

2

13

5

7

Hospitals Mary's Help Hospital

11

7

10

7

St. Francis Memorial Hospital Presbyterian Medical Center St. Joseph's Hospital Letterman General Hospital

10 10

9

U.

C.

French Hospital Elsewhere Home Other California Chinese Hospital Emebgency Hospital Out-of-State *

1

(

50

I 1

k

7

1

1

1

_ 1

5

5

-

-

5

2

3

-

3 2 2

1

3 3

3

i;

•H

1

1

_ _ -



1

1

1

1

1

1

-

Unknown.

-22-

FILIPINO

JAPANESE

NON'.'HI TC

1__

o

1

.

-23-

— lilt k-\—

O

I

<

)

on*-*

rr*o

I

•-

t

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t-

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CMUNLCN

In

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CM

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k\»-

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r*N«\»

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T*N

I

*— «— =** *— t-

II

t

I

UN

I

I

|

l

VO

tod — \c

I

1

icm-*

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(

ITOTX>K\ONC\|K\ TO f«NTJO rr\-r-

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|

|

Ol*>

f

I

t

I

|

|

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|

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>-



COMMUNICABLE DISE/iSES: During 1964 there was a 14% increase in the number of reported cases of communicable diseases chiefly because of the increase in gonorrhea discussed elsewhere in this report and in such childhood diseases as chickenpox, German measles and measles. 1964 was the second successive year with no cases of poliomyelitis or typhoid fever. There were no cases of diphtheria in 1964. The number of cases of infectious hepatitis declined to 150 in 1964 compared to 184 in 1963 but there were 5 deaths in 1964 compared to 3 in I963. The increase in the totel number of deaths from communicable diseases was chiefly due to pneumonia. Although there were 4 more cases of meningococcal meningitis in 1964 than in 1963 the number of deaths remained at 5« »

VENEREAL DISEASES: Data developed during 1964 revealed that venereal diseases, despite continuing and constantly expanding intensive efforts by the Division's personnel, could not be considered under control by any accepted standards. Early syphilis (primary, secondary and early latent), which had in 196l fallen below the previous high year of I960 and which had remained at a fairly even level for the next severel yerrs, rose to a new high of 619 cases in 1964. This represented an increase of more than 10% over the number of cases reported in 1963« The increases were in the categories of both lesion syphilis which is the most infectious diagnostic category (primary and secondary), 293 cases compared with 277 in 1963, and early latent syphilis, 326 cases, compared with 283 in 1963. Since infectious syphilis is generally thought to be a reasonable index of the problem in a community, it would appear that the situation previously thought to have been somewhat contained, if not controlled, had further deteriorated. It should be remembered that these numbers represent only the reported proportion of cases. It has been estimated that possibly 80% of all cases that have developed go unreported. Almost 60% of the total tabulated were reported by the City Clinic and only about 31% by physicians in private practice and 9% by other sources. Gonorrhea, of which little has been expected in the way of control, continued in character. The 4826 cases that were diagnosed represented about a 12% increase over 1963. It is noteworthy that epidemiologic efforts, to the extent possible with limited personnel time, continued despite certain obstacles inherent in the disease itself. Many among the 4826 cases diagnosed were brought to examination and treatment only through the tireless work needed in contact tracing. Also, al.most 1000 named contacts were treated prophylactically. Many of those so treated were probably incubating, thereby preventing the development of active disease, and many were actually diseased but with falsely negative cultures. Most of these latter were symptomless and would have unwittingly continued to infect many others. But for this form of treatment, the total of diagnosed cases undoubtedly would have been much greater. Again, it should be remembered that the data presented represent only cases that have been reported. Almost 90% of the total reported were by the City Clinic and about 10% were reported by private physicians and other sources.

In TABLE 21, are presented date showing involvement in the different age groups. In 1964, about one half of all reported cases were in those between 15 and 25 years of age. At the same time, this age group constituted 12% of the City's population. Only about one half of one percent of the problem, insofar as diagnoses were concerned, were in those under 15 years of age, and TABLE 27 points out that this was mostly confined to gonorrhea. Also, in the unrlei- 1 *> y«*ra of age £:roup, the gonorrhea was found principally amon^ f«ma!«s. -24-

TABLE 21 also shows the precentage increases in the various age groups during the five-year period since 1959* The startling fact is that the greatest percentage increase, by far, was in those between the ages of 15 and 19, or essentially children in high school. Whatever the reason or combination of reasons for this increase, one cannot help but be impressed with the need for properly presenting information about venereal diseases to these young people. At its very worst, it would result in confused children presenting themselves for diagnosis and treatment before late, serious complications develop. At its best, many cases of venereal diseases would be prevented. TABLE 21 INFECTIOUS VENEREAL DISEASES* BY AGE GROUP AGE 6R0UP

TOTAL - 14 15 - 1? 20 - 24 25 - 3^ 35 45 4 Over

J252

i960

1961

JL2£2.

1963

1964

?9?0

3176

3680

4267

4876

«**$

12

287

814 1317

W

4oo 90

AGE GROUP

14 408 1102 1504 519 133 PERCENT OF CASES 16

2.7

338 91? 1384

468 1332 1705

1

®

31

w

32

1785 2083 646 172

1523 1873 693 177

1252

1960

1961

196?

13&

02£i

100.0

100.0

100.0

100.0

100.0

100.0

— 1415 - 19 20 - 24

0,4 9,8 27.9

0.4

13 *§

*5.1 13.7 3.1

14.1

0.6 11.0 31.2 40.0 »3.*

0.7 11.9 31.2

25 -3* 35 - ** 45 A Over

0.5 10.7 28.9 43.6 13.6

3.6

3.8

TOTAL

11.1

29.9 40.9

2.7

o.5

38.4

32.8 38.2

14.2

11.9

3.6

3.1

PERCENT INCREASE 1959 - 1964

AGE GROUP TOTAL

0-14 25-

?5?5

86.5

100.0

13

IO8.3 155.7 119.3 58.2 61.5 91.1

0.5 17.7 38.5 30.3

447

15 - 1? 20 - 24

3*

35 - 44 45 * Over

IN EACH AGE GROUP

INCREASE

246 82

9.7 3.3

Infectious Venereal Disease includes Primary, secondary and early latent syphilis and all diagnosed cases of gonorrhea. TABLE 22

reported civilian cases of venereal disease 5_year median, by stage and sex, s an Francisco, 1964

TOTAL VENEREAL DISEASES

TOTAL

HALE

FEMALE

q_YEAR MEDIAN

7364

5389

1975

5?0?

SYPHILIS TOTAL

JL5.47

X27J.

.274

1346

Primary Secondary Early Latent Late Latent

186 107 326 299 28

274

8

2

41

494

9

4115

1700

3845

372? 388

1099

3

Late

Congenital All Stages, Report Only Epidemiologically Treated

GONORRHEA TOTAL

Diagnosed Cases Epidemiologically Treated

175

166 138

11

10 191

108

1

26 14

5815

-

4826 989

-25-

601

30

$

8

TABLE 23 REPORTED CIVILIAN CASES OF VENEREAL DISEASE San Francisco, 19TO-196*

GONORRHEA TOTAL

Diagnosed Cases epioemiologically treated SYPHILIS TOTAL

Primary Secondary Early Latent Other epidehiolcgically treated

19S9

1960

1961

1962

JL2£l

?9^

^m7

^m

*419

S2S1

lafift

Rf?1S 14-826

2399 536

2569 58

3132 713

3727 692

935

asq

1010

u*6

1<;?6

16^

W

175 156 190 36*

211

166 105

16* 97 279

139 138 283 517 557

186 107 326 3£* 5&>

'55

m

2*1 1-03

7

? 2

*o8

333

989

TABLE 2lf REPORTED CASES OF VENEREAL DISEASE BY SOURCE OF REPORT AND TYPE OR STAGE IF DISEASE, 196i
TOTAL PERCENT OF TOTAL

TOTAL

HUNT

OTHER CITY

7*8^

5826

396

100.0

SYPHILIS TOTAL

1571

Primary Secondary Early Latent Latent, Late Late Congenital Report Only EPIOEMIOLOGICALLY TREATED GONORRHEA TOTAL

Diagnosed Cases EPIOEMIOLOGICALLY TREATED

.

.

FEDERAL CIVILIAN

OTHER JURIS.

LOCAL HOSP.

PRIVATE H.D.

260

778

36

119

10.1).

n..9

n-«

tj

«

?0

9h 9 4

77-8

5.3

3.";

995.

25

8.1

381

.

98

_

7

72

9

_

111

61

1

5

_

205

5

9

32 92

8

333 301 30

13

2

91 12

10

195

8

3

39

1

2

1_

11

l 5

I

1

2 _

*

2

_

-

2

1

-

5?4

52^

6

5

18 29

-

-

-

win

Wftl

371

179

397

?1

16

95

1*920


23*

171

15

94

8

317 80

1*

137

_

_

990

OTHER TYPES TOTAL

?

1

6

U

_

_

1

7

-

2

TABLE 25

REPORTED CIVILIAN CASES OF VENEREAL DISEASE BY HEALTH DISTRICT .San Francisco, 196
HEALTH DISTRICT

ALEMANY CENTRAL EUREKA.NCE

ESTIMATED POPULATION

NO. OF CASES

755,700

5,735

758.9

100.0

78,700 81,200 75,800

251-

1,515 375

322.7 1865.8 *9*.7

26.* 6.6

52*

1025.*

9.1

HUNTERS POINT MAR|NA_RICHf10ND MISS ION

51,100 122,600 75,100

NORTH EAST SUNSET

91,600 132,000 *7,6oo

!

JESTS IDE

DISTRICT NOT REPORTED

MILITARY

hi 971 162

999 136

-26-

RATE FER 100,000

PERCENT

POPULATION

OF CASES

rm

1060.0 122.7 2098.7

M 5« 7

8.3

16.9 2.8 17.* 2.*

1



iEPORTEO CIVILIAN CASES

'of

JtNEREAL DISEASE

»Y

HEALTH DISTRICTS

EXCLUDING EPIOENIOLOGICALLY TREATED RATES PER 100,000 POPULATION

SAN FRANCISCO,

196*

Golden Gate

rmT

c Under

^iil

800 - 1199


Wfl - T99

___ 1300

& i-Nefi

REPORTED CIVILIAN CaSES OF GONORRHEA SAN FRANCISCO, I960 - 1964

Number

6000

5500 -~

5000

4500

4CO0 --

3500 "-

3000



2500



2000

1500



1000

I960

1961

1962

Diagnosed

1963

Epidemiologically Treated

Cases -28-

1964



)

REPORTED CIVILIAN CaSES OF SYPHILIS SAN FRANCISCO, I960 - 1964

Number 1800

1600 --

1400

"-

1200

--

1000 -

800

-

600

-

400

" -

200

-

-

~^

j.'

1

1

1

11

n

I960

1961

1962

Primary

Early Latent

Secondary

Other -29-

1964

1963



Ejpidemiologj eally treated (from 1961

TABLE 26 VENEREAL DISEASE * REFORTED TO THE HEALTH DEPARTMENT WITH PERCENTAGES REPORTED BY PRIVATE PHYSICIANS 1959-196*+

I960

1959

SYPHILIS

(

(

(

196*i

553 157

570

32.8

639 196 30.7

528 171 32.4

616 152 24.7

28.it

554 153 27.6

892 282 31.6

1023 295 28.8

1356 396 29.2

1543 432 28.0

1644 455 27.7

1571 381 24.3

3078

3316 172 5.2

3905 240 6.1

4473 295 6.6

5352 385 7.2

5910 397 6.7

187

All Classifications )

Reported from All Sources Reported by Private Physicians Percentage *

1963

All Stages )

Reported from All Sources Reported by Private Physicians Percentage

GONORRHEA

1962

Primary, Secondary, Early Latent ) .y Latent)

Reported from All Sources Reported by Private Physicians Percentage SYPHILIS

1961

169 5.5

Includes a small number reported by Military Facilities.

TABLE 27 REPORTED CIVILIAN CASES OF VENEREAL DISEASE IN 1964 By Age Group and Stage of Disease - SAN FRANCISCO 45 &

ALL AGES,

TOTAL

0-14

15-19

20-24

25-34

35-44

OVER

7364

37

941

2261

2722

983

420

1547

3

68

249

577

364

286

8 7

42 19

20

11

64

84 48 138 37

TOTAL

SYPHILIS TOTAL Primary Secondary Early Latent Late Latent Late Congenital All Stages Epidemiologically Treated

186 107 326 299 28

1

2 2

2 7

32 25 79 91 5 3 8

9

1

8

29

8 33 162 22 1

12

564

2

42

111

260

121

28

5815

>

872

2012

2145

618

134

Diagnosed cases Epi. Treated

4826 989

24 10

708 164

1660 352

1813 332

510 108

111 23

OTHER TYPES TOTAL

2

-

1

-

_

1

-

GONORRHEA TOTAL

-30-

§

:

TUBERCULOSIS For the year 1964 there were 502 newly reported cases of tuberculosis. Although this is a slight decrease from the 514 cases reported in 1963? it is still well above the 443 cases reported in 196l. Correspondingly, the 196*+ case rate of 66.4 per ICO, 000 population is significantly greater than that of 59.5 for 196l. The death rate declined to 7.9 per 100,000 from 9.9 per 100,000 for I963. Of the 60 deaths from tuberculosis, 26 were unreported until after death and hence were at large within the community without knowledge of the Health Department. It is this unknown reservoir of communicable tuberculosis that presents a serious health problem.

INCIDENCE BY RESIDENCE: As in previous years, the greater number of new cases are in the eastern half of the city: 424 cases, or 84.5% of the total number reported. Four of the nine Health Districts contributed 63.4% of all cases reported: Central Health Center, 105 cases or 20.9%, North East Health Center, 89 cases or 17.7%, Mission Health Center, 63 cases or 12.5% and Westside Health Center, 62 cases or 12.3%. Notable increases were in the Central, Eureka-Noe and westside Health districts, whereas decreases of note were in the Marina-Richmond and the North East Health districts. Other Health Districts showed only slight variation from the previous year.

INCIDENCE BY AGE: 250 cases, or 49.8% were over the age of 45. 84 cases, or 16.7% were under the age of 20. 168 cases, or 33.5% were between the ages of 20 to 45. Compared to 1963 there is a decrease in the under 20 age group, but an increase in the two older groups. INCIDENCE BY ETHNIC GROUP; Three groups showed an increase in case rate in 1964 compared to I963 and three groups had lower rates. PERCENT OF TOTAL POP. 1 9ft 13ft

ETHNIC GROUP

23£Z

White

80.9

79,3

Other

0.5

0.5

78.

0.6

NUMBER OF CASES

PERCENT OF CASES

CASE RATE PER 100.000 EST MATEO POPULATION wfi? iqft laft I

1362

lSQ

L2&

13fc

1^

n6n

2??,

322

279

62.2

62.7

55.6

^9.6

51.2

13

12

15

2.7

2.3

3.0

351.^

307.7

STAGE OF DISEASE: Of the 502 newly reported cases of tuberculosis reported in 1964, 38l were pulmonary, 68 were primary, and 53 were extra pulmonary. In only 369 of the 38I cases of pulmonary disease was the stage of infection reported: 31$ were minimal; 45% were moderately advanced, and 24% were f r advanced. These show a moderate decrease in minimal stage and a moderate increase in the advanced stages since 1963* <.

DEATHS 280 persons died with tuberculosis in 1964, but of this number only 60 deaths were directly attributable to tuberculosis. This compares with 295 and 74, respectively, for 1963. The death rate dropped from 9.9 to 7.9 per 100,000 population.

CASEFINDING BY X-RAY: 110,319 X-rays were taken at the various survey units during 1964, and the results are given in the following table:

-31-

TUBERCULOSIS C/J5E FINDING BY X-HAl Number Films 1964 1963

Unit Location

Active TB Found 1964 1963

Prev. Unknown

1963

1964

Cancer ,Lung 1964 1963

24,074

61

92

46

73

6

10

1,429 1,277 22,344 22,797 S.F. Hosp. Adm. Progm. 11,329 10,536 S.F. Jail #1 4,547 3,944 S.F. Medical Society 20,691 20,058 S.F. TBC. Association 46,671 49,238 North East Health Ctr v _2,74_2 2,h69 TOTALS 109,753 110,319

40 21 38 23 13 33

28 18 33 18

47 26 39

4 6

13 32

17 28

4 2 4 1 12

7

64 28 48 11 18 37 5

6

5

175

211

148

169

101 Grove Total

23,773

14 x 17

70 mm

7

NA

13

11 7 2

36

30

SCHOOL TUBERCULIN TESTING PROGRAM: Grades 1, 7, 10 and 12, are tested yearly as well as all students new to San Francisco schools. All previously known Positive Reactors who had 10 mm. or more induration were excluded from testing, but those who had mm. of induration were retested.

6-9

SCHOOL TUBERCULIN TESTING,

SCHOOL YEAR

TOTAL

STUDENTS TESTED

POSITIVE REACTORS

242,417

NUMBER 11,492

25,286 16,904 29,541 34,028 28,699 32,005 35,395 40,559

1,492 1,125 1,765 2,267 1,651 749 1,369 1,074

1956-57 1957-58 1958-59 1959-60 1960-61 1961-62 1962-63 1963-64

1956 -1964

PERCENT 4.7 5.9 6.7 6.0 6.7 5.8 2.3 3.9 2.6

255

384-

1.6

44 32 44 54 38 10 23 10

62 42 62 93 58 21 29 17

2.4 2.4 2.1 2.7 2.0 0.7 0.8 0.4

SUMMARY OF TYPES OF TUBLRCULOSIS FOUND aT SCHOOL LEVEL

1956- 196^

ELEMENTARY

SR. HIGH

255

68

40

147

147 85

4

57

21 16

122 12

Minimal Moderately Adv. Far Advanced

67

45

10

12

15 3

9 3

6

Extra Pulmonary

23

7

3

13

2 2

1

1

11

4 1

1 2

2 6 4

Grand Total

III.

-

TOTAL

Type of Tuberculosis

I. II.

family con- TOTAL CASE tact plus school Ca- RATE FER ses FOUND 1000 TESTS

SCHOOL CASUS FOUND

Primary Fulmonary

Meningitis Miliary Lymphadenitis Pleural Effusion Geni to-Urinary

7 1

1

-32-

JR. HIGH

Although more tuberculin tests were given in the schools during 1964 than any other year of the eight years of school testing, the table shows a decreasing reactor rate and a decreasing case rate, indicating a decreased prevalence of tuberculosis in the various areas of the city.

TABLE 28 CHEST CLINIC,

SAN FRANCISCO HOSPITAL,

1950 - 1964 Pt. Visits for "ollowup Without Treatment Visits for Treatment Observation and Pneumoperi toneum and Chemotherapy Contacts ;

Efc.

Total Pt. Visits

YEAR

NO.

1950 1951 1952 1955 195^ 1955

26,159 23,401 24,577 27,598 31,409 33,262 36,742 32,374 31,685 33,786 29,039 28,499 31,337 40,318 46,231

1956 1957 1958 1959 I960 1961 1962 1963 1964

22,306 19,279 18,806 19,364 17,678 13,287 12,250 6,856 5,244 5,207 3,073 3,450 2,692 2,898 2,938

14.7 17.6 23.5 29.8 43.7 60.1 66.7 78.8 83.4 84.6 89.4 89.4 91.4 92.8 93.6

3,833 4,122 5,771 8,234 13,731 19,975 24,492 25,518 26,441 28,579 25,966 25,049 28,645 37,420 43,293

%

NO.

%

85.3 82.4 76.5 70.2 56.3 39-9 33.3 21.2 16.6 15.4 10.6 10.6 8.6 7.2 6.4

TABLE 29 REPORTED TUBERCULOSIS CASES AND DEATHS AND RATES PER 100,000 POPULATION BY TYPE OF DISEASE AND ETHNIC GROUP San Francisco Residents, 1964

TOTAL CASES Pulmonary Primary Other

TOTAL DEATHS Pulmonary Other

TOTAL

WHITE

NEGRO

CHINESE

FILIPINO

502

279

110

65

24

381 68 53

236

60 39

49

18

9 7

4 2

14 29

11

_6

60 57

39

3

2

.

6

9

.

9

JAPANESE

OTHER NONWHITE

10 2 3

\

2 1

ESTIMATED POPULATION

733,700 393,200

89,4 00

42,4 00

15,300

11,300

4,100

CASE RATE

66.4

47.0

123.0

153.3

156.9

79.6

365.9

7.9

6.9

6.7

21.2

19.6

8.8

DEATH RATE

-33-

TABLE JO NEH CASES OF TU8ERCUL0SIS REPORTED BY ETHNIC GROUP TYPE OF DISEASE AND SEX L2£jt

ALL TYPES

ETHNIC GROUP TOTAL

HALE

M2

TOTAL

White Negro Chinese Filipino Japanese Other

.MALE

TOTAL

172

^1

26s<

u

11

236 60

ho 15

25

3 8

_F

-,30

279 110

II 9

15

HALE

OTHER

PRIMARY

PULMONARY FEMALE

__M_

T

__H

F

T

31

«

2<;

?8 15

F

11-

(A

17? ft

a

1ft

7

7

29

1*

3?

22

17

11

6

ft9

31

18

6

3

18

12

6

2

1

6

S

3

5

_

2 .

7 2

5

9

9 H _

1

-

1

7

10

7

3

2

-

2

3

1

2

200

57

i 1

TABLE 31 PERCENT OF CASES BY STAGE OF DISEASE FOR NEK CASES OF PULMONARY TUEERCULOSIS FOR HHOH STAGE OF DISEASE MAS REPORTED San FpANEisqc, 1960-196t-

— STAGE OF DISEASE

12£ft

12£i

1962

JL2£l

1960

ALL STAGES

lQfl

100

100

1DJ2

im

1

11

a

22

25

Minimal mooerate Far Advanced

8

I

2*

TABLE 32

NEW CASES OF TUBERCULOSIS REPORTED BY ETHNIC GROUP AGE AND SEX

San FranmspOj AGE GROUP (

TOTAL

196ft

WHITE

NEGRO

Years )

K

JQLAk. Under 1

s

in

15 20

25 30 35

W ft5

50 55 fio

1

_

4

_ _

9

— -

2ft

— _ _ -

-

14 19

u

.64 _

.AS.

4JL

JAPANESE !

OTHER E_

5

7_

32 25 9 15 25

35 20

8

44

3ft

ft9

48 46

5ft

39

30

9

59

48

3ft

111

25

22 23 52

10

64

ft6

FILIPINO F M

3

39

_ 69 65 70 AMD Over

F

CHIMESE F M

11

3ft

W

62

14 1?

3

7

TABLE 33 NEW CASES OF TUBERCULOSIS REPORTED BY HEALTH DISTRICT OF RESIDENCE S/yg Frjm£J3£Q }g&! <

_

HE ALTH DI STRICT

Alemany Central Eureka-Noe

CASES

ESTIMATED POPULATION

CASE RATE PER 100,000 POPUL ATION

PERCENT OF ALL CASE S

502

755,700

66,1*

100.0

36 105

78,700 81,200 75,800

ft5.7

7.2

ft2

Hunters Point Marina-Ri chhond Mission

51,100 122,600 75,100

North East Sunset Westside

91,600 132,000 $7,600

District Not Reported

129.3 55.ft

52.8 51.0 83.9

97.2 27.3 130.3

P

12-5

'H 12.3

0.8

-34-

TABLE 34 INTERVAL BETWEEN REPORTING OF TUBERCULOSIS AND DEATH San Francisco Residents, 1964

INTERVAL

DYING FROM TUBERCULOSIS

DYING FROM OTHER CAUSES

TOTAL

60

220

280

10 14 10

18 14 11

1

3

1 -

13 6

1 7

10 60

6 8

37

28

Ik 6 11 67 43 36

21

13

3k

5

18

23

TOTAL Less than 6 months 6-11 months 12 - 17 months 18 - 23 months

8 1 2

2 years 3 years 4 years

5-9

years 10 - 14 years 15 years and over

Reported after Death Reported only on Certificate

TABLE 35 PERSONS HAVING HAD TUBERCULOSIS WHOSE DEATHS WERE CODED TO OTHER CAUSES San Francisco Residents, 1964

CODED CAUSE OF DEATH

INTERN ''.TIONAL LIST NUMBER

NUMBER OF DEATHS

220

TOTAL Heart Disease Malignant Neoplasms

410-443 140-205

67 34

Cirrhosis of Liver Vascular Lesions of C.N.S.

581 330-334

17 12

Accidents Pneumonia

800-965 490-493

18

Diseases of Respiratory System

470-527

z8

450 260

3

Arteriosclerosis Diabetes All Others

12

4

25

-35-

TABLE 36 NEWLY REPORTED TUBERCULOSIS CASES AND DEATHS OCCURRING IN SAN FRANCISCO Date from 1920

m



YEAR

NEWLY REPORTED CASES

POPULATION

1920

676*

1921

777 512 247

DEATHS

1411 1347 1409

278,5 256.2 261,6

1230 1223

223.1 216.9

204.4

644

175.1 182.8 185.9

611 9 5 ?

634

103.1

232.0

621

98.9

561

453

88.4 88.7 84.0 74.2 71.4

2.2 1.9

454

71.6"

2.1

461

72.7

U9 hi

(>(>.*

2.0

66.2 65.2

2.2 2.0 2.5

1925 1926 1927 1928 1929

717 452 187 922 657

1179 1032

1930

394* 412

1309 1317 1199 1026 865

206.3 207.6 189.0 161.7 136.3

c P 893

1171 1012 827

147.5 140.7 184.6 159,5 130.3

21*5

148.9

426"

441

455

1935 1936 1937 1933 1939

469 484 498

194-0

536*

512 525

1101

1143 1456

1941

420 439

851

102.9 111.0 134.4 122.6 127.5

470 397 350 333 301

56.8 48.6 43.4 41.8 38.3

869 813 858

112.1

215

I2 7

92.5 103.7

6 25 581

91.2

785

*

424

1084 976 1002

100 800 600

300 900

316* 000 000 900 700

8 495

180

214 144

&i ki

131

17.3

116

i

15.7 12.5 10.6 10.3 9.7

58

10.3 8.9 7.8

H

72.4

gj

8:2

481

H

514 502

5*. 5

111.1

1

8

2C2

m

104.5

I?* 74.2 66.4 66.6

2.3 2.3

m

363

ioo

m

460

430

357* 200 200 700

1961

471

1.8 1.7 1.9 1.8 2.3

2.2 1.8 1.9

98.5

13L0

1950

1962

563 533

111.7 103.7

134.8 111.6

400* 400 600 200 800

196o

661

2.1 2.1

129.1

1945 1946 1947 1948 1949

1955 1956 1957 1958 1959

ii

132*2 121.3 118.3 120.8 117.2

869

682 255 828

195'

670 638

2S 9 837 1033

1942 1943 1944

1952 1953 1954

PER DEATH

RATE

RATE

982

1931

NUMBER

NUMBER

1922 1923 1924

1932 1933 1934

NEwlV reported CASES

1*8 2.3 3.1

8.9

3.3 4.0 4.5 4.0 4.9 6.0

1:1

hi «.»

8.3

B

9.9 7.9

U.S. Census

Rates per 100,000 Population.

Population estimates as of July t, for intercensal years beginning by California State Department of Finance.

-36-

in

1951

Reported Cases of Tuberculosis by Health District Sen Francisco, 1964 Rates per 100,000 Estimated Population

MARINA

RICHMOND

I

NORTH EkST

Under 35

70 - 104

35 - 69

105 and aver

-27-

REPORTS CaSES OF TUBERCULOSIS San Francisco, 1964 by Census Tract

5-9

Cases

10 or More Cases

10 Cases or More

Betwe en

Census Tract

Number Cases

Census Tract

A-6 A-L4 J-6

13 10 15 16 13 37 15 13 12

A-5 A-13 A-16 A-20 A-22 A-23 G-2

J-7 J-10

K-2 K-3

L-4 L~5a .

.

J-4 J-14 J-16

Nunber Cases

5

and 9 Cases

Census Tract

5

6 5

8 9 7 5

5

6 8

i

-38-

Number Cases

J-17 J-20 K-l L-l L-3 L-5B M-4 N-l

8 6 8

N-2

5

N-3

5

9 9 5

9 8

Census Tract N-6 N-7 ^-8 N-9

N-12 0-2 0-8B 0-9 Q-lA

Number Cases 5

6 6 5 5 5

9 7 5

DOCUMENTS SEP 13

1966

SAN FRANCISCO PUBLIC LIBRARY

SAN FRANCISCO DEPARTMENT OF PU3LIC HEALTH

STATISTICAL REPORT 1965

SAN FRANCISCO HEALTH DISTRICTS (Effective September

1,

19^)

City

and County of San Francisco DEPARTMENT OF PUBLIC HEALTH

Central Office lOI

GROVE STREET

San Francisco, California 94102

August 16, 1966

The information contained in the Statistical Report of the San Francisco Department of Public Health is obtained primarily through the birth Ind delth certificates sent to us by practicing physicians in San Francisco, or from those reallocated to us by the State Department of Public Health in the case of births and deaths of San Francisco residents which occur outside of San *ranclsco Another major source is the morbidity reports of reportable diseases which we receive from practicing physicians. Included in the statistical Report are data and information secured from the United States census Bureau.

The conclusions that we can draw from these data are dependent upon the accuracy of the original information, and are included in order that the reader may have some insight into the social and cultural structure of the City and County of San Francisco, which is the patient of the Department of

Public Health.

The information with reference to births and deaths and reportable diseases gives us an understanding of the problems that face the community of San Francisco in the field of community health, and the trends that are indicated enable us to judge where our activities have been successful, and where they have not; also, they point out the diseases or segments of the population toward which we should concentrate our attention.

Additional information about census data and birth and death statistics which were not included in this report are available from the Bureau of Records and Statistics of this department, through Miss Mildred Holota, Chief of that Bureau. /~~^

ELLIS D. SOX, 'M. D. Director of Public Health

~

CONTENTS

Page

BlrthS

C M Diseases m Co^unicable -

24

Infant Deaths m Marriages and Divorces Maternfl Deaths Population

pi ^ A >



I _ 1

tuberculosis Map Tuberculosis of Health Districts, 1 965 Tub ul °sis by Census Tract, 1 96 5 f« venereal Disease nu r, ?°™:7hea ' yP 196X " 65 ^n-' Map J Venereal Disease by Health Districts,

*P

^

£*

*.

S

,

37

38 oL ^ 2

,-

S&g»

30 29 28

1965

TABLES Deaths from important causes, San Francisco & U.S., 1965 Cal., 1964 2. Causes of death, all ages, number and rate, I96I-65 3. Causes of death by sex, rates and percent ] 1965 Maternal deaths, San Francisco, California and U.S. I96O-65 J. Causes of death and rates for 5. ethnic groups, 1 9 6 5 6-1 Causes of death by 10-year age groups, 1965 b-2 Causes of death, rates and percents by broad age groups, 1965 Causes of death by residence and 7. occurrence, 1965 Health district summary, 1964-65 0. Birth rates for ethnic groups, 1964 and 1965 10. Recorded, resident and non-resident births by place, 1964-65 11. en 1XVe births by place - nd ethnic group, 1965 S__^ ! live births in 12. Resident health districts by ethnic group, 1965 13. Trimester prenatal care began by place of birth, 1965 lght infants by place of birth a ** «thnic group, 1 9 65 15 ] £" ! by 6thniC birth wei Sht ' len 8 th & gelation, 1965 ' 15-2 S? S £***!! g estetion grOUp ° f 10*805 infants by ethnic group, 1965 I 16 Inf!l deaths 16. Infant and «-*« rates 1U1 for cuiiuc ethnic groups, 1961-65 iyoi-o> 19 T««* j 1*7 */. infant deaths by age, sex, ethnic group and cause, 1965 18. Communicable diseases - cases and deaths, 1961^5 ian Cases of * Venereal Disease, I96O-I965 Jo' r nerea Disease fe y type, stage & sex, 5-year median, 1960-1964 ^ 21 Venereal Disease by age group, type and stage, 1965 22 ll7 I Venereal Dise ase cases by age group, 196O-65 23 Pt . r! rivate Physician's reporting of Venereal Disease, I96O-65 5 ?£" W. Source of report of Venereal Disease cases, 1965 e ereal Disease cases by health districts, 1965 PR i, u CUl06i8 cases h ealth districts, 1965 ?Q gr ° UP and age of Tuberculosis cases, 1965 p rCe 30 f Tubercul osis cases in ethnic groups, 1963-65 31* T! £ of Tuber culosis cases and deaths by sex and ethnic group, 1965 S2* interval between reporting of g. and death, 1965 ». Causes of death of TuberculosisTuberculosis patients, 1965 06111 03563 by Stase of Tuberculosis and ethnic group, 1Q61-65 3S* t,!^ , ^ uberculos is case finding by X-ray, 1964-65 5* ^ l te8ting ' W56-65 37 f*T* ,a4B -?r. iuoerculdais cases, deaths and rate*, 1920-1965 1.

7 ft ft

8

,

SS

^

^

S2S« ^

mf SR

T^°

^

^

9

i? J_

jf 17 17 jfi

18 19 19

20 21 23 25 25 25 2* 2fc

5 J} tt

£ h %t

y33

\l 35

&

GENERAL INFORMATION

San Francisco, one of the original 27 counties in the State, was also incorporated as a city in I85O. Located on the tip of a hilly peninsula, its total area is 129*25 square miles of which less than one-half or 45.451 square miles is land; excluding islands, its land area is 29,089 acres. The estimated population density in 1965 was 16,512 people per square mile, the highest in the state* It has an equable climate with an average daily temperature range of 12.1 degrees, fromadaily mean maximum temperature of 62,6 to a daily mean minimum temperature of 50.5 degrees; rainfall averages about 21 c 6 inches yearly. The city enjoys about 66% of sunshine during the daylight hours. The provisional estimate of population for July 1, 1965, made by the California State Department of Finance was 750,500, a decrease of 5,200 or 0.7# from the 1964 estimate of 755,700 and an increase of 10, l&i or lA% over the April 1, i960 census figure of ?40,3l6.

POPULATION OF SAN FRANCISCO BY ETHNIC GROUPS

ESTIMATE

U

t

,S.

CENSUS

ETHNIC GROUP

1965

TOTAL

750,500

740,316

775,357

634,536

693,888

602,701

i960

1950

1940

White

585,500

604,403

Nonwhite

165,000

135,913

81,^69

31,835

Negro

91,000

7^,383

43,502

k,W

Chinese

42,600

36,445

24,813

17,782

Japanese

11,500

9,464

5,579

5,280

Filipino

15,500

12,327

4, 400

3,294

Other

Included in Other. 7,575

3,927

PERCENT IN EACH ETHNIC GROUP

TOTAL

100.0

100.0

100.0

100.0

White

78.0

81.6

89.5

95.0

Nonwhite

22.0

18.4

10.5

5.C

12.1 5.7 1.5 2.1

10.1 4.9 1.3 1.7

0.6

0.4

Negro Chinese Japanese Filipino

Other

-1-

0.8 5.6 2.8 3.2 0.8 0„7 Included in Other 1.0

0.6

:

;

POPULATION BY SEX

ESTIMATE

U.So CENSUS

I960

1965

1950

19j±0

TOTAL

750,500

7^0,316

775,357

63^,536

Male

367,000

363,^

389,866

322, Vtl

Female

383,500

376,892

385,^91

312,095

0,96

0.96

1.01

1.03

i960

1950

19^0

M/F Ratio

POPULATION BY AGE GROUP

AGE GROUP

ESTIMATE 1965

ALL AGES

750,500

7^0,316

775,357

63^,536

Under 5 Years 5 - Ik Years 15 - 2k Years

59,300 107,300 99,100

58,851 98,189 91,155

62,921 75, 9^+ 99,358

30,333 61,080 90,269

25 - kk Years k$ - 6^ Years 65 & Over

180,100 201,900 102,800

199,362 199,151 93,608

262,705 200,379 7^,050

229,821 171,32b 51,707

PERCENT IN EACH AGE GROUP U.S. CENSUS

ESTIMATE 1965

i960

1950

19^0

100.0

100.0

100.0

100.0

Under 5 Years 5 - 1^+ Years 15 - 2k

7.9 1^.3 13.2

8.0 13.3 12.3

8.1

9.8 12.8

k>8 9.6 ik.2

25 - kk k$ - 6k 65 & Over

2*+e0

26„9 26.9 12.6

33.9 25.8 9.6

TOTAL

26.9 13.7

36.2 27,0 8.2

MARRIAGES The number of marriages licenses issued during the calendar year 1965 was 7,685, an increase of 292 or 3«9# over the 196^ figure of 7,393 and 1,0^9 or 15.8% over the i960 figure of 6,636. The rate per 1,000 estimated population was 10.2 in I965, 9.8 in 196**, 9-^ in I963, 9.2 in 1962 and 9.0 inl960. D IVORCES During the calendar year 1965, 3077 divorce actions were filed, about the same number, 3089 in 196^. During i960, 3,28*+ divorce actions were filed; thus the number for 1965 was 6*3$ lower than I960.

-2-

MARRIAGE LICENSES ISSUED

DIVORCE ACTIONS FILED

FINAL DECREES OF DIVORCE

1950-51 1951-52 1952-53 1953-54 1954-55

8328 7306 7395 6860 6631

4543 4391 ^327 4096 3867

2842 29^0 2917 3088 2598

468 478 552 517 499

1955-56 1956-57 1957-58 1958-59 1959-60

6645 6965 6526 6665 6703

3676 3500 3508 3434 3350

2604 2432 2442 2257 2357

483 463 477 499 417

1960-61 1961-62 1962-63 1963-64 1964-65 1965-66

6670 6704 6921 7201 7618 7628

3322 3198 3108 3160 2975 3006

2275 2161 2243 2178 2134 2455

394 421 434 4l8 379 383

YEARS

ANNULMENTS GRANTED

Tentative and provisional rates for the United States, California and 4 Bay Area counties for the calendar years 1960-65 and final figures for San Franci.sco based on enumerated population for i960 and estimated population for I96I-65 are: BIRTH RATES PER 1,000

YEAR

U.S.

CALIF.

ALAMEDA

I960 1961 1962 1963 1964 1965

23.6 23.4 22.4 21.6 21.2 19.4

23.7 23.2 22.1 21.5 20.6 18.9

22.9 22.9 21.7 21.5 20.5 N.A.

I960 1961 1962 1963 1964 1965

9-5 9.3 9.5 9.6 9.4 9.4

8.6 8.3 8.2 8.4 8.3 8.1

F OPULATION

CONTRA COSTA

MARIN

22.8 22.3 20.7 19.5 18.9

22.9 21.8 20.7 19.3 18.5

N.;

N.A.

.

SAN FRANCISCO

SAN MATEO

19.9 19.8 19.0 18.5 17.5 16.4

22.5 21.8 20.6 19.7 18,7 N.A.

13.3 13.1 13.1 13.3 12.7 12.9

6.5 6.5 6.5 6.6 6.6

DEATH RATES PER 1,000 FOPULATION 9.3 9.0 8.9 9.3 9.1 N.A.

6.3 6.1 5.9 6.1 6.0

7.2 6.5 6.8 6.5 6.7

N.A.

N.A.

N.A.

In I965 birth rates continued the downward trend that began in 1957. However in all jurisdictions the number and rate for marriages continued to increase and in the next two or three years, the downward trend in both number and rate of births may be reversed. San Francisco as usual, had the lowest birth rate and the highest death rate. -3-

c

t

The age-adjusted rate, direct method, for San Francisco in 1965 was 7«8 per 1,0C0 population, an increase over the 1964 rate of 7.6, the record low. The estimated U.S, rate for I965 was 7»4, the same as its rate for 1964. Thus the San Francisco rate was a little over 3% higher than the U.S. rate. Using the indirect method of age-adjusting, the San Francisco rate in I965 was 8.1 as against 7*9 in. 1964 and 8.4 in 1963.

Crude birth and death rates for San Francisco since 1950 are based on population estimates prepared by the State Department of Finance for inter-censal years. The birth rate is continuing its downward trend; the death rate increased 1.6% over 1964, which had the lowest rate in the 1960«s.

YEAR

SAN FRANCISCO ESTIMATED FOPULATION

1950 1951 1952 1953 1954

RESIDENT DEATHS

DEATH RATE*

RESIDENT BIRTHS

BIRTH RATE*

775,357 (Census) 778,200 772,200 764,700 757,100

15,477 15,505 15,710 15,364 15,171

20.0 19.9 20,3 20.1 20.0

9,204 9,527 9,693 9,435 9,160

11,9 12.2 12 „6 12.3 12.1

1955 1956 1957 1958 1939

740,100 734,800 734,600 744,300 742,900

14,540 14,565 15,240 15,104 14,634

19»6 19.8 20.7 20.3 19.7

9,161 9,5^8 9,600 9,375 9,559

12,4

I960 1961

7 l'0,3l6 (Census) 744,000 745,000

749,900 755,700

14,728 14,703 14,177 13 , 839 13,239

19.9 19.8 19.0 18.5 17.5

9,825 9,736 9-777 10,004 9,598

13.3 13.1 13.1 13,3 12.7

750,500

12,322

16.4

9..704

12.9

1962 1963 1964

1965

13.

13.1 12.6 12c9

Rates per 1,000 population. DEATHS During the calendar year I965, there were 9,704 resident deaths, an increase of 106 or 1.1/J over the 1964 figure of 9v598. Since the estimated population decreased in 19o5, the death rate increased to 12.9, the same as in 1959»

The average age at death for men was 63»9 years, a slight decrease from the 1964 age of 64.0 but not as low as the 63.4 in 1962 and 62^8 in 1961. The average age The median age for women incrensed feo 68.7 years from the 1964 figure of 67«8. for males was again 6?. 7 years as it had been in 19^4; for females it increased to 73.9 yerrs in I965 as compared to 73.0 in 1964 and 73.7 in 1963.

-4-

TABLE 1, Deaths from Important Causes in San Francisco, California and the United States, lists lgo? final figures for San Francisco, provisional I965 figures for the United States and provisional 1964 figures for California. Crude death rates for the U.S, and California remained about the same in 1965 as in 1964 but the rate for San Francisco increased to 12.9 from 12.7 the year before. Heart diseases, cancer and vascular" lesions of the central nervous system were the first three leading causes with San Francisco having the highest rates, the U.S. second and California third. Cirrhosis of the liver, third cause in San Francisco, was seventh in California and ninth in the U.S, Accidents, the traditional fourth cause, were fifth in San Francisco in I965 although the rate in San Francisco was higher than in other jurisdictions. InflM-nza and pneumonia increased slightly in the U.S. and California but decreased in San Francisco. Suicides, the seventh cause in San Francisco were eighth in California and tenth in the U.S. ranking. Certain diseases of early infancy declined in all three jurisdictions, remaining in eighth, fifbh and sixth places respectively. Emphysema, ninth cause in San Francisco in 196^, was replared by arteriosclerosis in that rank in 1965; the latter disease continued in seventh place in the U.S. Diabetes was eleventh in San Francisco and California and again in eighth place nationally. Although the tuberculosis death rate increased slightly in 1965 it was well down on the list.

Deaths and rates from important causes in San Francisco for the past five years are shown in Table 2. Heart disease, the leading cause, accounted for J>6% of the deaths although both number and rate declined slightly in 1965« Arteriosclerotic heart disease including coronary artery conditions caused 84% of the deaths coded to heart disease. The rate for cancer, the second cause, increased to 248. 9 per 100,000 population from 228.7 in 1964, The rate for vascular lesions also increased* Accidents declined as in I96I and reverted to fifth place. Cirrhosis of the liver increased to 73 per 100,000 in 1965 from 62 in 1964 and became the fourth cause. Although influenza and pneumonia deaths decreased by nearly 100, they were still the sixth cause of death with suicides in their traditional seventh place. Emphysema, though still in the first ten causes, declined slightly. Causes of death for men and women are shown in Table 3- The rate for males was 15 per 1,000, the samein 1964 and I965. Female deaths increased 2.8% in number and 4.1% in rate. The first six leading causes had the same rank order for both men and women although men had higher rates for all these causes except vascular lesions of the central nervous system. Rates of both sexes for cirrhosis of the liver increased, displacing accidents, generally the fourth cause of death. Arteriosclerosis, tenth cause for men was the seventh cause for women. Suicides, seventh for men was the ninth cause for women, with a rate half as high. The male rate for emphysema, their eighth cause of death, was five times the rate for women. Marked differences in rate between the sexes also occur in relatively minor causes such as aortic aneurysms, ulcers, tuberculosis and homicides. Table 5 lists the leading causes of death for cisco. The rate for whites was 14.8 per 1,000 as a whole it was 6.4 per 1,000. Diseases of pal causes of death although rates for whites other groups because of the greater number of the white population. -5-

the major ethnic groups in San Franpopulation while for nonwhites taken the heart and cancer were the princiwere considerably higher than in the middle aged and elderly persons in

Vascular lesions, the third cause among whites and Chinese was the fifth oause for Negroes, being exceeded in that group by accidents and cirrhosis. Although the Negro rate for certain diseases of early infancy was still more than twice as high as the rate for whites, the rate in 1965 was much lower than in other years. Accidents were the third cause of death among Negroes, fourth for Chinese and fifth for whites. Cirrhosis increased sharply among both whites and Negroes but remained about the same for Chinese. Tuberculosis and emphysema rates among Chinese were still high. Important causes of death by age groups are in Tables 6-1 and 6-2* Table 6-1 lists major causes by more detailed age groups than are shown in Table 6-2; accidents are classified by type. Again in 1965 » as in prior years, accidents were the leading cause of death from ages 1 through Mt. Motor vehicles were implicated in 32% of the accidental deaths. Home accidents caused Jk%\ more than onehalf of the home accidents were falls. Cancer was the second leading cause of death from age one through the 65 and over group; here too the rate increased steadily with age. Heart disease was the leading cause for the two oldest age groups. Suicide was the third leading cause in age group 15-2^, followed closely by homicides. There were 5 maternal deaths in this age group, 3 as a result of self-induced or criminal abortions. In. .age groups 25-^ and ^5-64 % cirrhosis of the liver was third, cause of death.

-6-

:

TABLE 1 DEATHS FROM IMPORTANT CAUSES SAN FRANCISCO. CALIFORNIA* AND UNITED STATES,

CAUSE OF DEATH

PERCENT OF TOTAL DEATHS

RATE PER 100,000 POPULATION

RANK

1965

Cal.*

U.S.

1293.0

826.8

941.6

100.0

100.0

1OD.0

467.6

313.3

364.7

36.2

37.9

38.7

2

248.9

136.5

152.9

19.2

16.5

16.2

3

3

130*2

86.7

1C4.6

10.1

10.5

11.1

4

7

9

73.0

19.5

12.5

5.6

2.4

1.3

Accidents

5

4

4

62.8

54.5

55.2

4.9

6.6

5.9

Influenza and Pneunonia

6

6

5

35.8

27.1

31.6

2.8

3.3

3.4

fttteifles

7

a

10

27.4

16.7

11.6

2.1

2.0

1.2

Certain Diseases of Early Infancy

&

5

6

24.9

27.6

28.3

L.9

3.3

5.0

Art eriosc lerosia

9

9

7

25.7

15.8

19.4

2.0

1.9

2.1

Emphysema

10

10

11

20.^

12.6

10.3

1.6

1.5

1,3

Diabetes

11

11

S

17.1

10.1

17.1

1.3

1.2

1.8

Aortic Aneurysms

12

13

14

12.5

7.2

5.3

1.0

0.9

0.6

Ulcers of Stomach and Duodenum

13

14

Ik

10.9

5.8

5.3

0.8

Congenital Kail ^relations 14

12

12

9.1

9.9

9.9

0.7

1.2

l.l

15

15

16

8.5

4,4

5.1

0.7

0.5

0.5

Tuberculosis

16

19

19

3.1

3.2

4.2

0.6

0.4

0.4

Inf actions of Kidney

17

15

18

7.2

4.4

4.9

0.6

0,5

0-5

Obr.truction

18

15

17

6.9

4,4

5.0

0.5

0.5

Nephritis, Chronic ard Unspecified

19

18

13

".?

3.?

5.5

0.4

.

38.2

7.0

S.F. Cal.* U.S.

-

-

-

Heart diseases

1

1

1

Malignant Neoplasms

2

2

Vascular Lesions, C.N.S.

j

Cirrhosis of Liver

ALL CAUSES

ids

S.F.

h q¥

r.

Cal.* _U.So_

0.6

Herrir. and Intestinal

!AIi Other Cause?

BCES:

San Fran California: .

Public Health Reooroe Ccan»wc.catic>u from State Department of Public ilv :on.il Fi . ?.# stiea u?;o-t. Vol, -

»«f

.>

;

1

Table 2

DEATHS FROM IMPORTANT CAUSES, San Francisco Residents,

ALL AGES 1

961-196*;

NUMBER ALL CAUSES

Heart Disease Malignant Neoplasms Vascular Lesions of C.N.S.

Cirrhosis of the liver Accioents Influenza and Pneumonia Suicides arteriosclerosis Certain Diseases of Early Infancy

Emphysema Diabetes Aortic Aneurysms

1961

1963

12k

!2£i

1965

1961

9701

2528

10,001

9777

9736

1293,

1270.1

3509

3537

3?69

1868

1728

901

1716 1003

3759 1733 935

3683 1708

979

167. 218. 130.

168.0 22.87 119.6

5I8

169 535 367

193 529

153 192

I89 168

62.1 II:

269

316

315

281

35.

70.8 18.6

206

211

193

1 63 188

V71

1002

1262

1961

1312.3

1308.6

502,6 228.3 133.8

501.6 232.6 125.5

195.0 229.6 '31.7

65.7 70.5 12.1

60.8 66.0 12.3

65.7 62.9 37.8

196J 1331.

213 170 23I

211 i65 206

27. 2 5< 21,

27.2 21.6 21.9

30.3 21.3 29.9

28.6 22.8

221

3M

22.8 22.2 27.7

111

119

95

101 111

128

88 90

20. 17. 12.

22.1 11.2 12.1

19.2 13.5 11.8

16.0 17.2 12.5

12.3 11.8

90 60

88

108

10,

11.9

9.

38 71

17 58

6 '2

66

U

5.1

61

19 60

07 17

11.1 10.8

12.1

81

90 71

826

867

930

861

919

I87 1

Ulcers of Stomach and Duooenum Congenital Malformations

94

82 68 61

Homcides Tuberculosis

227 160

169 107

53

128 91

All Other

RATE PER 100.000 POPULATION

J9i£

93

1

8.

110.1

12,1

7.9

9.9

7.8

11.5 11.1 6.3 3.9

111,7

121.0

115.9

123.1

9.9

TABLE 3

IMPORTANT CAUSES OF DEATH BY SEX WITH RATES PER 100,000 POPULATION Sam Francisco Residents 196s FEMALE

MALE ^AUSE OF DEATH

ALL CAUSES

Heart Disease Malignant neoplasms Vascular Lesions of C.N.S.

number

RATE

PERCENT

NUMBER

RATE

5S86

1522.1

100.0

1118

1073.8

36.6 13.1

1«66 839

8.0

531

PERCENT

100.0

2013 1029 116

280.1 121.5

Cirrhosis of the Liver accidents Influenza and Pneumonia

367 317 151

100.0 86.1 12.0

6.6

181

17.2

5:1

151 115

30.0

1:1

SU c de

133 127 107

36.2 31.6 29.2

2.1 2.3 1.9

11 80

19.0 6.8 20.9

1.8 0,6 1.9

86

23.1 13.? I8.3

1.5 1.2 1,2

107 61

27.9 7.0 15.9

2.6 0.7 1.5

16.9 11.1 12.8 11.1

1.1

20

5.2

C5

0.9 0.3 0.7

8

2.1

I] 12

ll

1.1 6.8

0.2 0.1 0.6

139

119.6

7.9

387

100.9

9.1

i

Emphysema Diseases of Early Infancy

arteriosclerosis Aortic Aneurysms Diabetes

67

Ulcers of Stomach and Duodenum Tuberculosis Homicides Congenital Malformations All Other

62

382.3 218.8 138.5

rt

UNITED STATES. CALIFORNIA AND SAN FRANCISCO, RATIO PER 10 000 LIVE BIRTHS

YEAR U.S.

CAL.

'.r.

1960 1961

1:1

1962

IIS 1965

2.3

I:!

5.1

2.3 N.A

4.9

-8-

3.0

1.1

10.1

TABLE 1

MATERNAL DEATHS,

35.6 20.1 12-9

1960-196

1.

NUMBER IN S.F.

,

Table 5 LEADING CAUSES OF DEATHS FOR SaN FRANCISCO WHITES, NEGROES AND CHINESE WITH RANK ORDER AND RATE PER 100,000 POPULATION, 1965

NEGRO

WHITE

CHINESE

0' rHER NON WHITE

NO.

RATE

NO.

RATE

NO.

RATE

NO.

RATE

8645

1476.5

591

649.5

320

751.2

148

471.3

Heart Diseases 3251 Malignant Neoplasms 1667 Vascular Lesions C.N.S 883

555.3 284.7 150.8

127 91 49

139.6 100.0 53.8

96 78 32

225.4 183.1 75.1

35 32 13

111.4 101.9 41.4

Cirrhosis of Liver 484 Accidents 399 Influenza and Pneumonia 235

82.7 68.1 40.1

50 54 21

54.9 59-3 23.1

8

18.8 28.2 18.8

6

12 8

6 5

19.1 19.1 15.9

Suicides Arteriosclerosis Diseases of Circulatory System

191 178

32.6 30.4

2 7

2.2 7.7

10 4

23.5 9.4

3 4

9.6 12.7

166

28.4

17

18.7

10

23.5

4

12.7

Emphysema Diseases of Early Infancy Diabetes

140

23-9

5

5.5

8

18.8

125 106

21.3 18.1

44 11

48.4 12.1

3 6

14.1

15 5

47.8 15.9

Ulcers of Stomach and Duodenum 70 Congenital Malformations 51 Tuberculosis V?

12.0 8.7 8.0

3 12 4

3-3 13.2 4.4

7 3 7

16.4 7.0 16.4

2 2

6.4 6.4 9.6

ALL CAUSES

.

Infections of Kidney 45 Hernia and Intestinal Obstruction 44 Homicide 42 All Other

521

8.8

7.7

7.0

2.3

7.5 7.2

4.4 22.0

4

20

1

9.4 2.3

89.0

62

68.1

22

51.7

4

3

3.2 12

38.2

There were 78 deaths of Filipinos with a rate of 5«0 per 1,000 estimated population, among them 21 from heart disease, 14 malignant neoplasms, 9 vascular lesions of CNS 7 from certain diseases of early infancy, 3 each from cirrhosis, influenza and pneumonia and aortic aneurysms, 2 each from accidents, ulcers, congenital malformations, tuberculosis and nephritis. There were 49 deaths of Japanese with a rate of 4.3 per 1,000 estimated population; 18 cancers, 9 heart disease, 5 diabetes, 4 diseases of early infancy, 3 vascular lesions of CNS and 2 each suicide and influenza and pneumonia.

Thirteen American Indians died; 3 each from heart disease and accidents, 2 from cirrhosis and early infancy, 1 tuberculosis and 1 arteriosclerosis. There were 8 deaths of other nonwhites, 2 from heart disease and certain diseases of early infrncy and 1 vascular lesion of CNS and 1 arteriosclerosis. The rate for other nonwhites including American Indians was 4.8 per 1,000 estimated population. -9-

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1

TABLE 6-2

DEATHS FROM IMPORTANT CAUSES BY AGE GROUP WITH RATES PER 100,000 POPULATION SAN FRANCISCO, 1965 AGES 1 - 4 YEARS TOTAL NUMBER TOTAL M F

CAUSE Of DEATH ALL CAUSES

19

35

Accidents Malignant Neoplasms Influenza and Pneumonia Congenital Malformations

AGES

100,0

16

11

13

113

36

77

ALL OTHER

631

366

137

R

'8

80 4 s 23 19 il 13

173

239

M

325

42,5 14.2 10.6 8.8 4.4 2.6

48,4

100.0

i 28

11

1:1 3.0 2.0 1.8

12 12

1:1

2

111

16.2 12.1 10.1 5.1

3.0 2.0 2.0 2.0 2,0

4

62

•.

RATE

1.1

0.9 0.7 0,6 0.6 0.5

6.5

Z7 >'l

19.8 18.3 14.4 11.4 9.4 8.4

8

5.6 2.8

2.8

RATE

ft

accidents 105 Malignant Neoplasms 89 8* Cirrhosis of Liver 68 Heart Disease Suicides 26 H0MICI0ES vascular Lesions C.n.s, 15 Influenza and Pneumonia 10 Other Circulatory Diseases ! congeni tal mal forma t ons alcoholism 5 nephritis, chr. and unspec, 5

S2 35 SO 54

I

2

*

1

1.7 1.2 1,0 1.0

ALL OTHER

22

16

7.3

34

20.2

58.3

| fc

11.1

I9.*

14 25

13 =

id 10

3

6

I

2

1 1

38

6060

16.2 1

11c* 5.0 2.9 1.9

%

37.8 32.8 8.? 5.5

5.3

3o 2.8 2.8 21.1

RATE

3215 2845 100.0 589 t.9 :

1356 1249 612 468

Heart Disease malignant neoplasms Vascular lesions C.N.S. Influenza and Pneumonia Arteriosclerosis accidents Other circulatory Dis. Cirrhosis of liver Emphysema Diabetes Suicioes Ulcers, Stomach, Duodenum Tuberculosis Hernia, Int. Obstruction 01 s. Gallbladder, Biliary Ducts Infections of kioney Hypertension without hear Male Genital Organs Dis. nephritis ALL OTHER

M

36.3 11.2

F

ALL CAUSES

-11-

9.1 9.1

19* 100-O 282,2

CAUSE OF DEATH

85.7

27.3 18.2

NUMdtK

AGES 65 YEARS AND OVER TOTAL NUMBER F 1UIAL M

1315.0

RATE

44 YEARS

i

11.1

66.9 39,6 26.3

3? 18

11

5

519

1*2

8

7

ALL CAUSES

412.6 332.8 169.9

7

2

114.0

31.4 25.3 12.9

J 9

1

100.0

202 306 104 62

2? 16 10 9 12

3

10 FA.

47

25

1

TOTAL

AGES 45 - 64 YEARS NUMBER F M %

833

1

12

AGES 25

TOTAL TOTAL

672 3*3

2

5

2

CAUSE OF DEATH

1.8 1.8 1.8 1.3

501

7

6

RAT£.

9

175*

9

i

100.0 30.8

1

3

ALL OTHER

9.7

heart Disease malignant neoplasms Cirrhosis of Liver vascular Lesions C.N.S. Accidents Suicides Other Circulatory Dis. Emphysema Influenza and Pneumonia Diabetes Ulcers, Stomach, Duodenum Homicioes Infections of kidney Hernia, Int. Obstruction nephritis Tuberculosis

accidents Malignant Neoplasms Influenza ano Pneumonia Congenital Malformations

27.2

37

2655

22

33

37.2

ALL OTHER

ALL CAUSES

YEARS TOTAL NUMBER TOTAL F H

6.2

5

accidents Malignant Neoplasms Suicides Homicides Maternal Deaths Other Circulatory Diseases Meningococcemia Cirrhosis of Liver Other Metabolic Diseases Heart Disease

CAUSE OF OEATH

ALL CAUSES

5-1*

'fcl

AGES 1S - 2U- YEARS total 3BBEEB TOTAL F H

ALL CAUSES

73.2

M

3

_CAUSE OF OEATH

CAUSE OF DEATH

23.0

4 4

All Other

RATE

43.0 2534.0 17.| 1050.6 793.6

17.1 21.4 20.4

259

128

131

"*.3

2*2.0

Table 7

DEATHS FROM SELECTED CAUSES,

CITY AMD COUNTY OF SAN FRANCISCO

BY PLACE OF OCCURRENCE AND RESIDENTS,

1

SEVENTH REVISION INTERNATIONAL CAUSE OF DEATH TOTAL,

LISTS

ALL CAUSES

001-E999

1965

UL&Jt

9 6 5

DEATHS BY RESIDENCE NUMBER

RATE»

9,70^

1293.0

DEATHS

BY

RESIDENT

PERCENT'

OCCURRENCE

NUMBER

RATE"

100.0

10,127

9,598

1270.1

SELECTED COHKUNI CABLE DISEASES Tuberculosis. All Forms, Respiratory Other Forms

Total

001-01'

61

020-029

14

053 057 032-083 092

11

480-493

0.1

1.9 1.5 0.7

0.1 0.1 0.1

*

60



13

U9

7

0,7 0.7

I

0^7

0.4

0.3 26s

T80-t83 490-493

0.8

0.1

Other Infective and parasitic Diseases Residual 030-138 Influenza and Pneumonia, Total Influenza Pneumonia, except of newborn

0.6

"oTT

010-019

Syphilis Septicemia and pyemia Meningococcemia Infectious Encephalitis Infectious hepatitis

SELECTED DISEASES,

8.1

001 -OOS

1

C

2

2,8

m

367

18.

221

358

47 .,4

1728

228,7

134

17.7

o.3

T7?

267

35.5

2.8

248. 9 9 18.1

19.2

136

150,152-155,157-159

503

67.0

5.2

562

453

59.9

162-162

317

42.2

3.3

389

305

40.4 3.7

USUALLY CHRONIC IN NATURE

MALIGNANT NEOPLASMS: TOTAL Buccal Cavity ano pharynx Stomach OTHER Digestive Organs and peritoneum

J 40-205. 1~4o-f4S 151

Trachea, Bronchus and Lung Other Respiratory System not specified as Secondary

h

1.4

225

a-

155

%3

160,161,164

21

2.8

0.2

25

28

170

174

23.2

200

140

172-174 175-176

w

29 75

23

9.1

1.8 0.3 0.3 0.7

Male Genital Organs

177-179

76

10.1

0.8

95

89

11.8

Urinary Organs

180-181

89

11.9

0.9

102

81

10,7

201

12 72

1.6

0,1

9.6

0.7

23 112

12 67

1.6 S.9

79

10.5

0.8

117

63

8.3

203

27.0

2.1

251

171

22.6

Breast Cervix uteri Other Uterus Other Female Genital Organs

171 ,

Hodgmn's Disease

1:1

44

41 51

h

Leukemia and Aleukemia Other Lymphatic and Hematopoietic Tissues

204 200,202 203,205

OTHER AMD UNSPECIFIED SITES

156,165,190-199

Benign and Unspecified Neoplasms

210-129

27

3.6

0.3

31

19

2.5

260

128

17.1

1.3

130

107

14.2

h-M

2.1

210

6.9

0.5

55

-g.2

54

115

15.3

5F

m

469

122

123

B

510-541

82

10.9

0.8

96

90

11.9

560,561,570

52

6.9

0.5

60

74

9.8

Diabetes Mellitus

Selected Respiratory Diseases Emphysema Other Selected respiratory Diseases CIRRHOSIS OF TH E LIVER Without mention of Alcoholism mention of Alcoholism With

Ulcers of Stomach and Duodenum Hernia and Intestinal Obstruction

20

«2T0T5277r241

50I.502.I 525,526 5

52

gi

581.0 581.1

-12-

27

T 61

ns

8.1

62, 3

Continued

Table 7 f

DEATHS FROM SELECTED CAUSES

19 SEVENTH REVISION INTERNATIONAL LISTS

CAUSE pf DEATH

CARDIOVASCULAR RENAL DISEASES,

444-447

I

6 4

RATE*

OCCURRENCE

NUMBER

RATE*

660.8

51.1

4859

4883

646.2

130.2

10.1

888

904

H9o6

2

5

0.7

"IT.

468.0 9.S

DISEASES OF THE HEART, SUBTOTAL 410-443 chronic Rheumatic Heart disease
Hypertension without mention of heart Disease

9

RESIDENT

BY

NUMBER

vascular Lesions of the Central Nervous System 330-33* 400-402

430-434 440-443

1

DEATHS

TOP 1 4,959

Rheumatic Fever

Other Diseases of the Heart Hypertension with Heart Disease

6 5

DEATHS BY RESIDENCE

977

PERCENT**

610

467.6 8.4 81.3

36.2 9.6 6.3

3503 114 495

2320

307.1

23.9

2386

2

209

0.3 27.8

2?2

94

12.5

211

28.1

1.0 2.2

3509

609

80 o 6

2281

301,8

204

218

2878

206

105 250

13.9 33-1

2

40

5.3

0.4

35

41

5.4

General Arteriosclerosis

450

193

25.7

2.0

144

163

21.6

Aortic Aneurysm, Non-syphilitic and Dissecting

451

94

12.5

1.0

116

94

12.4

452-468

103

13.7

1.1

117

93

12.3

592-594

43

5.7

0.4

5*

46

6.1

frfl 20.0

M

HI 115

555 I73

l°A 22.9

Other Diseases of the

Circulatory System Nephritis, chronic and Unspecified

ACCtOENTS, POISONINGS AMD VIOLENCE Accidents, Tojal Motor Vehicle Other transport Home Other non-Transport Resioual

6 ?. 810-835,960 800-802, 840-866 870-936 with .0 870-936 with .1-. 9 940-959,961,962

Ht?

SUICIDES

HOMICIDES

471

150 14 160 147

175

1.9 21.3 19.6

0.1

1.6 1.5

16? 127

1

163

4.9 21.4 21.6

963,970-979

206

27.^

2.1

211

211

27o9

964,980-985

64

a. 5

0.7

62

49

6.5

6

0.8

0.1

7

4

0.5

ALL OTHER CAUSES

Complications of Pregnancy, Childbirth AND THE PUERPERIUM 640-689 Certain Diseases of Early Infancy

760-776

187

24.9

1.9

252

188

24.9

Congenital Malformations

750-759

68

9.1

0.7

147

60

7.9

26

3.5

0.3

33

38

5-0

432

57.6

4.5

466

417

55.2

1.2

0.1

J1

4.1

Gastritis, Duodenitis, Colitis

Enteritis,

543,571-572

All Other specified Causes

Residual

Symptoms, Senility, Ill-Defined and Unknown Causes

780-795

-13-

Table 8

SELECTED MORTALITY, NATALITY AND

ORBIDITY FOR HEALTH DISTRICTS, 12^5 .

SAN FRANCISCO

HEALTH DISTRICTS

ESTIMATED POPULATION 7-1-6S

ALL SAN FRANCISCO

EUREKAMISSiON

'ESTSIDE

SOUTHERN

750.500

HI ,000

163.500

151,500

1,601

1,972

11.4

12.1

62 19.8

27.3

TOTAL DEATHS Rate per 1,000 Population INFANT DEATHS Rate per 1,000 live births

288 23.4

FETAL DEATHS Ratio per 1,000 Live Births

161 13.1

TOTAL BIRTHS Rate per 1,000 population

12,322 Is.*

LOW WEIGHT BIRTHS Rate per 1,000 Live Births

1

083

87.9

S3

72

M

26,0

NORTHEAST 11V,30 2

^o

SUNSETRICHMOND 1

81,200

20,8

2.218 12.2

32 28.8

18.2

12

13

1*.*

11.7

3,132 22.2

2,6*1 16.2

2.925 19.3

9.8

13.1

*?

281

293 100.2

107

140 59.1

a

106.*

80.8

96

3

16.3

35 11.2

DISTRICT NOT REPORTED

25 10.6

3

2,367

96.2

9

TUBERCULOSIS Number of New Cases Rate per 100,000 Population

485 64.6

1W

52.

127.1

66 36.4

2.713 1659.3

988 652.1

1.617 1427.2

H3.5

102

5»!2

62.*

921

30

VENEREAL DISEASE Number of New Cases Rate per 100,000 Population

m

653.2

1

260

65S

964 DISTRICT SUNSETRICHMOND

ALL SAN FRANCISCO

EUREKAMISSION

WESTS IDE

SOUTHERN

7.55,700

141.600

164,630

152,300

114.A00

9.598

1,884 il.4

1,401

2,259

12.7

1,598 11.3

9.2

19.7

INFANT DEATHS Rate per 1,000 live births

276 20.8

69 21.9

64 22.0

72 23.0

3^ 26.2

fetal deaths ratio per 1,000 live births

176 13.3

47

10.3

16.2

47 15.6

12.3

us

3.150

2.909

22.2

17.7

3.124 20.5

\n

2,629 14.4

239 75.9

91.4

66,4

6$

7'.7

5,735 758.9

792 559.3

2,209 1341.8

ESTIMATED POPULATION 7-1- 64

.

.

TOTAL DEATHS Rate per 1,000 Population

TOTAL BIRTHS Rate per 1,000 Population LOW WEIGHT BIRTHS Rate per 1,000 live Births

13,239 17„5 1

092 82.5

266

.275

NORTHEAST

16

124 95.6

NOT

REPCRTED

182_,770

134

176

1

130

12

66„$

TUBERCULOSIS Number of New Cases Rate per 100,000 Population

502

118

to 53.

13HJ

,52 28.5

1,480 1293.7

232 126.9

VENEREAL OISEASE Number of New Cases Rate per 100,000 Population

581-7

136

LOH "EIGHT BIRTHS ARE THOSE WITH NEIGHT 5i LBS. OR LESS (2500 GRAMS AND UNDER)

Infant Deaths are included in Total Deaths Fetal Deaths are countfo separately ..14-

:

BIRTHS During 1965 there were lS,0?7 recorded births in San Francisco, continuing the downward trend that began in I962. For 7 years, the number of recorded births exceeded 20,000; the high point was 196l with 20,804 registered births. The percent of non-resident births increased to 33*2-% in 1965* surpassing the previous highs of 32.4% in 1964 and 32.0% in 1963; the number of non-resident births decreased to 6,005 in 1965 from 6,224 in 196'+ and 6,394 in 1963. Resident births occurring outside San Francisco totalled 250 in I965, as compared to 234 in 1964; the increase was because San Francisco mothers continued to deliver at Mary's Help Hospital even after the hospital moved to San Mateo County. The number of resident births in San Francisco was 12,322; the crude birth rate was 16.4 per 1,000 estimated population. Since i960, both numbers and rates have been dropping steadily; the number of resident births decreased 16.3% in 1965 compared to 14,728 in I960* The text table on Page 4 shows the number of events, the rates and the populations on which the rates were based. The male-female ratio in 1965 was 106, more typical of the expected ratio than 100,5, the 1964 ratio.

In 1965 the percent of primi paras rose to 40% from 37 »9% in 1964 and 36,9% in 1963; the percent having the second child decreased to 24.7 from 25.4 in both 1964 and 1963. The percent having borne three children or more decreased to 35«3 compared to 36.7% in 1964. All ethnic groups showed decreases in number and rate of births. The white birth rate dropped to 14.0 per 1,000 estimated population from 15.1 in 1964, 16.1 in 1963 and 17.3 in i960. The number of white deaths in 1965 exceeded the number of births by 432, the same number by which births exceeded deaths in 1964. The decrease in white births since i960 was 21.5%; the decrease in nonwhite births was 3*7%. The number of Negro births dropped by 2%; the rate decreased to 26.8 as against 27.9 in 1964 and 28.9 the year before that. Chinese births declined to 748 from 825 in Both Filipino and 1964; the rate decreased to 17„6 in 1965 from 19.5 in 1964. Japanese birth rates also continued to decline. In 1965 there were 123 AmericanIndian and I96 other nonwhite births; the rate for this group, 72.5 is based on a population estimated at 4,400. The following table shows the births in each ethnic group as a percent of all births for the years 1957 through 1965.

RESIDENT LIVE BIRTHS BY ETHNIC GROUPS AS A PERCENT OF ALL BIRTHS,

1937-65

OTHER

YEAR

WHITE

TOTAL NONWHITE

1957 1958 1959

73.7 72.9 71.4

26.3 27.1 28.6

15- .3 16. .3

I960 1961 1962

71.0 71.2 69.4

29.0 28.8 30.6

16. ,8

1963 1964 1965

69.I 67.7 66.6

30.9 32.3 33.4

17. ,8 18. ,8

NEGRO

CHINESE

16. ,8

17. ,1 18. ,1

-15-

FILIPINO

5.9 5.7 6.1

1.6 1.5 1.6

5.9 5.6 5.6

1.8 1.7 1.8

3. .0

6.0

1.5 1.6 1.7

6.2 6.1

19. ,8

JAPANESE

1, ,8

2, .3 2, .7

NCN WHITE 1.7 1.3 1.4

2, .8

1.5 1.6

3. .1

2.0

3. .4

2.2 2.6 2.6

3. .1

3. ,2

DOCUMENTS SEP 13

1966

SAN FRANCISCO PUBLIC LIBRARY

Curing 1965, 1,683 or 13.7% of the resident live births were to unmarried mothers, an increase of almost 10% over the 196** figure of 1,531. Since the California birth certificate does not have an item about "legitimacy", the decision about this is based on the way in which other items are or are not reported and it should be realized that both numbers and percents are estimates. The percent of white unmarried mothers of the total increased to **8% in I965 from **5% in 196*+ while the Negro percent decreased to **7% from 50%; the percent for other nonwhites remained the same. The increase in the number of white illegitimate births was 17.6%. The number of mothers delivered at San Francisco General Hospital decreased to **8.5% of the total in 1965 from 52% in 196**. Of these 32% were white and 62% Negro. Again in 1965, 65% of the Negro mothers were delivered at San Francisco General Hospital while 68% of the white mothers were delivered at other hospitals. The percent of mothers under 20 years of age increased to 35% in I965 from 31% in 196**; the percent 20-2** years of age decreased to 3**% from 36%. Fifty-five percent of the infants were first born children. V/eight at birth was reported on all but five of the 12,322 certificates;

length at birth was also reported on more than 99%; gestation period was not reported on 1,5**3 or 12.6% of the certificates. For ethnic groups, reporting of gestation varied from a high of 91.9% for American-Indians to the low of 6**. 3% for the Chinese; the percent reported for whites was 88.8 and for Negroes 89.5%.

Using a birth weight of 2500 grams or under as a criterion, 1,083 or 8,8% of all births were premature; 7.9% of the white and 13.1% of the Negro births fell into this category. Length at birth and gestation period are shown in Table 15-1, separately and in combinations of two of the three items. Using all three criteria, 3.1% of the total births were premature as were 2.7% of the whites and **.9% of the Negroes. Again in 1965, nearly 22% of the low weight births were delivered at San Francisco General Hospital, 11% at Kaiser Foundation Hospital, nearly 8% at Mt. Zion Hospital and Medical Center and 7.**% at University of California Hospital. Table 15-2 relates birth weight in three broad groups to length of gestation period. Almost 85% of the infants were fully mature by both factors; the lowest percent, 77.2, is for the Negro infants and the highest, 88.0, is for Chinese.,

Congenital malformations were reported on 1.1% of the birth certificates. Additional information from the medical items on bi rth certificates is available from the Bureau of Records and statistics*

-16-

..

TABLE 9 RESIDENT LIVE BIRTHS AND 8IRTH RATES BY ETHNIC GRCUP PER 1,000 ESTIMATED POPULATION San franci sco f 1965 & 196fr

LLi-5 ETHNIC GROUP

BIRTHS

TOTAL

White Negro Chinese

MALE

9 6

fr

FEMALE

B'.RTHS

RATE

l6.fr

6,338

5.?3fr

Ji.23.9_

J1.JL

8,213

ifr„o

3,997

8,959

15.1

2*frfr0 7fr8

26.8 17.6

fr.216 r;2fr3

2,fr9l

frofr

''III

27.9 19.5

395 207 319

25.5 18.0 72,5

199 108

196 99

fr12

151

3fro

Filipino Japanese Other* *

1

RATE

Includes 123 American-Indians,

71

825

26.9 18.8 82.9

212

Males and 52 Females.

Table 10 RECORDED, RESIDENT AND NON-RESIDENT LIVE BIRTHS BY PLACE San Francisco. 196s and 196fr

1965

196fr

18.077

19,119

Kaiser Foundation Hosp. 27fr2 U. Hospitals 2097 San Francisco General Hosp .1930 Children's Hospital 1832 St. Mary's Hospital 1fr82

2727 2222 I945 1953 1509

St. Luke's Hospital 1232 Mary's Help Hospital. (Through 12-12- •65) lofr6 Letterman General Hosp. 1007 Presbyterian Med. Center 955 St. Francis Memorial Hosp. 882

1178

1382 1218 983 9fr0

^6 712 5§ 8

762

375 302

fr19

56"

53

TOTAL

C

Mt. Zion Hosp. & Med. Ctr. French Hospital St. Joseph's Hospital Chinese Hospital St. Elizabeth Infant Hosp.

Home Elsewhere Emergency Hospital Doctor's Office

SAN

196S

196fr

12,322

13.239

6,00S

6,22fr

1619

1652 1277 1929 1256

1123 873 29

1075

9fr2

9

697 567

858

8fr6

37fr

332

7lfr

966

332 fr29

fr82

6fr7

Hi

615

6fr3

308 267

337 297

919

598

271

frfrl

6fr8 fr25

2fr8

711

271

286 262

23fr

203

_ 1

_ 6 2

1

-

122fr

1901

896

578

_

_

-

-

m 8 18 -

fr

Tc



TOTAL

12 322

San Francisco General 1901 Kaiser foundation hosp. 1619 122fr Uo C. Hospitals CHI loren's Hospital St. Mary's Hospital St Luke's Hospital 858



71fr Mary's Help Hospital Pre sbyterian Med. Center 6fr7 St. Francis memorial hos, ,615

Mt, Zion Hosp. A ."Ied.Ctr, .598 Letterman General Hosp.

a?

French Hospital

Chinese Hospital St. Joseph's Hospital St. Elizabeth Infant Hos. Home Elsewhere Emergency Other California Out of State

NEGRO

DTAL

3fr9 33fr .

68 56 1

8.213 773

1965

V

fr6

395

CHINESE 7fr8

JAPANESE 207

INDIAN 123

10

2

8

2fr

l

3fr

2fr

155

28

88

5 2

959

in

a

833

fro

80

fr3

l

OTHER NOMv'H

1

TE

L9-6__
17 3 8

51

81

2fr

16

727

68

28

8

I

I

19

582

39

11

17

Ifr

39fr

!i

506 357 352

125 22 206 125

6 56 9

1 -

36fr

2

ifr

11

g

9

13

fr?

6

fr7

6

ifr

1J 6

2

3

8

9

12 10

32fr

297

ifr

1

55

-

2

1

21

9 27

1

3

3

10

-

fr

-

fr

* 20fr

2,frfr0

FILIPINO

-

-

28

AMERICAN PLACE

frl6

206

Table 11 UlRTHS BY PLACE

f

16

30

52

1-

20 -

9fr5

500

33* 3*9 CS

1fr

1

Other California Cut of State

Ji£i

I96fr

269

I

NON-I RESIDENT

RESIDENT

RECORDED PLACE OF BIRTH

172 36

22 7

19

5 2 1

1

5

28 2

3

.

3

_ -

3

-

-

-

-

fr

_

2

1

-

1

-

2

-17-

1

1

2 -

7 1

Table 12 RESIDENT LIVE BIRTHS IN HEALTH DISTRICTS BY ETHNIC GROUPS,

HEALTH DISTRICT ETHNIC GROUP

DISTRICT

TOTAL

TOTAL

1

2

7

4

NOT REPORTED

5

12 r }22

3r

H2

2 r 64l

2,925

1.113

2 ?67

144

8,213

2,

603

1,267

1,677

539

2,011

116

Si 09

529

1,37*

1,248

574

356

28

WO

232

1,092

987

70

40

19

CHINESE

?48

73

76

46

397

148

3

FILIPINO

395

115

34

94

52

49

JAPANESE

207

26

55

9

13

102

2

AMERICAN INDIAN

123

4-1

27

30

21

2

2

OTHER

196

37

40

82

21

15

White NONWHITE NEGRO

2,

1

1

TABLE 13 LIVE BIRTHS BY TRIMESTER PRENATAL CARE BEGUN AND PERCENT BY PLACE OP BIRTH. San Francisco Residents. 1965

PLACE OF BIRTH

1ST TRIMESTER NO.

TOTAL

%

%

NO.

2 NO

TRIMESTER NO.

%

3rd TRIMESTER NO.

12,322

100.0

6707

_J&A

3761

30.5

1346

^10,9

San Francisco General Hosp. Kaiser Foundation Hospital

1,200 1,619

13o4 62.4 33.5

43,6

5§ 9

29o9

1,224

254 1010 410

828

U. C. Hospitals

100.0 100.0 100.0

18

51.1 46:

89 239

Children's Hospital St. Mary's hospital St. Luke's Hospital

858

100.0 100.0 100.0

865 699 527

74.8 78.0 61.4

227 170 262

19.6 19.0 30.5

Mary's Help Hospital Presbyterian Medical Center St. Francis Memorial Hospital

714 647 615

100.0 100.0 100.0

2 §3

IH 27.8 18.

598 578 441

100.0 100.0 100.0

445 263 347

349 334

100.0 100,0 100.0

281

100.0 100.0 100.0

10

100.0 100.0

113

Mt. Zion Hosp.

& Medical Ctr.

Letterman General Hospital French Hospital Chinese Hospital St. Joseph's Hospital St. Elizabeth Infant Hospital

68

Home Elsewhere Emergency Hospi tal Other California Out of state

204 46

m K 2g 2

74.4 ifrl 7S.7

180 115

4.1

13.1 1.0

.5:?

1,

0.9

a

10

0.9 0.3

3

7.0

9

1.1

46

6 -§

4.6

?!

12.8 3.9

33 29 33

y 4. r

.

19.8

22

3.8

79

17.9

12

fc!

3

o.7

51

17 3

4.9 2.7 13.2

1

0.3

4

3

16.1

21

2

15.4 25.0

2

50

14.6 15.0

30

44.1

17c8 15.4

16 6

28.6 46.2 25.0

1

27.9 4.3

.1J.

60

508^

250

118 249

8o„5 82.0 36.8

2

NO CARE OR NOT REPORTED

2

8

1

.'0 1

9.8 2.2

j

14 in

37.5 2^.0 50.0 6.9 89.2

H

TABLE PLACE OF BIRTH OF LOW HEIGHT LIVE BIRTHS BY ETHNIC GROUP San Francisco Residents. 1965

PLACE uF BIRTH

TOTAL

WHITE

NEGRO

TOTAL

1083

646

320

San Francisco General Hospital Kaiser Foundation Hospital Mt„ Zion Hospital and Medical Center

236 120

U. C. Hospitals

go"

St. Mary's Hospital Children's Hospital

t>9

St. Luke's Hospital Letterman General hospital Mary's Help Hospital

65 62

CHINESE

FILIPINO

w

JAPANESE

AMERICAN INDIAN OTHER

21

3JL

136

56

55

St. Francis Memorial Hospital St, Joseph's Hospital

57

French Hospital

11

Presbyterian Medical Center Home Chinese Hospital

8

35 55

5! 27 15 5

13

St. Elizabeth's Infant Hospital

Elsewhere

it

Other California Out of State

23 5

f

J

TABLE 15-1 PREMATURE LIVE BIRTHS BY ETHNIC GROUP, BIRTH WEIGHT, LENGTH AND GESTATION PERIOD 1965 San Fran c isc o Residents.

NUMBER PREMATURE BY ONE CRITERION:

Weight at birth Length at Birth Gestation Period

TOTAL PREMATURE 1083 1373 1183

WHITE

NEGRO

CHINESE

§f

?°2

44 69

693

360

n*

152

FILIPINO

JAPANESE

P 29

,

AMERICAN INDIAN

CTHcR NONWHITE

21

9

9

29 22

7

21

7.3 12.2 13.8

8.2 10.7

TWO CRITERIA:

Height and Gestation weight and length Length and Gestation ALL THREE CRITERIA:

419 25S

242 161

20* 32 22*

223

120

15*

B i

7-9

13.1

11.1 9.6

9.0

M

18.5 14.8

5.9 9.2 5.5*

8„6 14.2 7.3

5? 3

380

1 ? 3

PERCENT OF PREMATURE LIVE BIRTHS BY ONE CRITERION:

Weight at birth Length at Birth Gestation Period

10.1

14.Q 10.6

M

TWO CRITERIA:

Height and Gestation height and Length Length and Gestation ALL THREE CRITERIA:

*

2.0

4,2 6,0 3.8

3.8

6.2

*l

13

2.7* 4.3 2.9*

2.5

1,8 6.8 7.2

1.6

2.6

3.1

2.7

4.9

2.0*

2.0

4.3

1.6

1.5

Only 64?$ of the Chinese Mothers reported last day or normal menses from which length of gcstation period The figures for Chinese should be used cautiously if at all. is calculated.

-n-

TABLE 15-2 BIRTH HEIGHT, GESTATION AND ETHNIC GROUP OF 10.305* RESIDENT LIVE BIRTHS SAN FRANCISCO, 1965 II

UNDER 3 LB.

GESTATION IN HECK S TOTAL

WHITE NEGRO Chinese Filipino Japanese American Indian OTHER NONHHITE

TOTAL

5 OZ.

ANY GEST. PERIOD

THRU 3 LB. 5 02 5 LB. 3 OZ. UNDER 37

10,805

_2_

382

7,308 2,191

105

3*7

37 OR MORE

37 OR MORE

9159

234 112

380 208

ft*

16 8

21

«5

19 12 13

301 158 93

17

1*1

j__j

8 Z

1

173

UNDER 37

lUg

%~oT.

5 LB.

670

5 7

190 113

MURE THAN

1

1691

PERCENT IN EACH GROUP

TOTAL

100.0

1.6

h5.

3.9

6,2

white

100.0

1.*

3o2

3.*

5o2

negro

100.0

2.3

5.1

5.9

9.5

Chinese

100.0

1.2

3.3

3.1

M

88.0

Filipino

100.0

1,*

2.3

*.o

5.5

86.8

JAPANESE

100.0

3.7

2.6

*.2

6.3

83.2

American Indian

100.0

0.9

3.5

1.8

11.5

82.3

OTHER NONHHITE

100.0

0.6

1.7

2.9

9.8

85.O

77.2

* SAN FRANCISCO RESIDENT LIVE BIRTHS FOR t'HICH GESTATION. INFORMATION HAS NOT REPORTED BY HEIGHT GROUP

HEIGHT

i OF TOTAL

LIVE BIRTHS

3 LB.

GROUP II

I

UNDER 5

OZ.

K

IV

III

3 lb. 5 OZ. TO 5 LB. 8 OZ.

H

V

OVER 5

LB.

8 OZ.

HE 2HT AND GES TATICN NOT REF0R T ED» 1

1548

12.6

35

107

H05

923

11.2

21

62

839

1

Negro

257

10.5

8

28

221

-

Chinese

267

35.7

2

7

258

-

7


-

TOTAL

WHITE

FILIPINO

51

12.9

3

1

JAPANESE

18

8.7

1

1

16

American Indian

10

8.1

-

2

8

-

OTHER NONHHITE

22

11.2

-

-

22

-

infants, gestation over 37 weeks and 1 "Other" gestation ovr 37 weeks whose weight has not been reported are excluded from this table. 35 infants unoer 3 lbs. 5 oz. with no information on gestation are included in group t

3 White

.

INFANT DEATHS: During 1965 the number of infant deaths increased to 288 from the 1964 low of 276 but was well below the numbers for the years 196l through 1963c The infant death rate increased to 23*^ per 1,000 live births, compared to 20.8 in 1964* The increase was chiefly in the white group where the rate went to 23.6 after having reached a low of 18.6 in 1964. Filipinos were the only other ethnic group having an increase; infant deaths were nearly doubled over 1964 and tripled since 1963. The number of Negro infant deaths remained about the same for 1963> 1964 and 1965; because of the smaller number of births the rate increased slightly. Deaths in the first week of life for both I965 and 1964 remained the same, 200 but those dying in under 24 hours dropped from 51% to 43% and those dying in from 1 to 6 days increased. Deaths in the next time span more than doubled over 1964. Prematurity was coded as a causal factor in 53.5% of the deaths and in 73% of those who died within 24 hours of birth. Increases were in such causes as congenital malformations and asphyxia and atelectasis; pneumonia and accidents remained the same. Table 16 INFANT OEATHS AND DEATH RATES BY ETHNIC GROUPS San Fran cisco Resioents.196i-.1965 NUtlBER OF

WHITE NONWHITE

TOTAL

NEGRO Chinese Filipino

Japanese American-Indian Other

INFANT OEATHS

12ii

19ii

19ii

1962

1951

288

276

3t6

351

360

19^

167

23^

226

2^1

09

112

125

119

n

l\

S

82

II

9

5

3

9

'I

3

9

7

10

5

2M

2"».5

9^

1

Included in Other \

13

RATE PER 1,000 LIVE BIRTHS TOTAL

White ncni-jhite

Total

23.4

20.8

25.0

23.6

18.6

2^.5

23.0

23.0

25.5

26.2

28.8

28.1

28.5 15.8

28.8 27.3

3M

32.7

17.7 20.5

20.6

11.5

35.6

35.5

21.7

22.9

Negro Chinese Filipino

28.7 8.0 22.8

Japanese American-Indian Other

Hi 10.2

12.1

37.6 33.0 Included in Other 38.2 23.3

1"*.5

decreased to l6l in 1965 from 176 in 1964. The total fetal death was lT. 1 per 1,000 live births; the white ratio was also 13.1. The Negroes had the highest ratio, 17.2 and the Chinese the "lowest, or 1.3.

FETAL DEATHS rat

-21-

Table 17 INFANT DEATHS BY SEX, ETHNITT GROUP, CAUSE OF DEATH AMD AGE AT DEATH T SAN FRANCISCO RESIDENTS, 19^5

AGE UNDER ONE YEAR

UNDER CAUSE OF DEATH

DAYS

ALL CAUSES

288

12»

_7i_

HALE

173

70

Female

115

5*

Whi te

m

325.* 355 5^0 56o 983 180 795.5

23

18

I?

2 1 1

_L5J_

CONGENITAL MALFORMATIONS 4 CERTAIN DISEASES OF EARLY INFANCY EXCEPT INFECTIONS 220 congenital malformations Injury at birth Asphyxia and atelectasis l(> Disorders attributed to disease of mother during pregnancy 5 Hemolytic Disease of Newborn 3 Hemorrhage of Newborn 2 Ill-Defined Diseases ^7 Immaturity, Unqualified 33 Immaturity with Subsidiary Conditions INFECTIONS 10 Pneumonia of Newborn Other pneumonia 30 Other Respiratory 3 1 Congenital Syphilis 1 Septicemia and Pyemia 1 Meningococcemia German Measles Non-Men ngococcal meningitis Sepsis of newborn 1

~2T0~

57 ..

3?

2

~W

926

DAYS OVER

70

TOTAL HITH MENTION OF PREMATURITY

916 923

.6

Ik HRS.

nonwhite Negro filipino Chinese Japanese American Other

75T

1

TOTAL

accidents poisoning. Aspirin Fire and Explosion Foreign body entering other orifice Mechanical Suffocation Lack of Care OTHER PancreaTIc disorder other than Diabetes Hellitus Mongolism Other Diseases of Brain Ulcer of Stomach Hernia without Obstruction Assault Malignant Neopiasms Other Unkamiwn and Unspecified Causes

.22-

92

53

*

Tr

68

26

12 19

3

2

2 1

27 24

1

1

1 1

lb 6

3 5

*

i

1

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COMMUNICABLE DISEASES: Reported cases of childhood diseases such as chickenpox, measles and mumps decreased considerably in 1965. One case of typhoid fever was reported in 1965 after a 2-year period with no cases. 1965 was the third successive year with no poliomyelitis cases and the second year with no cases of diphtheria. Tuberculosis and Venereal Disease are discussed elsewhere in this report. Cases of infectious hepatitis increased to l8l from 150 the year before but deaths decreased to 3. Serum hepatitis cases more than tripled to 77 from 25 in 196*f. Meningococcal meningitis cases decreased to 20 from 28 but there were 5 deaths each year. Both cases of and deaths from influenza and pneumonia decreased marked'

ly.

VENEREAL DISEASE: Data presented are rather straightforward and hardly need comment or explanation except in several areas, since developments for 1965 did little to change trends already established during the past several years - syphilis rates are remaining fairly level, while gonorrhea is increasing by leaps and bounds.

In I960, the high point till then for early infectious syphilis in San Francisco since early post World-War II days, the total of primary, secondary and early latent syphilis together reached 607 cases. Since then, there has been some annual fluctuation, but with the total reaching only 565 cases in 1965 after another high of 619 cases in 196^. Gonorrhea during that period more than doubled, going from 3,157 cases in i960 to 7,359 cases in 1965. The San Francisco Department of Fublic Health City Clinic's reported cases has remained a constant percentage of the total of all cases reported from all sources. Since there is no reason to believe that the City Clinic is now seeing proportionately more of the Community's gonorrhea than formerly, it may be fair to assume that the level of syphilis has remained at a fairly constant level for several years in San Francisco. >

For years, the Division of Venereal Disease Control has devoted a major proportion of its epidemiological effort in the interest of syphilis control, largely with personnel supplied by the Federal government. While one cannot fully assess the value of this approach, logic and experience in many specific instances lead workers to believe this to be extremely worthwhile. However it6 success is limited in that it can only be applied to reported cases. It i6 estimated that approximately 85$ of cases of early infectious syphilis seen by private physicians are notrept'd. It is, therefore, expected that it will be continued with an increased effort to improve the level of reporting.

For years, it was thought that the reduction in the rate of syphilis in the earlier days of penicillin therapy was in port the result of extensive and frequently indiscriminate use of that drug by physicians. It was thought that many treated during the incubation period were unwittingly being cured. Subsequent restricted use of penicillin may have been partially responsible for increasing rates. Perhaps one can now speculate that the increasing rates in gonorrhea, with more extensive use of antibiotics fot its cure is at least partially responsible for the leveling off of the syphilis rate. All are at a loss as to what course to follow next in gonorrhea. Though it is generally thought that contact tracing as presently practiced is not the solution, the Health Department will continue. Figures for gonorrhea would be considerably greater were it not for this limited epidemiologic approach. In any event, if nothing else, many asymptomatic women who otherwise would not know of their infections are being found and cured before later serious complications develop. Also, some cases of syphilis are being discovered more quickly.

During the year, the sole venereal disease clinic on the West Coast represented, San Francisco engaged in a cooperative study with a number of clinics in other parts of the United States for the study of certain aspects of gonorrhea among females. Among other points, the study revealed what was already too well-known, that the organism causing gonorrhea was becoming increasingly more resistant to all of the drugs currently used for its cure. It was also found that San Francisco had more highly resistant strains of the gonococcus than any other area of the Country, and, one of the most highly resistant strains yet to be reported anywhere was among them. table 19

REPORTED CIVILIAN CASES OF VENEREAL DISEASE San Francisco 1960-1965

GONORRHEA TOTAL

Diagnosed Cases Epioemiologically Treated SYPHILIS

TOTAL.

PRIMARY Secondary Early Latent Other Epioemiologically Treated

1960

1961

1962

1963

19fo

3157

3845

4419

5251

5815

7359

2569 538

3132 713

3727 692

4316

61 86

935

4826 989

1010

1346

1526

163*

1547

1376

211

166 105 277 465

164 97 279

333

408

139 138 283 517 557

326 364 564

1 ?5 241

403 -

7

? !

I9ii

1173

107

81 407

Table 20 REPORTED CIVILIAN CASES OF VENEREAL DISEASE, 5-YEAR MEDIAN, BY STAGE AND SEX, San Francisco, 1965

TOTAL VENEREAL DISEASE

TOTAL

MALE

FEMALE

1960-1964 5-YEAR MEDIAN

_H3J_

608 2

2655

5951

SYPHILIS TOTAL

1376

1071

J05_

1526

Primary Seconoary Early Latent Late Latent

150 68 347

"I

166 107

LATE

25

142 56 285 234 19

Congenital All Stages, Report Only Epioemiologically Treated

18

6

12

407

3 29

78

7J52

5010

2349

6186

1508

37727

1173

4678 332

841

713

2

1

361

GONORRHEA TOTAL

Diagnoseo Cases Epioemiologically Treated

8

It

326 16

30

OTHER TYPES TOTAL

1_

Table 21

REPORTED CIVILIAN CASES OF VENEREAL DISEASE, BY AGE GROUP AND STAGE OF DISEASE, San Francisco. 1965 __

HUM, TOTAL

8737

0-14

15-19

20-24

25-34

35-44

*5 A OVER

ii'5

2849

3164

1102

476

31

SYPHILIS TOTAL PRIMARY Secondary Early Latent Late Latent Late Congeni tal all Stages Epioemiologically Treated 407

GONORRHEA TOTAL Diagnosed cases Epi. Treated

47* 1

9-

328 3?"

23

19

111

1173

177

OTHER TYPES TOTAL

.25-

89

2

20

774 tfr

174

25P -H5 381

n*

3

m

1

10

5

21

10 41

83

13 2

1066

-^

V

184

2633 rrp 2158 475

2685

rfr

Table 22 INFECTIOUS VENEREAL DISEASES* BY AGE GROUP San Francisco Reported Civilian Cases. 1960-1965

AGE GROUP

TOTAL

0-1* 15 - 19 20 - 24 25 - 3*

35 45

-

&

i960

1961

J9i2

1963

1964

1965

3176

3680

1267

4876

5445

J251

16

1*

734 1785 2083 646 172

910 2270 2537

338

1384 433

44 Over

31


iJ-03

1102 1504 519 133

579 1523 1873 693 177

792 217

PERCENT OF CASES AGE GROUP

TOTAL

0-14 15 - 1? 20 - 24 25 - 34 35 - 44

45

4

OVER

I9i0

1961

1262

100.0

100.0

100.0

0.5 10.7 28.4 43.6 13.6 2.7

0.4 29.9 4n.9

0.6 11.0 31.2 40.0

14,1

1

11.1

3.6

M

3.8

INCREASE 1960 - 1965

AGE GROUP

TOTAL

0-14 15 20 25 35 45

9 572

19 - 24 -

- 34 - 44

4

Over

196^

11.9 31.2 38.4 14.2 3.6

1964

i9ii

100.0

100.0

0, 5

0.4 13.5 33.6 37.6 11.7 3.2

13.

3 2' :! 38. .2 11, 9 3. ,1

PERCENT

1960-1965 PERCENT INCREASE

IN EACH AGE GROUP

112^6

100 J)

56.2 169.2 147.0 83.3 82.9 152.3

37.8 32.2

0.3 16.0

10.0 3.7

Infectious venereal Disease includes Primary, Secondary and early latent syphilis an all diagnosed cases of gonorrhea.

*

TABLE 23

VENEREAL DISEASE * REPORTED TO THE HEALTH DEPARTMENT WITH PERCENTAGES REPORTED BY PRIVATE PHYSICIANS l2fiO=lSL65.

SYPHILIS

(

(

(

554

5 i°

639

187

196

27.6

32.8

30.7

616 152 24.7

28.4

28.8

29.2

1543 432 28.0

27.7

2*.3

3316

3905

44]3

535^2

5910

172 5.2

6.1

1?65

594 167 28.1

Includes

1023 295

1644 381

1417 298 21.0

All Classifications )

Reported from All Sources Reported by Private physicians Percentage »

1964

1962

All Stages )

Reported from All Sources Reported by Private Physicians Percentage GONORRHEA

1963

1961

Primary, Secondary. Early latent )

Reported from all Sources Reported by Private Physicians Percentage SYPHILIS

.

1960

a

240

small number reported by military FACILITIES. -26-

7621

472 7.2

6 2

Table 24 REPORTED CASES OF VENEREaL DISEASES BY SOURCE OF REPORT AND TYPE OR STAGE OF DISEASE, San Francisco, 1965

TOTAL

33 Hunt

Other City

Local Hosp.

Private M.D.

Federal Civilian

Other Juris.

Military

9044

6772

776

325

770

61

33

307

PERCENT OF TOTAL 100.0

74.9

8,6

3.6

8.5

0.7

0.3

3.4

TOTAL

SYPHILIS TOTAL

1417

885

23

104

298

47

19

41

Primary Secondary Early Latent Late Latent Late Congenital Report Only Epi. Treated

161 72 361 372 26 18

82 37 217 i4i 8

1 -

53

6 6 13 16 3

1

11

-

-

6 11 2 1 -

7 4 15

407

392

7621

Diagnosed Cases 6447 Epi. Treated 1174

GONORRHEA TOTAL

Chancroid

-

4

3 15 -

14 11 1

-

-

8 4

21 93 113 4 2

-

-

2

1

12

3 "

5885

753

221

472

14

14

262

5120 765

415 338

216

408 64

14 -

13

261

1

1

8

65

5

-

-

4

Lymphopathia Venereura2

Table 25 REEORTED CIVILIAN CASES OF VENEREAL DISEASE BY HEALTH DISTRICT, SaN FRANCISCO, 1965 (

HEALTH DISTRICT

Excludes Jkt5.8p_Epi._ Treated Cases)

ESTIMATED POPULATION

TOTAL

NUMBER OF cases

Rate per 100 ,000 FOFULaTION

PERCENT OF CASES

750,500

7,157

953.6

100.0

1.

Eureka-Mission

141,000

921

653.2

12.9

2

Westside

163,500

2,713

1659.3

37.9

3# Southern

151,500

988

652.1

13.8

4. Northeast

113,300

1,617

1427.2

22.6

5. Sunset -Richmond

181,200

260

143.5

3.6

.

District Not Reported

658 -27-

-

9.2

REPORTED CIVILIAN CASES 0/ VENEREAL DISEASE BI HEALTH DISTRICTS EXCLUDING BHDEHIOLOOIC^LLI TREATED RATES PER 100,000 POPULATION

SAN FRANCISCO, lgfe

DISTRICT II

DISTRICT IV

Und.r 500

~i'

i,

I

f

|

I

I

ii

I

looo



500-999 -28-

I,

om

REPORTED CIVILIAN CASES OF SYFHILIS SAN FRANCISCO, 1961 - 65 Number 1800

1600

--

1400

--

1200

--

1000

--

800

--

600



'\y&

-

400

— 4

,

i-r-4

200



w .

.

1962

1963

1964

Primary

Early Latent

Secondary

Other -29-

.

1965

Epidemiol o^1 oa ly treated 1

REPORTED CIVILIAN CASES OF GONORRHEA SAN FRANCISCO, 1961 - 1965

Number

7500

7000

-

65OO -

6000

-

5500

5000

4500

4000

3500

3000 f

2500

2000

1500

1000

500

1961

1962

1963

Diagnosed Cases

1964 Epid emiologi cally Treated

-30-

1965

TUBERCULOSIS

There were 485 newly reported cases of tuberculosis in San Francisco during 1965. This is a moderate reduction from the prior year 1964 (502 cases), and even more so than the year 1963 (514 cases). However, considerably more cases were reported than for the year 196l in which 443 cases were reported. The case rate per 100,000 population for 1965 was 64„6 compared to 66.4 for 1964; 68.5 for 1963; and still further, 59.5 for 196l. Tuberculosis deaths reported in 1965 (61) are similar to 1964 (60) but less than 1963 (7*0. The death rates per 100,000 for these is 8.1 (1965), 7.9 (1964) and 9.9 (1963). The large numbers of cases reported for these years reflect, not only improved methods of case detection but a better public understanding of this disease through continuing health education in pulmonary diseases. The low death rate for the last two years is not only a reflection of improved methods of technology and treatment, but also of early case detection.

INCIDENCE BY RESIDENCE: The Eastern half of the city, involving 4 of the 5 city's health districts, contributed 403 or 83,1% of the newly reported cases. The remaining health district comprising mainly the Western half of the city contributed only 66 or 13.6% of the cases . Sixteen, or 3.3$ of reported cases could not be allocated to specific districts, The pattern of distribution of cases follows that of previous years; i.e., that over BO/o of all cases found are in the Eastern half of the city and that 29.8% of all cases are to be found in the Northeastern corner of the city characterized by a higher density of population, greater concentration of ethnic-cultural groups and a lower socio-economic status. Table 28 NEW CASES OF TUBERCULOSIS BY HEALTH DISTRICT San Francisco, 1965 _____

HEALTH DISTRICT

CASE RATE PER

ESTIMATED POPULATION

CASES

100,,000 POPULATION

PERCENT OF ALL CASES

750,500

64.6

100.0

77

141,000

54.6

15.8

2.

102

163,500

62.4

21.1

3.

80

151,500

52.8

16.4

4.

144

113,300

127*1

29.8

5.

66

181,200

36.4

13.6

16

_

TOTAL 1.

485

District Not Reported

_

3.5

Table 29 NEW CASES OF TUBERCULOSIS REPORTED BY ETHNIC GROUP A NO AGE San Francisco 12e5_ •;erican

TOTAL ALL AGES

4S_£

1-JH

I

TE

NEGRO

25i„!PiL

CHINESE 72

FILIPINO 32

UNDER

1

-

9

zz

14 19

13 17

24 29 5*

zG

15

4

3

3

41

15 9

9

11

2

1

s

10 15

-

20 25

-

™ 11

_ 50

P 65

-

-

4

:

8

29 Y) ZZ

-

49 5*

11 41

:

8

3*

-

69

?3

70 AND Over

1$

11

5

I

'I

g

5 2

19 ?7 27 22 17

6

46

2

3

2

6

8

?

2 6

6

6

4

1

1

1

3

JAPANESE 7

INDIAN

OTHER

i

:

INCIDENCE BY AGL: 229 cases, or 47.2% were over the age of 45 99 or 20.4% were under the age of 20. 157 cases, or 32.4% were between the ages of 20 to 45* Compared to 1964, the percentage distribution is essentially the same except for a slight increase of cases below the age of 20. Ages are shown in Table 29. .-

INCIDENCE BY ETHNIC GROUP: The incidence of cases in the white population continues to show a decreasing trend. Table 30 shows the percentage of population of each ethnic group, the number of cases and case rates Table 30 TOTAL

HHITE

100„0 100.0 100.0

78.5 78.0

NEGRO

CHINESE

JAPANESE

FILIPINO

OTHER

7ERCENT OF TOTAL POPULATION

1%3 1961 1965

11.* 11.8

5.6 5.7

1.9 2.0

1.5 1.5

12.1

2.1

U5

77 110 109

fz 65

22 2* 32

1*

til 100.0 100.0 100.0

62.7 55.6 52.3

15.0 21.9 22.5

*.3 *.8 6.8

2 <2

2.3

1M

1.8 1.1

3.0

68,5 66„4 64.6

54.2 £7.0 ^3.4

90.3 123.0 119.8

161.2 153.3 169.0

15J.7 156.9 206.5

129.6 79.6 60.9

307-7 365-9 250.0

0.5 0.6 0.6

NUMBER OF CASES

322 1965

72

9

12 15

7

11

PERCENT OF CASES

1965 CASE RATE PER 100 000 POPULATION r 196? 1964 1965

13.0 12.9

2.2

STAGE OF DISEASE; Table 34 shows an increasing trend in the discovery of new minimal disease, a marked decrease in far advanced disease, and little or no change in moderately advanced disease. Of the 485 cases reported, 365 (75.3%) were pulmonary; 80 (16.5%) were primary and 40 (8,2%) were extrapulmonary. Table 31 NEW CASES OF TUBERCULOSIS DEATHS AND DEATH RATES BY ETHNIC GROUP TYPE OF DISEASE AND SEX. San Francisco, 1965 AMi IRICaN IK IDIAN OTHER

'YPE AND SEX

TOTAL

WHITE

NEGRO

CHINESE

FILIPINO

ALL TYPES

485

254

109

72

32

7

3

8

324 161

177 77

65 44

52 20

20 12

3 4

1 2

6 2

PULMONAfiY

365

213

57

56

26

6

2

5

Male Female

26h 101

157 56

40

43 13

16

1 1

4

10

3 3

1

1

Male Female

PRIMARY

Male Female

17

JAPANESE

1

80

26

43

7

2

_

41 39

14 12

21 22

5

1 1

_

1

1 2

2

OTHER Male Female

40

? 4 5

9 4 5

4 3 1

1

19 21

15 6 9

-

1

-

DEATHS

61

47

4

7

2

.

m

1

55

42

3

7

2

-

-

1

6

5

1

-

-

-

-

-

DEATH RATE PER 100,000 POPULATION 8.1 8.0 4.4

16,4

12.9

_

-

22.7

Pulmonary

Other

32-

"5

:

.

,

DEATHS Tuberculosis was the underlying cause of 6l deaths but the presence of tuberculosis was unknown in 26 cases until after the persons had died. In addxtion, 206 persons having tuberculosis died from other causes, summarized in Table 33 Table 32 INTERVAL BETWEEN REPORTING OF TUBERCULOSIS AND DEATH San Francisco Resioents t 196*>

DYING FROM OTHER CAUSES

DYING FROM TUBERCULOSIS

INTERVAL TOTAL

LESS THAN

6"

6-11 12-17 13-23 2

3 4

-

9 10 - 14 5

15

TOTAL 267

206

MONTHS MONTHS MONTHS MONTHS

13

YEARS YEARS YEARS YEARS YEARS YEARS AND OVER

13 9 12

16 10

10 E

6

"

7

ii 13

to

Reported after death Reported only on Certificate

11

51

31

39

14 16

33 23

Table 33 PERSONS HAVING HAD TUBERCULOSIS WHOSE DEATHS WERE CODED TO OTHER CAUSES San Francisco Residents, 1965

CODED CAUSE OF DEATH

NUMBER OF DEATHS

INTERNATIONAL LIST NUMBER

206

TOTAL

Heart Disease Malignant neoplasms Cirrhosis of liver vascular lesions of C.N.S. accidents

41 0- 443

Pneumonia Diseases of Respiratory System Arteriosclerosis Diabetes Other

490-493 470-527 450 260

140-205 581 ,

530-32* 800-965

Table 34

PERCENT OF CASES BY STAGE OF DISEASE FOR NEW CASES OF PULMONARY TUBERCULOSIS FOR WHOM STAGE OF DISEASE WAS REPORTED

San Francisco, STAGE OF DISEASE

196*4

196S

ALL STAGES

1961-1965 1963

i9ii

1961

100

mo

100

Minimal Mooerate Far advanced

a

8 22

14

20

25

NUMBER AND PERCENT OF CASES BY STAGE OF DISEASE FOR NEW CASES 196S OF PULMONARY TUBERCULOSIS FOR WHOM STAGE DAS REPORTED,

MODERATELY ADVANCED

TOTAL STAGE REPORTED TOTAL

36"4

209 58

White Negro Chinese filipino Japanese American Inoian Other

4ft

Ii

31

S 2 4

TOTAL

49,

30

22 10

26

PERCENT.

White Negro Chinese Filipino Japanese American Inoian Other

_139_

Far

ADVANCED

1 2

EACH STAGE TO TOTAL,

196*?

H

LOO

rr

T07T 100 100 100 100 100 100

\i

10 12

25

-33-

CASEFINDING BY X-RAY: In the various x-ray survey units throughout the city 114,002 x-rays were taken and yielded 198 cases of active tuberculosis of which 165 were previously unknown. Additionally, 60 cases of lung cancer were also foundo The following table is illustrative of the results of each survey unit:

Unit Location

Table 35 TUBERCULOSIS CASE FINDING BY X-RAY Prev. Unknown Number Films Active TB Found 1964 1965 1964 1964 1965 1965

101 Grove Total 14 x 1? 70 mm

24,074 1,277 22,797

25,136 1,151 23,985

64 28

S.F. Hospital Adm. Program S.F. Jail #1 S.F. Med. Society S.F. TBC Ass'n.

10,536 3,944 20,058 ^9,238

13,024 5,619 21,008 46,759

48 11 18 37

Northeast Health Center

2,<+69

2,456

110,319

114,002

TOTALS

92

Cancer ,Lung 1964 1965

73 47 26

73 47 26

54 31 23

10

NA

4 6

15 9 6

16

49

39

20

7

15 36

17 28

43 14 14 35

5

5

5

5

2

1

211

198

169

165

30

60

11 7

3 16

9

SCHOOL TUBERCULIN TESTING PROGRAM: Following the protocol of previous years students in the 1st, 7th, 10th and 12th grades, and those entering the school system, for the first time, regardless of grade, received a tuberculin test. During the 1964-65 school year, 34,439 students were tested and 771 or 2.4% showed positive reactions of which 36 were found to have active tuberculosis. This is the largest number of cases found in the school population since the 1960-61 school year. Yet upon completion of epidemiologic investigation of the positive reactors, only 4 active cases were found in the household, family or associate contacts.

The tables below illustrate the results of the total program since its inception in the 1956-57 school year, and from them some conclusions can be made from school tuberculin testing: (l) it is an excellent method of identifying at an early age those at risk of developing tuberculosis and in need of constant follow-up; (2) it is an excellent case finding tool not only among children, but more importantly, those who are associated with children; (3) it points up the prevalence of tuberculosis for the community at large; (4) it identifies areas within the community where concentration of case finding, epidemiologic search and health education are most needed; and finally (5) It offers a good me«ns for the evaluation of a tuberculosis control program.

-34-

Table 36

SCHOOL TUBERCULIN TESTING,

1956-1965

SCHOOL YEAR

STUDENTS TESTED

NUMBER

PERCENT

TOTAL

274,856

12,263

4.4

291

25,286 16,904 29,541 34,028 28,699 32,005 35,395 40,559 32,439

1,492 1,125 1,765 2,267 1,651 749 1,369

5.9 6.7 6.0 6.7 5.8 2.3 3.9 2.6 2.4

44 32 kk 54 38 10 23 10 36

1956-57 1957-58 1958-59 1959-60 1960-61 1961-62 1962-63 1963-64 1964-65

POSITIVE REACTORS

1,0^4 771

FAMILY CONTACT PLUS SCHOOL CASES FOUND

SCHOOL CASES FOUND

"

SUMMARY OF TYPES OF TUBERCULOSIS FOUND AT SCHOOL LEVEL

TYPE OF TUBERCULOSIS

Grand Total I

.

II.

III.

Primary Pulmonary

TOTAL CASE RATE PER 1000 TESTS

388

1.4

62 42 62 93 58 21 29 17 4

2.4 2.4 2.1 2.7 2.0 0.7 0.8 0.4 1.1

-

1956-1965

TOTAL

SR. HIGH

JR. HIGR

ELEMENTARY

291

78

49

164

30

139 12

181

12

"36"

"K

TT

Minimal Moderately Adv. Far Advanced

67 16 3

45 10 3

10

Extra Pulmonary

24

Meningitis Miliary Lymphadenitis Pleural Effusion Genito-Urinary Epididymitis

2 2 11 7 1 1

12

6

13

-35-

Tablc 37

NEWLY REPORTED TUBERCULOSIS CASES AND DEATHS OCCURRING IN SAN FRANCISCO FROM 1920 to Date

NEWLY REPORTED CASES

NEWLY REPORTED YEAR

POPULATION

CASES

DUMBER

506.676* 525*777 538,5 2 551,2*7 563,982

PER DEATH

RATE

132.2 121.3 118.3 120.8 117.2

1409 1230 1223 1179 1032

204.4

1101

1143 1456

182.8 185.9 232.0

g*,g*»

1309 »3<7 1199 1026 865

206.3 207.6 189.0 161.7 136.3

88.4 88.7 84.0 74.2

147.5 140.7 184.6 159.5 130.3

71.6 72.7

M

634,525

6 893 1171 1012 827

634,536* 673,109 71 1 682 750,255 7881323

148.9

869 959 837 1033

66.2 65.2

§34>41 634,455 §34,469 634 484

63**93

827,400* 817,400 806,600 796,200 785,300

740,100 734,800 734,600 744,300 742,900 740,316» 744,000 745,000 749,900 755,700 750,500



NUMBER

576,717 $89,452 602,187 6l4,922 627,657

63
1955 1956

RATE

1411

V

175-1

129.1

111.7 103.7

98.5 103.1

98.9

7U4

c

134.8 111.6 131.0

8:1

907 1084 976 1062

102.9 111.0 134c4 122.6 127.5

56.8 48.6 43.4 41.8 38.3

869 813 858

112.1 104.5 111.1

2

V4

92.5 103.7

851

'£ isi 495

8f 481

91.2

54.5

1:1 2

l'l 18.8 17.3 1'

79.1

1;

74„2 66.4 66.6

10 :S 10.3 9.7

72.4

«

fa

514 502

h

li

485

64.6

8.1

7.9

U.S. Census

Rates per 100,000 Population Population estimates as of July 1, for intercensal years oewnninc in 1951 by California State ftFrARTMENT or Finance.

-?f_

Reported Gases of 'Tuberculosis by Health District ban Francisco, 1965 Rates per 100,000 Estimated Population

Under 45

45 - 89

90 - 154 -37-

REPORTED CASES OF TUBERCULOSIS BY CENSUS TRACT San Francisco, 1965

GOLD EN

GATE

sooo rcET

-

5-9

A cases

1960 Census Tract A-l A-5 A-6 A-7 A-9 A-Ht A-15 A-16 A-20

SAN

Nursber

Cases 6

E-3

8 5 5 9 6 6 7

H-l J-4 J-6 J-7 J-12 J-13 K-l

FRANCISCO

/////A

10 or more cases

CENSUS TRACTS

Between g and 9 case' Number* Census Cp^e", Tract A-22 5

5

canes

6 7

8 6 8 5 7

1

Coin

• i

Tn

10_C n ^T_or_' Ctrcun Ilurabor

NvaLor Cr

[y- r f

6 !t-6

IM, W-7 0-1 0-2 0-9 P-2

DEPARTMENT

-

7 9 5 6 6 5 5

J-10 J-17 K-2 K-3 L-l

9

0-83

L-2 1-5 A

O F

CITY

CnR*»r

11 12 15 2h 12 10 13 2k 11

PLANNING

141-5- >6 G 7

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