UNITED WAY IN MARIN

Introduction

This chapter presents information on particular health and human service needs and is arranged in four parts which correspond with the taxonomy recently adopted by the United Way.

Part A: Basic Subsistence

Part B: Health Care

Part C: Mental Health Care

Part D: Individual and Family Life

The topics that are covered in this chapter are those which the United Way in Marin is most directly concerned with and for which there was readily available information. There are a number of social service areas that are not included in this chapter due to time and information constraints.

This report reflects two major changes in how community assessment has been done by the United Way in Marin: 1. the focus of the report is on local variation and diversity rather than aggregate county-wide and regional comparisons and 2. the data was collected and arranged according to categories in the new taxonomy adopted by the United Way. In addition to providing more accurate and relevant information about social service needs in Marin, these changes uncovered a number of weaknesses in how the United Way has done community assessment in the past. Many of these weaknesses were addressed in this report resulting in a more complete community assessment.

Basic Subsistence

Basic subsistence programs feed, clothe and shelter the poor and are among the most critical of our charitable efforts. They do not prevent problems associated with poverty, but they do ensure a minimum level of survival for the most needy in our communities. The tremendous increase in homelessness throughout the nation, the Bay Area and in Marin County is an indication that these subsistence programs have not been able to adequately provide for all those in need.

This section focuses on the array of services and programs intended to provide homeless and at-risk individuals and families with basic material needs. These include: emergency shelters, emergency assistance, case management and transitional housing.

Food

Housing

Homelessness and Shelters

Accurate counts of the size of the homeless population are very difficult to obtain. As data in the table below show, on an average day there are about 250 people who are homeless in the county. Local experts estimate that between 1,500 and 2,000 individuals, parents and children experienced homelessness sometime last year. Regardless of the measure used to estimate the size of the population, the data below shows that the number of shelter beds is not adequate for their needs.

Source: Marin Housing Center, July 1994.

Material Resources

Temporary Financial Aid

The first two tables in this section reflect the growth in public assistance programs for very low income people. The remaining table addresses the size of the county's homeless population.

General Assistance is the most common form of income assistance for homeless individuals. This program provides cash assistance for single individuals who are certified as medically or psychologically unable to work or who have no other source of income. The data below show that the number of individuals receiving General Assistance has declined from a high of 644 cases in 1989 to 452 in 1993. Since 1992, however, the number of these cases has been on the upswing, rising 9% from 1992-1993. Time series data is very difficult to interpret, however, because regulations governing eligibility have changed over the years.

Source: Marin County Health and Human Services Department.

The caseload levels of the Aid to Families with Dependent Children (AFDC) program offer another perspective on the state of the local economy and its impact on Marin County's poor families. As data in the table below show, AFDC recipients increased 31.8% from 1989 to 1994.

Data for earliest available month. Total AFDC open cases.

Source: Marin County Health and Human Services Department

Health Care

For many residents, providers and community leaders, ensuring access to both prevention and treatment services regardless of income level or insurance status is a fundamental step to ensuring community well-being. Since health problems are both a cause and an indicator of poverty, preventing or treating these problems can reduce the number of people in need. Included in this section are programs which address various elements of health and health care including: maternal and child health, HIV/AIDS services, and prevention and treatment of substance abuse.

In addition to specific indicators of health care services, the issues of service access and adequacy are critical. A number of Marin County health facilities have noted that demand for health services for the poor far exceeds supply. For example, the Marin Community Clinic reports that 15-25 adults who request urgent care are turned away each day. This of course increases the burden on emergency rooms where a large number of these individuals turn seeking care.

Individuals and Families without Health Insurance

The lack of health insurance is an important indicator of the vulnerability of individuals and families to illness and poverty. As the table below shows, there are between 24,126 and 36,775 employed Marin residents who do not have health insurance. The total population of uninsured residents is about 45,540.

Source: Richard Brown, UCLA Study on Uninsured Populations in Marin County

(reference offered by MCC).

Maternal and Child Health

One of the most widely used indicators of a community's health relates to prenatal care, childbirth and early infancy. These statistics provide a marker for the availability of appropriate prenatal care and related services to support new or growing families in Marin County.

The data concerning infant mortality in Marin County shows that infant mortality declined significantly from 1989 to 1992. Interestingly, over this time period infant mortality declined in all of the major racial groups but increased in "Other" racial groups.

Source: California Department of Health

Low birth weight often indicates a problem in delivering appropriate and timely prenatal care which, in turn, can indicate difficulties in responding to the overall health needs of a particular community or population group (countering this interpretation, however, is the fact that improved technology may have actually reduced the rate of miscarriages and stillbirths over the last 20 years which increasing the rate of very low birth weight infants. A more in-depth analysis of the incidence of low birth weight babies and the meaning of such births would have to incorporate this observation). The figures in the table below are somewhat surprising because they indicate that low birth weight occurs relatively more frequently among babies born to mothers between 17 and 20 than to those under age 17, despite the fact that national statistics show that low birth weight is more likely to occur among younger than older teens. The reason for this is unclear and may be due to a reason such as a greater likelihood that younger teens will have abortions than older teens.

Source: Marin County Health and Human Services Department.

Childhood immunizations in Marin County is a mixed story. Due largely to public school requirements, nearly 94% of Marin County kindergarten students have received the five key immunizations against polio, diphtheria, measles, mumps and rubella. This compared to nearly 92% for all California students. A total of 5.5% students still require one or more immunizations in Marin County compared with 7.6% of students statewide. There is increasing concern, however, that the proportion of unimmunized children is significantly higher in refugee communities, communities of color and in non-English speaking families. In addition, the Marin Community Clinic reports that most of their pediatric patients fall are behind in their immunizations by the age of two. This trend is corroborated by regional evidence cited in The Children's Report Card for 1993 that only 58% of Bay Area kindergartners are adequately immunized at age two. This gap in immunizations poses a danger of serious and communicable diseases to young children and the population at large in Marin County.

Source: Marin County Department of Public Health.

HIV and AIDS

The number of AIDS and HIV infection cases are an indicator of society's ability to stop the spread of a preventable infection. The cumulative number of AIDS diagnoses in Marin County has increased by over 167% between 1990 and 1993. By the end of 1993, Marin County had recorded a total of 286 cases of AIDS. As data in the table below shows, AIDS in Marin County most affects white males between ages 30-39. The impact of AIDS and HIV infection is growing rapidly in communities of color, however, as shown by the fact that individuals of color accounted for about 42% of all diagnoses in 1993 compared with only 18% in 1990.

Source: Marin County Health Department

Transmission modalities have changed significantly from 1988 to 1993. Injection drug use accounted for 35% of all diagnoses in 1993 compared with only 7% in 1988. Cases attributed to homosexual/bisexual contact dropped from 55% to 50% of all cases in 1993 while heterosexual contact grew from 1% of all cases in 1988 to 5% in 1993. The increase in AIDS and HIV cases and the change in their transmission modalities signify the need for more education, prevention and treatment services in our community.

Drug and Alcohol Abuse

Drug and alcohol abuse has become an increasingly serious problem in Marin County. Abuse of alcohol and drugs undermine the quality of life in Marin County in direct and indirect ways, contributing to the problems of child abuse and neglect, domestic violence, crime, unemployment, auto crashes, homelessness, health problems, suicide and death. Drug problems, including alcohol abuse, occur in persons of every race, religion and socio-economic status. In Marin, there are at least 325 alcohol and/or other drug-exposed births each year, 8,200 persons with disabilities are estimated to have alcohol or other drug problems and an estimated 4 out of 10 adults grow up with alcoholics in their families.

In 1992 the Marin County Health and Human Services Department developed a strategic plan to reduce alcohol and drug problems. This plan involved a survey of the drinking and drug taking practices of nearly 2,000 adults in Marin County and compared those results with both similar practices regionally and nationally. This research found that Marin County residents drink more frequently and heavily than residents of the region or nation. In addition, far fewer Marin residents abstain from alcohol use than in the region or nation. In all, 81.6% of Marin residents reported using alcohol. Of those who drink, 11.3% report having experienced harmful effects of alcohol and the same percent report recently experiencing symptoms of dependence. The differences in alcohol and drug consumption between Marin County, the Bay Area and the nation may be due to socioeconomic, age distribution or other demographic factors not fully explored in this report.

Source: Marin County Department of Health and Human Services, Office of Alcohol and Drug

Programs. Marin County: A Strategic Plan to Reduce Alcohol and Drug Problems in Our

Community.

Reported drug taking in Marin is very comparable to the drug taking nationally but is significantly less than that in the region. As is true both regionally and nationally, the use of illicit drugs is far less prevalent than the use of alcohol. In Marin County, 12.4% report current use of illicit drugs and most of these individuals use marijuana.

Source: California Department of Alcohol and Drug Programs

There is a strong public perception that drug and alcohol problems are very serious in Marin County. This perception is reinforced by the significant increases in drug-related arrests and admissions to drug treatment programs between 1988 and 1992. Marin residents most frequently report drunk driving, crime and vandalism as the most significant problems related to drug use. The use of alcohol and drugs by young people is the second most frequently reported concern. The County Health and Human Services study shows that Marin County respondents, while divided, most commonly identify alcohol and drug problems in their community as "somewhat serious." Even though only about 20% view alcohol problems as "very serious" and a slightly larger number (23%) see drug problems as "very serious"; a striking majority of respondents support increased funding for both alcohol and drug prevention and treatment.

Mental Health Care

Clinical and supportive mental health services are a critical resource for persons with short-term and chronic needs and for their families. The continuing county and state budget crises have greatly limited the ability of public mental health providers to respond effectively and in a timely manner to the mental health needs of Marin County's children, adolescents, adults and elders.

The crisis in mental health care in Marin County has been described in the Community Mental Health Services Plan, 1994-97. This plan illustrates that the majority of basic mental health services, defined as those services without which an effective public mental health system does not exist, either are available on only a limited basis or are not available at all in Marin County. The lack of mental care in Marin is reflected in an inadequate number of treatment slots, long waits for service and a large number of individuals turned away because their needs are not acute. In the long term, according to mental health providers and advocates, inadequate mental health services will become manifest in higher rates of hospitalization, criminal activity, homelessness and unemployment.

The Community Mental Health Services Plan also notes that state-law mandated hospitalization and conservatorship services for children and youth, adults and the elderly are the only mental health services considered to be generally available in Marin County. Other critical services, many of which are also mandated by state law, have only limited availability or are not available at all. Perhaps most striking of all, crisis services are seriously limited in Marin County and several important components of emergency service, including short-term residential and respite care and mobile crisis teams that can provide in-home services, do not exist in this county.

The reductions in public funding have hit those individuals with the fewest treatment options the hardest. The high costs of mental health services and the need for extended periods of treatment for many clients has resulted in a two-tiered system of care. For individuals and families with insurance coverage and/or substantial private resources, mental health services are widely available. For those without these advantages, access to care is problematic and becoming more so every year. The deterioration of state and county support for mental health services is having a particularly troubling impact on preventive services and outreach to the mentally ill who are "invisible" to the system of care.

There are a number of possible immediate consequences of reductions in funding for mental health services in Marin County. There may be an increasing trend toward the use of medications to control mental and behavioral problems because face-to-face therapy is far more costly. Persons exhibiting criminal or other problem behaviors may be incarcerated much more readily and therefore deprived of adequate service which could address the root causes of their problems. In addition, those mentally ill individuals who are able to gain access to public services may not receive the level and amount of service commensurate with their acute and chronic needs.

Providers and advocates in mental health generally emphasize the growing needs of several population groups. Preventive and treatment services for children and youth are essential to reduce the incidence of adult mental health problems in the future. Children and youth services need to be oriented around individual development and the family unit. Recognizing the "warning signs" of emerging emotional problems and responding in an effective and timely manner increases the chances that young persons will overcome their emotional problems and lead productive lives.

Currently, few programs exist to assist older adults whose mental health needs are often connected to physical and family changes in their lives. Many older adults require only the less intensive forms of mental health services such as companionship and peer counseling to assist them in adjusting to physical and family changes, particularly the death of a spouse or other loved one. A much smaller proportion of older adults need more extensive mental health care as they experience dementias, neglect and abuse or problems stemming from substance abuse.

Individuals with a mental health diagnosis and a physical or developmental disability experience a special array of service needs which often prevent them from integrating fully into the community. Effective assessment and case management services are especially important to this population which often experiences service needs in the area of health care, rehabilitation and basic needs such as housing, meals, income support and respite for caregivers. Similar problems can be found in the population with the dual diagnoses of mental illness and substance abuse.

The rapid growth in the number and proportion of persons of color in Marin County is challenging the mental health system to respond. Many of these individuals are refugees with special mental health needs. Many do not speak English, seriously compromising the ability of traditional mental health therapies in the absence of bilingual/bicultural providers. As shown in the table below, in 1992-93 the vast majority of clients served by county mental health department in Marin were white. Although this percentage tracks roughly with the racial composition of the county, given the lower socio-economic status of minority groups in the county and the limited number of mental health programs specifically serving these populations, it is likely that mental health needs are particularly underserved in these communities.

Source: Marin County Health and Human Services Department.

Individual and Family Life

A "family," as used in this report, is defined inclusively to reflect the growing diversity of family units which provide nurturing and support to their members. As the notion of family expands to include single-parent families, Lesbian families, Gay families, multi generational families and others, so too must the network of programs and services which aim to prevent abuse and other forms of family violence and to care for affected family members.

While there is a considerable body of data that reflects the various challenges and problems experienced by families, little systematic information is available which describes the overall status of families in Marin County. The social indicators for adult and family services included in this report include child care, single parent households, child abuse, adoption and foster care, teen pregnancy, rape and elder care.

Gays and Lesbians

Based on a United Way of the Bay Area estimate that gay men and lesbians account for 15% to 20% of Bay Area populations, at least 34,514 Marin County residents are gay men or lesbians. Characteristics of this population are as diverse as the general population but homophobia, heterosexism and discrimination have created substantial and unique barriers to the ability of this population to meet basic needs and achieve equal rights.

There is limited research on the mental health, substance abuse and adaptation issues experienced by gays and lesbians in the United States. According to the Spectrum Center for Lesbian, Gay and Bisexual Concerns in Marin County, the research that does exist, indicates that homosexual orientation in a homophobic society is a significant risk factor for substance abuse and addiction and depression. In addition, studies have shown that individuals with a homosexual orientation face specific developmental tasks that are made more difficult by a heterosexist society. These tasks include internal recognition and reconciliation of sexual orientation, establishing a personal identity, identifying role models and peer groups, clarifying values and attitudes, assessing risk for disclosure, establishing self-esteem and self-regard, and managing the stresses of actual psychological and potential physical attacks. Gay men and lesbians often live lifestyles which are invalidated by institutions, family, friends and co-workers. As a result, these individuals often adopt guarded behaviors, have difficulty identifying and building a community of support and have low self-esteem. Youth and closeted lesbians and gay men are particularly isolated from support systems. This alienation and widespread homophobia severely affects youth who are 2-3 times more likely to attempt suicide than their peers.

Despite the perception that the Bay Area is somewhat of a safe haven for lesbians and gays, homophobia remains entrenched and profound. In Marin County, the doors to most congregations and social service agencies are not open and welcoming to lesbian, gay and bisexual people. Fear of discrimination and censure prevent many gays and lesbians from seeking services and support they need. These fears often become reality for gays and lesbians who disclose their sexual orientation only to experience loss of housing, employment, religious ordination, military status, family connections, child custody and friendships. For this reason, many gays and lesbians choose secrecy and suffer isolation and alienation that are tremendous risk factors for suicide, substance abuse, and other physical and emotional health problems.

For gays and lesbians to become a visible, accepted part of the community they need to be supported in disclosing their own sexual identities. Support should be provided by personal and social service networks that permit them to confide and share difficult and painful experiences in their lives. Greater access to social services, community resources and religious institutions is essential. Finally, schools, social service providers and congregations in Marin County must be sensitized , re-educated and supported in changing their discriminatory practices and policies so that as gay men and lesbians are empowered to seek and receive the assistance they need, the larger community is empowered to be supportive and welcoming. Specific services needed for gays and lesbians include legal services, AIDS education, prevention, treatment and support services, a central place for information and referral services to connect gays and lesbians to services, specialized counseling and suicide prevention services for lesbian and gay youth. Local services must be created so that Marin County gays and lesbians do not have to travel to San Francisco for assistance and existing services must become more sensitive to gays and lesbians and actively outreach to this population. Finally, public education efforts should be aimed at reducing prejudice, discrimination and harassment of gays and lesbians and employers, social services and other institutions must adopt, implement and enforce policies of non-discrimination.

Child Care

According to the Marin County Child Care Master Plan developed by the Marin Child Care Coordinating Council, the 1990 Census shows that over 37,000 children in Marin are under the age of 15 years. With over 22,252 children, 60% having parents in the workforce, provisions for quality child care and school age care programs are essential. Affordable, accessible child care of high quality is necessary in enabling families to balance their economic and child-raising responsibilities. Especially for lower income families, subsidized child care is key to allowing individuals to participate in job training and job seeking activities and to maintain steady employment.

This section examines the issues related to child care in Marin County. A key assumption underlying this analysis is that child care represents an important developmental and educational intervention for children, not simply "babysitting" which can be a common misperception. Unlike other fields of human service, the majority of child care services are provided by smaller, profit making entities in Marin County and are affected more by market forces than by public and private funding policies, with the major exception being subsidies for child care which are funded by a mix of public and private monies.

Source: 1990 U.S. Census

The data in the table above indicate that 26,007 children of child care age (0-9) resided in Marin County in 1990. According to the MCCPC, the majority of children in Marin live in homes where both parent work outside the home. Of children between ages 0-5, 67% have working parents. As a result there is a great need for high quality, affordable child care and youth programs in the county.

Source: Marin Child Care Planning Council

The high cost of living in Marin County extends to child care fees. Despite median income in Marin County that is about 42% higher than in other Bay Area counties, extremely high housing and child care costs can easily take from 30-60% of the monthly income of a two-parent family with only one child. These realities force many families with young children to move out of Marin County, adding to the aging of the county's population. While the poor economy and the declining number of families with young children in Marin County have begun to drive child care costs down, these costs still remain out of reach for many families.

Source: Marin Child Care Planning Council.

According to Marin Child Care Council's Draft Master Plan, in the 1990 Census there were 2216 children living below the federal poverty line. Yet, subsidies in Marin, whether private or public, served fewer than 1200 children in 1994. While the majority of the subsidized children come from low income families, some of those receiving Marin Education Fund scholarships are from moderate income households. The Master Plan notes that the most common denominators defining eligibility for voucher subsidies are income and parent participation in "training, school or work". The State Department of Education, Child Development Division contracts allows a portion of funds to be disbursed based on the needs of the child. Through Federal Block Grant and Child Protective Services there is minimal funding for respite child care in cases of child abuse and neglect.

In addition, the Master Plan finds that extremely limited child care funding exists in the county for families needing "training, school or work" readiness programs. There are low income families in the community who may need substance abuse treatment, psychological treatment, and other forms of attention necessary to be capable of entering into a training, education or work program. Finally, a number of obstacles exist in state and federal funding disbursed by county agencies. Some of the problems are because of state regulations and some are barriers of local administrations, both which have an impact on accessibility of quality child care for low income parents.

Single Parents

Single parent households often face increased financial and emotional stress in caring and providing for their families. Marin County has a high number of single parent households and these households are typically female-headed. Significant changes in the composition of single parent households in Marin County occurred between 1980 and 1990. Overall, female-headed households with children declined 1.4%, but this decline was entirely composed of white female-headed households. Single mothers of other racial groups, in contrast, grew dramatically, from an increase of 19.6% for African Americans, 69% for Latina and 116.7% for Asian households. In addition, male-headed households with children increased 21% over the decade. The most dramatic increases occurred in Latino, Asian and "Other" race households. In 1980, other race female-headed households with children accounted for 10% of all households in this category. In 1990, this percentage grew to 18%. The increasing concentration of female-headed households with children of other races than white will require that services to these families become more responsive to cultural, racial and ethnic differences.

Percentages will not add to 100 because Hispanic can be of any race and is a double count.

Source: 1980 and 1990 U.S. Census.

The 21% growth of male-headed households with children is another interesting change

that occurred since 1980. Every racial grouping of male-headed households with children posted significant increases over the decade. White male-headed households still account for the majority in this category but other race male-headed households tripled over this period from 10% in 1980 to 31% in 1990. This trend has important implications for service delivery to single parent households. In addition to being responsive to cultural, racial and ethnic differences, programs serving single parent households must become relevant to the concerns of male-headed households with children as well as those of female-headed households.

Teen Pregnancy

Another important indicator is the growing number of teenage pregnancies. Data on the number of teen miscarriages and abortions is difficult to find, but figures are available on teen births. The table below shows that the number of such births in the county increased steadily from 1989 to 1992. The county-wide total rose from 84 to 123 during this period. This increase occurred almost exclusively among Hispanics; birth to teens in this population increased 131% over this period to reach 60 in 1993. These figures strongly suggest that family planning services and support counseling that are relevant to Latino youth are needed to reduce teen births.

Source: Marin County Health and Human Services Department.

Battered Women

Violence against women within the context of intimate relationships continues to be a growing problem in Marin County. The number of women seeking practical assistance, emotional support and crisis intervention services from Marin Abused Women's Services (MAWS) has increased 30% since 1990. Men seeking help to stop their violence through the MAWS Men's Program increased 50% during the same period. MAWS estimates that 12,000 Marin County women are physically abused each year. Of that number, only 1 in 20 cases are reported to law enforcement agencies.

A 1992 study conducted by HomeBase illustrated the increase of domestic violence in Marin County. This report showed that 40% of all homeless women are on the streets because of domestic violence. During the last four years, the number of women and children served in MAWS shelters has doubled and the number served in transitional housing has grown 60%. In addition, the Marin District Attorney's Office reported that the average number of cases referred per month was up 14% between 1993 and 1994 and the percentage of cases filed also increased from 57% to 61% between 1993 and 1994.

Increased demand for emergency shelter and the decreasing availability of affordable housing in Marin has made locating housing the primary need for abused women and children in Marin County. This urgency of this need, according to MAWS, has diverted the efforts of some trained counselors from advising clients to locating housing. Finally, the importance of addressing domestic abuse in preventing poverty and homelessness was underscored by a report by the Marin County Housing and Services Continuum which identified in their final report to the Marin Community Foundation that increased education and prevention services for domestic violence was a number one funding priority for developing solutions to poverty.

Source: Marin Abused Women's Services.

Child Abuse

The data below suggests an increase in the level of reported cases of child abuse in Marin County between 1988 and 1994. In part, the problem of child abuse results from higher levels of financial uncertainty and stress on families as well as a continuing tolerance of violence in our culture. Most experts in the field agree that reported child abuse figures often under-represent the actual incidence of child abuse because many abusive incidents go unreported. An important factor in the increase in child abuse reports has been greater public acknowledgment of and concern with this problem. These figures show that there is a need to provide adequate support and intervention services to help all children in need.

Source: Marin County Health and Human Services Department

*January-June data.

Adoption and Foster Care

The number of Marin County children requiring and receiving out-of-home placement serves as an indicator of the need for family support services. The data below show that removing children from their natural parents in response to family problems has decreased 14% from 1989 to 1993. This is despite the widely held belief that family stress increased over this period. This is due in part to an emphasis on family preservation in the child protection field. Some service providers and child and family experts expect this trend to reverse, particularly as economic conditions cause greater family stresses and as lack of funding for support services continues to erode the capacity of the protective service system to responsibly serve the needs of children at risk.

Source: Marin County Health and Human Services Department

Elder Care

Elders, like all other age groups, are affected by persistent problems of unaffordable housing, inadequate health and mental health care, poverty, homelessness, unemployment and family violence. Alcohol and drug abuse among the elderly is of particular concern; according t the Bay Area Community Resources, there are 4,000 alcoholics and 6,000 prescription drub abusers among individuals 60+.

According to the 1990 Census, a total of 38,432 persons in Marin County are in the 60+ age group, constituting 16.7% of the total population. Within this group Whites are a larger proportion than countywide. There is, however, increasing diversity with respect to income, health and functional status and, most importantly for this report, access to services and needs. Of particular concern in Marin County's older population are individuals aged 75-84; the fastest growing age segment of Marin's population between 1980 and 1990. This age group often relies on fixed, low incomes and their need for a range of programs and services tends to be quite different from those of persons in their sixties.

Marin County is a rapidly aging county. Between 1980 and 1990, the 60+ population grew seven times faster than the general population. By 1990 individuals over 60 accounted for 16.7% of the total county population; in other words, one out of every six persons in Marin County is over age 60. Another measure of the rate at which the county is aging is the median age of its residents. The median age in Marin County climbed from 33.6 years in 1980 to 38.2 years in 1990. According to State Department of Finance projections, Marin County's median age will reach 42.6 years in year 2000, the second highest median age among all counties in the state. By year 2020, Marin County's median age will reach 47.7 years, the highest median age of any county in the state and nearly eleven years older than the state's median age of 36.7 years.

Source: Changing Marin, Marin County Division of Aging, 1993.

There was also increasing racial diversity in Marin County's older population over this period. In 1980 4% of the 60+ population in Marin County were of other races than white, by 1990 this proportion had grown to 7%. Asian/Pacific Islander elders were the fastest growing group, posting a 161% increase over this time while Hispanic elders grew 92% over this period. Clearly, there is a need to plan for long-term services to meet the growing demand for elder care into the next decade.

1980 1990

Source: Changing Marin, Marin County Division of Aging, 1993.

The median ($18,407) and mean ($29,557) incomes of the elderly are significantly that county-wide figures. As the table below shows, a large majority of Marin County elderly (63%) have annual incomes less than $25,000.

Source: 1990 U.S. Census

As the table below shows, there is a great difference in the percentage of monthly income the elderly spend on housing costs depending on whether they own or rent housing. Over 67% of elderly households that rent housing spend over 30% of their monthly income on housing costs, compared with just over 17% for elderly home owners. These figures signify the need for low income housing for the elderly.

Source: 1990 U.S. Census.

The table below provides comparative information about the number of elders living alone in Marin County. This data illustrates that most elderly individuals living alone are women both nationally and in Marin County. Due to the very large number of single person households of all ages in Marin County, the proportion of those households that that are elderly is lower than the national and regional percentages. Still, Marin County remains one of the oldest counties in the state and providing social services to Marin County elderly is critical. In addition, the data shows that the percentage of all single person households accounted for by elderly single households varies among communities in Marin County; San Rafael has the highest percentage (23.1%) followed by Marin City (21.9%). The significance of the number of elders who live alone is that these individuals often require assistance with everyday tasks, personal care, transportation and nutrition.

Source: 1990 U.S. Census.

The data in the table below provide an indication of mobility and self-care limitations among Marin County's elderly. About 13% of the 65+ population have mobility or self-care limitations. This suggests that while many Marin County seniors are increasingly healthy and active into their later years, significant social service needs exist for the county's elderly population.

Criminal Justice and Legal Services

Information needed on Legal Assistance Services and Legal Education Services.

Education

Information needed on Educational Programs and Support Services.

Environmental Quality

Information needed on Public Health, especially prevention of communicable diseases and Public Safety, especially disaster preparedness and relief efforts.

Income Security

Information needed on employment services and income maintenance programs.

Organizational/Community Services

Information needed on Community Groups, Community Services, Information Services and Organizational Development resources

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"The United Way Strategic Plan." United Way of the Bay Area, June 1993.

"Vital Signs: Checking the Pulse of Women and Children in Marin County." Marin Council of Agencies, October 1992.

1980 U.S. Census.

1990 U.S. Census.