Health

Health Insurance

Health insurance is the gateway to primary care, preventive screenings, treatment for illness and injury, and management of chronic conditions. Coverage tracks with academic and professional success.¹

The 2014 Medi-Cal and Children's Health Insurance Program (CHIP) expansion under the Affordable Care Act, combined with continuous-coverage protections during the COVID-19 pandemic, drove the rate of uninsured San Diego children to one of the lowest levels on record by 2022.²

Disparities by race and immigration status have narrowed to relatively small differences over the period.

Low Birth Weight

Low birth weight (under 2,500 grams) raises risks for infant mortality, developmental delays, and chronic conditions later in life. The County rate has fluctuated around 7%, but disparities by maternal race are sharp.

Black mothers had the highest rate of low-birth-weight infants among groups with reported data, and that rate jumped from 9% in 2021 to 13% in 2023. Asian mothers had the second-highest rate (9%); White mothers consistently had the lowest.

Sufficient Sleep

Adolescents need 8–10 hours per night. Insufficient sleep is linked to depression, lower academic performance, and increased risk of motor-vehicle crashes.⁷⁸ About 29% of SDUSD students hit that target in 2023.

Gaps run wide. AANHPI students reported the highest rates of sufficient sleep; "other" sexual orientation students (20%) and questioning youth (24%) reported the lowest. Boys reported more sufficient sleep than girls (32% versus 26%).

Healthy Eating

Around 35% of SDUSD students ate breakfast every day. Gaps by race are notable: 45% of White students ate breakfast daily versus around 28% of Black and Hispanic students.

Physical Activity

Daily physical activity in SDUSD has fallen from 25% in 2007 to 19% in 2021, lower than the US average (25%).

Substance Use

Long-term trends are encouraging: cigarette smoking and current alcohol use have both declined sharply since 2005. Vapes complicate the picture, and there's a recent uptick in alcohol use after a decade of declines.

Alcohol Use

Current drinking among SDUSD students fell from 39% in 2005 to 23% in 2021, then ticked up among most groups by 2023 — except Hispanic youth. Girls reported drinking at higher rates than boys (27% versus 19%); bisexual students reported 31%.

Cigarette Use

Cigarette smoking dropped from 15% in 2005 to 2% in 2021 in SDUSD. Frequent cigarette use went from 4% in 2005 to 0.5% in 2021.

Vape Use

Around 14% of SDUSD students reported current vape use, slightly below the 17% US average. Girls vape at higher rates than boys (19% versus 10%); 24% of bisexual youth report current vape use.

Mental Health

28% of SDUSD students reported their mental health as poor in 2023. The disparities by gender, race, and sexual orientation are sharp, and peer isolation has not recovered since the pandemic.

Multiracial students reached 42% reporting poor mental health by 2023, a sharp rise from earlier years. The gap by sexual orientation is the widest of any breakdown — 60% for "other" versus 21% for heterosexual students.

Peer Isolation

Almost 40% of SDUSD students reported feeling isolated from peers in 2023, up from 31% in 2019 and 43% in 2021. Black students (49%) and gay or lesbian students (56%) reported the highest rates.

Suicidal Ideation & Attempts

Rates of suicidal ideation and attempts have risen since 2005 (then 18%), tracking national trends. In 2023, 21% of SDUSD students reported suicidal ideation; 10% reported a suicide attempt.

Patterns mirror those for poor mental health, with girls experiencing much higher rates than boys (27% versus 15%). Multiracial students reported 29%, above the average. Sexual orientation drove the largest gap: heterosexual students at about 14%, rising to 30% for questioning students and 46% for those reporting another orientation.

If you or someone you know is in crisis, the 988 Suicide & Crisis Lifeline is available 24/7 by call or text.