South Region Health Concerns

CDC Health Survey

Return to South Region Health Concerns Homepage

Page originally published 10/1/2024. Page last updated 1/16/2025.

On this page:

Background
Results
Outcome
Resources

Background

What is a CASPER?

On October 17-19, 2024, the Centers for Disease Control and Prevention (CDC) and the County of San Diego completed a survey called a Community Assessment for Public Health Emergency Response, or CASPER. The purpose of this survey was to help public health and emergency response leaders learn more about health concerns and impacts from sewage and pollution in the Tijuana River Valley.

A CASPER is a type of household survey developed by the CDC. Its method is used to quickly gather information about a community's needs. It is done by interviewing people face-to-face in their community. Going door-to-door in the data collection process can build trust and improve cooperation within the community.

How was a CASPER Done?

A two-stage sampling method was used and designed to pick just the right number of households to interview.

The area surveyed was divided into smaller sections, often census blocks, called 'clusters.'
Then, 30 clusters were selected with probability proportional to size, meaning that those that are larger have a greater chance of being selected.
Within each selected cluster, 7 households were randomly picked to participate in the survey by field interview teams. This method ensures that the results represent the entire community.

Selected clusters were designed to represent the 40,911 households in the South Bay/Tijuana River Valley Region.

Why was a Survey Needed?

There has been a long history of cross-border flows containing untreated sewage, sediment, and trash entering the Tijuana River Valley. This impacts local recreation, damages sensitive habitats, threatens public health, and causes beach water contact closures.

There have been more concerns in recent years about water quality in the Tijuana River Valley due to more frequent infrastructure failures and increased flows all year round.
Trash and raw sewage flowing from the Tijuana River Valley into American waterways have been at elevated levels due to two years of near-record rainfall and infrastructure failures on both sides of the border.

What is the Data being Used For?

Input from interviews will help us better understand the health status, experiences, and needs in the South Region of San Diego County related to sewage exposure from the Tijuana River Valley, including air and water exposures.

Top of Page

Results

Expand All | Collapse All

How to use this dashboard
- To see the data for a specific category, click on one of the tabs at the top of the dashboard: About, Demographics, Household Awareness and Experiences, Disruptions to Household Life, Household Opinions and Beliefs, Communication Preferences, Physical Health, Mental and Behavioral Health, and Individual-level Mental Health.
- After choosing a category, the page will show a graph with results from specific survey questions pertaining to the chosen category. Use the "Show/Hide Data Table" button under each graph or hover your mouse over the graph to see a pop-up that displays more data and descriptions.

Top of Page

Outcome

Interview teams conducted the CASPER over three days (October 17-19, 2024) using both paper and electronic formats. Of the 480 homes contacted (knocked on), 333 answered. A total of 189 surveys were completed (39.4% contact rate). Response rates are comparable to other CASPERs conducted in non-emergent settings and are understandable given the timing of the data collection. Data are ‘weighted’, which means that each household that completed a survey was assigned a weight that is based on the household’s probability of being selected. This allows the survey results to accurately reflect the entire community.

Most households (85.1%) were either somewhat or very aware of the Tijuana River Valley sewage crisis.

Eight percent (7.7%) reported that at least one household member had come into direct contact with water from the Tijuana River in the past month and 16.2% had been in contact with beach water from Imperial Beach, Tijuana Slough, or Silver Strand shorelines during their closures.
Many households (44.2%) have taken frequent measures to avoid certain areas because of the sewage contamination.

The information gathered from households revealed a profound awareness of the Tijuana River sewage crisis, highlighting the pervasive impact on daily life, health, and well-being.

While most households are aware of the situation, many continue to risk exposure.
The widespread reporting of health symptoms and disruptions to routines underscore the impact of the crisis on both physical and behavioral health, particularly among groups more at risk such as those with pre-existing chronic conditions.
Community concerns about water and air quality are also compounded by a reported lack of trust in information sources, emphasizing the need for continued transparent and tailored communication and outreach.

To address these challenges, a coordinated response involving health education and communication, behavioral health support, and resource distribution is critical.