What’s the issue - Stanford Hospital



3524250-81661000What’s the issue? The U.S. Department of Housing and Urban Development defines housing as affordable when it costs no more than 30% of a household’s annual income. The physical condition of a home, its neighborhood, and the cost of rent or mortgage are strongly associated with the health, well-being, educational achievement, and economic success of those who live inside. Spending more than that makes household less able to afford other necessities, such as food, clothing, transportation, and medical care. Poor health can lead to homelessness and homelessness can lead to poor health. People without a home experience more health care issues, suffer from preventable illnesses at a greater rate, require longer hospital stays, and have a greater risk of premature death than their peers with a home. The average life expectancy for someone who lacks permanent housing is at least 25 years less than that of the average U.S. resident.What does the data show?The median rent is significantly higher in both San Mateo and Santa Clara counties compared to the state. Counts of individuals experiencing homelessness are higher in 2019 in both counties than they were in 2017, and the homelessness rate is significantly higher in Santa Clara County compared to the state average.HEALTH NEED INDICATORSTATE AVERAGESAN MATEO COUNTYSANTA CLARA COUNTYMedian Rent, 2-Bedroom Unit$2,150$3,495$2,930HUD-Assisted Housing Units (per 10,000)352.4235.9374.3Individuals Experiencing Homeless N/A1,5129,706Homelessness (per 10,000)33.019.650.1SOURCES: Rent: , 2018. HUD Units: U.S. Department, of Housing and Urban Development, 2016. Homeless Counts: SMC: County of San Mateo Human Services Agency, San Mateo County One Day Homeless Count and Survey, 2019; SCC: County of Santa Clara, Office of Supportive Housing, Santa Clara County Homeless Census & Survey, 2019. Homeless Rate: SMC & SCC, calculated based on U.S. Census Bureau, Population Division, 2018 county population estimates. CA: Public Policy Institute of California, A Snapshot of Homelessness in California, 2019.In San Mateo County, the number of county residents who have experienced housing instability recently has been rising, as has the proportion of residents who are sharing housing costs with a non-partner for the sake of affordability. Compared to 2013, a greater proportion of Health & Quality of Life survey respondents in 2018 indicated they were seriously considering leaving the county due to the cost of living. NOTEREF _Ref21972272 \f \h \* MERGEFORMAT 6 In part, this may be associated with the relatively low number of HUD-assisted housing units available in the county compared to the state average. Housing problems are concentrated in certain neighborhoods in San Mateo and Santa Clara counties. These areas include the Westlake neighborhood of Daly City, parts of East Palo Alto, parts of Redwood City, the Little Saigon, Seven Trees, and Spartan-Keyes neighborhoods of San Jose, the east side of San Jose, and areas near colleges, including San Jose City College, Santa Clara University, and Stanford University. Poor housing quality – evidence of leaks, mold, and pests – has been associated with asthma. The asthma prevalence statistics for adults and youth in San Mateo County are both higher than their respective benchmarks.What does the community say?The SHC 2019 Community Health Needs Assessment takes into account the perspectives of residents and local experts in San Mateo and Santa Clara counties. Community members ranked housing and homelessness as a high priority. Participants described stress over the high costs of housing and lack of affordable rent. In Santa Clara County, professionals serving families reported an increase in those seeking help from food banks and making difficult choices about how to spend remaining funds (healthy food, medicine, doctor visits, therapeutic services). It was noted that families are moving within or leaving the area due to increased cost of living. The number of people experiencing homelessness has recently increased, as has the proportion of people experiencing homelessness who are minors. A Santa Clara County health official noted that a lack of stable housing can prolong recovery time from diseases and surgical procedures.In San Mateo County, housing was mentioned in conjunction with mental health in more than two thirds of focus groups and key informant interviews. Many people in underserved populations may be experiencing either homelessness or housing instability. Community input also surfaced a growing call for help with basic needs among those with middle incomes for whom services are lacking because they do not qualify for most assistance programs.“I can't move people out of higher levels of care to lower levels of care because there literally is not a bed available to move that person into even though we provide the services at that lower level. We have to find a place for them to live.” —Behavioral Health ExpertCommitment to community healthSHC collaborated with 21 other health systems and organizations in San Mateo and Santa Clara counties on the 2019 Community Health Needs Assessment. Based on the statistics and community input collected, health care access and delivery emerged as a top health need. With findings from the CHNA, SHC developed a 2020–2022 Implementation Strategy, which will help determine the investments the hospital makes in the community, including programming and partnerships. Over the next three years, SHC will work to increase support for individuals experiencing homelessness or who are at risk of homelessness in San Mateo and Santa Clara counties. Strategies include increasing access to health care and supportive non-medical services for this population. SHC will also invest in solutions that prevent homelessness and increase available housing. The anticipated impacts range from improved health outcomes for individuals experiencing homelessness, improved access to social services, and reduce to reductions in the number of substandard and overcrowded dwellings. Results will be measured and reported in the next CHNA.SHC’s CHNA and Implementation Strategy reports are available publicly on its website. Comments are welcome and encouraged. ................
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