What’s the issue



3524250-68326000What’s the issue? Economic security is one of the most widely recognized social determinants of health. Higher incomes and a secure social support system -- families, friends, communities -- plays a significant role in people’s overall well-being. Access to economic security programs such as SNAP (Supplemental Nutrition Assistance Program, formerly referred to as food stamps) results in better long-term health outcomes. Despite this, childhood poverty has lasting effects: Even after conditions improve, it results in poorer health outcomes over time.What does the data show?Food insecurity is a significant issue in San Mateo and Santa Clara counties. Proportions of individuals in both counties who are food insecure but are ineligible for assistance (because they earn more than the federal threshold for assistance) are nearly double the state figures.HEALTH NEED INDICATORBENCH-MARKSAN MATEO COUNTYSANTA CLARA COUNTYFood Insecurity Rate6%H9%11%Food Insecure Population Ineligible for Assistance22%39%39%Food Insecure Population Ineligible for Assistance – Children29%46%46%H indicates Healthy People 2020 national aspirational goal. When not noted, benchmark is state average. / SOURCES: 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 with 2019 count based on county populations from U.S. Census Bureau, Population Division, 2018 estimates. CA: Public Policy Institute of California, A Snapshot of Homelessness in California, 2019.In Santa Clara County, African ancestry residents and those of “Other” races have rates of poverty that fail benchmarks. More than one in ten African/African Ancestry and one in four Latinx households in the county received food from a food bank in recent years. In San Mateo County, more than 6% of Quality of Life survey respondents countywide indicated that they had gone to a food bank or otherwise received free meals in the past year. This figure was higher among low-income respondents (17%) and respondents from the Coastside (12%). Of San Mateo County students eligible to participate in school meal programs, nearly one third (31%) do not participate in lunch programs and nearly two thirds (64%) do not participate in breakfast programs. The proportions of county residents receiving SNAP benefits and other government assistance have been increasing. NOTEREF _Ref21978190 \f \h \* MERGEFORMAT 5Income and education are strongly associated. Education indicators, which are predictors of economic security, are lower among ethnic minority groups in both counties. In particular, the proportions of adults age 25 and older with less than a high school diploma or equivalent are 231457512065Significant disparities in education exist among adults of different ethnicities.*“Other” is a U.S. Census category for ethnicities not specifically called out in data sets. SOURCE: U.S. Census Bureau, American Community Survey. 2012-16.Adults age 25+ with less than a high school diploma or equivalent, San Mateo and Santa Clara counties00Significant disparities in education exist among adults of different ethnicities.*“Other” is a U.S. Census category for ethnicities not specifically called out in data sets. SOURCE: U.S. Census Bureau, American Community Survey. 2012-16.Adults age 25+ with less than a high school diploma or equivalent, San Mateo and Santa Clara countiesmuch lower for Latinx, Native American, 234315081216500and “Other” residents than for members of other ethnic groups (see 2305050127000chart).What does the community say?The SHC 2019 Community Health Needs Assessment (CHNA) takes into account the perspectives of residents and local experts in San Mateo and Santa Clara counties. Community members ranked economic security as a high priority. Participants described the high cost of living, particularly for lower-income residents, across a variety of basic needs, including food, housing, transportation, and health care. Economic insecurity and housing instability were discussed as drivers of poor mental health and substance use in both counties. Mental health care costs were reported by Santa Clara County mental health providers to be difficult for middle-income parents. County CHNA participants were also concerned with the costs of long-term care for middle-class older adults with fixed incomes. In San Mateo County, economic stressors that affect housing instability and food insecurity were also identified by multiple sources as drivers of domestic violence. Human trafficking is an emerging issue in the county, which experts similarly rooted in chronic homelessness/housing issues and related economic stressors.“Food insecurity is very present among the people living in the Bay Area. … The homeless are a very small fraction of [who the food bank] serves. Most of the people served are working adults … $12 an hour is not enough. You cannot live on that, not in this area.” —Local Service ProviderCommitment 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 focus on the ways in which the intersection of food, transportation, and income and high-quality employment impacts health behaviors and outcomes in San Mateo and Santa Clara counties. Strategies include expanding access to programs addressing health care-related food access and workforce-related educational attainment. SHC will also invest in strategies to increase transportation options, affordable childcare, and financial literacy. The anticipated impacts range from reduced food insecurity and unemployment to improved health outcomes and health insurance rates?? among low-income individuals. 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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