SAN FRANCISCO’SVISITACION VALLEYNEIGHBORHOOD:NEIGHBORHOODCONDITIONS ANDHEALTH STATUSWayne Enanoria-7.18.17

Framework for Assessing Neighborhood Health2

Using a social determinants of healthmodel, we will cover:

• Socioeconomic Factors

• Living Conditions

• Health & Well-Being

• Access to healthcare services

VisitacionValley Neighborhood of San Francisco3

• Sunnydale Population: 4297 ± 398.5• Visitacion Valley Population: 17,793 ± 781• District: 10 (Bayview Hunters Point, Portola,

McLaren Park)• Zip code: 94134 (Portola, McLaren Park)

Source: American Community Survey 5-year estimates, 2011-15

30%

42%

22%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100% VisitacionValley is younger, less white, and has more persons who speak English less than well

4

Source: American Community Survey 5-year estimates, 2011-15

30%

13%

25%21%

11%5%

21%

11%

26% 29%

14%

6%13%

8%

39%

26%

14%7%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Under 18 TAY Young Adult Middle Age Seniors Elders

English Less than Very Well

Age

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

White Black/AfricanAmerican

Latino(a) Asian PacificIslander

Other

Race/Ethnicity

Sunnydale

Visitacion Valley

San Francisco

41%

66%

18%

42%

13%

27%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

At or Below 100% At or below 200%

Sunnydale

Visication Valley

San Francisco

VisitacionValley is one of San Francisco’s lowest income neighborhoods5

% living below 100% and 200% of the

Federal Poverty Level

Source: American Community Survey 5-year estimates, 2011-15

Homelessness is an important concern in VisitacionValley.6

Percent of Total Homeless Population in 2017District 10: 17%

Source: SF Homeless Count and Survey, 2017

Program Highlight:

The newly formed Department of Homelessness and Supportive Housing was formed to better coordinate resources to help homeless residents permanently exit the streets and move into housing and services

1459932

1245

5891

66076254

0

1000

2000

3000

4000

5000

6000

7000

2013 2015 2017

Total sheltered and unsheltered homeless individuals from General Count, 2013-2017

District 10

Remaining City

Housing is an important concern in VisitacionValley.7

Program Highlight:

The VisVision Transformation Plan

Developed with the input and ideas of hundreds of Sunnydale and Visitacion Valley residents, The VisVision Transformation Plan aims to transform this community into a safer, friendlier place with high-quality housing, inviting places for recreation and healthy living, and new opportunities for lifelong learning and development.

Source: American Community Survey 5-year estimates, 2011-15

Access to Healthy Eating and Opportunities for Physical Activity are limited.

8

Percent of retailers that accept CalFresh benefits:Visitacion Valley: ~3%San Francisco: 40%

Program Highlight:The San Francisco Tobacco-Free Project is looking forward to a new partnership with the Samoan Community Development Center to assess the need for healthy retail efforts and healthy food access in Visitation Valley.www.sftobaccofree.org

Sources USDA Food Access Research Atlas, 2017; California Nutrition Network GIS Map Viewer, SFIP, 2014; SFDPH ,2017

Limited transportation creates challenges in VisitacionValley9

Program Highlight:

MUNI Service Equity Strategy aims to identify and address high priority transit needs in neighborhoods than rely on transit services the most, including Visitation Valley. The strategy seeks to improve safety, reliability and frequency, and enhance connectivity, among other goals.

% of households with access to a carSunnydale: 55%Visitacion Valley: 70% San Francisco: 77%

Source: SFMUNI; 2017; ACS 2011-15

Crime and safety are important issues in VisitacionValley.

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Program Highlights:

• DPH Mobile Crisis Team provides on-site response for prevention and intervention after street violence.

• The UCSF Wraparound Project at ZSFG provides support services to violently injured youth and young adults to prevent future violence and injury.

http://violenceprevention.surgery.ucsf.edu

Violent Crime Rate per 1,000 Residents:Sunnydale: 49.5Visitacion Valley: 25.7San Francisco: 21.8

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

Sunnydale Visitacion Valley San Francisco

Rate

(per

100

0 pe

ople

)

Violent Crime Rate: 2010 and 2015

Source: SF City Survey, 2017; San Francisco Police Department, 2015

Mortality11

Leading causes of death, 2012-2016

Rank Sunnydale Visitacion Valley San Francisco

1) Ischemic Heart Diseases Ischemic Heart Diseases Ischemic Heart Diseases

2) Diabetes Cerebral VascularDisease

Cerebral Vascular Disease

3) Cerebral Vascular Disease

Lung Trachea/Bronchial Cancer

Alzheimer’s

4) Hypertensive Disease Hypertensive Disease Lung Trachea/Bronchial Cancer

5) Liver Cancer Chronic Obstructive Pulmonary Disease

Hypertensive Disease

6) Non-Cancer Kidney Disease

Alzheimer’s Disease Chronic Obstructive Pulmonary Disease

Source: CDPH, VRBIS, 2012-2016

The primary differences in mortality patterns in Sunnydale is that Diabetes, Liver Cancer, and Kidney Disease are among the leading 6 causes of death.

Rates of diabetes and diabetes hospitalizations are higher in Visitation Valley

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Sources: OSHPD: Hospital Discharge Data, 2012-2014; CDPH: Birth Statistical Master File, 2012; California Health Interview Survey, 2014

Age-adjusted hospitalizations rates for adults 18yrs+ per 10,000 residents Program Highlight:

The weekly Food Pharmacy at Silver Avenue family Health Center allows patients to fill healthy food prescriptions for free, get nutrition education, take part in cooking demos and samples, and get connected to additional local food resources. The pantry is available to patients with Diabetes or Hypertension.

0%

2%

4%

6%

8%

10%

12%

Ever Diagnosed with Diabetes Gestational Diabetes

0

2

4

6

8

10

12

14

Diabetes Hospitalizations

Hosp

italiz

atio

ns p

er 1

0,00

0San FranciscoVisitacion Valley (94134)

In VisitacionValley, rates of pediatric and adult hospitalizations due to asthma exceed those seen citywide

13

0,000 residentsProgram Highlights:

The Children’s Environmental Health Promotion Program provides Asthma education home visits for children with Asthma. Visits focus on teaching medical self management, assessing the home environment for triggers, teaching trigger control, and if needed and desired, creates code enforcement referrals for code violations such as mold, roaches, and lack of heat. Asthma trigger control supplies are also available.

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

Pediatric AsthmaHospitalizations

Adult AsthmaHospitalization

Visitacion Valley(94134)San Francisco

Sources: OSHPD: Hospital Discharge Data, 2012-2014

More Visitation Valley residents have insurance as a result of the ACA. Healthy SF remains an important resource.

14

Estimated Percent of residents enrolled in Healthy SF (2017)94134: # 1,148(~6%)San Francisco: # 13,082(~1.5%)

Healthy SF enrollment dropped by 73-77% between 2010 and 2017, in both Visitacion Valley and Citywide, indicating more individuals moved to MediCal or health insurance through the exchange. About 6% of VisitacionValley residents are still enrolled in Healthy SF as of July 2017.

4,180 3,783 4,148 4,5021,979 1,208 1,202 1,148

55,814

46,04748,937

52,899

26,118

15,321 14,405 13,082

0

10,000

20,000

30,000

40,000

50,000

60,000

2010 2011 2012 2013 2014 2015 2016 2017

Num

ber o

f Enr

olle

es

Number of Residents Enrolled in Healthy SF,July 2010- July 2017

94134 Total

Source: San Francisco Health Network, 2017

Compared to their proportion of the total population, more Visitacion Valley residents access care at ZSFG and DPH Primary Care Clinics.

15

Source: ZSFG, Clinic data sets, 2016

For FY 2015/16:

2%

% of City Population

8%

% of ZSFG/DPH Clinic Patients

Visitacion Valley(94134)

San Francisco

Primary Care Sites Most Used by VisitacionValley Residents: Silver Avenue Family Health CenterBalboa Teen ClinicChildren’s Health Center @ ZSFGHNurse Midwives Workup Southeast Health Center

Non-Profit Partners in Visitation Valley:

• Leland House Catholic Charities• Family Service Agency• CBHS: Southeast Family-Child Therapy

Center

An estimated 31% of Visitacion Valley residents are seen at DPH Primary Care Clinics

Thank You16

Wayne Enanoria – Wayne.Enanoria@sfdph.org