Sequoia Hospital 2019 Community Health Needs Assessment Volume 1: Main Report This report includes two volumes, the Main Report and Detailed Data Attachments, both of which are widely available to the public on dignityhealth.org/sequoia. 1. Acknowledgements HEALTHY COMMUNITY COLLABORATIVE (HCC) MEMBERS The Community Health Needs Assessment (CHNA) could not have been completed without the HCC’s efforts, tremendous input, many hours of dedication, and financial support. We wish to acknowledge the following organizations for their representatives’ contributions to promoting the health and well-being of San Mateo County. Dignity Health Sequoia Hospital Marie Violet, Director, Heath & Wellness Co-Chair, Healthy Community Collaborative [email protected] Tricia Coffey, Manager of Community Health [email protected] San Mateo County Health System Scott Morrow, MD, MPH, MBA, FACPM Health Officer, San Mateo County Co-Chair, Healthy Community Collaborative [email protected] Cassius Lockett, PhD, Director of Public Health, Policy, and Planning [email protected] Karen Pfister, MS, Supervising Epidemiologist [email protected] Hospital Consortium of San Mateo County Francine Serafin-Dickson, DNP, MBA, RN, Executive Director [email protected] County of San Mateo Human Services Agency Selina Toy Lee, MSW, Director of Collaborative Community Outcomes [email protected] Kaiser Permanente, San Mateo Area James Illig, Community Health Manager Kaiser Foundation Hospital, South San Francisco [email protected] Stephan Wahl, Community Health Manager, Kaiser Foundation Hospital, Redwood City [email protected] Lucile Packard Children’s Hospital Stanford Joseph Vaughan, Manager of Community Partnerships [email protected] 2 | Page Sequoia Hospital 2019 CHNA 1. Acknowledgements Peninsula Health Care District Ashley McDevitt, MPA, Community Benefit Manager [email protected] Seton Medical Center and Seton Coastside, part of Verity Health System Tina Ahn, MBA, Director, Business Development [email protected] Diana Ohlhaver, Director, Marketing & Communications [email protected] Stanford Health Care Colleen Haesloop Johnson, MPA, HSA, Director, Community Partnerships [email protected] Sutter Health Menlo Park Surgical Hospital and Sutter Health Mills Peninsula Medical Center Greg Karman, MPH, Senior Consultant, Community Benefit [email protected] 3 | Page Sequoia Hospital 2019 CHNA 1. Acknowledgements Table of Contents 1. Acknowledgements ..................................................................................................... 2 2. Executive Summary .................................................................................................... 5 3. Community Served .................................................................................................... 10 4. Assessment Process and Methods ........................................................................... 17 5. Assessment Data and Findings ................................................................................. 24 6. Sequoia Hospital Prioritized Significant Community Health Needs ........................... 48 Healthy Lifestyles ................................................................................................... 49 Housing and Homelessness .................................................................................. 49 Mental Health and Well-Being ................................................................................ 49 Health care Access and Delivery ........................................................................... 49 7. Community Resources .............................................................................................. 50 8. Evaluation Findings from FY16-FY18 Implemented Strategies ................................. 51 9. List of Attachments .................................................................................................... 60 4 | Page Sequoia Hospital 2019 CHNA Table of Contents 2. Executive Summary COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PURPOSE The purpose of this community health needs assessment (CHNA) is to identify and prioritize significant health needs of the community served by Sequoia Hospital. The priorities identified in this report help to guide the hospital’s community health improvement programs and community benefit activities, as well as its collaborative efforts with other organizations that share a mission to improve health. This CHNA report meets requirements of the Patient Protection and Affordable Care Act (and in California of Senate Bill 697) that not-for-profit hospitals conduct a community health needs assessment at least once every three years. COMMUNITY HEALTH NEEDS ASSESSMENT COLLABORATORS The CHNA process, completed in fiscal year 2019 and described in this report, was conducted collaboratively with the Healthy Community Collaborative (HCC) members in compliance with current federal requirements. The collaborative was created to identify and address the shared health needs of the community. Since its formation in 1995, the HCC has conducted prior community health assessments for San Mateo County (1995, 1998, 2001, 2004, 2008, 2011, 2013, and 2016). This 2019 report marks the ninth such assessment and builds upon those earlier assessments. The following health systems and organizations collaborated to prepare the 2019 CHNA: . County of San Mateo Human Services Agency . Dignity Health Sequoia Hospital . Kaiser Permanente, San Mateo Area (Redwood City and South San Francisco Kaiser Foundation Hospitals) . Lucile Packard Children’s Hospital Stanford . Peninsula Health Care District . San Mateo County Health . Stanford Health Care . Sutter Health (Menlo Park Surgical Hospital and Mills-Peninsula Medical Center) . Verity Health System (Seton Medical Center and Seton Coastside) The HCC specifically wishes to acknowledge the contributions of Karen Pfister, MS, Supervising Epidemiologist of San Mateo County Health, and her team. The team managed the countywide 2018 Health and Quality of Life Survey and provided extensive amounts of secondary data to the HCC for the 2019 CHNA. IDENTITY OF CONSULTANTS Actionable Insights, LLC (AI), an independent, local research firm, assisted with CHNA planning, conducted primary research, collected secondary data, synthesized primary and secondary data, and facilitated the processes of identifying community health needs and assets. 5 | Page Sequoia Hospital 2019 CHNA 2. Executive Summary SEQUOIA HOSPITAL DIGNITY HEALTH COMMITMENT AND MISSION The hospital’s dedication to engagement with the community, assessing priority needs, and helping to address them with community health program activities is in keeping with our mission. Dignity Health is committed to furthering the healing ministry of Jesus. We dedicate our resources to: . Delivering compassionate, high-quality, affordable health services; . Serving and advocating for our sisters and brothers who are poor and disenfranchised; and . Partnering with others in the community to improve the quality of life. SEQUOIA HOSPITAL’S DEFINITION OF COMMUNITY SERVED Sequoia Hospital defines “the community served by a hospital” as those people living within its hospital service area. A hospital service area includes all residents in a defined geographic area and does not exclude low-income or underserved populations. Dignity Health Sequoia Hospital is located at 170 Alameda de las Pulgas in Redwood City, California and serves the cities in mid-county, south county, and coastside of San Mateo County (SMC), including the cities of Belmont, Burlingame, Foster City, San Carlos, San Mateo, Atherton, East Palo Alto, Menlo Park, Portola Valley, Redwood City, Woodside, and Half Moon Bay. SMC residents are healthier than in many other places. However, the data also demonstrates that preventable diseases are on the rise and so we must do more to prevent these diseases from occurring in the first place. It also shows that health is not distributed evenly across the population, and there are many communities that still do not experience good health and a high quality of life. Despite the fact that half of households in the county earn more than $100,000 per year, nearly one in five (19.8%) county residents live below 200% of the federal poverty level. ASSESSMENT PROCESS & METHODS For the purposes of this assessment, the HCC did not limit the definition of “community health” to traditional measures of health. Instead, this definition included indicators about the physical health of the county’s residents, as well as the broader social and environmental determinants of health, such as access to health care, technology, affordable housing, childcare, education, and employment. This more inclusive definition reflects the hospital’s view that many factors impact community health. We cannot adequately understand or address community health without wider consideration of those factors. To assess community health trends, the HCC directed its consultants, Actionable Insights (AI), to obtain secondary data from a variety of sources (see Attachment 3: Secondary Data Sources for a complete list). Primary data were obtained through direct community input: (a) key informant interviews with local health experts, (b) focus groups with community leaders and representatives, and (c) resident focus groups. These discussions sought to answer five primary questions: • What are the most important/pressing