During the collection of assessments, the assessment team encountered challenges obtaining several assessments. In some instances community health program leaders were not sure about sharing assessments they deemed too small, to “unscientific”, and/or not “analytic” enough. Others were wary of handing over their findings to a group of city leaders they had not previously had direct contact with. For these reasons, several community providers decided not to share their assessments with SFHIP or contribute them to the CHNA process. The Working Group has submitted recommendations to SFHIP leadership to address these challenges.
Some assessments of important health needs are not included in the information considered for this assessment because while they analyze data for San Francisco alone and they draw explicit analytic connections to social determinants of health and health outcomes, they do not collect primary data and instead exclusively produced analyses of existing datasets. The Working Group passed these on and where appropriate, data from these reports were incorporated into the CHNAs datasheets and infographics and are referenced throughout.
Among the reports included in this assessment, the primary data collection activities included focus groups, key informant interviews, online and in-person surveys (including a point-in-time count), community forum feedback, and thematic analysis of meeting notes. Several assessments used a racial/ethnic and/or income equity framework to analyze the data they collected.
The Working Group read the assessment reports and extracted information using an online survey that allowed reviewers to confirm each criterion was met and answer questions pertaining to the target populations, primary data collection methods, and social determinants of health or health outcomes addressed in the assessment. The survey asks readers to extract information on the upstream determinants of health (“Root Causes”), downstream outcomes (“Consequences”) and intervention strategies (“Interventions”) . The data extraction tool is available here.
There are significant limitations to using an assessment of prior assessments in the determination of community health needs. The Working Group was attentive to the need for a wide range of assessment topics and interested in assuring that topics relevant to the experiences of historically oppressed and marginalized communities were represented, some topics may be overrepresented and some missing. Lacking standardized definitions, parameters and methodologies regarding health, populations, and interventions or programs, these assessments cannot be used to generalize or draw definitive conclusions about health needs or the health status of communities. This assessment is meant to provide SFHIP leadership with information to augment other data sources in order to glean more in-depth and detailed insights into the urgency and distribution of San Francisco’s health needs, health disparities, and promising practices to address them. These analyses engage a broad spectrum of San Francisco’s population, but not evenly and not every community. Some groups are not assessed at all, some only as a small segment of the population engaged in one small assessment. But thanks to that one segment, we might know something new about the health needs of that group. When taken into account along with more rigorously and regularly analyzed data, these assessments present themes and patterns to guide the interpretation of all the data available as a whole in the determination and prioritization of health needs and ultimately, planning for implementation of interventions to address those priorities.
When interpreting this assessment of prior assessments, care was taken to keep in mind that “target populations” are not the same as “assessed populations.” Assessment readers may have interpreted SFHIP Strategic Priority Areas and Modified BARHII Root Causes, Consequences and Interventions differently. Assessment topics as they are identified and listed in this report may be incomplete or may obfuscate sub-topics. We do the best we can to represent the topics, health needs assessed, interventions interrogated and their places in a framework that expands the meaning of health and how disparities and inequities happen and can be undone.
Readers interested in assessment topics are encouraged to access the assessments and read about the issue more deeply. All publicly available assessments are referenced in this summary [see Appendix Four – List of Assessments]. Requests for an assessment that is not publicly available should be directed to the program that conducted it.
The implementation of xenophobic policies at the federal level from 2016-present (2019) have caused local immigrant populations to avoid participating in programs, services and assessments. They are likely to be under-counted and their health needs unassessed.
List of Assessments
Andersen, R. (2016). Chief of Police Recruitment Public Process Report. City and County of San Francisco. Link here.
Applied Survey Research. (2017). San Francisco County Homeless Point-In-Time Count & Survey. Link here.
Applied Survey Research. (2017). San Francisco Homeless Unique Youth Count and Survey: Comprehensive Report. Link here.
Cohn, K., Ahmad, H., Brown, L., Herrera, M., Lo, D., Melgoza, C., Saavedra, S., Smith, A., and Yu, K. (2017). Promoting Housing Security and Healthy Homes for Families Served by Maternal, Child, and Adolescent Health Programs. Link here.
Healthy Southeast Coalition. Bayview HEAL. (2016). Food Access Survey Results. Link here.
Hennessy, V., Garcia, B., and Guy, R. (2016). Work Group to Re-Envision the Jail Replacement Program. Link here.
Hjord, H. (2016). An Assessment of San Francisco Department of Public Health’s Alcohol Prevention Efforts: Final Report and Recommendations. Link here.
Joint Perinatal Health Equity Project. (2018). Preterm Birth Initiative. Link here.
Nance, A. (2017). San Francisco Juvenile Probation Department 2017 Statistical Report. Link here.
Office of Early Care and Education. (2017). Summary of Stakeholder Input for Phase One Implementation of Citywide Plan for ECE. Link here.
San Francisco Budget and Legislative Analyst. (2017). Economic and Administrative Costs Related to Alcohol Abuse in the City and County of San Francisco. Link here.
San Francisco Human Services Agency Planning Unit. (2016). Assessment of the Needs of San Francisco Seniors and Adults with Disabilities; Part I: Demographic Profile. San Francisco Department of Aging and Adult Services. Link here.
San Francisco Human Services Agency Planning Unit. (2016). Assessment of the Needs of San Francisco Seniors and Adults with Disabilities; Part II: Analysis of Needs and Services. San Francisco Department of Aging and Adult Services. Link here.
San Francisco Department of Aging and Adult Services. (2018). Dignity Fund Community Needs Assessment. Link here.
San Francisco Department of Public Health, Environmental Health. (2014). Improving Health in SROs Health Impact Assessment. Key Informant Interview Summary here. Final report here.
San Francisco Department of Public Health. (2017). Cannabis Legalization in San Francisco: A Health Impact Assessment. Executive summary here. Final report here. Appendices here.
San Francisco Department of Public Health. (2016). Healthy Stores for a Healthy Community. Infographic here. Intercept survey findings here. Policy report here.
San Francisco Department of Public Health. (2017). San Francisco 2018 – 2023 Substance Use Disorder Prevention Strategic Plan. Link here.
San Francisco Office of Early Care and Education. (2017). Understanding and Improving the Child Care Experience for Families. Link here.
San Francisco Post-Acute Care Project Team. (2016). Framing San Francisco’s Post-Acute Care Challenge. Link here.
San Francisco Safe Injection Services Task Force. (2017). 2017 Final Report. San Francisco Department of Public Health. Link here.
San Francisco State University Health Equity Institute. (2016). Housing, Pregnancy and Preterm Birth in San Francisco: A Community-Academic Partnership for Research, Policy & Practice. Link here.
Su, M. (2016). A Snapshot of San Francisco’s Children and Families. San Francisco Department of Children, Youth and Their Families. Link here.
Tenderloin Health Corner Store Coalition. (2017). 2017 Tenderloin Healthy Shopping Guide. Link here.
Vietnamese Youth Development Center. (2018). Youth Attitudes on Menthol & Flavored Tobacco Survey Findings. VYDC findings here. Ten CAM findings here.
Youth Movement of Justice and Organizing. (2017). Our Healing in Our Hands: Findings from a Mental Health Survey with San Francisco Unified School District High School Youth. Link here.