GOOD AFTERNOON, EVERYONE. I AM A
SIMPLY MEMBER, DR. AKILA WEBER,
CHAIR OF THE ASSEMBLY SELECT
COMMITTEE ON THE SOCIAL
DETERMINANTS OF HEALTH. TONIGHT
I REPRESENT THE 79TH ASSEMBLY
DISTRICT, WHICH COVERS PARTS OF
SAN DIEGO COUNTY. BUT TODAY I'M
HERE ON BEHALF OF ALL
CALIFORNIANS. THANK YOU SO MUCH
FOR JOINING US FOR THIS VERY
IMPORTANT DISCUSSION TODAY ON
THE INTERSECTION BETWEEN HOUSING
AND HEALTH. IN DECEMBER OF 2021
. WE HAD OUR FIRST COMMITTEE
HEARING. IT WAS THERE THAT WE
HAD A THOROUGH DISCUSSION. ON
WHAT IT MEANS WHEN WE TALK ABOUT
THE SOCIAL DETERMINANTS OF
HEALTH AND THE ROLE OF THIS
COMMITTEE SO TO BRIEFLY RECAP.
THIS COMMITTEE WILL EXAMINE THE
RELATIONSHIP BETWEEN SOCIETAL
FACTORS SUCH AS WHERE YOU'RE
BORN LIVE WORK. PLAY. GO TO
SCHOOL AND AGE. AND HOW THEY
IMPACT ONE'S HEALTH QUALITY OF
LIFE AND RISK FACTORS. TODAY WE
ARE FOCUSING ON HOW HOUSING CAN
ADVERSELY AFFECT ONE'S HEALTH.
WE WILL TAKE INTO ACCOUNT THE
HISTORICAL ISSUES THAT HAVE
PLACED CERTAIN GROUPS IN CERTAIN
AREAS AND THE HEALTH CHALLENGES
THAT HAVE RESULTED FROM THOSE
DECISIONS. WE WILL ALSO DISCUSS
THE CHALLENGES THAT KEEP CERTAIN
GROUPS IN CERTAIN AREAS. AND
WE'LL DISCUSS THE ISSUE OF
HOMELESSNESS BUT FROM A HEALTH
PERSPECTIVE AND ALSO TOUCH ON
THINGS THAT GROUPS AND THE STATE
ARE DOING TO COMBAT THE NEGATIVE
IMPACTS THAT HOUSING POLICIES
HAVE HAD ON THE HEALTH OF
CALIFORNIA RESIDENTS. WE ARE
VERY HONORED TO HAVE EXPERTS
FROM CITY MANAGEMENT, STATE
AGENCIES EDUCATIONAL
INSTITUTIONS FROM THE FIELDS OF
MEDICINE, LAW AND HOMELESSNESS
ADVOCACY HERE TODAY TO TESTIFY.
OUR PANEL PRESENTATION WILL BE
FOLLOWED BY COMMENTS FROM THE
PUBLIC. THE PUBLIC IS WELCOME TO
CALL IN AND WE'LL HAVE A MINUTE
AND THEN HALF OR 90 SECONDS TO
COMMENT. THE PUBLIC TOLL FREE
NUMBER IS 87769. AND THE PUBLIC
ACCESS CODE IS 13151 TO 7. I
WILL BRIEFLY INTRODUCE OUR FULL
PANEL NOW AND THEN GIVE MORE OF
AN INTRODUCTION WHEN EACH OF
THEM COME UP. FIRST ONE HALF.
ADAM P. ROMERO WHO'S DEPUTY
DIRECTOR, EXECUTIVE PROGRAM
DIVISION, DEPARTMENT OF FAIR
EMPLOYMENT AND HOUSING, WHO WILL
ADDRESS COMBATING HOUSING
DISCRIMINATION. PRESENT
STRATEGIES AND HISTORICAL
LEGACIES. ADAM IS JOINING US
REMOTELY FROM LOS ANGELES. NEXT
WE'LL HEAR FROM DR MARGARET,
WHO'S DIRECTOR OF THE UCSF.
HOMELESSNESS AND HOUSING
INITIATIVE AND WILL GIVE A
PRESENTATION ON HEALTH EFFECTS
OF INADEQUATE HOUSING. AND THEN
WE WERE HAVE MR OMAR PASSION.
DEPUTY CITY MANAGER FOR THE CITY
OF SAN JOSE, WHO ILL DISCUSS A
WHOLE PERSON APPROACH TO
HOMELESSNESS. AND OUR FINAL
PANELIST IS DEBBIE CARROLL,
EXECUTIVE DIRECTOR. HABITAT FOR
HUMANITY CALIFORNIA. WHO WILL
TIE IT ALL TOGETHER WITH THE
PRESENTATION ON IMPROVING
QUALITY OF LIFE BY PROVIDING
SAFE, AFFORDABLE HOUSING. THANK
YOU TO THOSE. OF YOU WHO ARE
HERE IN THE CAPITAL WITH US
TODAY AND FOR THOSE WHO ARE
WATCHING FROM HOME SO WE'RE
GOING TO BEGIN. WITH ADAM. ADAM
ROMERO WAS APPOINTED BY GOVERNOR
GAVIN NEWSOM ON MARCH 5TH 2020
TO BE DEPUTY DIRECTOR OF
EXECUTIVE PROGRAMS AT THE
CALIFORNIA DEPARTMENT OF FAIR
EMPLOYMENT AND HOUSING. AN
EXPERT IN ANTI DISCRIMINATION
LAW AND MOST DISCIPLINARY
RESEARCH. MR ROMERO LEADS THE
DEPARTMENT'S EXECUTIVE PROGRAM
DIVISION, WHICH INCLUDES TEAMS
IN THE AREAS OF LEGISLATIVE AND
REGULATORY AFFAIRS, RESEARCH AND
REPORTING. OUTREACH EDUCATION,
APPEALS AND PUBLIC RECORDS ACT
RESPONSES. MR ADAM ROMERO. ARE
YOU ON THE LINE? ME TO SPEAK
TODAY. UM I AM THE DEPUTY
DIRECTOR OF THE CALIFORNIA
DEPARTMENT OF THEIR EMPLOYMENT
AND HOUSING, WHICH IS ALSO KNOWN
AS D F E H. NEXT SLIDE, PLEASE.
AS CALIFORNIA CIVIL RIGHTS
AGENCY. MY DEPARTMENT'S MISSION
IS TO ERADICATE DISCRIMINATION
IN OUR STATE. WE ENFORCE CIVIL
RIGHTS LAWS APPLICABLE NOT ONLY
TO EMPLOYMENT AND HOUSING, BUT
ALSO BUSINESS ESTABLISHMENTS,
INCLUDING HEALTHCARE. STATE
FUNDED PROGRAMS AND ACTIVITIES,
BIAS, MOTIVATED VIOLENCE AND
HUMAN TRAFFIC. I'LL BE FOCUSING
MY REMARKS ON ONGOING EFFORTS OF
DFB H TO COMBAT HOUSING
DISCRIMINATION. FIRST I WAS
ASKED BY COMMITTEE STAFF TO
DESCRIBE RESIDENTIAL SEGREGATION
AND ITS HISTORICAL ROOTS, WHICH
ARE IMPORTANT CONSIDERATIONS,
AMONG OTHERS, WHEN EXAMINING
HOUSING AND ITS IMPACTS ON
HEALTH. WITH THE CAVEAT. THIS IS
BY NO MEANS A FULL ACCOUNT IN
THE TIME I HAVE TODAY, I WILL DO
MY BEST TO SUCCINCTLY SUMMARIZE
A FEW LEGAL SLASH POLICY DRIVERS
OF RESIDENTIAL SEGREGATION OVER
THE PAST CENTURY. EXCELLENT
PLACE. FOR MANY YEARS IN OUR
NATION'S HISTORY, ZONING LAWS
EXCLUDED PARTICULAR RACIAL
GROUPS FROM LIVING OR OWNING
PROPERTY IN CERTAIN
NEIGHBORHOODS, EXCLUSIONARY
PRIVATE AGREEMENTS. NAMELY
RESTRICTIVE COVENANTS FOR LAWFUL
UNTIL 1948 WHEN THE U. S SUPREME
COURT DECLARED JUDICIAL
ENFORCEMENT OF THEM
UNCONSTITUTIONAL. YOU CAN SEE
HERE AN EXAMPLE OF SUCH A CLAUSE
, WHICH PROHIBITED THE ENDS OF
THE SAN DIEGO PROPERTY TO
ANYONE, NOT WHITE. EVEN THOUGH
SUCH A CONTRACTUAL PROVISIONS
WOULD NOT BE ENFORCEABLE. TODAY
THEY STILL PERSIST IN SOME DEEDS
IN CALIFORNIA FOR THIS REASON.
LAST YEAR THE LEGISLATURE PASSED
AND GOVERNOR NEWSOM SIGNED
ASSEMBLY BILL 14 66, WHICH
ENHANCED PROCEDURES TO CLEAR
PROPERTY DOCUMENTS OF THESE
RACIST PROVISION. NEXT SLIDE,
PLEASE. RESEARCHERS HAVE
IDENTIFIED VARIOUS GOVERNMENT,
HOUSING AND COMMUNITY
DEVELOPMENT POLICIES FROM THE 19
HUNDREDS AS GREATLY CONTRIBUTING
TO RESIDENTIAL SEGREGATION,
INCLUDING DECISIONS ABOUT WHERE
TO BUILD HOUSING, SCHOOLS AND
HIGHWAYS. FOR EXAMPLE, REDLINING
REFERS TO A PRACTICE THAT
ORIGINATED IN THE 19 THIRTIES.
BY WHICH FEDERAL AGENCIES WOULD
NOT ENSURE HOME MORTGAGES AND
PREDOMINANTLY BLACK
NEIGHBORHOODS. MORE SPECIFICALLY
, FEDERAL AGENCIES MADE
DECISIONS ABOUT WHICH PROPERTIES
WERE SAFE TO ENSURE BASED ON A
NEIGHBORHOOD RANKING SYSTEM.
ILLUSTRATED ON MAPS OF
METROPOLITAN AREAS ACROSS THE
COUNTRY. NEIGHBORHOOD BAR RANKED
ACCORDING TO, UH WERE RANKED AND
NEIGHBORHOODS THAT WERE HIGHEST
RANKED WERE DESCRIBED AS BEST
AND FOR COLORED GREEN. THOSE
CONSIDERED DESIRABLE WERE BLUE.
DECLINING WERE YELLOW AND THE
LOWEST RANKED WERE RED AND
DESCRIBED AS HAZARDOUS. SIMPLY
PUT WHAT THIS MEANT WAS THAT
PEOPLE LIVING IN THE RED
NEIGHBORHOODS WHO ARE
PREDOMINANTLY BLACK COULD NOT
GET HOME LOANS, WHEREAS PEOPLE
LIVING IN THE GREEN
NEIGHBORHOODS WERE PREDOMINANTLY
WHITE. COULD TAKE ADVANTAGE OF
THIS IMPORTANT GOVERNMENT
SUPPORT. AND HERE IS ONE SUCH
MAP OF SAN FRANCISCO FROM 1937.
TODAY CALIFORNIA LIKE OUR ENTIRE
NATION, CONTINUES TO GRAPPLE
WITH THE LEGACIES OF REDLINING,
EXCLUSIONS AND OTHER
CONTRIBUTORS TO RESIDENTIAL
SEGREGATION AS WELL AS HEALTH
WEALTH PATTERNS THAT EXIST
TODAY. REGRETTABLY I DO NOT HAVE
SPACE IN THE TIME ALLOTTED TO
ADDRESS MORE FACTORS AFFECTING
HOUSING AND HEALTH, INCLUDING
ACCESSIBILITY FOR AND SOCIAL
INCLUSION OF PEOPLE WITH
DISABILITIES AND
DISPROPORTIONATE HOMELESSNESS
AMONG LGBTQ YOUTH AND YOUNG
ADULTS, JUST TO MENTION TW NEXT
SLIDE, PLEASE. LET ME TURN TO
THE WORK OF DF TH TO COMBAT
HOUSING DISCRIMINATION, AS YOU
KNOW, DIFFERENT AGENCIES PLAY
DIFFERENT ROLES IN HELPING
ENSURE ALL CALIFORNIANS HAVE
STABLE, SUFFICIENT AFFORDABLE
AND SAFE HOUSING. MY
DEPARTMENT'S ROLE IS TO ENFORCE
CALIFORNIA'S ROBUST CIVIL RIGHTS
LAWS, MOST PRINCIPALLY THE FAIR
EMPLOYMENT AND HOUSING ACT, ALSO
KNOWN AS PROHIBITS
DISCRIMINATION, HARASSMENT AND
RETALIATION BY LANDLORDS. TENANT
SCREENING COMPANIES. HOMEOWNERS
ASSOCIATIONS, REALTORS, LENDERS
, SELLERS, SHELTERS AND OTHER
TYPES OF HOUSING PROVIDERS. EACH
YEAR. THE FBH INVESTIGATES ON
AVERAGE BETWEEN SIX AND 7000
CIVIL RIGHTS COMPLAINTS OF WHICH
APPROXIMATELY 800 TO 900
COMPLAINTS CONCERNED HOUSING
THESE COMPLAINTS FROM THE GAMUT
IN TERMS OF THE FACTS, THEY
ALLEGE. FOR EXAMPLE, HOUSING
AUTHORITY REFUSES TO ISSUE ABOUT
YOUR FOR A UNIT WITH A BEDROOM
FOR DISABLED CHILD'S LIVE IN
ATTENDANCE. COM PARK MANAGER
TREATS A TENANT AND EQUALLY
BECAUSE THE TENANT IS GAY AND
DISABLED. THE PROPERTY MANAGER
REFUSES TO RENT TO AN UNMARRIED
COUPLE HOMEOWNERS ASSOCIATION
RETALIATES AGAINST AN OWNER FOR
COMPLAINING THAT THAT GARDNER
WAS SEXUALLY HARASSING HER.
HOMEOWNERS ASSOCIATION REFUSES
TO ALLOW AN OWNER TO DISPLAY UM
AZUSA. THESE ARE JUST A FEW
EXAMPLES DRAWN FROM REAL
COMPLAINTS THAT THE FBH HAS
SETTLED OVER THE PAST TWO YEARS.
ONE OF THE FBH IS CRITICAL
FUNCTIONS IS TO PROVIDE THREE
CONCILIATION AND MEDIATION TO
PARTIES AND DISPUTE. EACH YEAR,
OUR DEPARTMENT CONCILIATE OR
MEDIATES THOUSANDS OF EMPLOYMENT
, EMPLOYMENT AND HOUSING CASES.
IN 2020 ALONE, THE FBH SETTLED
706 CASES. THE SETTLEMENTS
INCLUDED VARIETY OF TERMS TO
ENSURE DISCRIMINATORY CONDUCT
CEASES AS WELL AS ACCUMULATIVE,
CUMULATIVE MONETARY VALUE OF
MORE THAN $11 MILLION FOR
COMPLAINANTS. JUST THIS WEEK, WE
ANNOUNCED TWO MAJOR HOUSING
SETTLEMENTS, ONE WITH A LARGE
APARTMENT COMPLEX THAT HAD BEEN
REFUSING TO ACCEPT HOUSING
CHOICE SECTION EIGHT VOUCHERS
AND ANOTHER WITH A PROPERTY
MANAGEMENT COMPANY ALLEGED TO
HAVE DONE NOTHING WHEN IT'S
IMPORTANT, THE SEXUALLY
HARASSING A TENANT. WHEN OUR
INVESTIGATION FINDS REASONABLE
CAUSE THAT A CIVIL RIGHTS
VIOLATION HAS OCCURRED AND WE
CANNOT REACH A SETTLEMENT. OUR
DEPARTMENT AUTHORIZED TO
PROSECUTE THE MATTER IN COURT.
TO MAXIMIZE OUR IMPACT. WE
PROSECUTE THE PLANE STEP WILL
POSITIVELY AFFECT LARGE NUMBERS
OF CALIFORNIANS AND OR THE LAW.
FOR EXAMPLE, LAST MONTH WE STOOD
A LARGE, FEDERALLY SUBSIDIZED
APARTMENT COMPLEX. FOR
REPEATEDLY FAILING TO PROVIDE
DISABILITY OF COMPUTATION. AS
ANOTHER EXAMPLE, OUR DEPARTMENT
FILED A CIVIL ACTION AGAINST THE
LANDLORD WHO THREATENED TO CALL
IMMIGRATION AUTHORITIES ON
TENANTS UNLESS THEY MOVE. AND WE
SETTLED THAT CASE WITH A LARGE
MONETARY AWARD TO THE TENANTS,
AMONG OTHER RELIEF. IN ADDITION
TO THESE CORE FUNCTIONS, THE FBH
ENGAGES IN A VARIETY OF
PROACTIVE STRATEGIC INITIATIVES
TO ADVANCE THEIR HOUSING IN
CALIFORNIA. IN 2020 AND 2022 ARE
FAIR EMPLOYMENT AND HOUSING
COUNCIL COMPLETED TWO MAJOR SETS
UP THEIR HOUSING REGULATIONS.
THE FIRST SECTOR REGULATIONS IN
CALIFORNIA HISTORY. NEXT
LIBRARIES. FOLLOWING THE
COMPLETION OF EACH OF THESE
REGULATORY PACKAGES ARE
DEPARTMENT PROVIDED A FREE
SERIES OF WEBINARS TO EXPLAIN
THE REGULATION AND ANSWER
QUESTIONS. WE ALSO ISSUED
GUIDANCE DOCUMENTS AVAILABLE IN
MULTIPLE LANGUAGES ON SPECIFIC
TOPICS ADDRESSED IN THE
REGULATIONS, SUCH AS TENANT ON
TENANT HARASSMENT SOURCE OF
INCOME DISCRIMINATION,
LIMITATIONS ON THE USE OF
CRIMINAL HISTORY AND TENDENCY,
DECISIONS AND PROTECTIONS FOR
SERVICE AND SUPPORT ANIMALS. OUR
DEPARTMENT HAS ALSO RECENTLY
PRODUCED EDUCATIONAL MATERIALS
RELATED TO COVID 19
DISCRIMINATION AND SHELTERS,
PROTECTIONS FOR LICENSED
CHILDCARE PHONES AND OTHER
PRESSING ISSUES FACING
CALIFORNIANS. WE SPEAK WIDELY ON
THESE TOPICS TO VARIETY OF
AUDIENCES OUTREACH TO DIVERSE
STAKEHOLDERS ACROSS THE STATE
AND COLLABORATE WITH OTHER
AGENCIES ON FAIR HOUSING, AND
IT'S JUST INITIATIVES. TOUCHES
THE DEPARTMENT OF REAL ESTATE
AND THE DEPARTMENT OF
REHABILITATION. FOR EXAMPLE,
TOMORROW WE ARE PRESENTING ON
THE EDUCATIONAL ROUNDTABLE OF
THE BUREAU OF REAL ESTATE
APPRAISERS TO TRAIN A FRASER'S
ON CULTURAL COMPETENCY AND
ELIMINATION OF BIAS. THIS FALL.
WE ARE LAUNCHING THE CALIFORNIA
VERSUS HATE RESEARCH, RESOURCE
LINE AND NETWORK. WHICH WILL
PROVIDE SUPPORT AND RESOURCES TO
VICTIMS, A BIAS MOTIVATED
VIOLENCE, WHICH SOMETIMES OCCURS
IN HOUSING CONTEXTS. THIS
TRANSFORMATIVE RESOURCES MADE
POSSIBLE BY $10 MILLION
APPROPRIATION FROM THE
LEGISLATURE AND THE 2021 BUDGET
APP. TO EXEMPLIFY THE
MULTIFACETED WAY THAT WE
APPROACH OUR WORK. LET ME DIG IN
ON OUR DEPARTMENT'S EFFORTS TO
COMBAT SOURCE OF INCOME
DISCRIMINATION HOUSING, WHICH
THE FEE HAVE PROHIBITS. ONE FORM
OF SOURCE OF INCOME
DISCRIMINATION. IT'S BEEN A
HOUSING PROVIDER, REFUSES TO
ACCEPT GOVERNMENT ASSISTANCE
WITH THE TENANTS RENT THIS FORM
OF DISCRIMINATION, WHICH IMPAIRS
CALIFORNIANS ABILITIES TO
UTILIZE HOUSING ASSISTANCE AND
UNDERMINES OUR STATE'S HOUSING
GOALS. WAS EXPRESSLY PROHIBITED
BY SENATE BILL 3 29 FROM 2019.
AS I NOTED PREVIOUSLY THIS WEEK
, THE FBH SETTLED A COMPLAINT
AGAINST THE LARGE APARTMENT
COMPLEX THAT REFUSED ABOUT YOU.
IN ADDITION TO OUR CORE AND
INVESTIGATION AND ENFORCEMENT
ACTIVITIES, WHICH ARE COMPLAINT
DRIVEN, WE RECENTLY LAUNCHED
SEVERAL INITIATIVES AIMED AT
PROACTIVELY FINDING AND ROOTING
OUT UNLAWFUL DISCRIMINATION ON
THE BASIS OF SOURCE OF INCOME,
AS WELL AS CRIMINAL HISTORY AND
RACE. FIRST WITH FUNDING THIS
YEAR FROM THE LEGISLATURE AND
GRANTS FROM THE FEDERAL
GOVERNMENT. WE ARE BUILDING A
FAIR HOUSING TESTING PROGRAM
THAT USES ACTORS POSING AS
RENTERS TO TEST WHETHER HOUSING
PROVIDERS AND OF REAL WORLD
SCENARIOS ARE DISCRIMINATING.
IT'S ABOUT YOUR HOLDERS OR ON
THE BASIS OF RATES. IN THE
INITIAL ROUND OF TESTING. WE
FOUND EVIDENCE OF DISCRIMINATION
HAS THE VOUCHER TESTS AND ONE
THIRD OF THE RACE TESTS DF VHS
CURRENTLY RETESTING PROPERTIES
AND PLANS TO TAKE ENFORCEMENT
ACTION. WHERE APPROPRIATE.
SECOND DFE H IS USING WEB
SCRAPING TECHNOLOGY TO CONDUCT
MASS SEARCHES OF ONLINE HOUSING
AND EMPLOYMENT ADVERTISEMENTS
FOR STATEMENTS THAT VIOLATE THE
LAW, SUCH AS NO SECTION EIGHT OR
MUST HAVE A CLEAN RECORD. WE
HAVE FOUND THOUSANDS OF THESE
ADVERTISEMENTS AND WE ARE
NOTIFYING THE HOUSING PROVIDERS
AND EMPLOYERS HAVE THE VIOLATION
, PROVIDING THEM WITH
EDUCATIONAL MATERIALS AS A FIRST
STEP. THIRD WE LAUNCHED AN
ONLINE PORTAL THROUGH WHICH
CALIFORNIANS CAN SUBMIT TO THE
FBH ADVERTISEMENTS AND
APPLICATIONS THAT CONTAIN
DISCRIMINATORY STATE WITHOUT
FILING A FORMAL COMPLAINT. THIS
ALLOWS PEOPLE TO POTENTIALLY TO
SHARE WITH OUR DEPARTMENT
POTENTIALLY UNLAWFUL ACTIVITY,
EVEN THOUGH THEY MAY NOT HAVE
BEEN HARMED OR WHEN THEY DO NOT
WISH TO PURSUE A FORMAL
COMPLAINT. THE FDA INVESTIGATES
AND TAKES ACTION WHEN WARRANTED.
FOURTH THIS WEEK WE CONTRACTED
WITH THE CALIFORNIA HEALTH
INTERVIEW SURVEY A
REPRESENTATIVE SURVEY OF
CALIFORNIANS RUN OUT OF U C. L A
TO CONDUCT STUDIES ON THE IMPACT
OF COVID 19 ON HOUSING. HOUSING
DISCRIMINATION AND VOUCHER
CHOICE UTILIZATION. WE EXPECT
THIS RESEARCH TO YIELD PROFOUND
INSIGHTS FOR CALIFORNIA,
INCLUDING HOW DISCRIMINATION AND
VOUCHER UTILIZATION RELATED
HEALTH INVOLVED BEING ACROSS THE
STATE. IT'S THREE SEARCHABLE
BUILD ON EXISTING RESEARCH
FINDINGS THAT HOUSING AND
RESIDENTIAL SEGREGATION CAN
PROFOUNDLY IMPACT HEALTH AT THE
INDIVIDUAL, FAMILY AND COMMUNITY
LEVELS. EXPERIENCE OF
DISCRIMINATION ITSELF ALSO CAN
ADVERSELY IMPACT HEALTH BY, FOR
EXAMPLE, CHRONICALLY STRESSING
THE MIND. ON THESE ISSUES. I
RECOMMEND HEALTHY PEOPLE 2030,
THE FEDERAL GOVERNMENT'S PUBLIC
HEALTH GROUPS BLUEPRINT, WHICH
SYNTHESIZES RESEARCH ON SOCIAL
DETERMINANTS OF HEALTH. FOR ALL
OF THESE REASONS, MY COLLEAGUES
AND I AT D, F E H AND ACROSS THE
ADMINISTRATION COMMITTED TO
REDUCING HOUSING DISCRIMINATION
AND INCREASING HOUSING
STABILITY. THANK YOU. THANK YOU,
ADAM. SO MUCH FOR THAT
PRESENTATION. UM WE ARE GOING TO
GO TO OUR NEXT PRESENTER, AND
THEN WE'LL ASK QUESTIONS OR AT
THE END OF ALL PRESENTATION. SO
NOW WE'RE HERE FROM A FELLOW
PHYSICIAN. DR MARGO SOCIAL IS A
PROFESSOR OF MEDICINE AT THE
UNIVERSITY OF CALIFORNIA, SAN
FRANCISCO. DIVISION CHIEF AND
DIRECTOR OF THE UCSF CENTER FOR
VULNERABLE POPULATIONS AND
DIRECTOR OF THE UCSF BENIOFF
HOMELESSNESS AND HOUSING
INITIATIVE. SHE IS A PRACTICING
GENERAL INTERNIST AT ZUCKER BUGS
ZUCKERBERG SAN FRANCISCO GENERAL
HOSPITAL. DR KUSH ALS RESEARCH
FOCUSES ON THE CAUSES AND
CONSEQUENCES OF HOMELESSNESS AND
HOUSING INSTABILITY WITH THE
GOAL OF PREVENTING AND ENDING
HOMELESSNESS AND AMELIORATING
THE EFFECTS OF HOMELESSNESS ON
HEALTH. DOCTOR CUSHING. THE BOOK
OF VICTOR.
LUTELY FUNDAMENTAL TO HEALTH. I
WANT TO REMIND EVERYONE AND THIS
IS FROM A FANTASTIC NEW PAPER
THAT I ENCOURAGE PEOPLE TO READ
BY DOCTORS, LIFE LIFE HEIGHT,
SCHWARTZ AND POLLOCK AT ALL. WHO
NOTE THAT THE FIELD OF PUBLIC
HEALTH ITSELF REALLY EMERGED AS
A DISCIPLINE BASED ON STUDIES OF
INFECTIOUS DISEASE IN
OVERCROWDED HOUSING. DESPITE
THIS DEEP, DEEP KNOWLEDGE,
HOUSING MARKETS IN THE U. S AND
IN EUROPE ARE REALLY MARKED BY
HIGH RATES OF INADEQUATE
HOUSING. ONE IN THREE AMERICANS
LIVE IN RENTAL HOUSING, BUT HALF
OF THOSE RENTERS PAY MORE THAN
30% OF THEIR HOUSEHOLD INCOME
AND RENT AN AMOUNT THAT IS
REALLY UNAFFORDABLE AND DOESN'T
LEAVE ROOM FOR OTHER KEY THINGS.
ONE IN 40 RENTERS EVERY YEAR OR
FORMALLY EVICTED, AND WE THINK
THAT THIS IS A HUGE
UNDERREPRESENTATION. IN FACT,
EACH OF FORMULA EVICTION
PROBABLY STANDS IN FOR 5.5 WHAT
WE CALL INFORMAL EVICTIONS. NEXT
SLIDE. WHEN WE THINK ABOUT
HOUSING INSECURITY, WE THINK OF
TWO DIFFERENT DOMAINS, BUT WE'LL
CALL INADEQUATE HOUSING QUALITY
THINGS LIKE POOR HOUSING AND
NEIGHBORHOOD CONDITIONS, AS WELL
AS HOUSING CROWDING. AND THEN
HOUSING INSTABILITY WITH HIGH
COST BURDEN AND FREQUENT COST
DRIVEN MOVES FOR CLOSURES,
EVICTIONS AND AT THE VERY MOST
SEVERE MANIFESTATION IS
HOMELESSNESS. NEXT SLIDE.
HOUSING INSECURITY OF ALL KINDS
LEADS TO POOR HEALTH, AND IT
DOES THROUGH THROUGH MANY
MECHANISMS, INCLUDING THE
MATERIAL HARDSHIP. PEOPLE DON'T
HAVE MONEY FOR OTHER THINGS,
STRESS ENVIRONMENTAL AND
INFECTIOUS EXPOSURES. SOCIAL
NETWORK DISRUPTIONS. PEOPLE GET
DISCONNECTED FROM THEIR FRIENDS,
THEIR FAMILIES, THEIR CHURCHES,
OTHER IMPORTANT THINGS. THE MANY
BARRIERS TO HEALTH CARE THAT
PEOPLE FACE WHEN THEY'RE FACING
HOUSING, INSECURITY. AND PERHAPSMOST CRUEL OF ALL, IS THIS
NEGATIVE FEEDBACK LOOP HOUSING
INSECURITY LEADS TO POOR HEALTH.
IN POOR HEALTH CAN LEAD TO
INADEQUATE HOUSING BY DISRUPTING
PEOPLE'S ABILITY TO MAKE LIVINGS
OR TO STAY WHERE THEY REMAIN
NEXT SLIDE. IN THIS PAPER. THEY
PRESENT A FRAMEWORK HOW THESE
THINGS WORK. YOU START WITH
STRUCTURAL OPPRESSION OF
HISTORICAL AND CONTEMPORARY
POLICIES THAT DECIDE WHO GETS
HOUSING AND WHO DOESN'T BASED ON
RACIST AND OTHER INEQUITIES.
THAT LEADS TO COMMUNITIES WHERE
THERE'S INADEQUATE ACCESS TO
AFFORDABLE HOUSING OR INADEQUATE
SAFETY NET PROGRAMS FOR PEOPLE
WHO LACK HOUSING. THIS LEADS TO
THE COMMUNITY AND HOUSEHOLD
LEVEL HOUSING INSECURITY AS
WE'VE BEEN TALKING ABOUT IN THE
HOUSEHOLD LEVEL PEOPLE
EXPERIENCE THESE STRESSES
ENVIRONMENTAL EXPOSURES,
ETCETERA,AND THAT LEADS TO
INDIVIDUALS HAVING POOR HEALTH
NEXT SLIDE. HOUSING POLICIES
HAVE BEEN DEEPLY SHAPED BY
STRUCTURAL RACISM. AND IT'S NOT
A SURPRISE THAT BLACK AND BROWN
AMERICANS ARE DISPROPORTIONATELY
REPRESENTED AMONGST THOSE WHO
HAVE AN ADEQUATE HOUSING AND
DESPITE ITS CENTRALITY HEALTH
POLICIES HAVE NOT SUPPORTED
QUALITY, AFFORDABLE HOUSING FOR
ALL, EVEN THOUGH WE KNOW HOW
ESSENTIAL IT IS, THERE'S REALLY
BEEN LIMITED FEDERAL SUPPORT FOR
THE PRODUCTION PROTECTION,
PRESERVATION OF AFFORDABLE
HOUSING. HOUSING CHOICE VOUCHERS
, ONLY ONE IN FOUR HOUSEHOLDS
WHO MEET THE STRICT CRITERIA
RECEIVE THEM AND THIS
STRUCTURALLY RACIST POLICIES,
INCLUDING REDLINING, DENIAL OF
MORTGAGES, LACK OF ENFORCEMENT
OF FAIR HOUSING LAWS, PREDATORY
LENDING. LEAD TO THESE GROSS
RACIAL INEQUITIES AND HOUSING
NEXT SLIDE. AND THEN IN THE
UNITED STATES, THEY'RE ONLY 36
UNITS OF HOUSING THAT'S
AFFORDABLE AND AVAILABLE FOR
EVERY 100, EXTREMELY LOW INCOME
HOUSEHOLD AND IN CALIFORNIA,
WHERE THE SECOND WORST STATE IN
THE NATION WE HAVE ONLY 23 UNITS
OF HOUSING THAT ARE AFFORDABLE
AND AVAILABLE FOR EVERY 100
EXTREMELY LOW INCOME HOUSEHOLD
IN OUR STATE, A DEFICIT OF A
MILLION UNITS OF HOUSING. THIS
IS WHY WE HAVE SUCH A TERRIBLE
HOMELESSNESS CRISIS AND THE
IMPLICATIONS ARE ENORMOUS. NEXT
SLIDE. AS I SAID, FEWER THAN ONE
IN FOUR LOW INCOME AT RISK
HOUSEHOLDS WHO QUALIFY RECEIVE
RENTAL ASSISTANCE THROUGH THE
HOUSING CHOICE VOUCHER PROGRAM.
NEXT SLIDE. AND HOUSING
INSECURITY CONTRIBUTES TO OUR
WIDENING RACIAL DISPARITIES IN
HEALTH. HOUSING INSECURITY IS A
MAJOR, IF UNDERAPPRECIATED
CONTRIBUTOR TO RACIAL
DISPARITIES IN HEALTH. AND
REMINDER THAT RACIAL DISPARITIES
IN HEALTH RESULTS ACTUALLY FROM
RACISM AND NOT FROM RACE,
HOUSING INSECURITY IS DIRECTLY
ON THE PATHWAY BETWEEN RACISM
AND RACIALIZED. HEALTH
DISPARITIES NEXT SLIDE.
INADEQUATE HOUSING QUALITY
CROWDING POOR VENTILATION FOR
HEATING, COOLING ELECTRICITY OR
WHAT WE CALL ENERGY AND
SUFFICIENCY, WASTE DISPOSAL,
COMMUNAL FACILITIES, LACK OF
STOVES AND OVENS. DIRTY OLD
CARPETS DAMPENED MOTHER
CONDITIONS. THESE ALL LEAD TO
POOR HEALTH NEXT SLIDE. SOME
HEALTH MANIFESTATIONS OF
INADEQUATE HOUSING QUALITY ARE
THINGS LIKE LEAD EXPOSURE, WHICH
LEADS TO WORSE CHILD DEVELOPMENT
AND COGNITIVE IMPAIRMENT AND%
REALLY GENERATIONAL DEFICITS,
ASBESTOS, PESTICIDES AND
CHEMICALS CAN LEAD TO INCREASED
CANCERS. LACK OF COOKING
FACILITIES CAN LEAD TO POOR
NUTRITION, OLD AND POOR
VENTILATION, LEAD TO ASTHMA AND
RESPIRATORY INFECTIONS. AND POOR
HOUSING QUALITY OVERALL
INCREASES MENTAL HEALTH PROBLEMS
LIKE ANXIETY AND DEPRESSION.
NEXT SLIDE. SOME OTHERS. FAULTY
WIRING LEADS TO HOUSE FIRES
PREVENTED ELATION LEADS TO
CARBON MONOXIDE POISONING AND
POOR CONSTRUCTION LEADS TO HIGH
RATES OF UNINTENTIONAL INJURIES
THAT WE SEE IN OUR EMERGENCY
DEPARTMENTS NEXT SLIDE. AND
INADEQUATE HOUSING, QUALITY AND
HOUSING CROWDING WERE DIRECTLY
ASSOCIATED WITH WORSENING OF THE
COVID 19 PANDEMIC AND OF
INFECTION AND MORTALITY, EACH 5%
INCREASE IN A COMMUNITIES
HOUSEHOLDS OF POOR HOUSING
CONDITIONS. LED TO A COUNTY WITH
A 50% HIGHER RISK OF COVID 19
INCIDENTS ONCE WE CORRECTED FOR
EVERYTHING ELSE, AND A 42%
HIGHER INTEREST INCREASE IN
MORTALITY, WE KNOW THAT HOUSING
CROWDING AT THE HOUSEHOLD LEVEL
WAS ASSOCIATED WITH DRAMATICALLY
HIGHER RATES OF COVID 19
INFECTION NEXT SLIDE. FORMERLY
REDLINED NEIGHBORHOODS ARE
ASSOCIATED WITH POOR HEALTH WITH
LIMITED ACCESS TO HEALTH
SERVICES IN THOSE NEIGHBORHOODS
, FOOD DESERTS, NOISE POLLUTION
, LACK OF NATURE, WHICH IS
ASSOCIATED WITH HIGHER RATES OF
ANXIETY AND DEPRESSION. HIGHER
RATES OF VIOLENCE AND HIGHER
RATES OF OVERALL STRESS. NEXT
SLIDE. POVERTY IN NEIGHBORHOODS
IS ASSOCIATED WITH POOR HEALTH
OUTCOMES. LOWER BIRTH WEIGHT.
POOR MENTAL HEALTH, POOR
CHILDHOOD HEALTH AND OBESITY AND
HIGHER BEING MY NEXT SLIDE. THE
THREAT OF EVICTION. SO NOW WE'RE
TALKING ABOUT HOUSING INSECURITY
HAS BEEN SHOWN EVEN JUST THE
THREAT TO BE ASSOCIATED WITH
WORTH HEALTH, INCLUDING THINGS
LIKE AN INCREASED ODDS OF HAVING
A DETECTABLE HIV VIRAL LOAD
AMONG PEOPLE LIVING WITH HIV AND
AIDS. WORSE MENTAL HEALTH
INCREASED VISITS MORE INCIDENTS
OF SUBSTANCE USE RELAPSES.
COGNITIVE IMPAIRMENT IN
ELEMENTARY AGED CHILDREN AND
INCREASED ALL CAUSE MORTALITY IN
FAMILIES WHO HAVE BEEN EVEN JUST
THREATENED WITH EVICTION. NEXT
SLIDE. HOMELESSNESS OF COURSE,
IS THE MOST SEVERE MANIFESTATION
OF HOUSING INSECURITY, WHICH
DISPROPORTIONATELY IMPACTS BLACK
AND INDIGENOUS AMERICANS, AND
IT'S CONCENTRATED AMONGST
EXTREMELY LOW INCOME HOUSEHOLDS.
NEXT SLIDE. THE NIGHTLY POINT IN
TIME COUNTS IN AMERICA, SHOW
THAT OVER 580,000 INDIVIDUALS IN
THE US ARE HOMELESS EACH NIGHT,
AND WE KNOW THIS TO BE A
DRAMATIC UNDERCOUNT. NEXT SLIDE.
HOW MUCH PEOPLE REPORT WORSE
HOUSE STATUS THAN EITHER THE U.
S POPULATION A WHOLE OR POVERTY
POPULATIONS. WHEN WE SIMPLY
ASKED THE HIGHLY IMPORTANT
QUESTION OF HOW DO YOU RATE YOUR
HEALTH? PEOPLE WHO ARE HOMELESS
37% REPORT. THEIR HEALTH IS FAIR
POOR COMPARED TO ABOUT 10% IN
THE GENERAL POPULATION NEXT
LINE. HOMELESS PEOPLE HAVE
HIGHER PREVALENCE OF CHRONIC
DISEASES, WHETHER IT'S HIGH
BLOOD PRESSURE, DIABETES, HEART
PROBLEMS, HIV OR ANY OTHER. THEY
HAVE DISPROPORTIONATE
REPRESENTATION OF THESE
PROBLEMS. NEXT SLIDE.
HOMELESSNESS IS ASSOCIATED WITH
POOR HEALTH OUTCOMES AND OUT IN
ADULTS, WHETHER IT'S THE HIGH
PREVALENCE OF CO OCCURRING
MENTAL HEALTH AND SUBSTANCE USE
DISORDERS WHERE THERE'S A
BIDIRECTIONAL RELATIONSHIP.
THESE PROBLEMS INCREASE THE RISK
OF HOMELESSNESS AND HOMELESSNESS
INCREASES SEVERITY OF THESE
PROBLEMS. HIGH PREVALENCE OF
LIFETIME EXPOSURES TO HEALTH
THREATS LIKE ADVERSE CHILDHOOD
EXPOSURES, EXPOSURE TO RACISM,
POVERTY AND HIGH PREVALENCE OF
EXPOSURES THAT PEOPLE EXPERIENCE
WHILE THEY'RE HOMELESS.
VICTIMIZATION ENVIRONMENTAL
EXPOSURES, INFECTIOUS DISEASES
LIKE COVID. POOR DIET, FOOD
INSECURITY AND LOW ACCESS TO
LONGITUDINAL HEALTHCARE. NEXT
SLIDE. HOMELESSNESS AND CHILDREN
IS COMMON AND MORBID. ONE IN
FOUR PEOPLE IN THIS COUNTRY
EXPERIENCING HOMELESSNESS OR
CHILDREN LIVING WITH THEIR
FAMILIES AND THE MOST COMMON AGE
TO BE HOMELESS IN THIS COUNTRY
IS LESS THAN ONE. HOMELESSNESS
AND CHILDREN HAS BEEN ASSOCIATED
WITH ASTHMA, MENTAL HEALTH
PROBLEMS, POOR SCHOOL OUTCOMES,
INCREASED EMERGENCY DEPARTMENT
VISITS AND HOSPITALIZATIONS AND
HOMELESSNESS IS ASSOCIATED WITH
POOR MATERNAL HEALTH OUTCOMES,
PRETERM BIRTH AND POOR PERINATAL
HEALTH OUTCOMES. NEXT SLIDE. THE
U. S POPULATION IS AGING. ABOUT
HALF OF SINGLE HOMELESS ADULTS
NOW ARE 50 AND OLDER AND WE HAVE
FOUND THAT HOLMES ADULTS IN
THEIR FIFTIES AND SIXTIES HAVE
HEALTH PROBLEMS, MUCH MORE
SIMILAR TO THOSE THAT WE EXPECT
OF ADULTS IN THEIR SEVENTIES AND
EIGHTIES. NEXT SLIDE.
HOMELESSNESS IS ASSOCIATED WITH
VERY HIGH MORTALITY. PEOPLE WHO
ARE HOMELESS AFTER YOU ADJUST
FOR EVERYTHING ELSE HAVE BETWEEN
THREE AND EIGHT TIMES THE RISK
OF DYING AS THOSE WHO ARE
HOUSED. NEXT SLIDE. HOUSING
IMPROVES HEALTH CONDITIONS. WE
KNOW THAT HOUSING PROVIDES
PROTECTION FROM THE ELEMENTS. A
PLACE TO REST LOWERS THE RISK OF
INFECTIOUS DISEASE THAT PROVIDES
A PLACE TO COOK HEALTHY MEALS,
STORE, FOOD AND MEDICINE AND A
STABLE ADDRESS FOR RECEIVING
SERVICES, MAIL AND OTHERS NEXT
SLIDE. EVERYONE CAN BE HOUSED.
EVERYONE NEEDS HOUSING THAT THEY
CAN AFFORD. AND WE HAVE SHOWN
AGAIN AND AGAIN AND AGAIN THAT
SOME PEOPLE NEED SERVICES
WRAPPED AROUND THEM TO KEEP THEM
HOUSE SOME DON'T BUT HOUSING
MUST BE OFFERED ON WHAT WE CALL
A HOUSING FIRST BASIS. THAT
MEANS THAT YOU START THE HOUSING
AND YOU OFFER THE HOUSING
WITHOUT PRECONDITIONS. YOU
PROVIDE THE SERVICES NEEDED TO
ALLOW PEOPLE TO THRIVE AND YOU
DON'T MAKE THE SERVICES
ACCEPTANCE OF THEM A
PRECONDITION OF HOUSING NEXT
SLIDE. AS THEY SAID IN A RECENT
NEW YORK TIMES ARTICLE OF
HOUSTON SUCCESS IN HOUSING SO
MEMBER, MANY MEMBERS OF THE
HOMELESS COMMUNITY WHEN YOU'RE
DROWNING, IT DOESN'T HELP YOU.
IF YOU'RE A RESCUER INSIST YOU
LEARN TO SWIM. BEFORE RETURNING
YOU TO SHORE. WE NEED TO START
WITH THE HOUSING, PROVIDE THE
SERVICES AND ALLOW PEOPLE TO
THRIVE. NEXT LINE. PERMANENT
SUPPORTIVE HOUSING IS THE ANSWER
FOR THOSE WITH CHRONIC
HOMELESSNESS AND BEHAVIORAL
CONDITIONS, SUBSIDIZED HOUSING
WITH VOLUNTARY SUPPORTIVE
SERVICES OFFERED ON HOUSING
FIRST MODEL NEXT SLIDE. WE HAVE
SHOWN THAT PERMANENT SUPPORTIVE
HOUSING KEEPS EVEN THE MOST
BEHAVIOURALLY COMPLICATED PEOPLE
HOUSED IN INCREASES LONG TERM
HOUSING STABILITY FOR THOSE OF
MODERATE AND HIGH SUPPORT NEEDS,
AND WE FOUND THAT WHEN WE
OFFERED PERMANENT SUPPORTIVE
HOUSING TWO VERY BEHAVIOURALLY,
UH IMPAIRED PEOPLE THAT 87% WERE
HOUSED AND ONCE A HOUSE THEY
STAYED HOUSED 93% OF THE FOLLOW
UP PERIOD, WHICH LASTED SEVEN
YEARS DESPITE HAVING VERY SEVERE
IMPAIRMENTS NEXT SLIDE.
PERMANENT SUPPORTIVE HOUSING
IMPROVES SOME MEASURES OF HEALTH
AND HEALTHCARE OUTCOMES HAS BEEN
FOUND TO IMPROVE HIV OUTCOMES,
MEDICATION MANAGEMENT,
PREVENTIVE SCREENINGS AND NON
ACUTE HEALTH SERVICE
UTILIZATION. NEXT SLIDE. HOUSING
IS ABSOLUTELY FOUNDATIONAL TO
GOOD HEALTH, THE LACK OF
AFFORDABLE HIGH QUALITY HOUSING
IS A MAJOR CONTRIBUTOR TO POOR
HEALTH OUTCOMES, HOUSING
INSECURITY. IS DIRECTLY RELATED
TO STRUCTURALLY RACIST POLICIES
THAT PERSIST. HOUSING IS
DIRECTLY ON THE PATHWAY BETWEEN
RACISM AND POOR HEALTH, AND
EVERYONE CAN BE HOUSED IF
PROVIDED AND HOUSING FIRST
BASIS. NEXT SLIDE. SO I STAND
BEFORE YOU AS A PHYSICIAN WHO
SEES PATIENTS AND AS A
RESEARCHER AND AS A FELLOW
CALIFORNIA AND TO SAY THAT THERE
IS NO MEDICINE AS POWERFUL AS
HOUSING. THANK YOU SO MUCH.
THANK YOU SO MUCH, DOCTOR
CRUCIAL FOR THAT. VERY, VERY
INFORMATIVE PRESENTATION. OUR
NEXT SPEAKER IS GOING TO BE MR
OMAR PASSIONS WHO RECENTLY LEFT
MY CITY OF SAN DIEGO FOR A NEW
POSITION. THE DOCTOR, MR OMAR
PASSIONS AS A DEPUTY CITY
MANAGER FOR THE CITY OF SAN JOSE
, WHERE HIS PRIMARY FOCUS AREAS
ARE LEADERSHIP TO PREVENT IT AND
HOMELESSNESS AND ENHANCE THE
QUALITY OF LIFE. FOR ALL SAN
JOSE RESIDENTS PRIOR TO JOINING
THE CITY OF SAN JOSE, MR PASSION
WITH THE FIRST PERSON TO SERVE
AS THE DIRECTOR OF COUNTY OF SAN
DIEGO HEALTH AND HUMAN SERVICES
AGENCIES OFFICE OF HOMELESS
SOLUTIONS. IN THAT CAPACITY, HE
LED A TEAM TO ALIGN CRITICAL
SERVICES AND SUPPORT OFFERED BY
THE COUNTY TO PREVENT AND
HOMELESSNESS. THANK YOU FOR
BEING HERE. THANK YOU, DR WEBBER
. I APPRECIATE IT. UM AND I JUST
WANT TO UNDERSCORE EVEN BEFORE I
GET STARTED. DR KUSHNER
MENTIONED, SHE SAID THAT
EVERYONE CAN BE HOUSED. AND
WHILE I WAS IN SAN DIEGO COUNTY
TO UNDERSCORE THAT POINT, WE
ALSO SAW THAT 85% IN ONE IN ONE
COHORT AND OVER 90% RETENTION
RATE FOR THE PROJECT ONE FOR ALL
PROGRAMS IN SAN DIEGO COUNTY.
THE MOST SICK, THE MOST
BEHAVIORAL COMPROMISED, WHO WERE
ALSO CHRONICALLY HOMELESS. GOT
HOUSED, REMAINED HOUSED. IT IS
IT IS THERE. THERE'S A FALLACY
AS POLICYMAKERS AS YOU'RE DOING
THAT WORK, JUST UNDERSTAND THAT
THAT EVERYONE CAN BE HOUSED. UM
I JUST WANTED TO UNDERLINE THAT
POINT. THE CITY OF SAN JOSE IS
THE 10TH LARGEST CITY IN THE
NATION, THE CAPITAL OF SILICON
VALLEY. AND LIKE MANY LARGE
CITIES, IT'S GRAPPLING WITH A
SUBSTANTIAL CRISIS IN WHICH
THOUSANDS OF PEOPLE ARE
EXPERIENCING. HOMELESSNESS AS WE
TAKE LESSONS FROM BOTH THE
DECEMBER SELECT COMMITTEE THIS
SELECT COMMITTEE SESSION AND THE
COLLEAGUES WHO HAVE SPOKEN HERE
TODAY A KEY MESSAGE THAT DR
WEBBER HAS STRESSED AND
UNDERGRADS EVERYTHING THAT I
WILL SAY HERE TODAY. IS THE
IMPORTANCE OF BEING INTENTIONAL
, INTENTIONAL ABOUT OUR
UNDERSTANDING OF THE SOCIAL
DETERMINANTS OF HEALTH AND THEIR
IMPACT FOR PEOPLE WHO ARE AT
RISK OF OR EXPERIENCING
HOMELESSNESS. NEXT SLIDE,
PLEASE. HOMES AND HOMELESSNESS.
I ALWAYS TRY TO PUT THAT IN
BECAUSE IT'S A FOUNDATIONAL
NOTION THAT SEEMS SIMPLE. AND
YET THERE'S A FAIR AMOUNT OF
CONFUSION ABOUT IT, HOMES AND
HOMELESSNESS AND WE NEED MORE OF
THEM, ESPECIALLY FOR PEOPLE WHO
MAKE LESS THAN 30. OF THE MEDIAN
INCOME THAT'S THE MIDPOINT IN A
COMMUNITY. AFFORDABLE PLACES TO
LIVE OR AN ESSENTIAL PART OF THE
STORY, WITHOUT WHICH THE REST OF
THESE FACTORS CANNOT BE
ADDRESSED, BUT THEY ARE OFTEN
ONLY PART OF THE STORY. THE
SOCIAL DETERMINANTS OF HEALTH.
THE CONDITIONS IN WHICH A PERSON
IS BORN, RAISED LIVES. WORK AND
PLAYS ARE ANOTHER IMPORTANT PART
OF THE STORY HELPING PEOPLE TO
THRIVE. NOT HAVING A HOME,
WHETHER LIVING ON THE STREETS OR
IN A SHELTER, TEMPORARY
ENVIRONMENT CAN LEAD TO AN
EXACERBATE A RANGE OF HEALTH
OUTCOMES. LIVING WITHOUT A
PERMANENT HOME IS STRESSFUL.
WHICH HAS NEGATIVE IMPACTS ON
SLEEP AND WELL BEING, IT CAN
DISRUPT ACCESS TO HEALTH CARE,
MEDICATION, HYGIENE, DENTAL CARE
AND A HOST OF RELATED SERVICES
THAT COMPROMISE A PERSON'S
OVERALL WEALTH. HEALTH. EXCUSE
ME. WE MUST UNDERSTAND THE
SPECIFIC HEALTH CHALLENGES.
THERE ARE THREE WAYS THAT AN
INCREASED FOCUS ON THE WHOLE
PERSON ON THESE OTHER FACTORS
DESCRIBED ABOVE ARE IMPORTANT IN
THE CONTEXT OF HOMELESSNESS.
NEXT SLIDE. IN OUR NEXT CLICK.
THANK YOU. FIRST ADDRESSING THE
SOCIAL DETERMINANTS CAN HELP
SHORTEN APPEAR A PERSON'S
EXPERIENCE OF HOMELESSNESS NEXT
TIME. SECOND PROPERLY FACTORED
INTO SUPPORTING PEOPLE. THESE
OTHER DRIVERS OF HEALTH CAN
REDUCE THE LIKELIHOOD THAT A
PERSON WHO HAS LEFT THE STREET
WILL RETURN AND MASSIVELY
IMPORTANTLY, THIRD, A STRONG
FOCUS ON SOCIAL DETERMINANTS OF
HEALTH CAN PREVENT EXPERIENCES
OF HOMELESSNESS IN THE FIRST
PLACE. TODAY I'LL TAKE THESE IN
TURN. I CAN'T STRESS ENOUGH THAT
THIS NEXT POINT EVERYTHING ELSE
I SAY TODAY IS PREDICATED ON THE
OPPORTUNITY FOR A PERSON TO BE
IN A PERMANENT HOME THAT IS
AFFORDABLE, ESPECIALLY FOR THOSE
WITH EXTREMELY LOW INCOMES. THE
SAFEST, CLEANEST, WARMEST
ENVIRONMENT IN THE WORLD CAN'T
OVERCOME THE CRUSHING WEIGHT OF
UNREASONABLY EXPENSIVE RENTS FOR
PEOPLE WITH MODEST MEANS STILL
RECOGNIZING THE IMPACT OF THE
SOCIAL DETERMINANTS OF HEALTH
AND HOMELESSNESS CAN HAVE
PROFOUND POLICY IMPLICATIONS.
NEXT SLIDE, PLEASE. FIRST I'D
LIKE TO START WITH A QUICK
STORY. NEXT CLICK. I'D LIKE TO
SHARE THE STORY OF THIS
PRESCHOOLER. THIS LITTLE BOY WAS
BORN TO A MOTHER WHO WAS
MENTALLY ILL AND DISABLED. SHE
GREW UP IN THE SEGREGATED SOUTH
AND ENDURED THE EFFECTS OF BOTH
INTERPERSONAL AND THE SYSTEMIC
RACISM WE HEARD ABOUT EARLIER.
SHE WAS THE VICTIM OF VIOLENCE
IN HER HOME AND AT SCHOOL, AND
SHE RECEIVED AN EXTREMELY
LIMITED EDUCATION. WITHIN MONTHS
OF BEING BORN. THIS LITTLE BOY
WAS PLACED IN FOSTER CARE. DUE
TO HIS MOTHER'S LACK OF SUPPORT
AND PARENTING SKILLS. SHE NEEDS
THAT SHE NEEDED TO BE SUCCESSFUL
. HE GREW UP IN A HOME WITH
FOSTER SIBLINGS WHO HAD ENDURED
THEIR OWN FAMILY HORRORS, AND
HIS MOTHER WENT ON TO EXPERIENCE
HOMELESSNESS AT VARIOUS STAGES
OF HER OWN LIFE. HOWEVER HIS
STORY BEGINS TO CHANGE BECAUSE
OF THE VALUE OF THE SOCIAL
DETERMINANTS OF HEALTH. HE
RECEIVED HEALTHCARE FOR SPEECH,
IMPEDIMENTS AND PSYCHOLOGICAL
DEVELOPMENT. HE RECEIVED QUALITY
NUTRITION AND SAFE PLACES TO
PLAY OUTSIDE ACCESS TO
EDUCATIONAL OPPORTUNITIES. AND A
STABLE HOME IN WHICH TO GROW.
THESE VARIOUS FACTORS HEALTH,
NUTRITION, PHYSICAL ACTIVITY,
EDUCATION AND HOUSING ARE THE
SOCIAL DETERMINANTS OF HEALTH
AND ACTION. NOW YOU MAY NOT BE
ABLE TO TELL BECAUSE OF THE
DIFFERENCE IN OUR RESPECTIVE
AMOUNTS OF HAIR. BUT THAT LITTLE
GUY IS ME. I WAS ABLE TO GET A
MASTER'S DEGREE, BECOME A MEMBER
OF THE BAR AND PRACTICE AS AN
ATTORNEY IN THIS STATE AND NOW
WORK TO HELP FIGHT FOR THESE
OPPORTUNITIES FOR OTHERS,
BECAUSE OUR SYSTEM, ESPECIALLY
THE CHILD WELFARE WORKERS IN SAN
DIEGO COUNTY. PAID SERIOUS
ATTENTION TO THE SOCIAL
DETERMINANTS OF HEALTH. NEXT
SLIDE, PLEASE. THE PEOPLE IN MY
SLIDE THE PICTURES. THESE ARE
ACTUAL HUMAN BEINGS AND ACTUAL
STORIES. THESE ARE THESE ARE
ACTUAL LIVES THAT HAVE BEEN
TOUCHED IN THIS CASE WITHIN THE
CITY OF SAN JOSE. M A PROPERLY
FUNCTIONING SYSTEM. CAN MAKE
SURE THAT A PERSON'S EXPERIENCE
ON THE STREET IS A SHORT AS
POSSIBLE. IN ADDITION TO AN
AFFORDABLE HOME, WHICH WE'VE
TALKED ABOUT THIS CAN REQUIRE
CONNECTIONS TO HEALTHCARE FOR
PHYSICAL HEALTH CONDITIONS,
NUTRITIONAL AND SOCIAL SUPPORT.
THE TWO WAY CAUSALITY OF
BEHAVIORAL HEALTH CONDITIONS
WHEN TREATED THAT THEY CAN BOTH
MAKE IT HARDER TO EXIT
HOMELESSNESS AND EXACERBATE THAT
EXPERIENCE OF HOMELESSNESS.
NECESSITATE THE TYPE OF WHOLE
PERSON CARE THAT EMBRACES THE
COMPLEXITY OF THESE SOCIAL
DRIVERS. THE NEED FOR ONGOING
CASE SUPPORT, NOT MERELY ONE
TIME INDIVIDUALIZED FIXES IS
BORN OUT IN THE WORK OF TEAMS OF
PEER SPECIALISTS AND CASEWORKERS
THAT MANY EVIDENCE BASED
PROGRAMS ACROSS THE STATE HAVE
SHOWN MHM HAVE SHOWN MAKE A
DIFFERENCE. THESE TEAMS THAT IN
MANY CASES FOCUS NOT MERELY ON
SICKNESS AND DISEASE, BUT ON
THINGS LIKE SOCIAL ISOLATION AND
REPAIRING FAMILIAR RELATIONSHIPS
IN LINE WITH THE VALUE OF THE
SOCIAL DETERMINANTS. IN ADDITION
TO MAKING HOMELESSNESS BRIEF
ATTENTION ON THE SOCIAL
DETERMINANTS CAN HELP REDUCE
SUBSEQUENT EXPERIENCES. NEXT
SLIDE, PLEASE. NOT ONLY DO WE
WANT EXPERIENCES OF HOMELESSNESS
TO BE AS SHORT AS POSSIBLE, WE
WANT THEM TO BE LIMITED. ONCE A
PERSON GETS A HOME WE MUST DO
AND PROPERLY RESOURCED THE
THINGS NECESSARY TO SMOOTH THAT
TRANSITION. IN THE LIVING FULL
TIME IN A HOME AGAIN. THIS IS
BEST DESCRIBED IN A STORY. I
ONCE HAD A MEMBER OF OUR TEAM,
WONDERFUL DRIVEN GUY, FORMER
SERVICE MEMBER. HE WAS ALSO
OPENLY IN RECOVERY FROM
SUBSTANCE USE HIMSELF HE HAD
EXPERIENCED HOMELESSNESS. AND
HAD BEEN PREVIOUSLY INVOLVED
WITH THE JUSTICE SYSTEM WILL
CALL HIM RON RON HAD HAD PIVOTED
HIS LIFE AND BY THE TIME WE MET
, HE WAS WORKING ON A SORT OF
DAY TO DAY BASIS TO PROVIDE
OUTREACH HOUSING NAVIGATION TO
THOSE IN NEED. WE WERE DOING A
SORT OF STRATEGY SESSION WITH
THE TEAM AND GOING THROUGH WHAT
FOLKS NEEDED TO GET HOUSED AND
WHAT KIND OF SUPPORT HE NEEDED
AS A AS A HOUSING NAVIGATOR. AND
SAYS. SO WHAT'S THE BIGGEST
THING FROM YOUR PERSPECTIVE
AROUND KIND OF LEANED BACK IN
HIS CHAIR AND KIND OF LIKE
RUBBED HIS CHIN A LITTLE BIT.
AND HE LOOKED AT ME AND HE SAID,
WE GOTTA FOCUS ON THE WHAT COMES
NEXT. YOU KNOW, YOU KNOW, I KIND
OF JUST CHARCOAL THAT SOMEONE
YOU KNOW WHAT DO YOU MEAN BY
THAT? AND HE SAID, YOU KNOW, I
CAN GET SOMEBODY HOUSE AND HE
WAS ACTUALLY IT WAS VERY GOOD AT
GETTING PEOPLE HOUSED. BUT HE
STRESSED THE POINT THAT THE
RESOURCES FOR WHAT COMES NEXT.
THE SUPPORT ONCE YOU'RE IN
THERE, THEY'RE SORT OF
ADJUSTMENTS FOR THOSE WHO NEED
IT TO LIVING IN THAT HOME. THE
OPPORTUNITIES FOLKS THINK THAT
JUST BECAUSE SOMEBODY
EXPERIENCES HOMELESSNESS ONCE
THEY'RE IN A HOME A LOT OF TIMES
I'VE HAD PEOPLE SAY I'M READY TO
NOW. THINK ABOUT WORK. I'M READY
TO THINK ABOUT WHAT MIGHT BE
NEXT IN MY LIFE RIGHT?
HOMELESSNESS IS AN EXPERIENCE.
IT'S NOT A PERSONAL ATTRIBUTES,
AND SO GETTING OUT OF THAT
HOMELESSNESS CAN REALLY THAT
PART OF WHAT HE SAID THAT WHAT
COMES NEXT IS REALLY, REALLY
IMPORTANT. OKAY, NEXT SLIDE. AND
THEN LASTLY, I CAN'T STRESS THIS
THIS PIECE ENOUGH, RIGHT? THE
PREVENTION BEFORE IT HAPPENS.
JUST LAST WEEK, L A TIMES
REPORTER EMILY ALPERT RAISE
PUBLISHED A STORY ABOUT THE
POWERFUL PREVENTION AND
PREDICTIVE WORK BEING DONE. IN
COLLABORATION BETWEEN LA COUNTY
AND THE CALIFORNIA POLICY LAB AT
U. C L. A THE ARTICLE PROVIDED
IMPORTANT DETAILS ABOUT WHAT
HELPED PREVENT THE EXPERIENCES
OF HOMELESSNESS AND HOW THAT
SYSTEM WAS WORKING. THAT NOTION
OF PREVENTION BEFORE IT HAPPENS
. WE HAVE TALKED ABOUT
SHORTENING EXPERIENCES. UM BUT
THE MOST POWERFUL OPPORTUNITY IS
TO STOP THAT TRAUMA FROM EVER
HAPPENING IN THE FIRST PLACE. UM
AS A REMINDER REMAINS TRUE THAT
THE ONLY THING THAT ENDS
HOMELESSNESS IS A PERMANENT
HOME. WE KNOW THAT THE ECONOMIC
WARNING SIGNALS LIKE
DIFFICULTIES WITH UTILITIES OR
LANDLORD. DISPUTES OVER RENT CAN
BE HUGE, AND IF CAUGHT AND
MANAGED EARLY, THE FALLOUT DOES
NOT HAVE TO LEAD TO
HOMELESSNESS. ONE STUDY FROM
SANTIAGO STATE UNIVERSITY'S
SOCIAL AND ECONOMIC
VULNERABILITY INDEX REVEALED
THAT 62% OF PEOPLE WHO RECEIVED
THAT UTILITY ASSISTANCE WHEN
THEY NEEDED SUPPORT, UH REPORTED
THAT THAT THAT HELPED THEM
ENABLE THEM TO REMAIN IN THEIR
HOMES. STUDIES ON SHALLOW RENT
SUBSIDIES, SUBSIDIES OF PARTIAL
PAYMENT OF RENT, AS WELL AS
UNIVERSAL BASIC INCOME EFFORTS
ACROSS THE GLOBE AND ACROSS THE
COUNTRY HAVE DEMONSTRATED THE
IMPORTANT ROLE THAT ECONOMIC
STABILITY PLAYS IN A PERSON'S
OVERALL HEALTH. AND ABILITY TO
AVOID HOMELESSNESS ALTOGETHER,
PREVENTING FAMILY AND INTIMATE
PARTNER. VIOLENCE CAN DECREASE
ADVERSE CHILDHOOD EXPERIENCES.
IT CAN REDUCE DESTABILIZING
TRAUMA AND EVEN STOP WOULD BE
SURVIVORS AND THEIR CHILDREN
FROM EXPERIENCING HOMELESSNESS.
ADEQUATE AS NOTED BEFORE
ADEQUATELY FUNDING AND ENFORCING
ANTI DISCRIMINATION LAWS IS A
POWERFUL TOOL. NEXT SLIDE,
PLEASE. HAVING ACKNOWLEDGED
THESE, THESE, UM CHEE DRIVERS
THAT REALLY IMPACT A PERSON'S
HEALTH AND WHY THEY ARE
IMPORTANT FOR CONSIDERING
PREVENTING AND LIMITING
HOMELESSNESS. IT'S ALSO
IMPORTANT TO NOTE WHAT WORKS SO
THAT AS POLICYMAKERS ARE ABLE TO
SAY, WHAT DOES ENHANCED FOCUS
ACTUALLY MEAN IN PRACTICE? I'D
LIKE TO TURN TO A COUPLE OF
CONCRETE EXAMPLES. FROM THE CITY
OF SAN JOSE IN SANTA CLARA
COUNTY. THE CITY OF SAN JOSE
PASSED MEASURE E. A LOCAL SALES
TAX MEASURE TO FUND HOUSING AND
SERVICES, INCLUDING PREVENTION
FOR PEOPLE AT RISK OF ARE
EXPERIENCING HOMELESSNESS. END.
THE MAYOR AND COUNCIL ADOPTED A
REQUIREMENT TO USE 45% OF THOSE
RESOURCES FOR EXTREMELY LOW
INCOME RESIDENTS. THOSE ARE THE
ONES THAT MAKE 30% OR BELOW THAT
AREA MEDIAN OR MIDPOINT, AECOM
THE MOST THAT ARE HARDEST TO
HOUSE. THE ONES THAT DR CRUCIAL
REPORTED ONLY 23 UNITS FOR EVERY
100 THAT WE NEED IN THE STATE.
UM THOSE ARE THE ONES THAT ARE
SUBSTANTIALLY HARMED BY THE LACK
OF ATTENTION ON THE SOCIAL
DETERMINANTS OF HEALTH. NEXT
SLIDE, PLEASE. THE CITY OF SAN
JOSE HAS ADOPTED A STANCE TO
SUPPORT POLICIES THAT ELIMINATE
INSTITUTIONAL AND STRUCTURAL
RACISM THAT LEAD TO THE TYPE OF
DISPROPORTIONALITY FACED BY
BLACK, INDIGENOUS LATIN X AND
PEOPLE OF COLOR IN HOMELESSNESS.
FOR EXAMPLE, AND THAT NOTION OF
DISPROPORTIONALITY BLACK PEOPLE
ARE ONLY 6.5% OF CALIFORNIA'S
POPULATION BUT MAKE UP ALMOST
40% OF THE HOMELESS POPULATION.
THIS IS ROOTED IN RACIAL
DISCRIMINATION IN HOUSING,
LIMITED ECONOMIC AND WEALTH,
BUILDING OPPORTUNITIES AND
SEGREGATED LIVING ENVIRONMENTS.
NEXT SLIDE, PLEASE. AND FINALLY
IN THE NOTION OF INTENTIONALITY
AND OUR ACTIONS, RECOGNIZING THE
ESSENTIAL ROLE OF REGIONAL
PARTNERS, THE CITY OF SAN JOSE
HAS FORGED, DIRECT AND
INTENTIONAL COLLABORATION WITH
THE CITY OF SAN JOSE. NEXT
CLICK, YOU CAN CLICK THROUGH
THESE AND THE COUNTY OFFICE OF
SUPPORTIVE HOUSING THE IN THE
COMMUNITY WITH DESTINATION HOME
, A BACKBONE AGENCY, THE SANTA
CLARA COUNTY HOUSING AUTHORITY
AND IMPORTANTLY PEOPLE WITH
LIVED EXPERIENCE OF
HOMELESSNESS. FOR ALL OF OUR
POLICY WORK UP AND DOWN THE
STATE IN THE COMMUNITIES IT IS.
ABSOLUTELY ESSENTIAL THAT PEOPLE
WHO HAVE EXPERIENCED
HOMELESSNESS ARE AT THE TABLE,
NOT AS A CURSORY AFTERTHOUGHT,
BUT AT THE PLANNING STAGES WITH
DECISION MAKING AUTHORITY. NEXT
SLIDE, PLEASE. AND THEN ONE
EXAMPLE TO BRING THAT HOME IS
WHAT IS ACTUALLY HAPPENED. BY
PUTTING PEOPLE WITH LIVED
EXPERIENCE IN POSITION TO MAKE
DECISIONS BY HAVING REGIONALLY
COORDINATED EFFORTS. IN SENATE
CLARA COUNTY, THEY HAVE
PERMANENTLY HOUSED THOUSANDS OF
RESIDENTS WHO EXPERIENCED
HOMELESSNESS AND HAS KEPT THEM
THERE INCREASED TEMPORARY
HOUSING AND SHELTER FOCUSING ON
INDIVIDUALIZED OR NON CONGREGATE
SETTINGS THAT HELP GIVE PEOPLE
THE PEACE AND SECURITY THEY
NEED. EVEN WHILE AWAITING A
PERMANENT HOME AND ESTABLISHED A
REGION WIDE HOMELESSNESS
PREVENTION SYSTEM THAT CONTINUES
TO DECREASE THE RATE OF NEW
HOMELESSNESS. IT IS VITAL FOR
POLICYMAKERS TO UNDERSTAND. THAT
HOW MANY PEOPLE YOU GET INTO
HOMES IS IMPORTANT. AND TO MAKE
SUSTAINED PROGRESS. YOU MUST
ALSO PLACE ATTENTION AT THE MOST
COST, EFFECTIVE AND LEAST
TRAUMATIC STAGE ON PREVENTION
BEFORE A PERSON EXPERIENCES
HOMELESSNESS NEXT SLIDE, PLEASE.
FINALLY I THINK ONE OTHER
IMPORTANT POINT. IN ADDITION TO
A REGIONAL EFFORT AROUND LIVED
EXPERTISE, THE CITY OF SAN JOSE
HAS ACTUALLY CREATED AND
ESTABLISHED THE POSITION FOR A
DECISION MAKER ON THE HOUSING
AND COMMUNITY DEVELOPMENT
COMMISSION. WHO IS A PERSON WHO
HAS EXPERIENCED HOMELESSNESS SO
THAT THAT VITAL UM, DECISION
MAKING LENS IS PRESENT FOR
IMPORTANT DECISIONS NEXT SLIDE.
AND THIS IS WHERE I'LL END. THIS
IS A QUOTE FROM DR KING. I HAVE
THE AUDACITY TO BELIEVE THAT
PEOPLES EVERYWHERE CAN HAVE
THREE MEALS A DAY FOR THEIR
BODIES, EDUCATION AND CULTURE
FOR THEIR MINDS AND DIGNITY,
EQUALITY AND FREEDOM FOR THEIR
SPIRITS. THOSE ARE THE SOCIAL
DETERMINANTS OF HEALTH. PEOPLES
EVERYWHERE IS EQUITY AND THREE
MEALS A DAY IS NUTRITION AND
EDUCATION AND CULTURE IS ACCESS.
AS THE SLIDES DEMONSTRATE, OUR
STATE FACES A HOMELESSNESS
CRISIS. THAT CRISIS IS ROOTED IN
THE LEGACY OF RACIAL
DISSEMINATION AND DISCRIMINATION
AND SOCIAL EXCLUSION, AND IT'S
FUELED BY AN EXTREME LACK OF
AFFORDABLE HOMES. AND AS THIS
SELECT COMMITTEE HAS
DEMONSTRATED, THERE IS
SIGNIFICANT VALUE IN BEING
INTENTIONAL ABOUT THE ROLE OF
THE SOCIAL DETERMINANTS OF
HEALTH. THANK YOU
ASSEMBLYMEMBER'S WEBER FOR YOUR
LEADERSHIP AND COMMITMENT TO
LIFTING UP THESE HEALTH SPECIFIC
ASPECTS OF HOMELESSNESS AND
DEMANDING THAT WE ALL BE
INTENTIONAL IN ADDRESSING THEM
AS WE SEEK TO HELP. EVERY
RESIDENT, LEAD A LIFE OF DIGNITY
AND MEET THEIR BASIC HUMAN
NEEDS. THANK YOU. THANK YOU SO
MUCH, MR PASSION. I THINK I'M
GONNA USE THAT QUOTE IN THE
FUTURE. SO THANK YOU FOR THAT.
UM. SO OUR FINAL SPEAKER AS OUR
FINAL SPEAKER REPAIRS TO COME UP
. I WANT TO REMIND THOSE WHO ARE
WATCHING OR LISTENING THAT
MEMBERS OF THE PUBLIC MAY BEGIN
QUEUING IN ON THE PHONE LINES AS
YOU MOVE INTO OUR FINAL
PRESENTATION. IF YOU HAVE
QUESTIONS THE PUBLIC TOLL FREE
NUMBER IS 87769. AND THE ACCESS
CODE IS 131. 5127 YOU WILL HAVE
A MINUTE AND A HALF FOR 90
SECONDS FOR YOUR COMMENT. SO WE
ARE NOW GOING TO MOVE TO OUR
FINAL SPEAKER. OUR FINAL SPEAKER
IS DEBBIE. FOR ICAL ORACLE.
THANK YOU. SHE'S EXECUTIVE
DIRECTOR FOR HABITAT FOR
HUMANITY, CALIFORNIA. DEBBIE'S
PASSION FOR HOUSING AND
COMMUNITY DEVELOPMENT WAS FIRST
IGNITED BY VOLUNTEERING FOR
HABITAT FOR HUMANITY IN ETHIOPIA
IN 2000 AND TWO PRIOR TO
BECOMING HABITAT FOR HUMANITY IS
CALIFORNIA'S FIRST EXECUTIVE
DIRECTOR IN 2018 SEARCH FOR 10
YEARS AS THE EXECUTIVE DIRECTOR
WITH NEVADA COUNTY. CALIFORNIA
HABITAT FOR HUMANITY. DEBBIE
WORKS CLOSELY WITH THE CEO
NETWORK OF HABITAT AFFILIATES
THROUGHOUT CALIFORNIA ADVOCATING
FOR HOMEOWNERSHIP, AFFORDABILITY
AND HOUSING JUSTICE BY GROWING
THEIR CAPACITY SERVING LOW LOWER
INCOME HOUSEHOLDS THROUGH
AFFORDABLE HOME PRODUCTION,
PRESERVATION AND LENDING. THANK
YOU FOR BEING HERE TODAY. THANK
YOU. GOOD AFTERNOON, AND THANK
YOU SO MUCH FOR INVITING ME TO
SHARE TODAY. I APPRECIATE BEING
HERE, DOCTOR WEBER, AND I'M SO
ENCOURAGED BY THE CONVERSATIN.
I WOULD JUST LIKE TO START BY
EMPHASIZING THAT AFFORDABLE HOME
OWNERSHIP PROMOTES HEALTHY LIVES
AND HABITAT. CALIFORNIA IS A
COALITION OF HABITAT AFFILIATES
AND LOCAL COMMUNITY STATEWIDE.
AND WE HAVE HAD THE PRIVILEGE
AND THE OPPORTUNITY TO WORK IN
LOWER INCOME COMMUNITIES WORK
DIRECTLY WITH WITH HOUSEHOLDS TO
PROVIDE AFFORDABLE HOMEOWNERSHIP
AND BE ABLE TO PROVIDE HOME
PRESERVATION, CRITICAL REPAIRS
WITH LOWER INCOME FAMILIES. AND
AS BEING ABLE TO COLLECT
EVIDENCE BASED DATA SPECIFICALLY
IN CALIFORNIA, AS WELL AS ACROSS
THE US THAT REALLY ILLUSTRATE
HOW A SAFE, AFFORDABLE HOME
BENEFITS, DIRECT HEALTH OUTCOMES
. AND IF WE WANT TO PRIORITIZE
HEALTH, THEN WE MUST ALSO
PRIORITIZE AFFORDABLE
HOMEOWNERSHIP. SO I JUST WANTED
TO HIGHLIGHT A FEW OF THE
HOUSING IMPACTS ON HEALTH. I
KNOW WE'VE HEARD A LOT AND I
WHOLEHEARTEDLY AGREE WITH
EVERYTHING THAT HAS BEEN STATED
THE SOCIAL DETERMINANTS OF
HEALTH ENCOMPASS
COMPREHENSIVELY. HOW WERE BORN
HOW WE GROW, HOW WE LIVE, WORK
AND AGE AND POOR HOUSING
CONDITIONS AND THE LACK OF
AFFORDABLE HOUSING DIRECTLY. ARE
ASSOCIATED WITH NEGATIVE HEALTH
OUTCOMES. IF WE FLIP THAT TO
HAVE BETTER HOUSING CONDITIONS
AND AFFORDABLE HOUSING, THEN AS
YOU WOULD GUESS WE GET BETTER
HEALTH, POSITIVE OUTCOMES. THE
PHYSICAL ENVIRONMENT, INCLUDING
STABLE AND AFFORDABLE HOUSING IS
RECOGNIZED BY THE CDC AND OTHER
HEALTH ORGANIZATIONS AND
RESEARCHES RESEARCHERS AS
CRITICAL TO BE ABLE TO IMPROVE
HEALTH AND REDUCING HEALTH
DISPARITIES. DURING THE PANDEMIC
. UM IT WAS EXPOSED EVEN MORE.
THE WEALTH AND THE HEALTH
DISPARITIES ACROSS RACE AND
ETHNICITY AND, UNFORTUNATELY,
LOWER INCOME AND COMMUNITIES OF
COLOR. TEND TO RESIDE IN PLACES
WITH MORE HEALTH RISKS. THERE'S
GREATER EXPOSURE TO HEALTH
HAZARDS WITHIN THE HOME AND IN
THE COMMUNITY. SO I WANTED TO
CONNECT HOUSING AFFORDABILITY
WITH HOW WITH HEALTH OUTCOMES
AND SPECIFICALLY TALK ABOUT
HOUSING. COST BURDEN. UM 30 PING
30% OR MORE FOR LIVING EXPENSES
IS CONSIDERED HOUSE BURDENED,
PAYING 50% OR MORE IS CONSIDERED
SEVERELY HOUSE BURDENED AND IF
WE DO A COMPARISON BETWEEN
RENTAL AND HOME OWNERSHIP AND
IT'S ILLUSTRATED HERE. IT'S MORE
AFFORDABLE AT ALMOST EVERY
INCOME LEVEL TO ACTUALLY BE A
HOMEOWNER OVER 50% OF RENTERS IN
CALIFORNIA, MRS CALIFORNIA
SPECIFIC OVER 50% OF CALIFORNIA
RENTERS. ARE SEVERELY OR
MODERATELY HOUSE BURDEN, WHEREAS
IN CONTRAST FOR HOMEOWNERS ONLY
30% ARE COST BURDEN AND EVEN AT
THE VERY, VERY LOW, EXTREMELY
LOW INCOME LEVELS OF 25 $1000 A
YEAR. HOMEOWNERS ARE BETTER OFF
AND SO LOOKING AT THIS HOME
OWNERSHIP ACTUALLY HELPS RELIEVE
THE COST BURDEN. BY BEING COST
BURDEN. OBVIOUSLY HOUSEHOLDS ARE
NOT ABLE TO INVEST IN HEALTH
CARE NOT ABLE TO INVEST IN
OTHER, UM HEALTHY FOOD AND
HOUSEHOLDS THAT ARE SEVERELY
COST BURDEN DEVOTE 57% LESS IN
HEALTH CARE EXPENSES AND
APPROXIMATELY 21% OF CHILDHOOD
ASTHMA CASES ARE DUE TO EXPOSURE
, INDOOR MOISTURE AND MOLD AND
CHILDREN IN HOUSEHOLDS WITH
LOWER INCOMES SUFFER FROM AS
ASTHMA TWICE THE RATE OF
HOUSEHOLDS IN HIGHER INCOMES.
HOUSEHOLDS WITH LOWER INCOMES
TEND TO OWN OLDER HOMES, AND
THEY TEND TO HAVE POOR
CONDITIONS WITHIN THE HOME AND
EXTERNALLY IN THE COMMUNITY AS
WELL. SO TO SUMMARIZE HEALTHY
HOUSING EQUALS HEALTHY
HOUSEHOLDS AND THE THREE KEY
FACTORS HAVING STABILITY AND
AFFORDABLE HOUSING. WE KNOW THAT
LOWER INCOME FAMILIES,
HOUSEHOLDS TEND TO MOVE MORE
BECAUSE THEY FACE EVICTIONS.
THEY FACE FORECLOSURES. THEY'RE
CONSTANTLY LOOKING FOR MORE
AFFORDABLE RENT, AND THIS
NEGATIVELY IMPACTS MENTAL HEALTH
AS WELL. CHILDREN WHO EXPERIENCE
MULTIPLE MOVES THREE OR MORE
TIMES A YEAR OR MORE LIKELY TO
REPORT MODERATE AND SEVERE
CHRONIC CONDITIONS THAN CHILDREN
WHO HAVE NEVER MOVED. AND
HOUSING FREE OF PHYSICAL HAZARDS
. THE SAFETY OF A HOME THE
PHYSICAL IMPROVEMENTS OF THE
HOME LEAD TO POSITIVE HEALTH
OUTCOMES, AND IT REDUCED REDUCES
EXPOSURE TO TOXINS AND THEN ALSO
HAVING THE COMFORT OF THE HOME
CAN CAN INCREASE THE MENTAL
HEALTH AS WELL AS THE ABILITY TO
STAY MOBILE IN A HOME. AND THEN
THE NEIGHBORHOODS HAVE A DIRECT
IMPACT ON THE HEALTH OUTCOMES AS
WELL. HOMES THAT ARE IN AREAS
THAT HAVE ACCESS TO HEALTHY FOOD
AS WELL AS RACIAL RECREATIONAL
ACTIVITIES HAVE DECREASED
HEALTHCARE COSTS AND IMPROVED
HEALTH OUTCOMES. HOWEVER WE
STILL HAVE AN ENORMOUS RACIAL
BARRIERS, SO THE FACT THAT BASED
ON RACE AND ETHNICITY THERE ARE
BARRIERS TO BEING ABLE TO ACCESS
THIS, WE NEED TO BE ABLE TO
ADDRESS EQUALITY FOR HOUSING AS
WELL. NEXT SLIDE, PLEASE.
IMPROVING HOUSING QUALITY
IMPROVES GENERAL HEALTH STATUS
IN SPECIFICALLY IF YOU HAVE SAFE
, AFFORDABLE, STABLE HOUSING IF
THE HOME IS SAFE, AND IF YOU'RE
IN A POSITIVE, HEALTHY COMMUNITY
LOCATION THEN THERE ARE 18%
FEWER EMERGENCY ROOM VISITS AND
THERE ARE 20% INCREASED GENERAL
HEALTH VISITS REVENTATIVE CARE
. AND THEN FINALLY, THERE'S ALSO
$580 SAVINGS ANNUALLY IN
MEDICAID EXPENSES FOR THESE
HOUSEHOLDS. PLACE BASED BARRIERS
TO IMPROVING RACIAL DISPARITIES
IN HEALTH ARE CRITICAL TO
CLOSING THE GAP AND INCREASING
EQUITY. BLACK AND LATIN X
POPULATIONS ARE TWICE AS LIKELY
TO LIVE IN SUBSTANDARD HOUSING.
THAN WHITE POPULATIONS. BLACK
HOUSEHOLDS WITH LOWER INCOMES
LIVING MORE ENVIRONMENTALLY
HAZARDOUS NEIGHBORHOODS WITH UP
TO 3.3 TIMES THE AVERAGE TOXIC
CONCENTRATIONS OF THE AVERAGE
ALL WHITE NEIGHBORHOOD. AND
ACCESS TO SUPERMARKETS FOR BLACK
HOUSEHOLDS INCREASES CONSUMPTION
OF FRUIT AND VEGETABLES BY
ALMOST A THIRD, AND IN
COMPARISON IT IT ONLY HELPS 11%
FOR WHITE HOUSEHOLDS. HOWEVER
BLACK NEIGHBORHOODS HAVE ONLY A
THIRD TO ONE HALF OF THE NUMBER
OF SUPERMARKETS OF WHITE
NEIGHBORHOODS OF COMPARABLE
SOCIO ECONOMIC STATUS. SO ON A
POSITIVE NOTE. THERE ARE
SOLUTIONS AND I WANTED TO
HIGHLIGHT HOW HABITAT RESPONSE
HABITAT RESPONDS BY BUILDING AND
PRESERVING, AFFORDABLE OWNER
OCCUPIED HOMES. WE FOCUS ON
INCREASING ECUADOR ACCESS. T
AFFORDABLE HOME OWNERSHIP AND
ADDRESSING HOUSING DISPARITIES.
HABITAT, CALIFORNIA PROVIDES
AFFORDABLE HOME CONSTRUCTION.
WE'RE VERY COMMITTED TO
INCREASING THE SUPPLY AND
PRODUCTION. IT NEEDS TO EXIST IF
WE'RE GOING TO GET HEALTHIER,
AND WE'RE GOING TO MAKE ACCESS
AVAILABLE TO ALL CALIFORNIANS.
80% OF HABITAT. HOMEOWNERS ARE
BLACK, INDIGENOUS AND PEOPLE OF
COLOR AND WE SERVE UP TO 80% AM
I IT'S LOW AND VERY LOW INCOME
HOUSEHOLDS. WE INCLUDE RURAL AND
URBAN AREAS AND HABITAT BUILDS
MULTI FAMILY AS WELL AS SINGLE
FAMILY OWNERSHIP, HOUSING AND
OUR HOUSEHOLDS INCLUDE VETERANS
, OLDER ADULTS AND FAMILIES WITH
CHILDREN. AND I WANTED TO
MENTION CAL HOME BECAUSE CAL
HOME IS THE ONLY CALIFORNIA
STATE PROGRAM THAT HAS ANY
FUNDING THAT HELPS ACTUALLY
PRODUCE AFFORDABLE HOMES TO OWN
AND THAT FUNDING RUNS OUT THIS
YEAR. SO HABITAT IS ADVOCATING
STRONGLY THAT TO STATE BUDGET
INCLUDE FUNDING FOR CAL HOME AND
WE APPRECIATE THAT THE
COLLECTIVE LEGISLATIVE
PRIORITIES INCLUDE FUNDING FOR
CAL HOME. IN ANOTHER EXAMPLE OF
HABITAT RESPONDING IS WITH
CRITICAL REPAIRS AND BY
SOMETIMES A VERY SMALL
INVESTMENT. IT CAN BE THE
DIFFERENCE IN A FAMILY OR OLDER
ADULT FAMILY BEING ABLE TO KEEP
THEIR HOME. SO THAT THEY CAN AGE
IN PLACE AND OR PROVIDE AN ASSET
TO THEIR FAMILY FOR GENERATIONAL
WEALTH BUILDING DUE TO POOR
HEALTH AND DIS REPAIRS, MANY
FAMILIES AND ESPECIALLY LOWER
INCOME FAMILIES AND FAMILIES OF
COLOR END UP LOSING THEIR HOMES.
NEXT SLIDE, SO REAL LIFE LOCAL
EXAMPLE. THIS IS IVY AND SHE
LIVES IN OAK PARK HERE IN
SACRAMENTO, AND SHE HAS AN OLDER
ADULT ON A FIXED INCOME AND
SHE'S A CANCER SURVIVOR. SHE WAS
IN NEED OF CRITICAL REPAIRS,
INCLUDING A ROOF AND INCLUDING
AIR CONDITIONING, AND SHE WAS
ABLE TO WORK WITH HABITAT FOR
HUMANITY. SACRAMENTO TO HELP
MAKE THIS HAPPEN, AND IN HER OWN
WORDS, SHE SAYS. IT'S BEEN A
REALLY HARD YEAR. MY NIECE THAT
I HELPED RAISE DIED OF COVID AND
ALL THIS HAPPENED WHILE I WAS
GOING THROUGH CANCER. IF THE AIR
CONDITIONER WOULD HAVE FAILED
DURING THAT TIME, I THINK I
WOULD HAVE HAD A NERVOUS
BREAKDOWN. I COULD NEVER AFFORD
TO DO THE REPAIRS MYSELF AND I
DIDN'T KNOW WHAT I WAS GOING TO
DO. I WAS BALLED UP IN A CHAIR
FROM CHEMO AND EVERY REPAIR YOU
DID FELT LIKE YOU WERE TAKING
£1000 OFF ME. THE REPAIRS. HELP
ME FIGHT CANCER AND THEY HELPED
ME SURVIVE. AND THIS IS ONE
EXAMPLE OF HOW THESE CRITICAL
REPAIRS CAN REALLY HAVE A DIRECT
IMPACT. NEXT SLIDE, PLEASE.
ANOTHER EXAMPLE AT ANOTHER LOCAL
IN SACRAMENTO. AND JUST TO
REITERATE THESE EXAMPLES ARE
HAPPENING ALL OVER CALIFORNIA
AND DIFFERENT COMMUNITIES. THIS
IS THE LOW SICK FAMILY. THEY'RE
HARDWORKING FAMILY FROM UKRAINE
AND MOTHER AND FATHER BOTH WORK
AND THEY HAVE TWO YOUNG CHILDREN
, AGES FIVE AND THREE. THEY
LIVED IN A VERY OVERCROWDED
APARTMENT FOR YEARS WITH MOLD
AND MILDEW. AND DURING THE
PANDEMIC, THE ESPECIALLY HAD TO
ISOLATE IN PLACE AND THEIR SON
JUSTIN, WHO'S FIVE YEARS OLD,
REALLY SUFFERED FROM RESPIRATORY
PROBLEMS AND HAD MANY MANY
VISITS TO THE HOSPITAL AND FAST
FORWARD. THEY THEN APPLIED FOR
HABITAT HOME OWNERSHIP, AND THEY
QUALIFIED AND IN THE SUMMER OF
2021. THEY PURCHASED AND MOVED
INTO THEIR BRAND NEW HOME AND IN
INA'S WORDS, SHE SAID. HABITAT
HAS PROVIDED PHYSICAL AND MENTAL
HEALTH BENEFITS. MY SON IS NO
LONGER HAVING RESPIRATORY ISSUES
FROM THE MOLDY APARTMENT, AND
THIS PROVIDES US AN EQUITY
BUILDING OPPORTUNITY THROUGH
OWNERSHIP. IT'S SAFE AND IT'S
DECENT HOUSING. AND SHE AND HER
HUSBAND SAID THAT THEY NOW NO
LONGER HAVE THE STRESS THAT THEY
HAD FEELING LIKE THEY COULDN'T
PROVIDE FOR THEIR CHILDREN. SO
THESE ARE SOME SELF REPORTED
DATA. WE HAVE THE BENEFIT OF
BEING ABLE TO STAY CONNECTED
WITH OUR HOMEOWNERS WITH HABITAT
FOR HUMANITY, AND WE SURVEYED
ALL OF THEM AND COLLECTIVELY
THROUGHOUT CALIFORNIA SINCE
BUYING THEIR HABITAT HOMES. 89%
HAVE INDICATED THAT THEY HAVE
MORE SPACE FOR THEIR FAMILY.
IT'S NOT OVERCROWDED 84% ARE
ABLE TO STAY IN THE REGION. LONG
TERM. THEY DON'T HAVE THAT
INSTABILITY ANYMORE. THEY WERE
ACTUALLY ABLE TO REDUCE THEIR
HOUSING COSTS 84% OF THEM. THEN
80% ARE ABLE TO INCREASE THEIR
SAVINGS, WHETHER IT BE FOR
EDUCATION OR HEALTHCARE COSTS
AND 70% INDICATE THAT THEY CAN
CREATE BETTER EDUCATIONAL
OPPORTUNITIES. WE KNOW THAT IT
WORKS TO TRACK RECORD, BUT
HAVING THE DATA TO DEMONSTRATE
IT IS COMPELLING, EVEN MORE
COMPELLING THAN WE HAD IMAGINED
THAT IT MIGHT BE A COUPLE OF
OTHER COMMENTS. I WON'T GO
THROUGH ALL OF THESE, BUT SOME
OF THE CHANGES AND BECOMING A
HOMEOWNER, A FRESNO HOMEOWNER
SAID THAT BEING ABLE TO USE
GARDENING AND HIS OWN BACKSPACE
FOR THERAPY DUE TO PTSD. HAS
BEEN A HUGE IMPACT FOR HIM, SAN
DIEGO HOMEOWNER SAID. THE
FEELING OF SECURITY ONCE WE
LIVED IN A ROOM AND A HALF
BETWEEN SIX OF US AND TO BE ABLE
TO HAVE MY CHILDREN PLAY OUTSIDE
AND HAVE THEIR OWN ROOM AND LIVE
IN A COMMUNITY HAS BEEN
SUPPORTIVE. MY HOUSE HAS BECOME
A HOME TO THOSE WHO VISIT. AND
THEN IN ORANGE COUNTY. MY
CHILDREN'S BEHAVIOR IMPROVED. MY
SON HAS 80 HD AND IT HAS BEEN
VERY BENEFICIAL FOR HIM JUST
HAVING SPACE TO COOL OFF AND
CALM DOWN. SO IN WRAPPING UP I
WANTED TO HIGHLIGHT A COUPLE OF
THE CREATIVE PARTNERSHIPS THAT
HEPATITIS INVOLVED IN THESE
HAPPEN TO BE LOCAL. BUT WE
REALLY HAVE RECOGNIZED THAT THAT
THE PRIVATE PUBLIC PARTNERSHIP
IS HOW WE CAN ALL GET THROUGH
THIS TOGETHER AND BE ABLE TO
PROVIDE MORE OPPORTUNITIES. THIS
EXAMPLE IS CALLED THE
CORNERSTONE COMMUNITY, AND IT'S
A COLLABORATIVE WITH WITH
SACRAMENTO COUNTY MUTUAL HOUSING
AND THE SACRAMENTO HOUSING
REDEVELOPMENT AGENCY AND
SACRAMENTO HABITAT FOR HUMANITY
, AND THIS COMMUNITY WILL HOUSE
OVER 400 INDIVIDUALS AND IT'S A
COMBINATION OF OWNER OCCUPIED
HABITAT HOMES AND 108 MULTI
FAMILY RENTAL UNITS THROUGH
MUTUAL HOUSING. IT'S THE FIRST
OF ITS KIND OFTHIS KIND OF
DEVELOPMENT, AND WE THINK IT'S
GOING TO BE A GREAT MODEL TO
REPLICATE IN A LOT OF DIFFERENT
COMMUNITIES. IT ALSO HAPPENS TO
BE A PROJECT THAT IS LEVERAGING
CAL HOME FUNDS FROM THE STATE.
AND THEN ANOTHER EXAMPLE IS
AROUND NEIGHBORHOOD
REVITALIZATION AND HOME REPAIRS
. THIS IS CALLED ROCK THE BLOCK
, AND THIS IS THE PROGRAM THAT
IVY WAS PART OF IT IN OAK PARK.
THIS IS AN ANNUAL TWO DAY EVENT
INCLUDES 500, LOCAL COMMUNITY
VOLUNTEERS. AND HABITAT.
SACRAMENTO PARTNERS WITH
SACRAMENTO HOUSING REDEVELOPMENT
AGENCY AND SACRAMENTO PROMISE
ZONE FINANCIAL INSTITUTION, AND
THEY MADE A COMMITMENT TO
CONTINUE PARTNERING FOR THE NEXT
FOUR YEARS, AND THE PLAN IS TO
REPAIR OVER 200 HOMES IN THE OAK
PARK NEIGHBORHOOD FOR LOWER
INCOME HOMEOWNERS BY 2025. SO IN
CLOSING. I WANT TO EMPHASIZE
THAT TOGETHER WE CAN POSITIVELY
IMPACT HEALTH AND EVEN PROVIDE
PREVENTATIVE HEALTH MEASURES
THROUGH STABLE, AFFORDABLE
HOMEOWNERSHIP. POLICYMAKERS AND
LEADERS CAN HELP BY ENCOURAGING
HOMEOWNERSHIP. THE PERMANENT
SOLUTION TO SOLVING HOUSING IN
AFFORDABILITY AND HEALTH
BARRIERS. AND COLLECTIVELY, WE
NEED TO LOOK AT THE ENTIRE
ECOSYSTEM. IT'S IMPORTANT TO
INVEST IN TRANSITIONAL EMERGENCY
HOUSING, AS WELL AS AFFORDABLE
RENTAL RENTAL AS WELL AS
AFFORDABLE HOMEOWNERSHIP FOR
PERMANENT SOLUTIONS AND HABITAT
FOR HUMANITY. CALIFORNIA WOULD
LOVE TO CONTINUE PARTNERING FOR
THESE SOLUTIONS. THANK YOU.
THANK YOU SO MUCH FOR THAT
PRESENTATION. I'M ACTUALLY GOING
TO ASK ALL OF OUR PRESENTERS TO
COME TO THE TO THE DEATHS FOR
ANY QUESTIONS THAT WE MAY HAVE
FROM ANYONE WHO WAS CALLED IN.
BUT I ALSO HAVE SOME QUESTIONS
MYSELF. UM. SO NOW THAT WE HAVE
HEARD FROM ALL OF OUR WONDERFUL
EXPERTS ON THE PANEL ABOUT THE
INTERSECTION BETWEEN HEALTH AND
HOUSING WE'RE GOING TO FIRST
MOVED TO THE PHONE LINE AND OPEN
THE PHONE LINE FOR PUBLIC
COMMENTS. UM AND THEN IF WE
DON'T HAVE ANY WILL MOVE ON TO
MY QUESTIONS. SO 18 T OPERATOR,
ARE YOU THERE? YES, I'M HERE.
HER BIG. DO WE HAVE ANYONE ON
THE LINE WAITING TO ASK A
QUESTION OR COMMENT? YES, WE DO.
HAVE SOMEBODY ON THE WHOLE ARE
WE READY? OKAY JUST A MINUTE. I
JUST WANT TO REMIND PEOPLE THAT
IF YOU HAVE A PUBLIC COMMENT, OR
YOU HAVE A QUESTION YOU CAN CALL
IN THE TOLL FREE NUMBER IS
877692. AND THE PUBLIC ACCESS
CODE IS 13151 TO 7. OKAY
OPERATOR. WE'RE READY FOR THE
FIRST CALLER. OKAY? LINE. 13,
PLEASE GO AHEAD. MY CAN YOU HEAR
ME CAN HEAR YOU. WONDERFUL MY
NAME IS ADRIAN MOHAMMED. ALMOST
LIGHTHOUSE PUBLIC AFFAIRS HERE
ON BEHALF OF THE BLACK
LEADERSHIP COUNCIL AND THE BAY
AREA REGIONAL HEALTH INEQUITIES
INITIATIVES. FIRST AND FOREMOST
, I WANT TO SAY THANK YOU TO THE
CHAIR OF THE COMMITTEE AND ALL
OF THE SPEAKERS TODAY FOR, UM
BRINGING UP AND CENTERING SUCH
AN IMPORTANT CONVERSATION. UM WE
WANNA THANK YOU ALL FOR THE WORK
THAT'S BEEN DONE, ESPECIALLY IN
TERMS OF THE BUDGET. UM IN TERMS
OF JUST PROVIDING HOUSING
FUNDING THAT DIRECTLY GOES TO
THE HEART OF ADDRESSING. UM A
LOT OF THE INEQUITIES THAT
CREATE, UM, THESE DISPARITIES IN
TERMS OF THE SOCIAL DETERMINANTS
OF HEALTH. ONE BUDGET ASK, I DO
WANT TO HIGHLIGHT IS THE BLACK
HOUSING? ASKED UM, SOME REMEMBER
LORI WILSON AND THE BUDGET
CHAMPION. THAT IS A AREA CAUCUS
PRIORITY AND A BLACK CAUCUS
PRIORITY. AND I WANTED TO BRING
IT UP. JUST GIVEN THE
CONVERSATION THAT HAS HAPPENED
TODAY IN TERMS OF CREATING A
WHOLE PERSON APPROACH AND MAKING
SURE THAT THERE ARE WRAPAROUND
SERVICES. AND THE EMPHASIS ON
PROVIDING HOUSING HOUSING.
ACTIVE 500 MILLION, UM,
SPECIFICALLY FOR PRIVATE, A
PILOT, NOT PRIVATE, A PILOT
PROGRAM. WAS IN THE BAY AREA
THAT FOCUSES ON DEVELOPING NEW
HOUSING, PROVIDING DOWN PAYMENT
ASSISTANCE. UM EMPOWERING AND
FINANCIALLY SUPPORTING. BLACK
DEVELOPERS AND THEIR ABILITY TO
ACTUALLY CREATE THESE AFFORDABLE
HOUSING UNITS. AND ALSO IN
FRANCHISING THE COMMUNITY BASED
ORGANIZATIONS AND THESE AREAS.
SO THAT THEY ARE ABLE TO WORK
WITH THE FAMILIES THAT WILL BE
PLACED AND THESE NEW HOMES SO
THAT THEY CAN CONTINUE TO STAY
THERE. THIS IS ABSOLUTELY A
HOLISTIC, ANTI DISPLACEMENT
APPROACH. AND REALLY, I JUST
ASKED THAT, UM DR WEBBER IS IF
YOU WERE ABLE TO PLEASE WORK
WITH US AS WE MOVE FORWARD, UM
AND WITH THIS BUDGET, ASK AND
CREATING THESE POLICIES SO THAT
WE REALLY AND TRULY CAN HAVE UM
, A SUBSTANTIAL CHANGE IN THE
SHIFT IN TERMS OF HOW WE ARE
DEALING WITH HOMELESSNESS AS WE
AS WE SAY, YOU KNOW, RISING
TIDES LEFT ALL SALES ALL VOTES
RIGHT AND WE KNOW THAT IT THE
BLACK POPULATION IS
DISPROPORTIONATELY REPRESENTED
IN TERMS OF HOMELESSNESS,
ESPECIALLY WHEN YOU LOOK AT, UM
THE BLACK QUEER POPULATION, SO
EVERYTHING THAT WE ARE ABLE TO
DO IN ORDER TO FURTHER
ENFRANCHISE THEM. GET THEM
HOUSE, GET THEM TAKEN CARE OF
AND TREATED. AND PLACED AND
SUSTAINED. I THINK IT'S
ABSOLUTELY IMPERATIVE AND
NECESSARY AND AGAIN. I JUST WANT
TO THANK YOU FOR ALL THE WORK
THAT YOU'VE DONE. THANK YOU SO
MUCH FOR THAT THAT VERY
IMPORTANT COMMENT AND BRINGING
UP THAT THAT BUDGET REQUEST. UM
AND ALSO RECOGNIZING THE FACT AS
WE TALK ABOUT THE HISTORICAL
NATURE OF RACISM AND
DISCRIMINATORY PRACTICES. WITHIN
THE BUILDING OF HOUSING. IT ALSO
HAS IMPACTED WHO BUILDS THE
HOUSING AND SO UM, YOU KNOW,
THERE'S SO MANY THINGS THAT WE
CAN TALK ABOUT IN THAT IN THAT
REALM, BUT I DO APPRECIATE YOU
BRINGING UP THAT FACT AS WELL.
UM OPERATOR. IS THERE ANYONE
ELSE ON THE LINE FOR A COMMENT
OR QUESTION AT THIS TIME? MADAM
CHAIR. WE HAVE NO ONE ELSE IN Q
AT THIS TIME, THANK YOU SO MUCH,
BECAUSE THAT KIND OF GOES INTO
ONE OF MY FIRST QUESTION. UM AND
I THINK I'M GOING TO ASK W THIS
QUESTION. HOW DOES HABITAT
DECIDE THE COMMUNITY IN WHICH
THEY'RE GOING TO BUILD A HOME
BECAUSE I THINK IT'S ONE THING
TO JUST BUILD A HOME. BUT WHEN
WE'RE TALKING ABOUT THE ISSUES
OF HEALTH. UM AND THE SOCIAL
DETERMINANTS. HOW DO YOU BUILD A
HOME OR HOW DO YOU SELECT THE
AREA AND IN WHICH YOU'LL BUILD A
HOME SO THAT THAT FAMILY THAT
MOVES IN WILL BE AS HEALTHY AND
SUCCESSFUL AS POSSIBLE? YEAH
THAT'S A GREAT QUESTION, AND,
UM, WE EVALUATE ACCESS. WE THINK
ABOUT TRANSPORTATION. WE THINK
ABOUT ACCESS TO SCHOOLS. WE
THINK ABOUT ACCESS TO HEALTHY
RECREATIONAL ENVIRONMENTS ALL OF
THOSE THINGS SO THAT THE
FAMILIES CAN THRIVE.
UNFORTUNATELY THE BARRIER AND
THE CHALLENGE IS THE COST SO
OFTEN TIMES WHERE WE'RE HAVING
TO WORK WITH PROPERTY THAT WE
CAN AFFORD TO BUILD. WE'RE
WORKING WITHIN ZONING
RESTRICTIONS, BUT WE WORK REALLY
HARD TO MAKE SURE THAT WE INVEST
A LOT IN THE INFRASTRUCTURE AS
WELL AS AS THE OVERALL COMMUNITY
TO HELP MAKE SURE THAT FAMILIES
CAN THRIVE SO THE SHORT ANSWER
IS WE EVALUATE ALL OF THAT. UM
THE REALITY IS WHERE REFLECTING
AS WELL IN TERMS OF MAKING SURE
THAT WE'RE BUILDING IN THE
HEALTHIEST COMMUNITIES POSSIBLE
, AND THAT'S WHERE THE PUBLIC
PARTNERSHIPS CAN REALLY HELP US
. BECAUSE TYPICALLY, IT'S OKAY.
BUILD OVER HERE. THIS IS LOWER
INCOME. THIS IS WHAT YOU CAN
AFFORD SO THAT SOMETIMES IS WHAT
HAPPENS, BUT WE'RE TURNING THAT
SIDEWAYS AND MAKING SURE THAT
THAT EVERYBODY HAS EVERYTHING
THAT THEY NEED TO LIVE IN A
HEALTHY ENVIRONMENT, BUT I CAN'T
SPEAK TO THE HOMES IN TERMS OF
BEING HIGH QUALITY. HEALTHY NO
CONTAMINANTS, YOU ALL OF THOSE
THINGS AND THERE'S A LOT OF
EDUCATION. PUT INTO KEEPING AND
MAINTAINING A HEALTHY HOME.
THANK YOU. AND THAT KIND OF
COMING TO YOU NEXT. UM, I'M
COMING TO YOU BECAUSE YOU KNOW,
WE TALK ABOUT HOUSING FIRST,
RIGHT? BUT HOUSING WHERE TO? YOU
KNOW HER POINT WHEN I WAS
ASKING, LIKE, WHERE EXACTLY ARE
YOU BUILDING THE HOME? SO WHEN
WE TALK ABOUT WE NEED TO HOUSE
PEOPLE WE NEED TO HOUSE PEOPLE
NEED TO BUILD MORE HOUSING. WE
TALK ABOUT THE HOUSING CRISIS
HERE IN CALIFORNIA AND BUILDING
MORE AFFORDABLE HOMES. WHERE
EXACTLY SHOULD WE BE LOOKING AT
AND FROM BECAUSE I KNOW YOU HAVE
, UM, A LOT OF EXPERIENCE WITH
LIKE LOCAL POLITICS. YOU ALWAYS
HAVE THE NIMBY. UM WHEN YOU'RE
TALKING ABOUT BUILDING CERTAIN
TYPES OF HOMES OR RESIDENCES, SO
WHAT? WHEN WE ARE HERE IN
SACRAMENTO, THINKING ABOUT
DIFFERENT PIECES OF LEGISLATION
AND EVEN FOR THOSE WHO ARE OUR
LOCAL ELECTED, UM. WHERE SHOULD
WE BE LOOKING AT? AND HOW DO WE
DEAL WITH, UM, THE NIMBY
SITUATION AND MANY OF THE
NEIGHBORHOODS THAT HAVE YOU KNOW
ACCESS TO GROCERY STORES, ACCESS
TO OPEN GREEN SPACES. ACCESS TO
GREAT SCHOOL. UM. AND MANY TIMES
THE NEIGHBORS DON'T WANT TO SEE
OTHERS EITHER. THEY DON'T LOOK
LIKE THEM OR WHO AREN'T ON THE
SAME SOCIOECONOMIC STATUS AS
THEM IN THOSE AREAS, AND I WILL
DO MY BEST TO BE LIMITED, DR
WEBBER, I'LL SAY A COUPLE OF
THINGS ONE RAJ CHETTY IS AN
ECONOMIST WHO I THINK HE'S BACK
AT HARVARD NOW, UM HIS WORK AND
OPPORTUNITY INSIGHTS REVEALED
THAT WHEN YOU BUILD, UM
AFFORDABLE HOMES WHEN PEOPLE WHO
HAVE MODEST MEANS ARE ALLOWED
INTO HIGH OPPORTUNITY
NEIGHBORHOODS. THERE IS A
$320,000 LIFETIME EARNING BUMP
FOR THOSE CHILDREN OVER THE
COURSE OF THEIR LIFETIME. SO IT
IS. THE REALITY IS INCREASING
HOUSING SUPPLY. IN SOME CASES
WHERE IT IS ACTUALLY A LITTLE
BIT. IT'S NOT AS AFFORDABLE TO
BUILD IN A PLACE WHERE THE LAND
IS EXTREMELY HIGH, BUT THERE ARE
SOME REALLY SUBSTANTIAL BENEFITS
OF DOING SO, ONE OF THE WAYS TO
PULL THAT OFF SORT OF LENS INTO
MY SECOND POINT. SO ONE IS, UM
INCREASING AFFORDABLE HOMES AND
HIGH OPPORTUNITY NEIGHBORHOODS
MATTERS. PUBLIC ENTITIES UP AND
DOWN THE STATE OWNED PROPERTY IN
VARIOUS PARTS OF COMMUNITIES,
INCLUDING ONE PLACE IN SAN DIEGO
THAT YOU MAY BE FAMILIAR WITH.
THERE'S A FORMER CRIME LAB
PROPERTY AND CLAREMONT, WHERE
HUNDREDS OF AFFORDABLE HOMES ARE
BEING BUILT RIGHT NOW. THAT WILL
INCREASE THE OPPORTUNITY. THE
ELEMENTARY SCHOOLS IT'S OVER BY
HOLMES ELEMENTARY, A COUPLE OF
OTHERS WILL IMMEDIATELY INCREASE
THE OPPORTUNITIES FOR THOSE
YOUNG PEOPLE. SO WHERE CREATING
ADDITIONAL POTENTIAL INCENTIVES
TO MAKE IT EASIER FOR LOCAL
JURISDICTIONS TO PARTNER ON
STATE OWNED PROPERTY AND COUNTY
OWNED PROPERTY ON PROPERTY THAT
ONE JURISDICTION OWNS IN ANOTHER
JURISDICTION, WHICH SOUNDS
STRANGE, BUT WHEN YOU GET DOWN
TO THE LOCAL LEVEL, YOU FIND OUT
WAIT. CITY OF SAN DIEGO AND HIS
PROPERTY WAY OUT IN X Y Z,
RIGHT. SO THE OTHER IS THE
PUBLIC PEACE. AND THEN ONE THING
I'LL MENTION I THINK THE STATE
IS PARTIALLY INVESTED IN THE
HEALTHY PLACES INDEX. HEALTHY
PLACES INDEX THREE POINT OH,
JUST RECENTLY, SOMETIME IN THE
LAST 69 MONTHS CAME OUT AND IN
THE QUESTION FOR US IN OUR
VARIOUS ROLES FOR THE STATE
POLICYMAKERS IS THE OPPORTUNITY
TO USE DATA TO DRIVE. WHERE
MIGHT WE LOOK RIGHT? WHERE ARE
OUR BIGGEST CHALLENGES? AND I
THINK THE HEALTHY PLACES IN NEXT
WHICH LOOKS AT ECONOMICS,
ETCETERA, REALLY, OF VERY, VERY
IMPORTANT TOOL, SO I'LL STOP
THERE PROBABLY WENT ON TOO LONG.
THANK YOU SO MUCH FOR THAT
ANSWER, AND ALSO REMINDING US
ABOUT THE HEALTHY PLACES INDEX.
UM THE STATE USES IT, BUT ALSO A
LOT OF LOCAL GOVERNMENTS USE IT
IN AND I WAS TALKING TO SOMEONE
RIGHT BEFORE I CAME IN AND
REMINDED THEM THAT YOU KNOW YOU
CAN GO ON THE WEBSITE AND YOU
CAN PUT IN DIFFERENT AREAS,
DIFFERENT ZIP CODES, AND IT WILL
TELL YOU BASED ON THAT ZIP CODE
. WHAT IS THE LIFE EXPECTANCY OF
PEOPLE WHO LIVE THERE? AND THAT
HAS A DIRECT PROPORTION TO AGAIN
WHAT IS ACCESSIBLE IN THEIR AREA
. THE SCHOOLS JOBS, WATER AIR.
UM YOU KNOW, DO THEY HAVE YOU
KNOW, FREEWAYS AND HIGHWAYS THAT
HAVE BEEN CUT THROUGH THE
COMMUNITIES AND SO THEY'RE
EXPOSED TO ALL OF THE POLLUTANTS
OR NOT? UM AND SO THANK YOU SO
MUCH FOR REMINDING US OF THAT.
WE TALKED ABOUT THAT IN
DECEMBER, BUT THAT IS A VERY
IMPORTANT TOOL TO USE DATA TO
SAY, WHERE SHOULD WE BE BUILDING
BUT ALSO IN WHAT AREAS SHOULD WE
BE PUTTING MORE RESOURCES TO
IMPROVE? THE LIVES OF THE PEOPLE
THAT THAT CURRENTLY LIVE THERE.
UM DR KUSHNER. I WAS WONDERING
IF MAYBE YOU COULD ELABORATE A
LITTLE BIT MORE ON THE IMPACT OF
A SCORES, UM, AND HOUSING
LOCATIONS. UM, YOU KNOW, I R
PREVIOUS SERGENT GENERAL
CALIFORNIA SURGEON GENERAL DID A
LOT OF WORK IN THE IN THE IN THE
REALM OF ACES FOR OUR PD EIGHT
FOR OUR PEDIATRIC POPULATION. UM
REALLY KIND OF HIGHLIGHTING THE
IMPORTANCE OF A LOT OF THESE
ADVERSE CHILDHOOD EVENTS AND HOW
THEY CAUSE CAN LEAD TO
SIGNIFICANT MEDICAL PROBLEMS
LATER ON IN LIFE AND SOME MENTAL
PROBLEMS AS WELL AND REALLY
TRYING TO FIGURE OUT WAYS IN
WHICH WE CAN LOWER THE ACE
SCORES OF OUR CHILDREN, SO I WAS
WONDERING IF YOU CAN KIND OF
TOUCH ON THAT A LITTLE BIT MORE.
YEAH, WE KNOW THAT WHEN WE LOOK
AT ADULTS, FOR INSTANCE,
EXPERIENCING HOMELESSNESS, THEY
HAVE DISPROPORTIONATELY HIGH
SCORES, AND IT'S PROBABLY IN
SOME WAYS THE DIRECT EFFECT OF
THESE ON PEOPLE'S DEVELOPMENT ON
THE OPPORTUNITIES ARE OPEN TO
THEM. BUT ALSO IN A WAY AS A
MARKER THAT THEY'RE OFTEN
CHILDREN WHO DON'T HAVE FAMILIAL
SUPPORT OR HAVE BEEN REMOVED BY
THE STATE FROM THEIR HOME. BUT I
THINK THE OTHER THING IS, YOU
KNOW, I A LOT OF OUR
UNDERSTANDING OF A SCORES COMES
FROM THIS FAMOUS KAISER STUDY
DONE IN SOUTHERN CALIFORNIA, AND
I'M REALLY INTERESTED IN WHETHER
WE SHOULD BE EXPANDING. OUR
NOTION OF WHAT AN ADVERSE
CHILDHOOD EVENT IS, YOU KNOW
WHAT IS THE LONG TERM EFFECT OF
HAVING WITNESSED VIOLENCE ON THE
STREET? WHAT IS THE LONG TERM
EFFECT OF HAVING A LOVED ONE?
SUCCUMB TO VIOLENCE OR ANOTHER?
YOU KNOW, CHILD YOU GREW UP WITH
OR OTHER THINGS THAT WE KNOW
THAT ARE MORE LIKELY TO HAPPEN.
IN THESE HIGH ADVERSITY,
NEIGHBORHOODS, YOU KNOW, BECAUSE
OF THE ADVERSITY IN THOSE
NEIGHBORHOODS, SO IN A WAY, I
THINK THERE ARE THINGS THAT ARE
NOT CURRENTLY INCLUDED IN THE S
SCORES THAT WOULD PROBABLY BE
REALLY IMPORTANT TO TAKE INTO
ACCOUNT. WHAT WE DO KNOW,
THOUGH, IS NO MATTER HOW YOU
MEASURE THEM. THEY LEAD TO LONG
TERM OUTCOMES, A STUDY THAT WE
DID THAT I WAS TO BE HONEST,
SURPRISED ABOUT BUT I THINK IT'S
WORTH NOTING IS, YOU KNOW WE
HAVE THIS LONG TERM STUDY OF
OLDER HOMELESS ADULTS IN OAKLAND
, SO EVERYBODY WAS HOMELESS WHEN
THEY ENTER THE STUDY, SO
EVERYONE HAD A LOT OF ACES. BUT
WE WERE ABLE TO SHOW THAT
AMONGST PEOPLE IN THEIR FIFTIES
SIXTIES AND SEVENTIES, THE
NUMBER OF CASES THEY EXPERIENCED
WAS DIRECTLY CORRELATED WITH
THEIR CURRENT MENTAL HEALTH
STATUS IN THEIR SIXTIES AND
SEVENTIES, AND THIS IS AMONGST
THE POPULATION OF PEOPLE. YOU
KNOW WHO IN GENERAL HAD MUCH
HIGHER SCORES THAN THE
POPULATION. BUT IF YOU HAD FOUR
OR MORE POINTS ON YOUR ACE
SCORES, YOU WERE MUCH MORE
LIKELY RIGHT NOW. TO HAVE VERY
SIGNIFICANT DEPRESSION TO HAVE
AN EXPERIENCE SUICIDAL IDEATION
EVEN COMPARED, YOU KNOW, EVEN
THOUGH EVERYONE IN THE
POPULATION WAS EXPERIENCING
HOMELESSNESS, AND SO WAS
UNDERGOING INCREDIBLE STRESS AND
TO ME THE FACT THAT THERE WAS A
DIFFERENCE NOT ONLY SO MUCH
LATER IN LIFE, BUT EVEN WHEN WE
WERE ONLY LOOKING AT PEOPLE WHO
HAD ALL EXPERIENCED A LOT OF
ACES AND WHO WERE CURRENTLY
EXPERIENCING OVERWHELMING
AMOUNTS OF, YOU KNOW, THREATS TO
THEIR HEALTH AND THEIR WELL
BEING. THAT WE COULD STILL
DETECT THAT DIFFERENCE, I THINK
TELLS US HOW POWERFUL THOSE ACES
ARE IN DETERMINING SORT OF
LIFELONG HEALTH AND WELL BEING.
WOW THAT'S YEAH, DEFINITELY
AMAZING. UM. WE TALK ABOUT A
SCORES A LOT, ESPECIALLY IN THE
PEDIATRIC POPULATION, BUT UM
THAT STUDY IS SO POWERFUL
BECAUSE IT SAYS THAT YOU KNOW IF
YOU DON'T FIX THEM IF YOU DON'T
ADDRESS THEM, RIGHT, WHATEVER
CAUSED THEM, WHETHER IT WAS
VIOLENCE OR NEGLECT. UM IT IS
GOING TO HAVE A LIFELONG IMPACT
ON THE HEALTH, PHYSICAL AND
MENTAL HEALTH. OF THAT
PARTICULAR INDIVIDUAL, EVEN EVEN
WHEN THEY WERE ALL OF THESE
OTHER STRESSORS THAT HAPPENED IN
ADULTHOOD THAT ALL OF THE FOLKS
IN THE GROUP EXPERIENCE YOU
COULD TELL SORT PEOPLE SORT OF
CURRENT MENTAL HEALTH BASICALLY.
BY WHAT HAPPENED TO THEM WHEN
THEY WERE CHILDREN, EVEN IN THIS
GROUP THAT WAS EXPERIENCING SO
MUCH STRESS AND DEPRIVATION. IT
WAS REALLY STRIKING. WOW. OKAY?
DEBBIE I HAVE ANOTHER QUESTION
FOR YOU. BASED ON, UM ONE OF
YOUR SLIDES THAT JUST KIND OF
YOU KNOW, PICKED MY ENTRANCE SO
WHEN YOU'RE ON THE SLIDE WHEN
YOU WERE TALKING ABOUT PLACE
BASED BARRIERS TO IMPROVING
RACIAL DISPARITIES IN HEALTH.
AND YOU SAID BLACK NEIGHBORHOODS
HAVE ONLY ONE THIRD TO ONE HALF
THE NUMBER OF SUPERMARKETS OF
WHITE NEIGHBORHOODS. TWO OF
COMPARABLE SOCIO ECONOMIC STATUS
, BUT 2 TO 4 TIMES, MORE FAST
FOOD RESTAURANTS AND CONVENIENCE
STORES, WHICH STOCK LESS HEALTHY
FOODS. SO IF WE'RE TALKING ABOUT
PEOPLE ON THE SAME SOCIAL
ECONOMIC STATUS, HOW HOW? HOW IS
THIS HAPPENED? YEAH AND I CAN I
CAN PROVIDE THE RESEARCH PAPERS
WITH WITH MORE BEHIND IT, BUT,
UM, ESSENTIALLY, IT'S
DISCRIMINATION. AND YOU KNOW IF
WE GO BACK, YOU KNOW AND
ADVOCATING. SO EVEN THOUGH
THAT'S I THINK ONE OF THE THINGS
THAT WAS MOST STRIKING TO US AS
WELL AS BECAUSE A LOT OF TIMES
WE LOOK AT IT AS ECONOMIC BASED
EXCLUSIVELY, AND SO THAT'S
REALLY COMPELLING WHEN IT'S
CLEARLY ISN'T AND I THINK IT
COMES DOWN TO BIAS. UM ACCORDING
TO THE RESEARCH, IT'S BIAS. IT'S
ALLOWABLE DISCRIMINATION LIKE
YOU, YOU KNOW, MOVING MOVING
PEOPLE AND HOUSEHOLDS TO PUT IN
INFRASTRUCTURE, DIFFERENT THINGS
OVER DECADES OF TIME. AND WITH
ONGOING SEGREGATION, SO EVEN IF
IT'S A LOWER INCOME,
PREDOMINANTLY WHITE NEIGHBORHOOD
THERE HAS STILL BEEN INCREASED
INVESTMENT IN IN, UM. GROCERY
STORES AND PARKS AND SCHOOLS AND
OTHER THINGS, SO IT'S STILL IN
UNEQUAL. EVEN IN THE SAME
ECONOMIC AREAS. HMM. HMM. YEAH,
THAT, UM. THAT SIDE. MAYBE HMM.
KIND OF LIKE, LIKE, REALLY, YOU
KNOW, BECAUSE A LOT OF TIMES WE
DO LIKE TO JUST KIND OF PUT IT
ON, YOU KNOW, SOCIOECONOMIC
FACTORS. AND I KNOW IN MY REALM
OF BEING AN O B G Y N WE TALK
ABOUT LIKE POOR. YOU KNOW, WE'RE
ETERNAL, UM, OUTCOMES AS FAR AS
LIKE MATERNAL MORBIDITY AND
MORTALITY. AND THEN WE LOOK AT
AFRICAN AMERICAN FEMALES AND
THEY HAVE THE WORST OUTCOME, BUT
THAT, TOO, IS REGARDLESS OF YOUR
SOCIAL ECONOMIC STATUS. THAT IS
THAT REALLY FOCUSES ON THE
RACIAL COMPONENT OF IT, AND SO
WHEN I SAW THAT SLIDE, I WAS
LIKE I'VE GOT TO ASK HER ABOUT
THAT, BECAUSE, UM, A LOT OF
TIMES. WE THINK THAT WILL ONCE
WE MAKE THIS MONEY OR ONCE WE
KIND OF YEAH, YOU KNOW. GET TO
THIS LEVEL THAN SOME OF THE
OTHER THINGS WE WON'T HAVE TO
DEAL WITH. SO IT'S INTERESTING
THAT, UM, THAT WHEN WE TALK
ABOUT WHERE YOU'RE LIVING THE
THINGS IN YOUR NEIGHBORHOOD UM,
THE HEALTHY FOODS THAT YOU'RE
EXPOSED TO VERSUS THE, UM, THE
UNHEALTHY FOODS THAT CONVENIENCE
STORES AND OTHER THINGS THAT GO
ALONG WITH THOSE, UM YOU STILL
HAVE A HIGHER RISK OF BEING
EXPOSED TO THOSE NEGATIVE HEALTH
OUTCOMES EVEN WHEN YOU ATTAIN
THE SAME SOCIAL ECONOMIC STATUS
. IT'S OTHERS. YEAH, I WAS JUST
GONNA ADD THEIR SIMILAR DATA
AROUND EXTERNAL ENVIRONMENTAL.
UM FROM A CLIMATE STANDPOINT TO
WHERE WHERE ARE TREES SO THERE'S
SHADE, SO THE TEMPERATURE IN THE
SAME AREA. SAME REGION IN
CERTAIN NEIGHBORHOODS IS MUCH
HIGHER, HOTTER, UM AND MORE
EXTREME IN, UM IN BLACK
NEIGHBORHOODS THAN IN
PREDOMINANTLY WHITE
NEIGHBORHOODS. I KNOW I WAS JUST
GONNA ADD. I MEAN, I THINK FOR
SO IT'S A GREAT EXAMPLE OF
RACISM AND NOT RACE. I MEAN, THE
ANSWER IS IT'S NOT SOCIOECONOMIC
STATUS, RIGHT? IT'S LIKE RACISM
REALLY IS REARING ITS UGLY HEAD.
BUT SO THINK ABOUT HOW MUCH
MONEY WE POUR INTO OUR HEALTH
SYSTEM AND YOU KNOW, A HEALTH
SYSTEM RESPONSE TO DIET IS TO
TALK ABOUT, YOU KNOW, TO SORT OF
LECTURE DISCUSSED WITH THE
PATIENT CHOOSING HEALTHIER
FOODS. BUT IF YOU LIVE IN A
NEIGHBORHOOD WHERE THOSE FOODS
ARE NOT AVAILABLE, IT'S YOU KNOW
, THIS IS REALLY THE SOCIAL
DETERMINANTS OF HEALTH ARE
REALLY WHERE IT'S AT. AND IF WE
CARE ABOUT PEOPLE'S HEALTH WE
REALLY NEED TO BE ADDRESSING
THOSE AND NEEDING TO BE HONEST
ABOUT THE IMPACT OF RACISM AND
NOT JUST WRITING IT ALL OFF SCS
BUT ALSO REALIZING THAT THAT'S
WHERE THE BIG GAINS ARE GOING TO
BE IS CHANGING THOSE
NEIGHBORHOOD ENVIRONMENT AS
OPPOSED TO ONE PHYSICIAN AND ONE
PATIENT OR ONE NURSE, AND ONE
PATIENT, SORT OF TALKING ABOUT
SOMEONE'S DIETARY CHOICES
BECAUSE THOSE CHOICES ARE
CONSTRAINED. BY THE ENVIRONMENT
IN WHICH PEOPLE LIVE, RIGHT?
EXACTLY. YOU KNOW, IT REMINDS ME
OF UM. PROBABLY LIKE WHEN I WAS
IN MEDICAL SCHOOL, AND WE WOULD
TALK ABOUT THE NONCOMPLIANT
PATIENTS. AND UM, WHETHER IT'S
NOT COMPLIANCE BECAUSE WE'VE
TALKED TO YOU 15 TIMES ABOUT
WHAT IT IS, YOU SHOULD BE EATING
AND HOW MUCH WEIGHT YOU SHOULD
BE LOSING WITHOUT ACTUALLY
TAKING INTO ACCOUNT. WHERE YOU
LIVE, AND THE FOOD THAT YOU'RE
EXPOSED TO. AND DO YOU HAVE
ACCESS TO THE THINGS THAT WE'VE
BEEN TELLING YOU TO DO? UM AND
YOU KNOW ALSO WHEN WE ON THE
OTHER END, WHEN WE SAY OH, WELL,
THEY NEVER SHOW UP FOR THEIR
APPOINTMENT. WELL DO THEY HAVE
TRANSPORTATION OR DO THEY HAVE
TO TAKE OFF TIME FROM WORK AND
THEN TAKE THREE BUSSES TO GET TO
WHERE YOU ARE, AND SO YOU KNOW,
I THINK THAT IN MANY ASPECTS
WITHIN THE HEALTHCARE HEALTHCARE
SPACE. WE HAVE KIND OF OPENED
OUR EYES A BIT TO REALIZE THAT
THERE ARE SO MANY THINGS THAT
PLAY INTO, UM YOU KNOW THE
HEALTH OF OUR PATIENTS AND IT'S
I THINK US BRINGING SO MANY
OTHER GROUPS, EVEN OUR PUBLIC
POLICY MAKERS HERE IN THE
LEGISLATURE, WHICH IS WHY IT WAS
SO IMPORTANT FOR ME TO FORM THIS
COMMITTEE TO SAY. EVERYTHING
THAT WE DO THAT IMPACTS THEIR
SOCIETY, OUR RESIDENT SOCIETY
WHERE THEY LIVE, WHERE THEY
WORK, WHERE THEY PLAY, WHERE
THEY'RE EDUCATED, IS GOING TO
HAVE A DIRECT IMPACT ON THEIR
HEALTH. AND COVID LIKE YOU SAID,
SHOWED UP BRIGHT SPOTLIGHT ON A
LOT OF THE DISPARITIES THAT HAVE
BEEN THERE FOR A VERY, VERY,
VERY LONG TIME. BUT IF WE REALLY
TRULY WANT TO IMPROVE THOSE THAT
WE'VE GOT TO IMPROVE ALL OF
THESE OTHER FACTORS. SO, UM WITH
THAT I AM GOING TO THANK YOU,
EACH OF YOU FOR COMING AND
PARTICIPATING IN THIS PANEL. UM
I HAVE DEFINITELY LEARNED SO
MUCH FROM MYSELF. I LOVE ALL OF
YOUR YOUR YOUR SLIDES. UM. I
WANT TO. THANK UM YOU KNOW MY
COLLEAGUES AND YOU KNOW A LOT OF
THE COMMITTEE MEMBERS. THIS IS A
VERY BUSY WEEKS OR JUST
BALANCING A LOT OF DIFFERENT
STUFF, UM WITH OTHER COMMITTEES
AND TRYING TO PRESENT OUR BILLS.
BECAUSE WE HAVE DEADLINES NEXT
WEEK. UM, BUT I ALSO WANT TO
TAKE THE TIME TO THANK MY STAFF
WHO COORDINATED THIS WHO
CONTACTED ALL OF YOU, UM AND GOT
YOU ALL TO COME UP HERE TODAY
AND YOU KNOW, JUST IN CLOSING.
YOU KNOW, WE ARE ALL AWARE THAT
CALIFORNIA IS IN A HOUSING
CRISIS. AND HOPEFULLY AFTER OUR
DISCUSSION TODAY, YOU CAN SEE
WHY OUR PAST HOUSING POLICIES
HAVE LED TO SOME OF OUR CURRENT
HEALTH CRISIS. AND THIS IS A
CRISIS THAT HAS BEEN INFLUENCED
BY DISCRIMINATION. INEQUITY AND
INEQUALITY. AND LIKE WE'VE
DISCUSSED THE CRISIS THAT WE ALL
SOLVED. VERY MUCH DURING THIS
COVID PANDEMIC. BUT AS WE FOCUS
ON FIXING THE HOUSING CRISIS IN
CALIFORNIA AND INCREASING THE
INVENTORY OF AFFORDABLE HOUSING
WE MUST LEARN FROM THIS THE
MISTAKES FROM OUR PAST AND NOT
RECREATE HOUSING COMMUNITIES
THAT WOULD HAVE ADVERSE EFFECTS
ON THE HEALTH. QUALITY OF LIFE
AND LIFE EXPECTANCY OF THOSE WHO
LIVE THERE. SO THANK YOU ALL FOR
THOSE WHO JOINED US TODAY AND I
HOPE YOU WILL JOIN US AGAIN FOR
OUR NEXT COMMITTEE HEARING.
THANK YOU. THANK YOU. THANK YOU.
HMM.
THINKING, MAYBE RIGHT HERE.
SINCE EVERYBODY'S KIND OF
HANGING OUT JUST RIGHT RIGHT
BACK HERE. MIKE, IT'S OKAY.
WHATEVER WE'RE UPSET, YOU CAN
STAND BACK THERE OR RIGHT HERE.
IT DOESN'T MATTER TO ME, YOU
KNOW? WHATEVER WORKS BEST. I'M
GONNA SHOOT RIGHT OVER. ALL OF
THIS.