The County of Santa Clara Public Health Department (SCCPHD) serves a very diverse population. Santa Clara County’s (SCC) racial-ethnic composition is 30.4% White, 37.6% Asian, 25.0% Hispanic, 2.4% African American, 0.2% Native American, and 3.7% two or more races. SCC has inequitable health outcomes driven by multiple factors, including extreme income inequality, high cost of living and rates of homelessness, and longstanding racial inequities. Though the county has a high median household income, the Brookings Institution recently found that the county ranks 6th in the nation for income inequality. Despite the affluence in SCC, 7.5% of residents live at or below the federal poverty level. However, the true prevalence of local poverty is notably higher when allowing for the uniquely high cost of living. When utilizing the Self-Sufficiency Standard (the amount of income an individual needs to pay all their expenses), 59% and 44% of Latino and Black people, respectively, live below the standard. Households with children in certain areas of SCC, such as East San Jose, show that 73% of families live below the Self-Sufficiency Standard.
COVID-19 exacerbated and amplified deeply rooted inequities in communities of color, as evidenced by the disproportionate impact of COVID-19 morbidity and mortality, as well as loss of wages, threat of displacement, disproportionate numbers of people serving as disaster service workers, poor or unsafe working conditions, school closures, etc. The impacts of food insecurity and climate change also worsened in communities of color throughout the pandemic. Proposed projects enable SCCPHD to launch and grow community-based initiatives addressing food insecurity and climate change impacts at community Resiliency Hubs while also expanding work beyond COVID to encompass a broader approach to addressing social determinants of health. Investing in and expanding the capacity of neighborhood organizations that will co-operate Resiliency Hubs help BIPOC residents rebound stronger from the disproportionate impacts of COVID-19.
COVID had profound impacts on SCCPHD’s workforce. The majority of staff were redirected from their regular roles to support the COVID response, resulting in a major source of hardship on the workforce that resulted in numerous retirements, staff departures, lack of career advancement opportunities, and an overall low feeling of belonging among staff. This proposal includes projects aimed at augmenting the workforce by recruiting staff from the communities the Department serves, creating promotional opportunities for SCCPHD staff, increasing training opportunities for SCCPHD staff, and launching support systems to address stress, burnout, and wellbeing of the SCCPHD workforce. The pandemic illuminated critical gaps in SCCPHD’s administrative infrastructure, particularly in strategic planning, policy development, and grants management. Expanding department foundational capacity directly targets our SCCPHD workforce, though its impact has ripple effects beyond our workforce and into the community. Building foundational capacity enables SCCPHD to develop and implement programs and policies that are data-driven, culturally responsive, and directly address health inequities.
The pandemic brought into sharp focus SCCPHD’s limited capacity to efficiently collect, access, integrate, and analyze data to inform rapidly evolving policy choices, operations, and communications with the public. To modernize its data infrastructure and move away from a fractured data reporting and analytics system, SCCPHD secured one-time funding that sunsets imminently. The need to sustain and expand this data infrastructure enables the Department and community partners to analyze populations impacted by myriad infectious, communicable, and chronic diseases. Access to these data results in programs and policies informed by quality data sources, ultimately improving health outcomes and reducing disparities.
