Community Input – Social Determinants of Health Stakeholder interviews identified the following issues, challenges and barriers related to social determinants of health. Their comments, quotes and opinions are edited for clarity: • Low-income communities of color and immigrant populations experience higher disparities and gaps in services. • Vulnerable elderly populations are immigrants who are low-income and those with low English literacy. Isolation is a significant problem. • There are a lot of undocumented Asian and Vietnamese people in Orange County. Many came as tourists or on student visas and they overstayed. A huge number of these people are considered undocumented. We need better services if we want to target Cambodians and Chinese because current services are not tailored to these populations. • We have divisions by socioeconomic status according to cities and immigration issues that could make populations more vulnerable. Even though we are supposed to be an affluent county, we have a large number of elderly who do not have food and shelter security. There are a lot of problems with homelessness for an affluent county as well. Those are the most vulnerable populations. • The Korean, Iranian, Arabic and Chinese populations are sizable, and they are emerging populations for which there needs to be some countywide conversations to create and sustain services. • Even among legal immigrants there is so much fear about changing rules on public charge. When monolingual communities are looking for specialty care it can be hard to find cultural and language competency. • When we do reach out to underrepresented communities, the messages must be tailor-made for each community. Simply translating information from English to other languages doesn’t work. We have to make sure we are giving the same message, not just a literal translation. Also, we need to build trust in those communities. The disenfranchised feel or perceive that they are stigmatized or looked down upon. • There are cultural differences and socioeconomic differences that play into equity in educating communities of immigrants and lower socioeconomic status when it comes to the value of healthy eating and healthy lifestyles. • Senior populations are more isolated and do not have access to transportation. • Social isolation and poverty, hunger and stable housing are issues for seniors. • Women live longer. They may have a smaller nest egg, smaller social security payments and may not have a 401K or employer-based health coverage, leaving them struggling more to meet their needs, which impacts their health. • Poverty, housing costs and systemic inequities that are not being addressed could be related to race, ethnicity and immigration status. UCI Medical Center Community Health Needs Assessment
22
