Health & Fitness

Homelessness, chronic diseases, substance abuse: Stanislaus Public Health seeks answers

Stanislaus County’s Health Services Agency is developing a grand plan to tackle the big issues of housing and homelessness, tobacco and substance use, and communicable and chronic diseases.

And HSA doesn’t want to do it alone.

It wants community members to participate in developing a Community Health Improvement Plan, or CHIP.

“Today is about solutions,” said Lori Williams, director of public health for the Stanislaus County Health Services Agency (SCHSA) at a conference on Aug. 29 in Modesto. SCHSA convened the meeting, including community members, partner organizations and other stakeholders, to start identifying solutions for the health issues.

Stanislaus County residents struggle with health problems. The county ranks 53rd out of the 58 California counties for health behaviors.

“For the past 16 months, we have been performing a community health assessment,” said Williams. She said the agency has been looking at data from all reliable sources, such as nonprofit groups, community organizations and public health agencies at local, state and national levels.

Identifying priorities

The goal of this comprehensive assessment was to identify priorities to improve the well-being of county residents. The four focus areas identified are:

  • Housing and homelessness
  • Communicable diseases such as sexually transmitted diseases
  • Tobacco and substance abuse
  • Chronic diseases, such as heart disease, cancer and diabetes.

The health assessment final report is expected in the fall.

The health and safety issues within the four focus areas cost more than $1.2 billion, according to a 2015 report from the California Department of Public Health. This estimate doesn’t include all of the focus area problems, so the costs are likely much higher.

Some of the highlighted concerns include that Stanislaus County has an estimated nearly 1,400 homeless individuals, and the numbers continue to climb.

“Climate change may be a factor for health in the county,” said Julie Vaishampayan, public health officer. Cases of valley fever increased by 90 percent from 2012 to 2017. Vaishampayan said the fungus that causes the infection lives in the soil, and likely the drought years contributed.

Among communicable diseases, Chlamydia and gonorrhea cases increased by 40 percent from 2013 to 2017. Teens and young adults, 15-24, count for 58 percent of the more than 2.500 chlamydia cases. Stanislaus County is No. 3 of the 58 counties in the state for cases of congenital syphilis, a potentially deadly and disabling infection of newborns.

For tobacco use, 14 percent of adults smoke cigarettes and one in three 11th-graders have used e-cigarettes. Among chronic diseases, heart disease is still the leading killer in the county, with stroke and diabetes not far behind, to which unhealthy lifestyle choices may contribute.

But, there was some good news: 96 percent of kindergartners are up to date on immunizations. This is slightly higher than the 95 percent for all kindergartners in the state.

The high vaccination rate likely reflects that state law mandates immunizations to attend public school. But local partnerships also contribute. For example, Golden Valley Health Centers work with local school districts to operate immunization clinics at schools, making access easier for some families.

Vision of CHIP

“The vision is to create a thriving community, where everyone has a chance to be healthy and safe,” said Williams. SCHSA is using a structured approach, called results-based accountability, to work for that vision.

With this method, the agency looks at the results it wants to achieve and then works backward to identify the actions needed to get those results.

Using communicable diseases as an example, the desired result is to eliminate STDs from the county. For chlamydia, gonorrhea and syphilis, available preventive measures include condoms, education and easy access to testing and treatment. One proposed solution was to make condoms readily available in public places, such as college campuses and parks.

Williams emphasized that everyone in the community has something to contribute to the improvement plan, such as an idea, resources or funding.

“Because this is a community-driven process, we want community members, no matter who they are or where they are, if they’re interested to contact Public Health,” said Williams.

Public Health’s phone number is 209-558-7000, and all of its contact information can be found at

This story was produced with financial support from The Stanislaus County Office of Education and the Stanislaus Community Foundation, along with the GroundTruth Project’s Report for America initiative. The Modesto Bee maintains full editorial control of this work.

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ChrisAnna Mink is pediatrician and health reporter for The Modesto Bee. She covers children’s health in Stanislaus County and the Central Valley. Her position is funded through the financial support from The Stanislaus County Office of Education and the Stanislaus Community Foundation, along with The GroundTruth Project’s Report for America initiative. The Modesto Bee maintains full editorial control of her work.