The COVID-19 pandemic and the health gaps it exposed has forced Santa Ana City Council members to ask themselves whether it’s time to create a city-run public health department.
In the beginning of the pandemic last year, testing resources and educational outreach throughout Santa Ana’s working class neighborhoods were scarce.
The city also struggled to get vaccines to its residents quickly, pushing Mayor Vicente Sarmiento to publicly criticize local, state and federal officials in March.
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Now, the city has hired a firm to study if it’s possible for Santa Ana to create a full-fledged health department, a hybrid of sorts that will work with the county agency or create a health officer of its own who acts as a liaison to bring targeted services to the city’s neighborhoods.
The city has been hit particularly hard by COVID-19, with more than 48,000 cases and nearly 900 deaths since the pandemic started early last year.
Before the pandemic, many of the city’s residents struggled with a host of health issues.
“We have many immunocompromised residents with diabetes, hypertension,” Sarmiento said in a phone interview.
Sarmiento said the disparities were laid bare when the pandemic hit.
“That just became magnified during the pandemic when it came to COVID-19 testing and later when it came to delivery of vaccines,” he said. “Which begs the question for me to ask, can we do better? … COVID just made that question even more necessary for us to ask now.”
Nancy Mejia, chief program officer for the community organization Latino Health Access, also said the pandemic has shed light on the various health disparities throughout the city.
“Santa Ana has a very vulnerable population when we talk about health care access, but also the different social determinants of health that include housing, employment, education — we really saw that in this pandemic,” she said in a phone interview.
Latino Health Access has been critical in getting testing, education and isolation resources to residents throughout the hard hit communities of Orange County.
The organization switched much of their efforts to vaccinations once they became widely available earlier this year.
Meijia said addressing the various health gaps up front helps curb long term issues.
“We have been advocating for health equity for a long time. And the concept of equity in practice means that you invest more in the communities that are the most vulnerable so that everyone is better in the long run.”
She said creating a public health department or some type of health officer position is a step in the right direction.
“We are supportive of an initiative like this,” Mejia said. “This is something that is only going to add to all of the work that we’re all doing.”
Many census tracts throughout Santa Ana have a high prevalence of obesity and diabetes, according to a county-commissioned health equity map.
Chronic conditions like obesity and diabetes increase the chances of people having severe COVID symptoms, which can lead to death.
Sarmiento said the city’s still in a research phase and has hired a firm for roughly $180,000 to examine the cost of creating its own health department.
The firm, Health Management Associates, will spend the next year examining the different possibilities of Santa Ana creating its own health department or health officer.
Sarmiento also said the health officer or department would work closely with community based organizations like Latino Health Access to drill down on community health disparities.
The city already has existing partnerships with many organizations and health care clinics, especially since the pandemic hit.
“The way I envision this is if we decide to venture out and create our own public health department, we expect to partner with Latino Health Access and the community health care clinics. In fact we just received a $4 million grant from the Office of Minority Affairs for a health and equity and literacy grant. So we actually partnered with not only Latino Health Access and the community health care clinics, but also UC Irvine and the Orange County API Alliance,” Sarmiento said.
Anaheim City Councilman Jose Moreno, who floated the idea of creating a city health department last year, said Santa Ana’s move is a step in the right direction.
“When I look at comparable cities, I look at Long Beach and how well they did — they did really well in a unified and efficient and well resourced way to attack the pandemic,” Moreno said in a phone interview. “They were able to mobilize their departments in a way that was quite powerful.”
Sarmiento also noted city-run public health department efforts.
“I do see other communities, like Long Beach and Pasadena, where they were able to quickly respond to pockets of their cities that were being impacted,” he said.
Moreno said cities had to rely on county officials when OC Supervisors were pushing back on pandemic mandates like masks and business restrictions last year.
“We didn’t have that in anaheim. We had to instead rely on a county government who was wrestling with whether the pandemic was real or not while Anaheim was getting hit hard,” Moreno said.
Like Santa Ana, Anaheim’s also been hit hard by the virus, with more than 46,000 cases and 943 deaths.
The two cities have large Latino communities, who have been disproportionately affected by the virus.
Public health experts interviewed over the past year and a half attribute the disproportionate impact to overcrowded housing, the inability to work from home and a lack of access to health care.
Moreno pitched the idea of creating a city health department to his Anaheim council colleagues, but failed to get enough support to have an official discussion on the issue.
“There was no analysis given to us about our vulnerability in Anaheim. We had to rely on the county dashboard to derive it,” he said, adding that a health department would’ve made the city “better equipped to partner with our public systems and our faith-based organizations — and of course our nonprofit sector.”
Long Beach Mayor Robert Garcia said having a city health department allowed officials to respond quicker to community needs during the pandemic.
“It did allow us to move faster, move quickly. But it’s also important to note that we integrated a relationship with [the Los Angeles County Department of Public Health],” Garcia said at a news conference convened by Supervisor Katrina Foley.
Garcia noted that only Long Beach, Pasadena and Berkely are the only cities in the state to have their own health departments and it might be too expensive for cities to create their own departments.
But, he said, a liaison or a health officer could be a good move.
“What I do think is a good intermediate step … is having a public health liaison, officer, public health office that is integrated into the public health system,” Garcia said.
Foley said it was difficult to get more detailed information from the OC Health Care Agency during her time as Costa Mesa mayor.
“We need to do a better job of allowing our health officials to engage with each of our cities more, to have more direct communication with our cities. That to me is the crux of the concern,” Foley said.
Spencer Custodio is a Voice of OC staff reporter. You can reach him at firstname.lastname@example.org. Follow him on Twitter @SpencerCustodio