Tacoma, Washington

Tacoma, Washington is a mid-sized port city located along the Pacific Northwest’s Puget Sound, just 34 miles south of Seattle.

Military and industrial jobs have been at the forefront of Tacoma’s economy for the past 100 years. Paper manufacturing and copper smelting historically provided employment for blue-collar workers, but in recent years these industrial jobs have faded from the economic landscape, making way for a growing number of jobs with local public schools and health care systems.

Tacoma grapples with multiple challenges to health and well-being, including residents who have not benefited from the relatively stable job market, unsafe neighborhoods, environmental pollution, and insufficient capacity to meet its citizens’ mental health needs. At the same time, the city must contend with lead and arsenic that is leaking into the environment from defunct smelting operations. Despite these challenges, Tacoma has a history of cross-sector collaborations and civic engagement that provides hope for a brighter future.

Overview

Population and Demographics

Population: 201,794

SOURCES:
U.S. Census Bureau; photography courtesy Flickr user Kris Symer, CC BY-NC-ND 2.0.

Context and Actions

Community Context and Challenges

The unemployment rate is higher in Tacoma (11%) than in Washington State (9%), while poverty rates in Tacoma among all residents (18%) exceed rates in Pierce County (13%) and Washington State (16%).
Historically, many of the same neighborhoods where Tacoma’s poorest residents lived have also been rife with gang violence and related crime.
The rate of violent crimes in Tacoma (792 per 100,000) is more than 3 times the rate in Washington State (285 per 100,000); the burglary rate in Tacoma (1,524 per 100,000) is approximately three times higher than the state rate (543 per 100,000).
The city lacks the capacity to treat widespread mental health challenges. Between 2010 and 2012, 21% of regional residents reported mental illness and about 5% had thought seriously about committing suicide, however between 2006 and 2010, the region lost two inpatient facilities for mental health care.
Direct contact with polluted soil and water toxins found in former industrial sites can have harmful effects on the eyes, skin, liver, and respiratory and central nervous systems.

SOURCES:
U.S. Census Bureau. (2014). 2010–2014 American Community Survey 5-year Estimates.

Taking Action

Today, the city of Tacoma is deeply committed to efforts that will improve the health and well-being of its residents.

Earlier efforts to make Tacoma a healthy and safe community faced overwhelming barriers, but a comprehensive planning effort underway has engaged city residents, highlighted the city’s most pressing problems, and targeted those problems with concentrated action. This targeted approach and the city’s demonstrated capacity for collective action have the potential to make Tacoma a healthier and safer city.

NOTE:
These baseline reports, created in 2016, reflect our initial observations on select community programs and initiatives to gauge ongoing, as well as newer, efforts to improve community health. Future reports will provide more in-depth insights and analysis into this community’s activities.

Community Health Improvement Plan

The Community Health Improvement Plan (CHIP) lists mental health, access to quality health care and preventive services, and chronic disease as the top three priorities in Tacoma.

Published in May 2014, the plan describes a vision for a healthier community that focuses on increasing Health Equity, improving civic engagement among those living in marginalized communities, recognizing and focusing on social determinants of health, expanding partnerships and increasing the use of evidence-based practices.

Safe Streets

The “Ash Street Shootout” was a turning point in the community’s approach to crime and violence. In the wake of this event, more than 2,500 residents and leaders from the business, municipal and nonprofit sectors created Safe Streets, an initiative to improve neighborhoods safety and reach youth at-risk for gang recruitment.

Health Equity Assessment

The comprehensive assessments led by the city and the county have recently been augmented by a health equity assessment. Led by the Tacoma-Pierce County Health Department, this assessment focused on geographic areas of the city where residents face difficulties accessing health care and behavioral health care, have a high prevalence of chronic health conditions and obesity, and lack access to healthy foods. The health department is working directly with these communities and local organizations to craft solutions to the challenges they face.

Funding Mental Health Programs

Efforts to address Tacoma’s unmet needs for mental health disorder prevention and treatment were begun in December 2012, when the city commissioned the Tacoma Pierce County Health Department to conduct a mental health and chemical dependency assessment as part of the city’s tax ordinance planning process. The Tacoma City Council unanimously passed a 0.1% increase in the sales tax to support wider access to substance abuse and mental health treatment programs and services, including therapeutic court programs and case management.

Going Forward

Tacoma has a long history of engaging residents and multisector partners to find solutions to community problems. Additional surveillance, data and information gathering, and analysis will examine some of the ways in which stakeholders are working to create a healthier, more equitable community; the impact of new and ongoing initiatives to address priority health concerns; and whether gaps are emerging in priority areas.

Additional surveillance, data and information gathering, analysis, and reporting will examine how Tacoma responds to lingering concerns, including:

In what ways is the city of Tacoma addressing economic disparities throughout the county?
What impact has Tacoma’s Community Health Improvement Plan had on improving the health of all residents? Which goals have been reached? Which goals have been reevaluated?
How has the city of Tacoma used information from the health equity assessment to inform activity planning?
To what extent have efforts by local residents and nonprofit organizations been successful in reducing the influence of gangs in Tacoma?
In what ways is Tacoma addressing health inequity throughout the county, and specifically among low-income residents?
In what ways have recent initiatives addressed the top priorities listed in the CHIP (mental health, access to health care, and chronic disease prevention)?
How can the success stories for smaller community-driven initiatives be scaled up to address other drivers of health and well-being?
To what extent are other coalitions and collaborations addressing the social, structural, and economic drivers being leveraged to consider their role in health and well-being? What are key facilitators and barriers to initiating or maintaining those linkages?