Health Matters in San Francisco: Community Benefit and its True Benefits for San Francisco

Nov 5, 2012, 10:40 AM

SF Sunday Streets Games at San Francisco Sunday Streets, created by SF Department of Health and diverse partners in response to need for community physical activity opportunities. Photo credit: Jackie Hasa

Several sessions at this week’s American Public Health Association meeting in San Francisco urged nonprofit hospitals and public health departments seeking national accreditation to join forces on community assessment reports that both are required to file.

Assessments can reveal critical needs in a community, such as asthma trends that could point to poor housing conditions. In a growing number of cities, such reports are providing the evidence needed to marshal resources and action such as dispatching case workers to make home visits to help prevent and reduce asthma emergencies. Such expenditures can reduce the cost burden of paying for emergency care and prevent more health crises in the first place.

In San Francisco, the health department and the city’s non-profit hospitals have been collaborating on community benefit and needs assessments reports since 1994 and have achieved much more than “just a sheaf of papers that sits on a shelf,” says Jim Soos, Assistant Director of Policy & Planning at San Francisco Department of Public Health. The collaboration has resulted in a number of critical efforts to improve health here, including San Francisco’s Community Health Improvement Plan (CHIP), which will be launched by early in 2013. 

file Kids playing Sloth Chase at Sunday Streets. Photo credit: Jackie Hasa

According to Soos, the goal of the plan is to improve the health of the community, by fostering ownership and accountability among critical partners including the health department, hospitals, private business, nonprofit groups, community residents, and other stakeholders.

And San Francisco has critical health data to rely upon in order to move forward. Since 2007, traditional hospital community benefit reports have been replaced by the website, Health Matters in San Francisco, developed by the Building a Healthier San Francisco coalition (BHSF) and the Healthy Communities Institute. BHSF, a citywide collaborative with a wide variety of health and health care partners, has three current priorities: increase healthy living environments, increase healthy eating and physical activity, and increase access to high quality health care and services. The website is continually updated as new data becomes available in an effort called Community Vital Signs, which makes use of more than 30 data indicators and has set 10 priority health goals that will be measured every year to track their progress.

file Sloth Chase game at Sunday Streets. Photo credit: Jackie Hasa

The collaborative is looking at each priority area and taking action steps to achieve measureable improvements. One dynamic example is San Francisco’s Sunday Streets program.

San Francisco was the third U.S. city to introduce a Sunday Streets program, which features car-free events to get residents out and active. In San Francisco, the monthly events run from spring through fall, and bar vehicular traffic from designated streets while adding many active opportunities such as free bike rentals. Partners for the 2012 season included Bank of America, the Mayor’s Office, the San Francisco Police Department, the Department of Public Works and the Recreation and Parks Department. “The Sunday Streets program has a tremendous impact on San Franciscans and visitors alike, who have started to envision the streets in a whole new way; not just as a means to get from place to place, but as an opportunity to create a healthier, more connected city for all,” says Ed Reiskin, San Francisco’s Transportation Director.

And getting people out helps build communities. “Sunday Streets and Bank of America share a commitment to building economically strong, connected, healthy communities in San Francisco and to celebrate the many diverse communities that benefit from the program,” says Martin Richards, president of Bank of America San Francisco. 

file Families biking at Sunday Streets. Photo credit: Leah A. Cole, photographer based in San Francisco, Calif., and Petoskey, Mich.

October 20 was the last Sunday Streets of the season for Season, and Allyson Ritger of the city’s Excelsior district was there with her family. “We went to Sunday Streets last weekend, and my daughter, 6, rode a bike for the first time. It was really a sweet experience. We met lots of neighborhood folks, and rode up and down Mission Street for several hours. My husband got the bike the day before for $20 at the Sunnyside Elementary Bike Swap…they gave her a free horn to boot,” said Ritger.

Other participants delighted in coming together out of doors. “Sunday Streets presented me with a sense of community and a reminder that I am one part of a much greater whole,” says Leah Cole, who lives in the area. “In San Francisco,” said Cole, “it is easy fall into patterns of self-absorption and over-scheduling. Sunday Streets counters this because it is community-based (both geographically and socially) and casual; folks being folks in the place they live.”

Sunday Streets also highlights the value of community-sponsored activities that push people to get out and move, especially if they aren’t always motivated to do it on their own. “I brought a friend who [lives in a different neighborhood.] She saw my check-in on Facebook and walked up to join me and others. I mostly rode around by bike. I love riding in the street and feeling safe from cars, especially in areas where there aren't dedicated bike lanes. I pledged to use a reusable bag and got a nifty bag from the Department of the Environment. I watched the SF Bicycle Coalition's Freedom From Training Wheels project—possibly the cutest ever event at Sunday Streets.” 

file Road Race game at Sunday Streets. Photo credit: Jackie Hasa

A challenge of Sunday Streets is to literally to keep the movement going—and that’s the idea behind getting kids to ride bikes and take their training wheels off, and other activities such as Come Out and Play (COAP). COAP is an all-volunteer group started in New York City in 2006. The idea is to offer the public new ways to enjoy and experience their city through games played in public spaces, called “public gaming.” At the last Sunday Streets event, COAP organized several games, many created by design students. While years ago kids might have been content to play tag and stick ball, says Ian Kizu-Blair, COAP’s games director, the creativity behind video games has ramped up the need to make outdoor games much more complex and interesting. Games at the recent Sunday Streets included:

  • Road Race: Participants must pass a sculptural ball (a felt-covered weather balloon) down the road, avoiding obstacles to get it to the end of the line. Students will be testing out different variables–creating obstacles and various metaphorical bumps and pot holes–as well as means of recruiting players out on the street.

file Family walking home from Sunday Streets, after an impromptu soccer game. Photo credit: Leah A. Cole
  • Sloth Chase: This game is “lava tag” with a twist, and creates new and challenging ways to move. It is intended to be slow-moving and accessible to people of average physical ability.
  • Origami Fishing: A variation on the classic carnival fishing game, it's played in the street, and participants make their own game pieces out of recycled materials before starting, combining artistic craft and physical activity.

Later this month, Come Out and Play/San Francisco will be joining up with Playworks, a national nonprofit that is working to help transform the lives of kids by providing safe, healthy and inclusive play and physical activity at recess and throughout the school day, supported by the Robert Wood Johnson Foundation. Come Out and Play will be hosting game design workshops at a San Francisco elementary school, with ten year olds designing active games for younger kids. At least one of the kids-designed games will get its public debut at the Come Out and Play festival in San Francisco in early December.

>>Bonus Link: The Come Out and Play website offers lists of innovative outdoor and physically active games.

This commentary originally appeared on the RWJF New Public Health blog.