Report Publish Date: October 2022
This report summarizes San Diego County, California’s health, wellbeing, and equity journey from 2016 to 2021, as part of RWJF’s Sentinel Communities Surveillance project.
“San Diego County benefits from the capacity of well-funded and innovative
government agencies, healthcare systems, and nonprofit organizations,” the authors write. Health promotion efforts over the period studied focused on mental and behavioral health, affordability and addressing homelessness and food access, and advocacy and services for immigrants.
San Diego County has a reputation for being a healthy place, but awareness of deep health disparities has mobilized cross-sector collaboration. The authors say the community has made progress on expanding budgets and community conversation to include mental health, housing, and equity.
“San Diego County is leveraging a long-time commitment to health, along
with collaborative structures and increased community engagement,
to make progress toward addressing health and wellbeing,” they write. “However, inequality within the vast county is driven by legacy policy choices, coupled with current affordability challenges; and collaboration is challenged by the diverse needs of different residents.”
Begun in 2016, RWJF’s Sentinel Communities Surveillance project tracks how a Culture of Health is developing in 29 communities across the country. The authors wanted to describe key challenges, opportunities, and insights in San Diego County.
The authors gathered information from phone interviews with Sentinel Community leaders; online, published, and local materials and media about the communities; and data sources including the Census Bureau’s American Community Survey, the CDC’s Behavioral Risk Factor Surveillance System, County Health Rankings, and state and local data collection systems.
For this report, the authors conducted 34 hourlong, semi-structured interviews between early 2017 and spring 2022. Interviewees came from several different types of organizations and sectors.
“Since 2017, local leaders have expanded efforts to increase equitable access to services and health-promoting amenities as part of a broadening understanding of the drivers of health. They have also explicitly named systemic racism as one of those drivers.”
—RAND Corporation
"San Diego County’s journey to promote health, wellbeing, and equity is one that illustrates how a community can embed collaboration into its government structures,” the authors write, “but also one that sheds light on how a shared vision and apparent prioritization of health are not always sufficient to make rapid progress.”
San Diego County is a vast, racially and ethnically diverse county in coastal southern California. It is known as one of the healthiest communities in the country, a recognition that masks significant inequality in health and wellbeing outcomes among different parts and populations of the county. San Diego County has an integrated health and human services department and many engaged health systems, academic institutions, and nonprofit organizations. Over the past five years, the county has ramped up collaborative health promotion efforts and capacity to address persistent challenges related to homelessness and mental health, transportation, and food access. These efforts reflect a broadening of the local narrative around health—one that already prioritized healthy lifestyles—to center mental health and the social drivers of health. Though leaders for health in San Diego County had been talking about equity for many years, racial equity became a central aspect of the approach over the past five years. The county realigned approaches to measurement and data reporting, hired new staff, and redoubled commitments to community engagement to try to make progress on systemic barriers to health and wellbeing.
Robert Wood Johnson Foundation, October 2022
This study and report was conducted and created:
With an activist history and long-standing commitment to health, see why Vermont consistently ranks as one of the healthiest U.S. states.
A library of research and perspectives about Sentinel Communities, 30 diverse communities around the country.