As impacts from the COVID-19 pandemic linger, maintaining good health remains at the top of mind for many, including physical, mental, emotional and even financial.

The demand for adequate, accessible health care in the Tri-Valley is only growing and local health care providers like John Muir Health have recently shared ways in which they are addressing the community's needs.

John Muir's 2022 Community Health Needs Assessment (CHNA) zooms in on the top priority health needs of the Tri-Valley and their subsequent implementation strategy identifies plans to tackle them.

The 212-page CHNA -- initially released in December -- was a collaborative effort among several local and regional health care providers, including John Muir and Stanford Health Care Tri-Valley as well as Sutter Health, St. Rose Hospital and UCSF Benioff Children's Hospitals. Kaiser Permanente, the Alameda County Public Health Department and Contra Costa Health Services were also partners involved.

Behavioral health, structural racism, economic security, housing and homelessness, health care access and delivery, community and family safety, food security and transportation were identified as the Tri-Valley's top eight priority health needs.

Behavioral health was No. 1 on the list across the board for all of John Muir's service areas, including the Tri-Valley along with eastern Contra Costa County, central Contra Costa County, western Contra Costa County and northern Alameda County.

The report is conducted every three years as required by the state for nonprofit hospitals. As part of the requirement, the CHNA must include input from experts in public health, local health departments and the community, including representatives of minority, low-income, medically underserved and other high-need populations.

According to Jamie Elmasu, director of community health improvement for John Muir, once priority areas are identified -- through a process that involves collecting and analyzing various sets of health data and engaging community focus groups -- each health care system brings the information back to their respective internal stakeholders to figure out a strategy to address those needs over the next three years.

John Muir Health has developed a 2023-2025 Community Health Implementation Strategy that thoroughly outlines their approach to tackling the needs of the communities they serve.

With behavioral health being the top need throughout the region, Elmasu said that was an obvious key focus area for the health system. According to the CHNA, behavioral health refers to mental health, emotional and psychological well-being, along with the ability to cope with normal, daily life. Behavioral health also covers substance abuse, which affects many other aspects of a person's overall health.

While none of the region's top health needs are new issues, Elmasu reiterated that they were exacerbated by the COVID-19 pandemic and are affecting a broader range of people than typically seen during pre-pandemic years.

Citing behavioral health as an example, Elmasu said, "We're seeing it across the board, so not only uninsured and low-income folks that we typically serve; it's now insured people and even youth. We know issues with our young people -- and specifically our teens -- have become so severe and figuring out how can we better serve our young community through our community benefit opportunities is critical."

The health system's other focus areas for this cycle include health care access and housing and homelessness, which are also issues that had a new light shed on them as a result of COVID-19, particularly as it relates to accessing vaccines.

John Muir's mobile clinic is one of their offerings that played a significant role in bringing the vaccines to the community. "Our Mobile Health Clinic and our nurses were actually one of the first to become trained in vaccine administration and in COVID testing," Elmasu said, adding that they are proud of their ability to serve the community during such a critical time.

In addition to structural racism overall being recognized as a significant health need in the report, the CHNA identified racial disparities within the other categories, with African American and Latino communities being impacted by several of the various health needs at a higher rate than other demographics. As a result of these findings, John Muir is also taking a closer look at how to improve the issue.

Part of their implementation strategy involves investing additional funding dollars to all of their nonprofit partners to provide workshops and education sessions and those organizations are tasked with creating an intervention to address structural racism internally like employment practices, human resources policies, board of director involvement and other aspects of the organization.

"It's very innovative and it's very new as it relates to how our community health team is partnering with our nonprofits," Elmasu said.

Accomplishing the goals to improve upon the community's needs is a process that takes time and does not come without its challenges. While their strategy aims to make an impact, there is no quick fix to the health issues affecting the Tri-Valley and beyond.

"The single most pressing barrier, in my experience, is the fact that we're trying to solve societal problems at large," Elmasu said. "We're only a few people. We have limited budget, so we have our limitations internally and of course we're limited in terms of which nonprofit partners that exist in the area."

She continued, "When we look at Contra Costa County versus Alameda County, Alameda County has a more robust nonprofit network providing services to the community, but Contra Costa County is growing so our nonprofit organizations, many of them that started in central county in Concord now have secondary or satellite offices out in Antioch or east county."

Elmasu said that while there isn't a magic amount of dollars that's going to resolve the issues overnight, she feels strongly that through their efforts and those of other health care systems in the area, they can impact a number of people and families to significantly change their health trajectory.

One of their newest partners as of this year is Livermore-based Goodness Village. John Muir is providing the nonprofit tiny home community with funding to support a full-time case manager for the next three years as the organization also plans to expand with additional housing units.

Elmasu also highlighted that once John Muir fully acquires San Ramon Regional Medical Center, they will be able to better serve the Tri-Valley region at large.

"We're already doing some things, but we're not doing a tremendous amount in the Tri-Valley -- the reason being is that our hospitals currently are located in Concord and Walnut Creek and so our primary focus area is going to be around those hospitals. But we do have an outpatient center in Pleasanton and now of course if we're expanding to purchase another hospital, I think what does that mean to make those services more robust is the question," she said.

John Muir's CHNA and Implementation Strategy are available to the public on their website.