In this report, many readers will find information significant to their areas of interest or concern. Among the findings, several stand out as especially notable.

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Health areas where we fare well

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• Heart disease is still a leading cause of death, but rates of coronary heart disease have been declining in recent years in SLO County.
   

• In the last 20 years, the number of adults diagnosed with diabetes has more than doubled in the U.S., however, in SLO County, the rate of diagnosis and deaths from diabetes both continue to remain lower than the state overall.
   

• The rate of teen births has been declining steadily over the past several years and has historically been lower in SLO County compared to the state overall.
   

• COVID-19 deaths have been on a downward trend, thanks to now readily available vaccine and treatment options. The disease, which was the 4th leading cause of death in SLO County in 2021 and was responsible for over 3 deaths a day in the county in early 2021, is now responsible for approximately 3 deaths a month, a number that continues to drop.

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Areas for improvement

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• Improving access to health care was voted the number one health issue that must be addressed to improve the quality of life in our community in the 2023 SLO County Community Health Survey. ​This theme consistently came up in focus group discussions, stakeholder interviews, and in open-ended survey responses.
   

• Mental health was voted the #2 health issue that must be addressed to improve the quality of life in our community. In particular, youth mental health came up frequently in discussions, with the persisting high levels of sad or hopeless feelings and suicidal ideation among surveyed students cited as cause for concern, particularly among LGBTQ+ students.  Social isolation for older adults was also a persisting theme. Suicide rates among the general population also continue to remain at unacceptably high levels.
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• Insufficient affordable housing was also an area noted for improvement, voted as the #3 health issue that must be addressed to improve quality of life. SLO County was ranked the 7th least affordable area for housing out of 234 communities in the U.S. and the issue was cited as a persistent source of stress even for those currently housed.
   

• Drug overdose deaths, driven by fentanyl, have been rising dramatically with 71 opioid-related deaths in SLO County in 2021, up from 13 opioid-related deaths in 2018.
   

• Deaths from strokes also continue to be higher than the state average and greater than the Healthy People 2030 target. 
   

• Obesity rates are on the rise, nationally and in SLO County. Those who are overweight or obese have a higher risk of heart disease, type 2 diabetes and certain cancers. The rise is attributed to changes in food environments that make non-nutritious food more available, affordable, and appealing, as well as social and environmental changes that have reduced physical activity among children.

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Finally, it is important to recognize that income often provides access to resources that promote good health—like good schools, health care, healthy food, and safe neighborhoods. Conversely, having a higher income can also help individuals avoid health hazards like air pollution and subpar housing conditions. As a result, low-income groups in the U.S. are more vulnerable to a variety of health issues compared to their higher-income counterparts. Throughout this assessment, we found this to be true in SLO County as well, with low-income groups more likely to rate their health more poorly.

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hEALTH dISPARITIES by population group

The assessment also employed an equity lens to identify populations who experience poorer health than others. Understanding their unique health needs will be essential for improving the health of SLO County as a whole. They are:

 

• Hispanic/Latino populations

• LGBTQ+

• Youth (< 18 years old)

• Older Adults (> 65 years old)

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Analysis of health data by these population groups is utilized throughout this report wherever possible.

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hEALTH dISPARITIES by PLACE

Members of the collaborative also recognized that SLO County's unique geography poses unique challenges and opportunities, with access to health impacted by service distribution, transportation, and community investment, among others. Because of this, analysis of data by city was also employed throughout the assessment wherever possible.