Community Health
Needs Assessment
and Health Improvement Plan
Kayla Gupta
Community Outreach Manager
Purpose of the CHNA and CHIP
• Federally mandated every three
years
• Based on data analysis and
community interviews
• Identify local health needs,
highlight areas of focus
• Enable development of outreach
and education strategies
Washington T ownship Health Care District Population, 2024 District T otal Population: 340,642
• Fremont: 228,192
• Newark: 46,254
• Union City: 66,196
AC Most Common Languages Spoken:
• English
• Spanish
• Chinese (Cantonese and Mandarin)
• Tagalog/Filipino
• Hindi
• 54% of Tri-City speak languages other than
English at home (regardless of English
proficiency)
Racial and Ethnic Demographics of Fremont
Key Health Needs from 2025 Assessment
1. Economic Security
2. Behavioral Health
3. Healthcare Access & Delivery
4. Inequity & Discrimination
5. Cognitive Decline
6. Diabetes & Obesity
7. Heart/Stroke
8. Cancer
9. Maternal/Infant Health
10. Unintended Injuries
City vs. Alameda County
5 Fremont health indicators worse than Alameda County
0% 5% 10% 15% 20% 25% 30%
Heart/Stroke: Stroke Hosp
Unintended Inj: Pedestrian Mort
Heart/stroke: Cardiac Dysrhythmia ED
Heart/Stroke: Ischemic Stroke Hosp
Cognitive: Alz/Dementias ED
Disease Incidence compared to Alameda County Rate, per 100,000 pop.
Focus Areas for 2026-28 CHIP
1. Healthcare Access & Delivery
2. Healthy Lifestyles
• Diabetes & Obesity
• Heart/Stroke
• Cognitive Decline
3. Cancer
4. Unintended Injuries
Healthcare Access & Delivery
Healthcare Access & Delivery
• Prioritized in 50% of all discussions
• Emphasis on language barriers which can hinder access (between healthcare providers and patients)
• Need for culturally relevant care, providers who
understand and reflect identities/cultures of patients. • >90% of South County Residents are insured but
around 25% have difficulty accessing care.
• Racial inequities:
o Undocumented residents increasingly delaying or
cancelling care
Limited access to health care services in
languages other than English and a lack of
culturally sensitive providers can create
challenges for diverse populations.
–Focus Group participant
People have waited months and months and
months for appointments with their primary
care provider. It is crazy.
– Key Informant Interviewee
Increasing Healthcare Access & Delivery
• Level II Trauma Center (opened July 2024)
• Urgent Care Center (opened December, 2025)
• Warm Springs Outpatient Center (under development)
• Subsidized Resources:
• ReCARES, community DME program, hosted on campus
• Community Lymphedema Garment Program
• Free Health Insurance Information Service
• Increasing WH’s cultural competency and provision of care in multiple languages
• Washington Health Financial Assistance and Charity Care Policy • Participation in Medi-Cal program (Alameda Alliance)
• Increased collaboration with Federally Qualified Health Centers • Adding opportunities for community engagement with
Community Advisory Board
Healthy Lifestyles
Healthy Lifestyles
• Diabetes
• Community expressed need for better access to healthy foods and safe places to exercise. • Diabetes rates in the Healthcare District consistently worse than the county overall. • Heart/Stroke
• Stroke, heart disease, and heart attack are among the top causes of death in the county. • Ischemic Heart Disease ED Visits and Hospitalizations worse in Fremont than Alameda County.
• Cognitive Decline
• Risk factors associated with cognitive decline (ex: diabetes, high blood pressure, obesity) are of concern in the healthcare district
• Alzheimer’s Disease mortality is substantially higher for both Black and White community members
Diabetes prevalence increasing year over year
Alzheimer’s disease mortality highest in the Black population
Promoting Healthy Lifestyles
• Health education programming (education seminars, speaker’s bureau and community wellness fairs)
• FY24-FY25: 160 events
• Community groups, schools, businesses, senior centers, senior living communities
• Support Groups
• Diabetes Matters and Diabetes support group
• Mended Hearts support group
• Better Breathers support group
• Stroke Support Group
• Partnerships and Education Focus Areas to explore:
• Heart Smart Walking Challenge with Union City and Newark • Stroke and heart disease education with school districts • Diabetes education for Latino population
• Alzheimer’s Association
Cancer
Cancer
• Cancer was the number one cause of
death countywide in 2022.
• Community concerns:
• Financial burden of cancer
treatment
• Lack of access to comprehensive
cancer screenings
• Need for mental health support for
cancer patients and families.
“First of all, I would like to talk about cancer. In many ways, when you hear that someone has cancer, [you
think about their] income, work, …losing their job.”
—Key Informant Interviewee
Treating and Preventing Cancer, Supporting Patients
• UCSF partnership:
• access to oncology clinical trials
• Sub-specialization of physicians and staff
• Academic-level care in South County
• Resources for patients:
• Celebration of Life
• Think Pink breast cancer awareness event
• HERS Breast Cancer Foundation on campus
• Community Mammography Program
• Breast Cancer Support Group
• Oncology Support Group (planned)
• Prevention
• Skin Cancer Screening Program
• Low Dose CT Lung Cancer Screening
• Medi-Cal cancer screening campaign
• Colorectal and prostate cancer education and screening for Black residents
Unintended Injuries
Unintended Injury
• Unintended injuries were the number one reason for
preventable ED visits and hospitalizations in all three district cities and the county.
• Includes falls, motor vehicle crashes, drownings,
poisonings, pedestrian-related injuries, and industrial accidents
• Community concerns:
• Undocumented individuals in unsafe work places
• Homeless residents injured on the street
• Racial and Economic inequities:
• Data for unintended injuries mortality highest for
the black population
• Racial inequities tied to lack of access to safe
transportation and absence of sidewalks in low-
income neighborhoods
“That’s how so many people die. They get an injury,
the injury gets infected. And then what? You know, they don’t have a place to like rest, they don’t have a place to shower regularly. But health care is huge. That is
very much a basic need.”
—Key Informant Interviewee, discussing
unhoused individuals
Death rates due to unintended injuries highest in White population in Newark
Preventing Unintended Injuries
• Level II Trauma Center
• Fire, police and EMS partnerships
• Injury prevention programming, including falls
prevention, Stop the Bleed, choking first aid education, distracted driving
• Balance classes for Seniors (Bingocize and Matter of
Balance programs)
• Screening and intervention programs for alcohol abuse • Screening and referral programs for PTSD and
depression post traumatic injury
• Community Safety Fair
• Trauma survivor network
• Y outh Alive! Recidivism Reduction Partnership
Thank Y ou!