‘Hotspotting’ pinpoints low-income areas that need health care the most

For almost a century, the historic California Hotel in West Oakland, California, has been a hot spot showcase for legendary singers like Billy Holiday, B.B. King and James Brown.

Now, the building on Pablo Avenue - that was added to the National Register of Historic Places in 1988 - is no longer a hotel and entertainment venue but home to more than 100 low-income residents in this increasingly diverse community.

But it remains a hot spot – for completely different reasons.

The site was chosen for a blood pressure “hotspotting” pilot program that pinpoints communities with disproportionately high rates of blood pressure problems to improve health care where it’s needed the most. Known in the health care system as “superutilizers,” these high-need patients, who are more likely to go to emergency rooms, account for 30 percent of health care costs.

Every Tuesday, more than half the residents of the California Hotel come to the lobby to have their blood pressure taken, receive nutritional information, exercise advice and so on.

Kokavulu Lumukanda, 67, a retired antiquarian bookseller, has lived there for a year, a place he calls a refuge “from distressed places in the urban American environment.”

Keeping residents healthy helps keep them housed, he said.

“I go every week,” Lumukanda said. “I use it as a benchmark for my overall health. I have hypertension that I’m being treated for and I need to know where these numbers are … Knowing that I have this blood pressure check coming up up every week causes me to adjust my behavior.”

What is most unique about this program is that developers are spearheading the initiative along with health care partners.

“The public health department came out with natural causes of deaths,” said Romi Hall, Healthy Neighborhoods Manager at East Bay Asian Local Development Corporation (EBALDC). “People live 14 years less in that neighborhood than in more affluent areas.”

EBALDC, non-profit affordable housing developer of mixed-income and mixed-use properties throughout Oakland – many in distressed neighborhoods in Chinatown, West Oakland and East Oakland – decided to do more than house people.

The result was the blood pressure “hotspotting” initiative, part of the San Pablo Revitalization Collaborative (SPARC) of residents, the city, bankers, health department, grocery stores and housing organizations.

“We started to look at what we can do to help the community,” Hall said, an effort that starts with health and will expand to arts and culture, quality-of-life issues such as graffiti cleanup, housing and job creation. A grocery store will come to the neighborhood next month.

About 8,000 people live in three neighborhoods along the San Pablo Avenue Corridor and more than half are African American. The other half is a mix of whites, Asians and Latinos.

“That whole corridor is one big hot spot,” said Brenda Goldstein, psychosocial services director at LifeLong Medical Care, a partner in the initiative and a community health center that provides care to about 50,000 resident of low-income communities in Oakland, Berkeley and part of Contra Costa County.

“We try to keep them out of the emergency department,” Goldstein said.

She calls EBALDC’s initiative “amazing.”

“That a housing developer is leading the effort speaks volume to their understanding of the depth of the problem,” she said. “That’s been very exciting. We’re all learning from each other.”

The initiative is inspired by the Camden Coalition of Healthcare Providers in New Jersey, which uses hotspotting to connect underserved communities with heath clinics and support services in their neighborhoods.

Another partner in the Oakland initiative is Sutter Health, a non-profit organization of 26 hospitals, doctors groups and urgent care centers throughout northern California.

“We know the areas that have the highest most vulnerable residents by ZIP code,” said Mindy Landmark, regional lead for community benefit at Sutter Health. “West Oakland is our No. 1 vulnerable ZIP code.”

The collaboration between health groups and housing developers is “pretty remarkable,” she said. “I don’t know a lot of organizations that are looking through a health lens … how health connects to their residents.”

Longtime California Hotel resident Tyana Rose, the mother of a 2.5-year-old son, is unemployed and six months pregnant. She’s a regular visitor to the weekly clinic to get her blood pressure checked.

“I’m learning about food and blood pressure and what we can do to be healthy,” she said. “I go every week. I’m just making sure I’m healthy and the baby is healthy.”