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PAGE 11 as root causes. In this needs assessment, these included housing and land use policies, racism and discrimination, the cost of living and inflation, policy, various structures and institutions, and funding streams. The integration of this framework was particularly important in the development of recommendations. There is an immediate need to provide human services for those suffering in the Tri-Valley. However, there is an equally pressing need to work systemically to remove the root causes of that suffering. This need informed the Approach Recommendations to consider a series of North Star questions to guide the selection and implementation of any strategy to support the health and wellbeing of Tri- Valley residents. It also called for community- and organizational-level challenges and opportunities to answer ‘What are the upstream conditions that have created this need that we might address through strategies that have a community impact?’ Report Considerations A needs assessment is a powerful tool, representing the elevated needs of community members, nonprofit organizations, and direct service providers. Triangulation with census and other published data sources gives a representation of the human service needs and resources in the Tri-Valley. However, while we made significant efforts to engage a broad subsection of people from each of the three cities across a variety of identity characteristics, it is believed that complete representation is not possible. Further, although efforts were made to project future needs, especially in the grounding of the life- course perspective, time will age these findings as the cities and region evolve after these results and recommendations are published. This is not to suggest that these findings are inherently invalid, but rather a call for the varied audiences to use this report as a starting point for conversation and reflection. The perspectives of those who do not see their experiences and priorities represented here are just as valid as those who do. If you disagree with the findings or recommendations here, or identify needs that have not been elevated, EASTERN ALAMEDA COUNTY HUMAN SERVICES NEEDS ASSESSMENT consider this an invitation to advocate for change by raising your individual or collective voice in service of continuing to advance collaborative change. Additionally, as indicated in the discussion of Root Causes and Social and Structural Determinants of Health, many of the needs identified herein represent downstream consequences of structural conditions outside the control of those meeting human service needs. This document can also serve as evidence of the need for continued upstream efforts to reduce the need for human services more broadly. We encourage the use of this document as a mobilizing force to those continuing to advance systemic change. Let’s go back to the G family. Laura does not speak English very well and feels shame when trying to begin a conversation with her neighbor who only speaks English. This shame was magnified one day when she was walking with her daughter Alexa on a beautiful spring day. Laura and Alexa were having a conversation in Spanish when a person walking behind them said: “Speak English, this is America.” As limited as Laura’s English is, she knew what this person meant. Not only did this make Laura even more insecure, but Alexa began to doubt whether she should speak a language other than English in public. Recently, she missed a few medical appointments because the worried about her ability to communicate with her providers. Page 69 of 554