Glimpse into SROs paints ‘disheartening’ picture of health risks

San Francisco’s largest supply of low-cost housing for the most vulnerable residents poses significant health risks, a new report has found.

Those living in and around single-room occupancy (SRO) hotels are much more likely to end up in the hospital for illnesses like asthma or falls than residents living elsewhere in The City, according to the Department of Public Health’s health impact assessment report, “Improving the Health of Residents in SRO Hotels.”

The report provides a rare glimpse into what life may be like for the estimated 19,000 residents living in these SRO units spread out across some 580 buildings — some of which are city-funded — in neighborhoods like the Tenderloin, Chinatown, South of Market and the Mission.

While the units are intended for single-room occupancy, many families live in them, including an estimated 1,000 public school students.

Among the report’s conclusions is that adults in the areas of the most SRO units are hospitalized for asthma hospitalization twice as often as The City average; COPD rates are three times The City’s average; emergency room admissions for falls are two to three times The City’s average; and emergency room admissions for self-inflicted injuries are three to four times The City’s average.

These illnesses are associated with the most commonly cited single room occupancy building code violations. Fatal drug overdoses are also considered high and increasing, raising concerns of social isolation and people dying alone in their rooms.

The findings are the result of a study that began in late 2013, which didn’t measure the health of SRO residents directly. The mean age of SRO residents is 55, and about 65 to75 percent are people of color.

The economic boom beginning in 2011 has put increased strain on the SRO model, the report also found.

“SROs have been an integral part of low-income housing in San Francisco,” Cynthia Comerford, Department of Public Health Impact Assessment Project Director, told the Health Commission on Tuesday.

“Although tenants of SROs have been facing problems for a long time now, rising rents, affordability issues with building repairs, increasing homelessness and also a spiraling drug epidemic has caused a lot of issues with SRO operators and SRO tenants,” she said.

A draft of the report’s findings was presented to the commission Tuesday, and a final report and recommendations are expected to be adopted by the commission during its Sept. 6 meeting that will be held in the Tenderloin.

“Having been somebody who worked in SROs, these datas actually are not a surprise, unfortunately,” said Health Commissioner Cecilia Chung. “It’s kind of disheartening.”

The report makes five recommendations to improve the conditions, including mandatory training for SRO operators on how to handle tenants and manage building conditions. The report also recommends operators report annually more building details such as if rooms have a kitchen or microwave, and encourages improving data of building inspections, which is performed by three departments: Building Inspection, Fire and Health.

“We have three different data systems that don’t really talk to each other,” Comerford said. She added, “There is no consolidated way to find inspections and violations of housing — let alone SROs — in San Francisco.”

Comerford said building violations in SROs are “very common,” for such things as bed bugs, mold, garbage and structural conditions.

In addition to living conditions, the area around SROs also pose significant health risks: High concentrations of alcohol sales, 70 percent of vehicle-versus-pedestrian crashes taking place within a fourth mile of SR0s, and more heavily concentrated crime.

“It’s very harsh conditions in which these people are living,” Comerford said.

SRO operators said during interviews they are aware of building laws but complained of “fragmentation” of The City’s enforcement and codes. The report found the operators lacked appropriate skills to deal with tenants with issues such as hoarding and were unaware poor building conditions could lead to health problems for tenants.

Operators also said “there has been a dramatic increase in mental health issues over the last five years and the notion of ‘extreme tenants’ impacting the health of other SRO tenants,” according to the report.

SROs rooms are not just a resource for low-income tenants, but also a vital housing resource for The City’s social service programs. The Public Health Department’s homeless outreach team places people found living on the streets into SRO rooms, for example.

“We want healthy communities … throughout our SRO system in all the ways that we define health,” said Health Commissioner David Pating.

How to achieve that, however, remains unclear and many “problems” persist outside the purview of the department, according to Comerford.

One example, she said, is that some tenants never are afforded tenants rights since they are moved around before becoming official tenants, which is defined as staying longer than 30 days.

“Basically, what happens, some of the ones, they try to do something called musical rooms where they try and shuffle them from room to room so that they never get tenant rights,” Comerford said.

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