Lane County community health assessment finds worsening housing, access and youth mental‑health gaps

Lane County Public Health staff presented the county’s 2024–25 community health assessment to the Board of County Commissioners on Sept. 25, outlining widespread challenges including housing affordability, declining access to care and high rates of poor mental and emotional health among youth.

The assessment, produced through the Live Healthy Lane collaboration of county public health, coordinated care organizations and other community partners, draws on three assessment streams: a community partner survey of more than 120 organizations, an online community survey with more than 600 responses, and multiple focused data reviews and focus groups conducted between January 2024 and May 2025. Presenters said the design team met every two weeks during the assessment period to guide outreach and interpret findings.

Live Healthy Lane’s work identified recurring themes across the assessments: many residents lack livable incomes and cannot meet basic needs; affordable housing is scarce; access to health care has declined since 2020; youth mental health is a growing concern; climate impacts are increasing and unequally distributed; and structural inequities persist for people who are Black, Indigenous, Latine, Asian, Native Hawaiian and Pacific Islander, LGBTQIA+ people and people with disabilities.

"Together we can do more than we can do alone," Lane County Public Health staff said, citing the Live Healthy Lane collaboration as the vehicle for turning the assessment into an actionable community health improvement plan.

Key findings and illustrative data included: - Economic strain and basic needs: Presenters reported housing, child care and transportation as the highest costs; they noted the county median household income is insufficient for a family of four. The assessment estimated about 56,000 Lane County residents experienced food insecurity in 2021 and said roughly one-third of community survey respondents reported access to affordable healthy food had worsened in the prior three years. - Housing: Presenters said 56% of renters are housing‑burdened (spending 30% or more of income on rent). In 2023, more than 10,000 people who sought services met the U.S. Department of Housing and Urban Development definition of homelessness. Built‑environment analysis found rural and some metro areas with relatively affordable housing had poorer access to public transit, increasing transportation costs for residents. - Health care access: While county BRFSS (Behavioral Risk Factor Surveillance System) data showed improvements between 2014 and 2021, community members and local health system assessment work cited post‑2020 closures, mergers and staffing shortages that have reduced access. Presenters said the county saw long waits for primary care, specialists and mental health services, and that access varied by insurance type and geography. - Youth and mental health: The assessment reported more than one‑third of students who completed the 2022 student health survey rated their mental or emotional health as fair or poor. Presenters also noted higher unmet behavioral‑health needs among students who identify as Black, transgender, nonbinary or LGTBQIA+. - Climate impacts: Presenters said extreme weather and wildfire smoke since 2020 have affected many residents, with some communities (for example, Mackenzie River area) reporting particularly high impacts. A 2024 community survey found nearly 75% of respondents had experienced wildfire smoke in the prior two years; two‑thirds of those said it affected their physical health and more than half said it affected their mental health.

Presenters described assets in the county, including an active network of community organizations (more than half of surveyed organizations reported providing material supports such as food or transportation at least occasionally) and broad willingness among residents to work on equity. The assessment team reported that roughly 60% of organizations surveyed said they use an equity lens in program and policy decisions.

Next steps: Live Healthy Lane is convening a community health improvement coalition that has identified three priority areas—access to inclusive, affordable health care; community resilience and basic needs; and mental health and well‑being—and will develop goals and strategies within those priorities. Presenters and county staff said the assessment data are already informing the county’s strategic plan and have been shared with community partners for grant and program planning. Presenters told the board they will return later this year with a draft community health improvement plan for public and county review.

Board discussion centered on how commissioners and county policy can use the assessment to direct resources and influence state and federal policy. Commissioners noted limited local authority over some drivers (for example, broader health‑care financing and market forces affecting housing) and asked county staff to identify near‑term policy and investment options that align with the assessment priorities.