Safety, stress and public health: Chinatown-International District neighborhood voices

In the first segment, What you may not know about health in the CID, we shared insights about the Chinatown-International District from the perspective of analyzing neighborhood-level health data.  In this second segment, we talk with Valerie Tran, Healthy Communities Program Manager of the InterIm Community Development Association (InterIm CDA) to learn about their recent community public safety survey and how chronic stress and public safety affect the community.

Residents discuss their aspirations for a healthier neighborhood at InterIm CDA’s monthly community meeting

How does public safety connect with health?
Ms. Tran: Public safety is a major social determinant of health for our neighborhood as it is in many other low-income communities of color. From a public health standpoint, we often think about immediate injury and trauma that results from violent crime. What we learned from our community survey is that it’s equally important to think about the long-term physical and mental health consequences of living and working in a state of chronic stress due to a lack of real or perceived safety.

Community members often tell us that they won’t leave their homes after 4pm because they’re afraid to go outside. When people stay cooped up in their homes, they can easily become isolated and sedentary. Social isolation and sedentary lifestyles can lead to serious health outcomes including anxiety, depression, diabetes, heart disease, high blood pressure, and obesity.



Do residents feel safe in their neighborhood?
Ms. Tran: We learned from the public safety survey that 70% selected the response “somewhat true” to “very true” that they experienced anxiety or stress as a result of feeling unsafe in the CID. All ages and language groups reported feeling some level of anxiety or stress due to their perception of CID as a dangerous neighborhood. Constant stress and anxiety can be damaging to physical and mental health. In addition, fear of going outside keeps people from engaging in meaningful physical or social activity.

In addition, 45% of respondents felt that they do not have a safe place to go in the CID in the event of an emergency. This was really disheartening. Not having a place to go in the case of an emergency is a source of stress for the community.

Seattle’s booming economy continues to place our neighborhood under significant pressure and threat of residential and commercial displacement. When your environment, social network and existence as a community is under threat in every way, how can you lead your healthiest life?   These are questions we hoped the survey and 2020 Healthy Community Action Plan could inform.

How does stress, anxiety and mental health manifest differently for Asian Pacific Islander communities?
Ms. Tran: The survey findings reinforce what we know from data:

More people report having poor mental health in the CID than anywhere else in King County.

We also know from our extensive community engagement that many community members—especially elders and newly-arrived immigrants—experience a greater degree of social isolation which negatively affects physical and mental health.

Asian and Pacific Islander (API) communities historically have not had the tools or support to appropriately cope with stress and associated mental health issues. Addressing mental health is particularly challenging for API communities because of cultural factors that place stigma on seeking care for mental illness, language barriers that make it difficult to access mental health services, and a lack of awareness of available resources. As a result, many APIs tend to dismiss, deny, or neglect their symptoms which can exacerbate their mental health conditions.

Thankfully, there are many local organizations, including the International Community Health Services (ICHS) and Asian Counseling and Referral Service (ACRS), which have spent decades working to reduce stigma around mental health and increasing access to care for APIs and other immigrant and refugee groups.

We know there is still more work to be done. Look for Part 3: A way forward:  Chinatown-International District community perspectives in the upcoming weeks.

And if you would like more information about the Healthy Communities project, email

 Photos courtesy of Interim Community Development Association