The Snohomish Health District building in Everett. (Sue Misao / The Herald)

The Snohomish Health District building in Everett. (Sue Misao / The Herald)

Report: Homelessness, mental illness trending up in Snohomish County

The report synthesizes health data and identifies “top health priorities,” including food insecurity, prenatal care and more.

EVERETT — One-third of pregnant women get inadequate prenatal care in Snohomish County.

Girls are twice as likely as boys to report depression and anxiety symptoms.

And food insecurity affects one in 11 people in the county.

Those are some of the jarring realities in a new Community Health Assessment, released Tuesday by the Snohomish County Health Department.

The report summarizes health data for Snohomish County and identifies six “top health priorities:” homelessness, opioid overdoses, mental health access, Adverse Childhood Experiences, prenatal care and food insecurity. A 15-person committee voted on the priorities after going over data for “nearly 200 health-related indicators” with health department staff, the report said.

Lead epidemiologist Miyuki Blatt said the report was intended as a tool for health officials, community organizations and “individual people who just want to know about the health of their community.”

Here are six big takeaways.

1. Homelessness is rising

Homelessness continues to rise in Snohomish County. That’s based on a metric called the point-in-time count, which identifies the number of people without permanent housing on a particular day each year.

Last year, it was 1,184 people. This year, it was even higher at 1,285, though the report doesn’t include 2023 data.

The statistic comes with the caveat that the count points to trends rather than exact numbers. Still, it’s telling that it has continued to climb in recent years, according to the report.

More than half, 57.7%, of the homeless population is male, according to an average of count data between 2016 and 2020.

Demographic averages from the same time period show a disproportionate number of homeless people are Black or Native American.

2. Overdose deaths are rising too

Overdose deaths have increased dramatically in recent years.

In 2015, around 17 in every 100,000 people died of a drug overdose in the county. In 2020, that number rose to 27, significantly higher than the state’s 22.5.

When you isolate opioid overdoses, it becomes clear what is driving that increase. The county’s opioid overdose mortality rate has almost doubled since 2015. That change is “widely attributed” to fentanyl, the report points out.

Fentanyl is especially deadly because of its potency — it’s 50 to 100 times more potent than morphine. That means the overdose risk is higher.

This year drug overdoses increased in Everett by almost 500%, according to preliminary data released this month by the Everett Police Department. In an interview, Mayor Cassie Franklin said the majority of the overdoses involved fentanyl.

Nationwide, opioids accounted for almost 75% of fatal drug overdoses in 2020.

3. Young people are struggling

Almost 40% of students between eighth and 12th grade reported symptoms of depression in 2021, increasing about 5 percentage points from 2016.

A similar amount — 37.4% — reported anxiety symptoms, a rise of 10 percentage points in the same time period.

Notably, girls were twice as likely as boys to say they had depression or anxiety symptoms.

Girls were almost twice as likely to have three or more Adverse Childhood Experiences, or ACEs, according to the report.

ACEs are traumatic experiences like abuse or incarceration of a family member. Native American and multiracial students were more likely to have an ACEs score of three or more than white students.

4. Mental health issues among adults are worsening

It’s not just young people struggling with their mental health. Half of adults surveyed in the county reported at least one poor mental health day in the past 30 days in 2021, almost 10 percentage points more than in 2017.

And 16.3% of adults said their poor mental health days numbered 14 or more in the past 30. Women, white people and adults younger than 35 were more likely to fall into that group than others.

The statistics for serious mental illness are more dire: The percentage of adults with serious mental illness has doubled since 2015, from 2.9% to 5.8%, according to data from the health department.

There were more mental health care providers in 2021 than in previous years. A small percentage of those providers are psychiatrists, according to an estimate in the report.

5. Prenatal care is a pressing need

Almost one-third of pregnant women in the county aren’t getting adequate prenatal care, which the report defines as going to at least 80% of expected prenatal checkups.

There are racial disparities in prenatal care. Among Pacific Islander women, the amount getting inadequate care is closer to one in two.

Pacific Islander and Native American women are also about twice as likely as white women to have a baby born prematurely.

Teens between 15 and 19 were also more likely to have inadequate prenatal care.

Child care is also a major issue — less than one-third of the county’s child care needs for young children were met in 2021.

6. Food insecurity is a major issue

One out of 11 people is food insecure in Snohomish County, though food insecurity has gone down slightly since 2017.

The report quotes a definition of food insecurity from the nonprofit Feeding America: “a lack of consistent access to enough food for every person in a household to live an active, healthy life.”

It also draws on the nonprofit’s data on food insecurity in the county and state.

Though the food insecurity statistics weren’t broken down by race, the report does highlight the demographic breakdown of households receiving Supplemental Nutrition Assistance Program benefits, also known as food stamps.

People of color were more likely to be enrolled in the program than white people.

The report notes 45% of people who are food insecure in the county don’t qualify for food assistance programs because their income is too high.

“We don’t necessarily get the best food because it’s out of our price range,” said a high school student quoted in the report. “And so, we can’t afford to get good food for us. Even though we try.”

What happens next

Assessments happen in Snohomish County every three to five years, with the last one completed in 2018.

Now work will turn toward creating a Community Health Improvement Plan, which will have strategies to tackle the health issues identified in the report.

“The end goal is to have that long-term, systematic effort to address these top health priorities and have a plan that can be used not only by us, but by all our partners,” said Kari Bray, a spokesperson for the health department.

People can provide feedback on the assessment using an online form.

Sophia Gates: 425-339-3035;; Twitter: @SophiaSGates.

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