Friday, February 14, 2020

Rich Hillis: San Francisco's new Planning Director

From the SF Examiner:

[Rich]Hillis is[sic] the executive director of the Fort Mason Center and has previously served as Deputy Director of the Office of Economic and Workforce Development, where he led development projects such as the acquisition and redevelopment of Treasure Island and Yerba Buena Island and oversaw plans for the development of the Octavia Boulevard corridor.

As Planning Director, Hillis means more of the same for the city: accelerating gentrification and population density with lip-service to "affordable" housing, a word that always requires quotation marks. (What does "affordable" even mean in San Francisco?)

The dumb Treasure Island project: allowing 20,000 more residents on an island that now has a population of 3,000. What could go wrong with that? Think traffic is already bad on the Bay Bridge and in downtown SF?

And Octavia Boulevard, the name---and the cause---of that daily traffic jam in the Hayes Valley neighborhood. 

Back in 2010, Hillis told us that developments among that chronic congestion were somehow "healing" that part of the city:

"At one time the freeway bisected the area and developing the parcels is helping to heal the neighborhood," said Rich Hillis, deputy director in the Mayor's Office of Economic and Workforce Development. "A lot of the changes in Hayes Valley were sparked by the removal of the freeway and we think the developments near Octavia Boulevard will close out a project that has been successful."

In the SF Chronicle:

“It’s not just building 50,000 [housing]units, it’s figuring out how to do that in an equitable way.” He added that he’ll take a proactive approach to finding sites, including meeting with executives from Safeway, which owns multiple stores with large surface parking lots.

He compared the Safeway to Whole Foods, which has opened stores below housing developments on Ocean Avenue and Upper Market Street, and has another under construction in Mid-Market. “There is no reason to have large parking lots with Safeways throughout the city,” he said. “Those are prime sites for new housing.”

No "reason," except supermarkets need customer parking, particularly for families that can't haul their groceries home in backpacks or on bicycles. Single people like me can do that on Muni.

As Planning Director, Hillis will make $265,854 a year. He and his wife have three children. Hard to believe they don't have a car to help with their grocery shopping.

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Poverty breaks more hearts than love

From today's LA Times:

Because I am a cardiologist, people often ask me how they should live to help their hearts. The truth is, it matters more where you live than how you live. 

Traditionally, heart disease was considered a disease of affluence; today, it is more an economic ailment than a medical disorder, correlated far more closely with one’s ZIP Code and bank balance than with one’s gene pool. 

As medical treatments have rapidly advanced, the chasm in heart disease risk between haves and have-nots has stretched farther...

Some of the recently developed life-saving medications for heart failure, high cholesterol and diabetes aren’t reaching the people who most need them. Affluent people have far better access to quality healthcare than those living in poverty, and they are better able to afford medication. 

They also are more likely to live in healthier neighborhoods, eat healthier foods, outsource stressful activities such as care-giving for old parents, and partake in aerobic exercise. Deepening income inequality will exacerbate the situation...

Heart disease is also political, and who wins the 2020 U.S. presidential election matters to those with heart issues. Gaining insurance has been found to lead to a reduction in deaths among people with heart disease and its risk factors, such as high blood pressure and diabetes.

Political polarization, though, can drive people to vote against their own health interests. Many more rural Americans die of heart disease, for example, than those living in large metropolitan areas, and that gap, instead of getting smaller as it has for cancer, has actually widened over time. 

But rural Americans are more likely than those in cities to vote for politicians who oppose Medicaid expansion, a policy associated with a drop in deaths from heart disease and fewer rural hospital closures.

When I was growing up in Pakistan, I was told that heart disease was a side effect of high-income countries’ relentless pursuit of material progress. The tables have turned though, and heart disease is sky-rocketing in low- and middle-income countries in part because of the globalization of the Western lifestyle.

If we are to continue making headway against heart disease in the next century, we will have to ensure that innovations are accessible to all. Drug pricing reform has bipartisan support, and progress on that issue would be a win for lawmakers on both sides of the aisle as well as their constituents.

But access to heart treatments is not just about cost. With my colleagues, I have shown that almost half of patients with heart disease aren’t even prescribed statins, life-saving cholesterol-lowering medications for those with heart disease. 

Women, racial and ethnic minorities, and the uninsured are the least likely to get these dirt-cheap drugs. Of those prescribed statins, few are given the right dose. We need to develop systems that can help deliver the right therapies to all who would benefit from them.

One way to do that is to change the incentives in medicine: Health systems get paid for treating heart attacks but not for those they prevent. 

Another is through better public policy. Not only must clinicians advocate for patients at their bedsides; they need to put pressure on elected officials to expand access to healthcare. A healthy heart should be a right, not a privilege.

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