The Tenderloin is one of San Francisco’s most dangerous and vulnerable neighborhoods. For decades, the Tenderloin has served as a haven for criminals, drug abusers, the mentally ill, and the homeless. Open-air drug dealing and drug use are rampant, and crime is 35 percent higher than in any other part of San Francisco. And yet, with 33,000 residents living inside one-half a square mile, the Tenderloin also boasts the densest concentration of children and families in the city, and more low-income seniors than almost any other neighborhood. More than one in four of those residents live below the federal poverty line. The Tenderloin’s illness and chronic disease rates are also among the city’s highest.

Despite these challenges, it is the community’s permanent residents—and the solidarity and fellowship among them—that tell the neighborhood’s real story. The families, merchants, and immigrants who call the Tenderloin home are a remarkably tightknit community. After years of being the city’s “forgotten” neighborhood, the Tenderloin and its demographics were beginning to shift rapidly—and these shifts were opening a window of opportunity for an even broader kind of alignment to emerge.

Launched by the Saint Francis Foundation and Saint Francis Memorial Hospital in 2014, the Tenderloin Health Improvement Partnership (Tenderloin HIP) is a first-of-its-kind effort designed to help all the nonprofits, businesses, government agencies, and funders operating within a single neighborhood work together in more coordinated ways to improve residents’ health outcomes.