The Health Collaborative Releases 2010 Bexar County Community Health Assessment

February 23, 2011

Key Findings Reveal Opportunity for Area Organizations, Agencies and Community Partners to Take Leadership Role in Health Improvement

Media Contacts:
Shirley Wills, 210-822-2378/210-365-4488 (cell) or
Elizabeth De La Fuentes, 210-481-2573

The Health Collaborative today (Feb. 23) released its 2010 Bexar County Community Health Assessment, a comprehensive report of local health, guiding the community’s efforts toward prevention and health improvement.

“While it is clear that current health-related efforts being implemented in Bexar County address many of the significant health issues identified in our assessment, organizations, agencies and community partners have a great opportunity ahead to coalesce around these important issues and address them in a more comprehensive way,” said Steve Blanchard, M.P.H., Ph.D., chair of the 2010 Community Health Assessment. “This is an important time, and area organizations are poised to take a collaborative leadership role in future initiatives. Our findings suggest that leaders look beyond developing specific, individual programs and address these important issues using a long-term, coordinated strategic approach.”

The 2010 assessment is the fourth in a series of assessments that have been issued by The Health Collaborative (THC) since 1998. THC contracted Health Resources in Action (HRiA) of Boston to conduct the 2010 assessment, which was implemented in three phases beginning in January 2010 and engaged a range of stakeholders and community partners through focus groups and interviews. The study used the social determinant model as the approach to describing community health. This model views outcomes as a product of health-related behaviors and the behaviors themselves as a likely product of social dynamics at the level of the social context of the neighborhood.

Key Themes

Some of the key themes noted in the assessment include:

Data on behavioral and disease distribution consistently follow social and economic patterns. Communities with the poorest socio-economic conditions and greatest percentage of minorities generally suffer from the highest prevalence of specific diseases and risk behaviors. From a community perspective, there are a number of health issues that impact more impoverished neighborhoods: higher crime rates, lack of green space, unsafe parks, limited power to advocate for resources, and fewer food outlets to provide fresh fruits and vegetables are only a few.

Health equity is an important end goal in health-related programming and policy.

Obesity, physical activity, and nutrition were considered top-of-mind health concerns. While focus group and interview participants discussed chronic diseases such as heart disease and diabetes, behavioral risk factors for these conditions—namely sedentary activity, unhealthy eating, and obesity—were considered critical to address.

Teen pregnancy was considered a significant health issue. All focus group audiences—from teenagers themselves to social service workers to adults to nursing students—indicated that teen pregnancy was consistently a pressing health concern in the region.

Early intervention can help alter the health trajectory of young children

Residents viewed prevention as critical, but they believed the health care system focused more on clinical care and disease management than prevention.

Programs and services should be culturally appropriate to meet the diversity of cultures in the region. Focus group and interview participants noted that health care services and public health programs are not necessarily culturally sensitive to the rich diversity of residents from different cultures where English is not the primary language.

Communities are rich in resources. While several of Bexar subsectors studied are considered poorer financially, many residents of these neighborhoods embraced positive aspects of their community, such as neighborhood cohesion and the strength of the residents themselves—their spirit, cultural diversity, and determination to make their community a better place.

Increasing awareness of existing programs and services is critical. Increasing marketing efforts of current resources and improving collaborations across organizations so that residents can be referred to different services from one location were seen as critically important for maximizing current resource utilization.

It is important for health programs and services to address people’s daily lives and needs. It was considered critical to include community members’ perspectives when developing and implementing programs to ensure that activities are salient to their needs.

“Guided by these key themes, our report recommends action steps for the organizations, agencies and community partners working to improve health in Bexar County,” continued Dr. Blanchard.

Key Recommendations for Community Strategic Directions

Address the social determinants of health of a specific issue. The assessment notes that health is not a uni-dimensional concept, and a multitude of social and economic factors have a significant impact on health. Organizations and agencies focusing on health need to recognize that addressing the larger social and economic issues in people’s lives will result in improved health with greater sustainability. Workforce development, public transportation access and violence are all public health issues.

Focus on policy/systems change. Many organizations and agencies currently address health through programs and interventions targeting change at the individual level (e.g., by providing health information or clinical services). Focusing on policy, environmental, and systems change can have a larger impact on the population, address the community context, and provide greater sustainability over time. Developing strong collaborations with decision-makers and active leaders in the community can help build a more grassroots movement to advocate for improved policies, practices, and regulations at the neighborhood, city, and county level.

Convene multi-sector partners and increase awareness and support of their role in health. When considering the social determinants of health, it is important to recognize that representatives from non-traditional sectors (e.g., housing, transportation, business, city planning, public safety, parks and recreation) have a significant role in improving health.

Engage the community through all steps of initiative development, implementation and evaluation. Community members are energized and ready to make change in their community and already have important skills and salient experience to offer. Stakeholders and residents desire a sense of ownership over large programs and initiatives, and, without their support and buy-in, programs will not be successful. Additionally, community engagement from the inception will help ensure that approaches, messages, and materials will be culturally appropriate. Issues related to obesity, mental health, teen pregnancy, and health care access emerged during the assessment as critical concerns.

Assess current programming. Existing organizations and agencies are currently implementing a multitude of health-related programs. However, many of these programs are not coordinated with each other and only reach a small sub-population. As community health planning moves forward, it is critical to understand what programs and services are currently being implemented, with whom, and where there might be opportunities for collaboration and expansion.

A Major Initiative of The Health Collaborative

The assessment is a major initiative of THC, which serves as a convening organization bringing together the area’s healthcare systems, community organizations, and businesses to implement a more synergistic approach to solving the region’s critical community health needs, while efficiently utilizing resources. The mission of the organization is to improve the health status of the community through collaborative means. The Health Collaborative compiles and publishes the assessment as a gift to the community with the understanding that the more the community knows about its health status, the better able the community will be to take collaborative action to improve it.

THC partners include Baptist Health System, Bexar County Department of Community Resources, CHRISTUS Santa Rosa Health System, Community First Health Plans, Methodist Healthcare Ministries of South Texas, Methodist Healthcare System, San Antonio Metropolitan Health District (Metro Health), University Health System, WellMed Medical Management, Inc., the YMCA of Greater San Antonio, and Steve Blanchard, Ph.D.

Non-profit organizations throughout the city have found the assessment to be an insightful planning tool, using its data when writing grants and evaluating and developing their programs. Area health care systems have used data from previous assessments to make critical program decisions.

Funders of the 2010 assessment are The Baptist Health Foundation, the Kronkosky Charitable Foundation, the United Way of San Antonio and Bexar County and Methodist Healthcare Ministries of South Texas.

The complete 2010 Bexar County Community Health Assessment executive summary is available at For more information on The Health Collaborative, contact Elizabeth De La Fuentes, 210-481-2573 or