The 2017 Bexar County Community Health Improvement Plan
The 2016 Community Health Needs Assessment (CHNA) presented the most recent data on the status of the community’s health as well as areas needing improvement. By community, we refer throughout this report to the county of Bexar (pronounced “bear”), Texas. Following the CHNA, more than 200 community stakeholders and members started working together to develop the 2017 Healthy Bexar Plan, previously known as the Community Health Improvement Plan.
The plan proposes to improve the community’s health in five priority areas: Behavioral and Mental Well-Being, Healthy Child and Family Development, Healthy Eating and Active Living, Safe Communities, and Sexual Health. These priority areas are supported by local data and community feedback in the CHNA as well as an analysis of other local plans. Each priority area was addressed by one workgroup composed of partners and community members.
In contrast to the previous two CHIPs, the 2017 CHIP used selected attributes of the Results Based Accountability (RBA) framework. Starting with the end in mind, the modified RBA process helped each workgroup and its members focus on the results they want to achieve, select key headline indicators to measure success toward this vision, identify and prioritize root causes influencing the indicators, and develop strategies and actions to impact these causes and ultimately make a positive change in the community.
Throughout this process, workgroups were strongly encouraged to keep in the forefront of their work four overarching themes, which were also prominent themes driving the results of the CHNA: life expectancy especially in disparate areas, health outcomes, access to care, and health inequity.
The 2017 Healthy Bexar Plan represents the culmination of this collaborative process where partners worked together cohesively to plan how to address the needs of our community. However, this plan has little value if it is not executed. It is the community’s responsibility to implement the actions and strategies set forth in this plan, to monitor and report on the progress made on a regular basis, and to use the next three years as an opportunity to positively impact the health status of Bexar County residents.
A SNAPSHOT OF THE POPULATION SERVED
Located in South Texas approximately two hours from the Mexican border (See Figure 1), Bexar County has a population of 1.9 million people (U.S. Census Bureau, 2017). The City of San Antonio is the largest city within Bexar County with approximately 1.4 million people. It represents the seventh most populated city in the country. San Antonio’s population is expected to grow by 1 million people by 2040 (SA Tomorrow, 2017).
Figure 1. Map of Bexar County within Texas (Source: Metro Health, 2017)
Table 1 below presents some characteristics of the county’s population.
Table 1. Bexar County Demographics
Non-Hispanic white 28.2
Non-Hispanic African American 7.3
1 to 17 26.0
18 to 64 62.2
Language other than English at home 40.8
Source: U.S. Census Bureau, 2017. *This ratio makes it one of the first majority-minority county in the United States.
Based on the 2016 Bexar County CHNA, significant disparities exist in Bexar County. Approximately 335,000 residents or 18.4 percent of the population live in poverty, with females, minorities, and children being disproportionately impacted (Bexar County Community Health Collaborative, 2016). Approximately 17 percent of all Bexar County residents aged 25 and older have not completed high school (Bexar County Community Health Collaborative, 2016). Almost one in five adults in Bexar County has reported delaying health care because of cost. Limited health insurance among adults is an important barrier to accessing care. In fact, about 32.7 percent of adults without a high school diploma or Texas Certificate of High School Equivalency do not have health insurance. Hispanics and non-Hispanic African Americans are less likely to have coverage compared to non-Hispanic Whites. Overall, residents in the north of Bexar County tend to live 20 years longer than residents living in the south (Bexar County Community Health Collaborative, 2016). See Figure 2. This premature mortality is especially prominent among minorities and low-income individuals.
Figure 2. Life Expectancy by Zip Code (Source: Bexar County Community Health Collaborative, 2016, p.85)
Bexar County Community Health Collaborative. (2016). Bexar County Community Health Needs Assessment. Retrieved from http://healthcollaborative.net/wp-content/uploads/reports/chna-2016.pdf
SA Tomorrow. (2017). What is SA Tomorrow? Retrieved from https://satomorrow.com/
U.S. Census Bureau. (2017). Annual estimates of the resident population by sex, race, and Hispanic origin for the United States, states, and counties: April 1, 2010 to July 1, 2016. Retrieved from https://www.census.gov/quickfacts/fact/table/bexarcountytexas,US/PST045216
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