About the Assessment

Every three years the Health Collaborative commissions a comprehensive community health needs assessment for Bexar County. This 2022 Bexar County Community Health Needs Assessment includes over 100 indicators visualized by close to 200 charts and maps. Beyond conforming with federal requirements,¹ the 2022 assessment is intended to help stakeholders understand local trends and demographic and geographic disparities in a broad range of social, economic, and environmental determinants of health; healthrelated behaviors; well-being, illness, and injury; and death. The 2022 Bexar County Community Health Needs Assessment was guided by a volunteer Steering Committee representing diverse local perspectives, and conducted primarily by Community Information Now with substantial community voice data-gathering by The Health Collaborative.

 

What's new for this assessment

The most obvious departure from the 2019 Bexar County and Atascosa County Community Health Needs Assessment is that the Bexar County and Atascosa County assessments have been split into two separate documents. This document focuses solely on Bexar County.

 

For better content flow, this assessment is also organized somewhat differently from the 2016 assessment. Some sections that may have stood alone in the 2016 are now folded together under major headers.

 

Another improvement for 2022 is that references to other local reports are embedded into the relevant section of the report, highlighting more in-depth analysis and planning around issues covered more briefly in this assessment. Those references can be found in boxes titled “Learn more about…” throughout the document. Unfortunately, the COVID-19 pandemic is another new development since 2019.

 

Several charts specifically address COVID-19 vaccination (Section 2), case (Section 3), and death (Section 4) rates, including place-level correlation of COVID-19 with social determinants of health and racial disparities. COVID-19 is mentioned throughout the data narrative, however, as it affects both the issues in this assessment and the collection and management of data that quantifies those issues.

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What continues with this Assessment

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As with the 2016 and 2019 assessments, this report follows the Bay Area Regional Health Inequities Initiative’s (BARHII) health equity framework. That framework explicitly situates social, economic, environmental, and structural factors as upstream drivers of health-related behaviors; well-being, illness and injury, and death. The relative contribution of medical care to health and well-being is only 10% to 20%². As in past reports, this assessment devotes significant attention to the determinants of the other 90% of health and well-being. This assessment continues extensive disaggregation of the data, breaking it out wherever possible by race/ ethnicity group, age group, sex, and smaller-than-county geography. Disaggregation helps uncover disparities and inequities that are hidden in measures like averages and medians. As with prior reports, unfortunately, breaking the data down into many categories sacrifices certainty and precision due to smaller samples and suppression. Administrative data (e.g. deaths, abuse and neglect) may be suppressed for privacy reasons or because small numbers result in unstable rates. Small sample sizes in survey data mean wide margins of error or confidence intervals, particularly for the Behavioral Risk Factor Surveillance System (BRFSS) survey.