Commentaries at the San Antonio Report provide space for our community to share perspectives and offer solutions to pressing local issues. The views expressed in this commentary belong to the author alone.
San Antonio and the broader South Texas region are situated at a crossroads between a long history and vibrant culture of strength and resilience and the emergence of long-awaited economic growth.
Toyota and JCB North America’s investment of $1 billion in manufacturing facilities with up to 2,000 well-paying jobs is still being celebrated, and recent announcements of new residential and commercial developments nearby are expected to continue the momentum.
Yet, a loud alarm bell is alerting us to a stark and troubling reality: a 20-year life expectancy gap exists between Southside residents and those living in some Northside communities.
This disparity isn’t just a statistic — it’s a reflection of deep-seated inequities causing profound and devastating effects not only on Southside residents, but also on the health, well-being and economic opportunities of the broader Bexar County and South Texas communities. To address these issues, we urgently need solutions drawn from the strength of collaborative partnerships within San Antonio and across South Texas.
University Health’s South Bexar County Community Health Needs Assessment Report highlights these social and health inequities, including a range of preventable and treatable illnesses that, if addressed early, could significantly improve life expectancy and quality of life for the 500,000 residents living south of Highway 90. Furthermore, data from the 2018-2022 American Community Survey and the 2024 San Antonio Status of Poverty Report reveal a persistent pattern of economic distress.
Southside neighborhoods face higher poverty rates, lower educational attainment and limited access to essential services, all of which are tightly intertwined with the observed health disparities. Diabetes, coronary, liver and kidney disease, asthma and cancer disproportionately affect this community. The area was also disproportionately impacted during the COVID-19 pandemic.
As the population grows, so does the shortage of primary, specialty and allied health care service providers. University Health, federally qualified health centers and other providers serve Southside residents, but access to many services are limited or nonexistent. Out of the city’s 5,000 hospital beds, only 100 are located south of Hwy 90. Many residents lack access to public transportation, health insurance or broadband internet. Consequently, they must travel farther to seek needed health and social services, reducing their opportunities for pursuing good health and well-being.
These challenges have resulted in chronic health issues that impede residents’ abilities to reach their full potential for workforce productivity and community well-being. The economic losses reverberate throughout the broader area, affecting local businesses and the city’s overall health.
There is a significant economic cost associated with health disparities, as documented in a 2024 report, which states:
“By 2030, if current disparities remain, we estimate it will cost Texas: $3.4 billion in excess medical care spending annually, $6.1 billion in lost productivity annually, and 551,000 life years lost, conservatively valued at $27.6 billion.”
It is important to note, however, that these disparities are rooted in a lack of investment over generations and cannot be attributed solely to individual behaviors.
Consequently, the enormous impact of disparities requires targeted policies and investments to improve access to health care, enhance living conditions and provide support to better-paying jobs. As the area attracts new businesses, neighborhoods and residents, it is imperative to leverage this growth into tangible economic and health benefits for all, especially residents of the older Southside neighborhoods.
Elements of the solution are emerging. For example, University Health is building a new hospital designed for up to 286 beds across from Texas A&M University-San Antonio. This comprehensive hospital with an attached medical office building will significantly expand access to emergency, inpatient, surgical and outpatient specialty care on the Southside. Also on the property, University Health Vida, will open by early 2026 with the headquarters of its Institute for Public Health. These initiatives will also provide more than 1,000 jobs.
In addition, Bexar County has established a new health department to better serve outlying areas of the county. The San Antonio Metro Health Department is targeting domestic violence and has launched SA Forward, a community-oriented blueprint for addressing the root causes of health disparities.
There is extensive evidence that being poor leads to shorter life spans. This also leads to less productive lives, often filled with chronic illnesses. A concerted effort to raise income levels would have a dramatic impact by increasing life spans and reducing community costs.
The growth of TAMU-SA and Palo Alto College is a good indicator of potential increases in Southside educational attainment and income. The Workforce Solutions Alamo and the city’s Ready to Work programs are also good resources for job training and advancement leading to higher incomes. The South Bexar County school district superintendents are meeting regularly to exchange best practices.
While these initiatives are significant, much more is needed. The life expectancy gap is too great; the health disparities are too overwhelming for single-purpose solutions.
Silencing the life expectancy alarm bell requires a dedicated catalyst to convene a collaborative partnership addressing the vast health disparities. It needs to engage the community, enlist the support of organizations and help prioritize strategic investments in the productive future of San Antonio and the South Texas region.
This partnership will help prioritize early detection and preventive care, thereby mitigating the negative impacts of advanced illness. It will also focus on promoting healthy living and addressing longer-term community priorities, such as affordable housing development, environmental improvements, recreational green space, educational opportunities and workforce pipelines. A proactive collaborative approach not only promises better health outcomes but also a more sustainable path to well-being and prosperity for the entire region.
This initiative dedicated to building community-wide momentum is the Center for Health Equity in South Texas (CHEST), which will be described in a future commentary.
