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 stands as the economic nucleus of South Texas, with its influence extending across the South Texas Triangle, encompassing the border, the Rio Grande Valley, and Gulf Coast communities — a region poised for a new era of diverse, job-generating economic growth. We are already seeing some of this growth on the city’s South Side.
Amid this growth, we must tackle the significant health disparities that have long afflicted our community. The stark difference in life expectancy between Southside and Northside residents — a gap stretching nearly two decades — calls for urgent action and comprehensive solutions.
Guarding against uneven growth
San Antonio’s historical ties with Mexico, our nation’s number one trading partner, further enhance its competitive edge. Laredo is the nation’s busiest land port with 18,500 freight crossings daily. Much of this freight continues along Interstate 35, establishing San Antonio as a vital gateway to the U.S. trade economy.
The Southside is not only the gateway, but is benefiting from new local jobs. The Biden Administration’s Build America, Buy America Act focuses on manufacturing and nearshoring opportunities, which has led to Toyota, Navistar, JCB and other firms growing a major advanced manufacturing hub with well-paying jobs.
City records indicate that new residential building permits are focused on the Southwest area in undeveloped land between SW Military Drive and Loop 1604. Most are clustered along Loop 410 between Interstate 35 and Interstate 37. New commercial permits are also substantially located in this area.
Despite this economic upswing, the South Side’s growth is uneven. While expanding enrollments at Texas A&M University-San Antonio and Palo Alto College and the numerous new residential projects signal progress, older Southside neighborhoods continue to struggle. The older Harlandale and South San Antonio school districts closed schools this year, while Southside and Southwest districts in the growth areas are opening new schools.
As we experience Southside growth, it is crucial to guard against the “leapfrog” phenomenon, when development investments bypass older neighborhoods. Historically, this redlining type of pattern has contributed to San Antonio’s distinction as one of the most economically segregated cities in the U.S. Economic progress in newer areas mustn’t leave older neighborhoods behind, and adequate public and private investments must be made in their revitalization.
Growth must include health care access
At the same time, we must ensure that the area’s growth includes growing access to health care. Texas Vista Medical Center, with its 356 beds including wings for birthing and mental health, served the South Side and surrounding communities for over 30 years. Its sudden closure last year left a significant void in local health care services with no short-term viable replacement.
Of the city’s 5,000 staffed hospital beds, only 100 are available south of Highway 90, providing just 70 acute care and 30 maternal and childbirth beds at Mission Trail Baptist Hospital.
This shortage is in stark contrast to the investments made in other parts of the city, where major hospital providers such as Methodist, Baptist, and Christus, as well as University Health System, are expanding their facilities in the northwest and northeast growth areas. This disparity reflects a broader pattern of historic disinvestment in the South Side.
The case for health equity
According to a report by the Urban Institute for the Episcopal Health Foundation, health disparities impose a heavy economic burden on Texas. In 2018, Texas had the highest cost burden attributable to health disparities in the nation. The follow-up 2020 report estimated a $591.7 million economic burden for Bexar County. This translates to a $150 million annual burden for the South Side’s 500,000 residents, though the actual costs are likely higher given the disparities.
Achieving health equity is vital for ensuring that the benefits of Southside economic growth are inclusive. As new opportunities arise from manufacturing and other initiatives, these jobs must be accessible to Southside residents as pathways from working poor to middle-class incomes.
This requires not only job readiness but also improvements in health care services and living conditions. A healthy workforce is more productive and less distracted by health issues, benefiting the individual, the employer and the broader economy. The economic rationale for investing in health equity is clear: addressing health disparities reduces individual health care costs, enhances productivity and minimizes economic burdens.
To effectively address these challenges and promote economic progress, we must adhere to five core principles of health equity:
- Quality living environments: Ensure that all residents have access to safe, stable, affordable and sustainable housing, which is fundamental for promoting healthy lives from infancy through old age.
- Access to quality education: Provide high-quality education for children and career training for youth and adults to enable their skill development and upward mobility.
- Healthy food and recreation: Increase access to nutritious food sources, recreational areas such as parks, and essential services, while improving transportation options.
- Resilient infrastructure: Develop and maintain robust infrastructure, including utilities, streets, sidewalks, and drainage systems, to support healthy living conditions.
- Accessible health care services: Guarantee reasonable access to comprehensive healthcare services, from primary care to specialized hospitals, with staff who understand and address the community’s specific health needs.
San Antonio’s role as the South Texas Triangle economic gateway presents an opportunity to address health equity proactively. As the city’s economy expands, it must benefit all residents. By investing in health equity, we will enhance productivity, reduce economic burdens, and foster a more equitably prosperous community.
In the coming weeks, the team at the Center for Health Equity in South Texas (CHEST) will present commentaries addressing specific issues and solutions, including strategies to rectify the lifespan disparity, improve health care access, address non-medical social determinants of health, fill the Southside health careers pipeline and describing the Comprehensive CHEST Action Plan.
