The City public health agency’s strategic plan will continue to focus on preventing obesity and type 2 diabetes, the new director of the Metropolitan Health District told City Council.

Colleen Bridger, who came to San Antonio in March from North Carolina, addressed City Council at its B session meeting Wednesday, reviewing Metro Health’s three-year strategic plan developed to achieve a population of “healthy people thriving in a healthy community.”

In a city with high obesity rates, targeting adults and children for prevention efforts is an ongoing endeavor, and Metro Health is using efforts from the Community Health Improvement Plan (CHIP) from 2014 that have proven successful. That includes addressing the socioeconomic and demographic factors that impact obesity for all ages, including paying specific attention to lifestyle, diet, and how city infrastructure – having walkable streets and public spaces for outdoor, physical activities – can support a healthy environment.

Bridger called fighting type 2 diabetes “a challenge,” as rates in Bexar County continue to climb. Although current data puts the city’s adult type 2 diabetes rate at just under 25% in 2016, Metro Health estimates that the rate actually is closer to 35%, with many undiagnosed cases.

Bridger said one way the City is working to address this issue is by putting renewed emphasis on the San Antonio Diabetes Collaborative, which held its first meeting several weeks ago to discuss community partnerships to help educate individuals about taking control of their health.

A noted success was Metro Health’s current “Take Control of Diabetes Self-Management Program,” which has helped educate 4,018 Bexar County residents on managing their diagnosis since October 2013. The new strategic plan includes a continuation of this program, as well as the YMCA’s diabetes prevention and healthy living programs.

Regarding environmental health and safety, Metro Health’s focus is on ozone levels. Bridger said she expects the EPA to declare San Antonio in nonattainment for ozone in October 2017, meaning the city has exceeded the geographic threshold level for pollutants. Ozone that occurs at ground level can affect people’s respiratory health.

“We have been making good progress, and we have to continue and work together with all of our partners to bring it down to the attainment level,” Bridger stated.

Councilwoman Shirley Gonzales (D5) asked whether people’s asthma is being affected directly by ozone, or if it’s more relevant to demographic and social barriers.

“Air quality is an important issue for a big city like San Antonio,” Bridger said.

Bridger said that someone may go to the hospital for an asthma-related issue because they may not be using medications appropriately, they don’t know how, or they don’t have money to obtain medication. However, ozone often contributes to a flareup of asthma.

“We have to focus on what are the top three reasons – ozone, medication access, indoor air quality – and how do we address all three,” Bridger said.

Bridger also discussed focusing on immunizations to prevent diseases in children, acknowledging that “mixed messages” on the topic may be confusing to parents.

“We want to get the right information out to parents – at the right time – so they know that vaccinating their kids is the best thing that they can do for their child and the community,” Bridger said.

She explained the need to develop grassroots support for vaccinations by helping parents understand the right information.

“The water has been muddy with misinformation,” she said. “For the next few years we can make parents aware of facts regarding immunizations, and [at the same time] can be working on support.”

Bridger started work March 6, coming to San Antonio from North Carolina’s Orange County, where she was head of the health department. She succeeded Dr. Thomas Schlenker, who was fired by City Manager Sheryl Sculley for “unprofessional conduct” in July 2015. Dr. Vincent Nathan, who has served as the department’s assistant director since 2012, led the agency during the interim.

Controversy surrounded the firing of Schlenker, who maintained that his strong stance against soda and other sugary beverages prompted Sculley to push for his removal.

“Definitely sugar-sweetened beverages contribute to obesity and diabetes in children and adults, and that is something that we need to come up with a strategy to address,” Bridger said when asked about her position on the issue. “[We have to] educate people to reduce or completely eliminate sugar-sweetened beverages and we need to look at our policies, too.”

Bridger said that progress has already been made on the department’s priorities during the first quarter of 2017. Metro Health conducted 29 educational outreach events on immunizations, 353 businesses registered to receive information on how to decrease ozone emissions, and 259 residents have completed diabetes prevention and education programs.

“If we have more [community] support, we have more progress,” Bridger said.

Metro Health will share its strategic plan with community members and other stakeholders and align the 2018 budget with the plan’s priorities, Bridger added.

Roseanna Garza reports on health and bioscience for the San Antonio Report.