The third installment of the countywide health plan, which will be officially released Tuesday, takes the collaborative effort to improve the health of San Antonio residents from analysis to action.

“There was previously no dedicated effort [in the plan for] following up with implementation,” Jennifer Herriott, San Antonio Metropolitan Health District’s associate director, told the Rivard Report, but that changed this year.

The 2017 Healthy Bexar Plan, formerly the Community Health Improvement Plan, is a working document put together by the Metro Health and the Bexar County Community Health Collaborative. It brings together representatives from various sectors including residents, nonprofit organizations, businesses, and community and government organizations to find solutions to gaps in health outcomes and access.

Many of the Healthy Bexar Plan’s points of focus remain unchanged since the 2014 report because they are areas of focus that need long-term, constant attention, Herriott said.

“We want to make more progress,” she said. “In some of the areas like healthy eating and active living, it will take years to really see a change.”

Healthy eating, active living, healthy child and family development, safe communities, behavioral and mental well-being, and sexual health are the five priority areas analyzed in the report, which is produced every three years to give health professionals and residents a comprehensive update on the county’s health status.

Part of what will help spark changes in these areas is a push toward better metric tracking and ensuring that organizations are actually implementing the strategies determined as best-practice, Herriott said.

The plan is revisited biannually to determine the effectiveness of implemented strategies and to modify them, if necessary, to make greater progress toward their goals.

Another big change this year is that the plan includes a more intentional focus on addressing the systematic and structural barriers that cause inequities across sectors including education, employment, housing, and health care, said Dr. Robert Ferrer, board chair for the Health Collaborative.

“I hope everyone takes seriously [that] we have a lot of work to do to improve public health in the city,” Ferrer said. “Whether that be at the corporate level or the neighborhood association level, all of us can do a little more to do our part for public health. ”

Echoing the City’s push to look through at community issues and budgets through an “equity lens” to address disparities in access to resources throughout San Antonio, the Healthy Bexar Plan focuses on achieving health equity as one of four overarching themes within the community health improvement process.

Community voices were included within each priority area as an attempt to understand and address “stories behind the baseline,” which provide deeper insight into how community members are utilizing resources, real and perceived barriers to access, and the outcome/effectiveness of services.

Regarding behavioral and mental well-being, readers are introduced to Carol and Ted, parents of a 14-year-old suicidal male, who was kept in the emergency room for 16 hours without mental health support while waiting to be admitted to a psychiatric hospital. The intention is to draw awareness to the psychiatric bed shortage in Bexar County, the prevalence of mental health issues within the community, and the lack of service capacity to meet targeted mental health needs, according to the report. 

Carol and Ted’s son represents the one in five children in the U.S. who has a diagnosed mental health disorder, and is one of the 37,500 Bexar County children who has experienced a serious emotional disturbance, according to the report.

To address this growing issue, strategies include working to establish a community-wide system of care, and increasing awareness and education regarding mental health issues. The plan also suggests facilitating telemedicine to address behavioral health and increasing interest in behavioral health training and careers.

To download the plan in either English or Spanish, click here.

Public health professionals often view problem-solving from behind a data lens, which focuses on statistics and achieving numerical outcomes, Ferrer said, making it easy to “lose sight that every person who contributes to the statistics is an unhappy story.

“This is a way to remind people that under all those teenage pregnancies, under all the cases of diabetes with amputations – all of them have suffering in the lives of real people associated with them.”

Elizabeth Lutz, executive director at the Health Collaborative, told the Rivard Report that while there are a lot of organizations throughout Bexar County who want to do good work, “they often get caught up in what they think is important, or what they think will be a successful outcome.”

To develop this year’s plan, five workgroup meetings were held between March and July 2017 with 210 unique individuals representing 121 departments and community programs. An average of 97 people, attended each meeting including Bexar County residents and representatives from organizations such as the Ryan White Program, UT Health San Antonio, the Children’s Shelter, and area school districts.

These voices worked together to determine indicators of success that are equally reliant on an analysis of numbers as well as feedback from real-world experiences while receiving services – and whether they were truly helpful.

Lutz explained that changing the name from Community Health Improvement Plan (CHIP) to the Healthy Bexar Plan was an effort to make the initiative more “community friendly,” and approachable to people outside of the public health industry.

“CHIP was not resonating with families, and we spent [a lot of] time explaining what it meant,” Lutz said. “Healthy Bexar Plan is something that everyone can grab onto. It’s a call to action for people to get healthy as a community.”

Roseanna Garza

Roseanna Garza

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