A small health equity nonprofit led by a former San Antonio city councilwoman has an ambitious goal of closing the life expectancy gap between the city’s north and south.
The Center for Health Empowerment in South Texas (CHEST) was formed at the end of 2024 and in July former Councilwoman Adriana Rocha Garcia took the CEO job.
“Our moon-shot goal is closing the life expectancy gap,” Rocha Garcia said, referencing life expectancy differences between residents from disadvantaged ZIP codes within San Antonio compared to those who live in more affluent areas.
Shorter life expectancies are concentrated in parts of the east, west and south sides of Bexar County, with life expectancy for those living in the northern and outer portions of the county reaching the 80s, according to the 2022 Bexar County Community Health Needs Assessment.
The organization’s strategy is three-fold: creating an economic environment that incentivizes health care clinics and workers to come to the South Side, creating career pipelines from South Side schools to health care fields, and partnering with other nonprofits to address what’s called the social determinants of health.
How CHEST started
When vascular surgeon Dr. Lyssa Ochoa started practicing in San Antonio 14 years ago, the health disparities were immediately obvious to her.
“I saw outcomes that were so much worse than I even saw in training,” said Ochoa, who founded the San Antonio Vascular and Endovascular Clinic (SAVE) in 2018. “I was seeing patients as young as their 30s with uncontrolled Type 2 diabetes suffering all those chronic conditions that come with it: heart disease, chronic kidney disease, going blind, having heart attacks, strokes and needing amputations. Something very, very different was happening in San Antonio and was not normal.”
Fast forward to the COVID-19 pandemic, and many of the longstanding health inequities across Bexar County were brought into the spotlight. Rocha Garcia was working to get COVID-19 vaccines to her Southside constituents, who faced higher risk of serious illness from the disease due to the high prevalence of diabetes, heart disease and other conditions.
“There were all these comorbidities in these areas, and that’s why people were dying unfortunately at higher rates also catching COVID at higher rates,” she said.
And in 2023, the closure of Texas Vista Medical Center (formerly Southwest General Hospital) exacerbated the region’s geographic gap in health care access, leaving residents with even fewer options for emergency care.
“I immediately noticed in the following three months of the hospital and shut down, that the number of diabetes-related amputations I was doing in patients doubled, almost tripled,” Ochoa said, “especially in those younger than 50 years old, just from lack of access to acute care. That’s when we realized that we needed some kind of community response.”
University Health, the county-owned hospital system which serves the underinsured and uninsured, will open Palo Alto Hospital next year in addition to the Vida health clinic it opened last month near Texas A&M University-San Antonio.
It’s a big investment and win for increasing access to care, Ochoa said, but there’s much more to be done, especially on the preventative side.
“To have a response as large as a problem, we need a response that really addresses the root causes of how we got here in the first place,” she said.
What next?
Addressing health inequities was personal for Rocha Garcia. Dozens of her family members contracted COVID-19 during the height of the pandemic, many of them hospitalized on ventilators. The first time her parents used Zoom was to attend a double funeral for their relatives, she said.
“I realized then that there really needed to be a more concentrated effort on health care,” said Rocha Garcia, who represented District 4 for six years on council and last year ran for mayor. She was appointed as the first CEO and president for CHEST in July after a search conducted by the nonprofit’s 25-member board.
CHEST began with $10,000 in seed funding from Ochoa and her husband. The nonprofit secured a temporary $300,000 grant for two years from the city. They’re searching for additional grant opportunities as they get up and running.
And while their pilot program is focused on the South Side, they plan on expanding their efforts to the near east and west sides of the city, which face similar health disparities, and eventually to the wider South Texas region.
The nonprofit secured a lease with South San ISD to operate out of a closed school building on Lovett Avenue near Lackland Air Force Base.
The plan is to bring various nonprofits into the space, potentially creating a small resource center with a food pantry, clothing closet, basketball court and also counseling services for families, Rocha Garcia said.
The organization is also looking at ways to partner with schools and get South Side residents into the health care field, which is important given health care workforce shortages and the need for providers who are culturally competent to South Side residents’ needs and barriers, Ochoa and Rocha Garcia emphasized.
“We envision that we will hopefully be an influence to be able to bring additional acute care beds to the South Side, help address the access to mental health, help address the housing issues that we have, and be a partner with every other entity on how to address these issues on the South Side,” Ochoa said.
