Five female St. Mary’s University economists, biologists and public health educators were awarded a $553,000 National Science Foundation grant to study how diabetes impacts San Antonio’s workforce.
The three-year study will focus on working San Antonians living with diabetes, many of whom are Hispanic, Latino and migrant populations in Bexar County.
The project is funded through August 2026 and will task community health workers from the Bexar County Health Collaborative, Young Women’s Christian Association (YWCA) of Greater San Antonio and CommuniCare with collecting information from those communities.
Lead researcher for the project and St. Mary’s associate professor of economics Belinda Román said talks with the National Science Foundation included a specific interest in why San Antonio’s diabetes rates remain higher than the national average. The study will focus on gestational and type 2 diabetes.
“This is the perfect place to study Hispanics, as well as other minorities because we have those populations,” Román said. “San Antonio doesn’t always get looked at as a place where researchers do this kind of work, so I went for it.”
The group is taking a scientific approach, she said; conducting research trials and using social science to study the effects of diabetes on work and personal earnings in San Antonio.
“How does your health influence what happens when you work?” Román asked. “You’re going to miss work, you might have other health issues, and that influences how much money you earn, how much you can save, whether or not you can buy a house. We need to really understand this, but at a ground level.”
According to the latest Bexar County Community Health Needs Assessment, 13% of adults in the county have been diagnosed with diabetes. Of that population, 14.2% are Black and 13.5% are Hispanic. Complications surrounding diabetes include nerve damage and poor blood circulation, which can lead to ulcers on the feet that quickly worsen — often complicating someone’s ability to work. About six in 10 adult diabetics in San Antonio report that they check their feet daily.
Public health officials in San Antonio have long said social determinants of health like economic stability have an impact on health outcomes in local neighborhoods. How health affects work attendance is a key piece of that puzzle, Román said.
In a few months, the bilingual community health workers will start collecting information from underserved and high-risk communities that they’re trained to work in for a year.
The questions will ask about employment status, commutes, their savings and retirement balances, social security, whether they’re taking medication, working full or part-time, how they’re getting paid, how many hours they work and whether they need to miss work for treatment.
“Educational programs are one thing: Eat right, exercise. But we want to go a little bit deeper and see how much more we can add to those programs,” Román said. “If it’s a question of, ‘I can’t get here. I don’t have enough resources to buy glucose meters, so I don’t check my sugar regularly,’ then … maybe we need to put money into these activities to help, from a public policy perspective.”
The underserved and high-risk communities the study will measure are on the far South Side, said Elizabeth Lutz, executive director of the Health Collaborative, which compiles and publishes data across the area. And that data shows the far South Side is a resource desert, she said.
“As we look at the geography, look at the footprint, as we look at the resources available in infrastructure, we do have areas that have less access than others,” she said.
After gathering data for a year and studying what’s changing and how diabetes influences people’s ability to work, the results will be written and published on a rolling basis over three years.
The latest community health needs assessment report showed San Antonio’s diabetes rates have largely stayed the same, Lutz said.
“When people are supported in a way where they’re not only just given information about a condition, but then also supported to addresses those barriers they’re facing, then the likelihood of them staying employed is going to be better,” Lutz said.
Health economics examines how health care providers, hospitals and clinics, managed care and local governments promote health activities, Román said, and results of the data can be used to question if existing methods are effective for people who live with health issues. At least 10 St. Mary’s University students who want to become data scientists and public health professionals will also work on the project to learn about the challenges health problems like diabetes have on the local economy.
Lutz said challenges for working people struggling to manage their diabetes could include becoming overwhelmed, putting their job in jeopardy, giving up on managing their disease or losing their homes.
“That is a vicious cycle we want to try to avoid,” Lutz said.
