If the coronavirus pandemic has taught San Antonio anything about health equity, it’s that public health crises require far more coordination between agencies and a more targeted, data-informed approach to provide resources to the most vulnerable, three experts agreed on Tuesday.
“We have resources, but collaboration and strategic planning [is lacking],” said Dr. Lyssa Ochoa, president and CEO of San Antonio Vascular and Endovascular Clinic. “We could have predicted where COVID was going to hit hardest, we could have predicted where vaccines are going to be hard to access.”
COVID-19 hit Bexar County in the same geographic and socioeconomic patterns as chronic illnesses, which disproportionately impact low-income families and people of color in the same neighborhoods, Ochoa said. The same targeted approach used to provide resources to those communities during the pandemic can also be used to address historic health inequities.
Several state and local approaches to health equity were discussed during the San Antonio Report’s latest panel discussion in its medical forum series. The virtual event also featured Marisa Bono, CEO of Every Texan, and Claude Jacob, director of San Antonio Metropolitan Health District. The conversation was moderated by Senior Reporter Iris Dimmick.
Dimmick asked who will oversee the effort to improve coordination and make sure San Antonio does a better job in health crisis management and health equity.
“Our public health framework requires that we mobilize partnerships that work and that we enhance and improve the linkages to health care and health services,” Jacob said. “So what I will remind folks is that we’re still building the plane while flying it.”
From a statewide perspective, Bono is cautiously optimistic that the pandemic has invigorated the push for Texas to expand Medicaid.
While a vast majority of states expanded Medicaid eligibility under the Affordable Care Act, the Texas Legislature continues to opt out of the expansion that would insure 1.4 million Texans, Bono noted.
But her optimism comes from efforts at the federal level, not with the state.
“I think we’re really at a crisis point,” she said. “The tension that we’ve seen in Texas — with the impact that the uninsured rate has on our economy and our schools and our families — that’s playing out across the country. So hopefully, we’ll see some action at the federal level.”
The social determinants of health have an even larger impact on health outcomes than the actual health care you receive, Ochoa said.
Those determinants include “transportation, care, healthy foods, … access to healthy and safe places to exercise [and] to walk, education, property value, sidewalks, internet access, and the list goes on and on,” she said. “I honestly believe that it’s going to take the entire community, from the patient to the family … to our city, to our county, to the state to really enact changes that will affect all of these health care outcomes.”