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From lack of food to chronic illness, 2018 Health of Houston Survey sheds light on residents

Downtown Houston skyline
Downtown Houston skyline (Image created by UTHealth)
Stephen H. Linder, PhD
Stephen H. Linder, PhD, director of the Institute for Health Policy at UTHealth School of Public Health and principal investigator of the 2018 Health of Houston Survey. (Photo by Maricruz Kwon/UTHealth)

A snapshot of health conditions revealing the disparities across 38 neighborhood areas in Harris County has been published in the 2018 Health of Houston Survey by The University of Texas Health Science Center at Houston (UTHealth) School of Public Health.

The report, available online to the public, details patterns of illness and health practices, insurance coverage, access to care, mental health, prenatal care, diet and exercise, and neighborhood problems of greatest concern to residents. It also pinpoints where the highest percentage of residents live in the poorest health, have the greatest food insecurity, report the lowest rates of health insurance coverage, or suffer from serious chronic health conditions.

The survey gathered information about adults and children from telephone interviews in English and Spanish with residents in 5,694 Harris County households.

“This kind of data is critical to identifying unmet health needs throughout the county and being able to pinpoint areas and groups of residents where the need is greatest. Relying on it, organizations and authorities can target services more effectively and ensure that interventions are directed where they will help the most,” said Stephen H. Linder, PhD, director of the Institute for Health Policy at UTHealth School of Public Health and principal investigator of the survey. 

The 2018 edition, which builds on the landmark 2010 survey, is one of the largest and most comprehensive of its kind nationally, and is unique in offering its data to the public on two web-based platforms, one using maps and the other, simple tabulations of survey responses. The emphasis is placed on both access and ease of use, since the intent is to reach different users, from researchers to health systems, and from nonprofits to city and county officials.    

Some key findings from the 2018 Survey:

  • On a range from poor to excellent health, 20% of Harris County residents rated themselves in fair or poor health with the highest percentages of those living in Aldine and Settegast, followed by Edgebrook, Gulfton, and South Acres Homes.
  • Along with Settegast, Aldine, and Gulfton, the areas of North Acres Home, Champions, Galena Park, and South Alief reported the highest percentage of adults facing economic hardship. Black residents were more likely than any other group to experience economic hardship and face food insecurity regularly.
  • Obesity, high blood pressure, and diabetes were the most common chronic conditions affecting county residents. Diabetes rates in the county varied from less than 9% in the far northwest to 17%-26% in the northeast and east. Areas with the highest rates of diabetes included Humble, Galena Park, East End, Settegast, and Gulfton. Some areas saw large increases. In the 2010 survey, for example, the rate of diabetes in Gulfton was 15% while the 2018 rate rose to 21.3%.
  • With the Affordable Care Act implemented fully in 2014, fewer Harris County residents were uninsured in the 2018 survey, 27%, compared to 31% in 2010. Respondents reported that 11% of children were uninsured versus 13% in 2010. Of adults under age 65, 37% were without health insurance at some point in the last year. Hispanics were disproportionately affected, with 56% going without health insurance at some point. Areas where residents were most likely to be uninsured included Pasadena, Bellaire, Galena Park, Gulfton, and Aldine. Areas with the greatest number of uninsured children were Aldine, Settegast, Pasadena, Edgebrook, and South Houston.
  • Nearly 16% of all residents reported that they could not afford or delayed filling a prescription for themselves or a family member in the past year; 18% could not see or delayed seeing a specialist; 10% did not seek or delayed seeking mental health care; and 24% delayed or could not get dental care services.
  • Gulfton and Aldine areas had the highest percentage of uninsured and faced three or more barriers to access. Areas with both high percentages of uninsured children and access barriers included La Porte, West Clear Lake, East End, and Galena Park.
  • Obesity rates of teens age 14-17 rose from 11% in 2010 to 16% in 2018. Areas of children with unhealthy weights (overweight and obese) ages 12-17 included Gulfton, Bellaire and South Alief, North FM 1960, Champions, Katy, and Tomball with rates ranging from 43% to 46%. The average for the county was 32.8%.
  • The rate of serious psychological distress was 7%, the same as in 2010, still, it had decreased to 6% just before Hurricane Harvey in 2017, rising just after and remaining at 8% six to nine months after Harvey. Frequent mental distress, defined as 14 or more days of poor mental health over the last 30 days, was reported by 17% six to nine months after Harvey, which is nearly 5 percentage points higher than the average before the storm (13%). Rates of distress rose with severity of storm damage experienced by the residents.
  • Of the 17% of county residents who reported they needed mental health care in the last year, only 44% in that group received it. Areas with the highest need for mental care services were South Acres Home, Edgebrook, South Alief, Greater Uptown, Spring, and Champions. The South Alief area had one of the highest rates of residents needing mental health services, 23%, and one of the lower rates of mental health care visits, 6%.
  • Overall there was a drop in the percentage of county residents who reported neighborhood and environmental concerns but stray animals continued to be the top concern at 34%, particularly in Aldine, Edgebrook, Settegast, South Acres Home, and Galena Park. Other concerns were crime, 22%; lack of fresh fruits and vegetables, 21%; no sidewalks, 22%; and no park or playground near where they lived, 21%.  

The 2018 survey was funded by Houston Endowment, Episcopal Health Foundation, Texas Children’s Hospital, Memorial Hermann Health System, Community Health Choice/Harris Health System, UTHealth-President’s Excellence Fund, UTHealth School of Public Health-Office of the Dean, and TMC-Health Policy Institute.

The full report and data from 2010 and 2018 can be found at www.healthofhouston.org.

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