National Study Recognizes San Antonio’s Health Policy Initiatives

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Supporters of Tobacco 21 hold signs at a media briefing in City Hall.

Bonnie Arbittier / Rivard Report

Supporters of the Tobacco 21 ordinance hold up signs at a media briefing in City Hall last December.

A project that analyzes health policies in the nation’s 40 largest cities recognized San Antonio for implementing measures to address community health and well-being, including access to safe streets, educational opportunities, and access to healthy food.

The report published Tuesday was compiled by CityHealth, a policy analysis initiative funded by the de Beaumont Foundation and Kaiser Permanente.

San Antonio is among nine cities nationwide – and the only one in Texas – to receive an overall silver medal, or “good” quality rating, in 2018 for its policy efforts toward food safety, smoke-free indoor air, and availability of healthy food options. The city was recognized for making a dramatic improvement compared to the initial report where the city received no overall medal.

The report is the follow-up to a two-year analysis published by CityHealth in 2017, which looked at how cities fare across nine policy categories that impact health, and awarded bronze, silver, or gold medals – or no medal at all – in each category.

Austin and Houston received bronze medals; Dallas, Fort Worth, and El Paso did not earn medals. Only five cities received an overall gold medal: Boston, Chicago, Los Angeles, New York, and San Jose, California.

While CityHealth lauded San Antonio for having raised the legal age to buy tobacco to 21 and for its City-funded Pre-K 4 SA program, other measures indicate that San Antonio and Bexar County face significant disparities in health, with high rates of obesity and diabetes, and teen pregnancy rates nearly 50 percent higher than the national average.

Shelley Hearne, CityHealth's principal investigator and president, said that San Antonio’s leap in ranking from no overall medal to a silver medal represents the most significant improvement in health policy of any city included in the report.

“What happened in San Antonio is an example of how leadership [at all levels of government] can make a difference,” Hearne said. “San Antonio is now leading the pack for Texas as the top medal winner, and is showing not only Texas, but others around the country how to lead” efforts to implement policies that encourage health.

Collaborative efforts by the mayor, City Council, and the San Antonio Metropolitan Health District toward improving local health policy initiatives, Hearne said, will be recognized at the U.S. Conference of Mayors in Boston on June 8, where Mayor Ron Nirenberg will be presented with a health leadership award and the city’s silver medal.

“The award is to [acknowledge San Antonio’s] emboldened recognition that health matters as a part of the economic engine of a city,” Hearne said.

Of the health policy improvements San Antonio implemented, Hearne said the most significant was passing Tobacco 21 legislation, which raised the minimum age to purchase tobacco products in the city from 18 to 21. 

Over the next two years, the City will work on increasing access to healthy food, improving restaurant inspection policies and procedures, and increasing “complete streets” initiatives that encourage residents to exercise and utilize streets for more than just motor vehicles, Metro Health Director Colleen Bridger said.

Improving San Antonio streets, which calls for a balance between people’s needs and safety across all forms of transportation, including walking, biking, public transit, and cars, is where San Antonio is most lacking in progress, Bridger said. An increase in events such as Síclovía will help to move San Antonio away from being an “occasional complete street environment” to one where all modes of transportation may coexist.

“San Antonio is in the right environment” to address these issues, Bridger said. "The time is right to push for change.”

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