When it comes to resident health and well-being, Bexar County ranks 115th for overall health out of 242 Texas counties measured, according to an annual report released Wednesday by the Robert Wood Johnson Foundation and the University of Wisconsin.
In 2017, Bexar County ranked 78th for overall health in Texas.
While it may appear as though the outlook for Bexar County is dramatically worse this year, the change is not unusual given the method of comparison, said Ericka Burroughs-Girardi, community coach with County Health Rankings and Roadmaps, which produced the report.
“I would not panic about that,” Burroughs-Girardi said of the drop, nothing that how well a community performs is relative to gains or losses made by surrounding counties within a given category. “If other counties are making gains quicker than [Bexar County] is, or if they are making losses, all of that factors in” to an overall ranking, she said.
The report utilizes more than 20 data sources to compare counties within each state on more than 30 health-influencing factors such as access to quality health care, education, and jobs, aiming to provide insight into how health is influenced by location. And for the first time, the report examined the differences in health outcomes in Bexar County by race and ethnicity in an attempt to “tell a more complete story,” Burroughs-Girardi explained.
For example, the rate of premature deaths in Bexar County – while slightly higher than the overall state average of 6,700 deaths per 100,000 – has continued to improve since 2011.
“You guys are doing better which means that people are living longer in Bexar County,” Burroughs-Girardi said. “But even though you are trending well for this measure, not everyone in Bexar County is experiencing the same opportunity.”
While the overall average of premature death in Bexar County is 6,900 per 100,000, the rate of premature death in black people is 9,500 per 100,000 people, compared to 6,500 for their white counterparts.
The percentage of Bexar County children who live in poverty is the same as the overall average for the state – 22 percent – but the numbers vary widely according to race and ethnicity. In 2018, 32 percent of black children will live in poverty, compared to 10 percent of white children. The rate of poverty among Hispanic children is 29 percent.
Bexar County had a slightly lower teen pregnancy rate than the state, with 40 births per 1,000 teens aged 15-19 compared to 41 per 1,000 for Texas. But when broken down by race and ethnicity there are wide disparities, with the rate of pregnancy among Hispanic teens at 49 per 1,000 births, 35 per 1,000 for blacks, and 18 per 1,000 for whites.
Kori Eberle, program manager with Healthy Start, San Antonio Metropolitan Health District's program to address maternal and child health, said the repeat teen birth rate in San Antonio contributes greatly to the overall teen birth rate.
"In addition to the disparities among demographics, [Bexar County] also [has] a higher repeat teen pregnancy rate – that is something that we are specifically addressing as well," Eberle said. "Focusing on repeat teen births is extremely important."
Project Worth, Metro Health's teen pregnancy program, works to develop "internal assets," Eberle said, including increasing youth's self-esteem, improving parent-child communication, "and other things that we need to bolster in order to prevent teens from making choices that are not so healthy for them, including teen pregnancy."
Burroughs-Girardi said the report's intention is to provide a snapshot in time of a county's health so that local government and healthcare organizations may identify the drivers behind health factors in order to continue improving.
For Bexar County, the only health-related category that has not improved over time has been the rate of sexually transmitted infections, which is measured by the rate of chlamydia diagnoses. In 2017, there were 10,335 newly diagnosed cases of chlamydia; in 2018, 13,148 are expected.
According to the 2018 rankings, the healthiest county in Texas is Denton County, located around 300 miles North of Bexar County. The least healthy county is Duval, which is 130 miles south. Seven Texas counties were not ranked.
“[Communities] need to invest in health like you invest in a bank account – you do not become rich over night,” Burroughs-Girardi said. “Invest in your community and invest in health right now so that you can have success later on.”