Largest Houston health survey reveals unmet needs of both adults and children
HOUSTON – (Nov. 7, 2011) – Barriers to health care services, high rates of chronic and mental health conditions, low rates of preventive screenings and unsafe neighborhood conditions are among Houston’s top health care concerns, according to a survey by The Institute for Health Policy at The University of Texas Health Science Center at Houston (UTHealth).
With respondents from more than 5,000 randomly selected households, the Health of Houston Survey is the area’s most extensive health survey, assembling facts on health status, health care and lifestyle, as well as on social, economic and neighborhood risk factors.
“By collecting this information directly from the public, we have a timely and accurate picture of health care needs that will make a difference in transforming health services and programs in communities,” said Stephen Linder, Ph.D., principal investigator for the survey, associate director of the Institute for Health Policy and professor at The University of Texas School of Public Health, part of UTHealth. “This is a vehicle for identifying and addressing Houston’s greatest health needs.”
The survey, sponsored by Houston Endowment Inc., examined residents’ health status, chronic health conditions, mental and behavioral health, social and economic conditions, insurance coverage and access to health care across neighborhoods in Harris County.
“The survey is a tool for policymakers, providers, funders, advocates and researchers to use toward improving the health of all Houstonians,” said Necole Irvin, health officer at Houston Endowment Inc. “We look forward to using it in our future support of health care solutions.”
The survey data, an interactive mapping program and a summary of initial findings are available to the public at www.hhs2010.net.
Key findings include:
- On average, 20 percent of Houston area residents are in fair or poor health (not in good health). Nationwide, the figure is just below 10 percent. Significantly, 36 percent of Vietnamese residents in the Houston area consider themselves in fair or poor health, the highest level for any ethnic group.
- More than a third of all adults under 65 were without insurance at the time of the survey.
- Forty-six percent of Hispanic citizens were uninsured, more than any other group. When including undocumented Hispanic residents, 56 percent of all Hispanics were uninsured – four times the rate for non-Hispanic white residents. “Could not afford” is the No. 1 reason most Houston area residents do not have insurance.
- Adults in Houston appear to be less healthy than the state average. The survey found that 30 percent have high blood pressure, compared to the state average of 28 percent. Thirty-two percent of Houston area adults are obese, compared to the state average of 29 percent. Local residents also have higher incidences of diabetes, asthma and cardiovascular disease.
- Houston area residents had lower cancer screening participation rates than the Centers for Disease Control and Prevention’s Healthy People 2020 goals. Half of Asian residents had no screening for cervical or colon cancer. Hispanic residents were more likely than other groups to be unscreened for breast and colon cancer.
- Almost half of area residents – 48 percent – experienced difficulty buying food or paying their rent or mortgage at some point in the last year. This economic hardship impacts health status, according to Linder.
- Fifty percent of area adults had no dental insurance last year.
- In the area of mental health, serious psychological distress affects 7 percent of residents – twice the corresponding national figure - and area women are affected twice as often as men. One in 10 adults took a prescription drug for at least 14 days for mental or emotional health problems at some point in the last year. Six in 10 of those with unmet needs for mental health services cited cost as the main barrier.
- The highest proportions of uninsured adults (34 to 62 percent) reside in Northline, Downtown-East End and Gulfton areas. Those areas also have some of the highest levels of disadvantage, coupled with the highest proportion of residents in fair or poor health.
- Northline-Eastex, Acres Homes-Greater Inwood and Sunnyside-Greater Hobby have the highest levels of children who lack insurance (18 to 31 percent) and face other barriers to health care. Overall, girls were more likely to be uninsured.
- The area average for prenatal care is 84 percent. However, 16 percent either received late or no prenatal care. More than 30 percent cite cost or lack of insurance as reasons for receiving delayed or no prenatal care.
- The rates of initiating breastfeeding exceed the CDC’s Healthy People 2020 objectives while the rates for sustaining breastfeeding for six months drop 20 percent below the national goal.
- The Houston area fares better than the state and national averages when it comes to obesity among teens. In Houston, 11 percent of teens are considered obese, compared to 14 percent statewide and 12 percent nationwide.
- The Downtown-East End areas have the highest proportion of children ages 12-17 at an unhealthy weight combined with the greatest density of fast food establishments.
- Crime is a concern for 26 percent of residents. Almost 1 in 5 residents have concerns about their drinking water, dumping and being exposed to air pollution due to traffic.
“The data captured in this survey is certainly invaluable to the Houston community in many ways. It’s important, however, to remember that this survey is just a baseline,” said Roberta B. Ness, M.D., M.P.H., dean of the UT School of Public Health and vice president for innovation at UTHealth. “With each subsequent Health of Houston survey that is completed, Houstonians will learn more and more about needs in specific areas of the community. Our goal at the UT School of Public Health is to keep this survey active for years to come.” Ness added that additional research funding will be needed to sustain the survey going forward.
Survey results will be used to support the efforts of health agencies, service providers and community organizations, giving them more accurate and up-to-date health information on residents across neighborhoods in Harris County. For example, if there is a high concentration of residents affected by diabetes in an area that lacks adequate health care services, local organizations can use this information to apply for grants and assistance to establish clinics and prevention programs. Health agencies could send resources to the area.
To ensure a comprehensive look at a broad range of health conditions affecting the Greater Houston population, UTHealth researchers sought input from more than 150 organizations on topics to be included in the survey. Collaborating organizations include the Harris County Healthcare Alliance, Gateway to Care, OneVoice, the Houston Department of Health and Human Services, Harris County Public Health and Environmental Services, St. Luke’s Episcopal Health Charities and neighborhood and civic associations.
“The Health of Houston survey is a great tool that, if used well, can help our community plan better to close gaps in health care services and make us better understand the effect of socioeconomic factors on Houston residents’ health,” said Raouf Arafat, M.D., M.P.H., assistant director of the Houston Department of Health and Human Services.
Linder believes the Health of Houston Survey is a first step in documenting pathways to a healthier future through a reliable, efficient and flexible system for tracking emerging health issues, assessing the impact of health programs and documenting health improvements.
The Health of Houston Survey received support from the UTHealth Center for Clinical and Translational Sciences. A follow-up survey is planned for 2012-2013. The Institute for Health Policy survey team includes Linder; Dritana Marko, M.D., faculty associate; Jessica Tullar, Ph.D., faculty associate; Tom Reynolds, Ph.D., research associate; Amy Beaven, research associate; Ashish Deshmukh, graduate assistant; and Chris Manuel, graduate assistant, as well as Larissa Estes, DrPH, of the City of Houston Department of Health and Human Services
About the Institute for Health Policy: The Institute for Health Policy was established to assist researchers in translating their technical findings into usable advice for program administrators and practical recommendations for health policymakers. The primary mission of the Institute for Health Policy is to meet this challenge by translating research findings into practical advice for problem solving and by fostering more productive exchanges between academic researchers and public policymakers.
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