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LOCATING PROVIDERS Providers are expanding in areas with demand for low-cost services.
ACCESS TO CARE
counties for almost 50 years, provides health care for anyone that has no health insurance or no ability to pay. Data from AccessHealth showed an increase in the number of mental health or substance abuse visits since the onset of the COVID-19 pandemic in 2020. According to the data, there were 8,681 of these visits in 2022, re ecting a 45.68% jump from 2020. “These gures indicate an elevated demand for mental health services, potentially in uenced by the ongo- ing e ects of the pandemic and the current global landscape,” an emailed statement from AccessHealth reads. Lara Hamilton, executive director of nonpro t health care provider Christ Clinic, said the Katy area is seeing high demand for a ordable health care due to its rapid growth. Christ Clinic pro- vides primary care to uninsured and underinsured people, or someone with insurance that may not su ciently cover their medical needs. “As communities grow ... the num- ber of individuals that you need to run those businesses [increases], which are typically going to be part-time workers or hourly workers that are making less than a living wage,” Ham- ilton said. “[Massachusetts Institute of Technology] has a living wage calcula- tor, and in the Katy area, it’s $32.20 per hour for one adult with one child. If you’re working retail or something like that, you’re not touching that.” Barriers to care The CHA report identi ed a variety of social barriers preventing residents from accessing quality care. Factors such as a lack of transportation and a lack of bilingual providers were key contributors, according to the CHA. “With our patient population, the primary barrier, the reason that we are needed is socio-economic,” Ham- ilton said. “It’s income, employment. Most of our patients are employed, but as part-time workers or something like that, so their income is just not high enough or they’re not eligible for group bene ts.” Hamilton said the No. 1 reason for no-shows and cancellations at Christ Clinic is a lack of access to transpor- tation. She pointed to an absence of public transportation or walkable infrastructure in Katy. Palak Jalan, AccessHealth chief population health o cer, referred to the factors preventing people from accessing care as “social determinants
U.S. Census Bureau data from 2020 shows Texas has the highest uninsured population of all states in the country, with Fort Bend County’s rates being signi cantly higher than the average in the country. 1,200-1 ratio of residents to primary care physicians in Fort Bend County, compared to 1,640-1 in the state 30% of uninsured respondents to a Fort Bend County 2022 health survey reported having very good health compared to 45% of survey respondents with private health insurance. 1,050-1 ratio of residents to mental health providers, compared to 690-1 in the state
Federally quali ed health centers Existing
Coming & expansions
10
6
99
BEECHNUT RD.
Texas
Fort Bend County
U.S.
W. BELLFORT BLVD.
Projected 15.3%
25% 20% 15% 10% 5% 0%
723
W. AIRPORT BLVD.
69
90
N
SOURCES: U.S. CENSUS BUREAU 2020 SMALL AREA HEALTH INSURANCE ESTIMATES, ANNUAL COMMUNITY SURVEY LOCAL SNAPSHOT DATA, FORT BEND COUNTY, ACCESSHEALTH, SAN JOSE CLINIC COMMUNITY IMPACT
Identifying needs Survey data and anecdotal accounts from health care o cials that indicate household income and pandemic-era health trends point providers in the direction of the people who are most in need of support. Fort Bend County overall has a lower percentage of uninsured people in its population than in the state, which has the highest population and per- centage of uninsured residents in the nation, according to the Texas comp- troller’s website. The ratio of providers to patients has improved over time in the county, but statewide trends—such as many essential labor employers not providing health care to workers—are also present in Fort Bend County. In the CHA report, 25 “key infor- mants” were consulted to represent di erent sectors and populations, such as primary health care providers, elected o cials and hospitals. These informants were asked to assess the health status of Fort Bend County residents. According to the report, the assessed individuals gen- erally identi ed people with insurance and higher socioeconomic status as being relatively healthy, while peo- ple without insurance or with a low annual household income—or making
Areas north of Richmond, parts of Houston and the more rural areas in the county see uninsured popu- lation rates higher than 20%, said Kaila Williams, Fort Bend County’s director of health communications, equity and engagement. Overall, 17% of adults and 11% of children were uninsured in the county in 2022, with the percentage of unin- sured people reaching over 16% in the 77498 and 77489 Sugar Land and Mis- souri City ZIP Code Tabulation Areas in 2020. These ZCTAs—which are gener- alized representations of United States Postal Service ZIP code service areas— are located in the northeast part of the county near the city of Houston. “Twenty-two percent of [CHA] respondents, they or a family member needed medical care in the past year but was unable to receive it,” she said. “The top reason was because they did not have health insurance.” Williams also indicated 45% of respondents said free or low-cost medical services were the top miss- ing services in their community. However, some local health clinics that provide low-cost services are undergoing expansions in areas with larger uninsured and low-income populations.
less than $40,000—tended to have unmet health needs. The observations made by infor- mants were supported in the coun- ty’s health report. Only 29% of people with a low annual household income reported having “very good” health versus 41%-53% of people with middle and high annual household incomes. Local nonpro t health care provid- ers that cater to low income and unin- sured populations, such as San Jose Clinic and AccessHealth, are expand- ing to better serve high-demand areas in the county. San Jose Clinic aims to provide qual- ity care and education to people with constraints keeping them from access- ing health care. Kimberlyn Clarkson, chief advancement o cer for San Jose Clinic, said chronic conditions were exacerbated over the course of the COVID-19 pandemic among patients. She said managing chronic conditions, such as diabetes and hypertension, is the current focus for the majority of San Jose Clinic patients. “When a patient or person goes without consistent health care for a number of years, things like diabetes arise,” Clarkson said. Meanwhile, AccessHealth, which has been based in Fort Bend and Waller
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