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LOCATING PROVIDERS Providers are expanding in areas with demand for low cost services.
ACCESS TO CARE
So I start o with diabetes, then end up with some pancreatic and liver issues, maybe even heart issues.” Meanwhile, AccessHealth, which has been based in Fort Bend and Waller counties for almost 50 years, serves its communities by not turn- ing anyone away for a lack of ability to pay or a lack of insurance. 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 5,959 visits in 2020. “These gures indicate an elevated demand for mental health services, potentially in uenced by the ongoing e ects of the pandemic and the current global landscape,” an emailed state- ment from AccessHealth reads. The CHA’s section relating to mental health needs in the county states there is one mental health provider for every 1,050 Fort Bend County residents, compared to one provider per 690 resi- dents in the state overall. “We’ve seen an increase in suicide ideation at our Fort Bend clinic since the start of the pandemic,” Clark- son said in regards to San Jose Clinic patients. “We think that isolation could play a factor in that.” Barriers to care The CHA report identi ed a variety of social barriers preventing residents from accessing quality care. Outside of being uninsured or underinsured, fac- tors such as a lack of transportation and a lack of bilingual providers were key contributors, according to the CHA. An underinsured person is someone with insurance that may not su ciently cover their medical needs. “One of the No. 1 barriers for people dealing with health care is transpor- tation,” Clarkson said. “In our area, where a county can span 100 miles like Harris County, having reliable trans- portation to get to and from the doctor is quite a challenge for underserved and under-resourced people.” Clarkson said often people seeking care without reliable transportation would need to have a family member take them to a clinic. In these cases, both could be missing out on work hours with no paid time o bene ts, she said. AccessHealth Chief Population Health O cer Palak Jalan referred to the factors preventing people from
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 residents per one primary care physician 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 residents per one mental health provider, 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 people without insurance or with a low annual household income—or making less
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 uninsured people reaching over 16% in the 77498 and 77489 Sugar Land and Missouri City ZIP Code Tabulation Areas in 2020. These ZCTAs—which are generalized rep- resentations 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 med- ical services were the top missing ser- vices in their community. However, some local health clinics that provide low-cost services are undergoing expansions in areas with larger unin- sured and low-income populations.
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 quality care and education to people with constraints keeping them from accessing health care. Kimberlyn Clarkson, chief advance- ment o cer for San Jose Clinic, said chronic conditions were exacerbated over the course of the COVID-19 pan- demic among patients. She said man- aging chronic conditions, such as diabetes and hypertension, is the cur- rent focus for the majority of San Jose Clinic patients. “When a patient or person goes with- out consistent health care for a number of years, things like diabetes arise,” Clarkson said. “Chronic conditions often lead to other chronic conditions.
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