Diverse Patient Care- The LGBTQ+ Community in Houston

Something I have emphasized throughout my blogs up to this point is Houston’s diversity. Diversity to me means the acknowledgment of different characteristics in groups of people within a single space. The differences can be racial, ethnic, socioeconomic, religious, cultural, sexual orientation, etc.

Previously, I have touched upon the topic of accessibility of healthcare facilities for the general Houston population while also going a bit more in-depth for what that means for the Hispanic and Black communities residing in Houston. I have mentioned how these communities tend to be uninsured at higher percentages but, a diverse population that I have not mentioned yet is the LGBTQ+ community and their disparities in healthcare. In this post, I will shine a light on some factors that may influence their access to healthcare resources and also link places that are LGBTQ+ friendly.

 

Health Disparities

The University of Houston published an article in their school’s magazine that states that researchers and healthcare providers are focused on solving inequities that can be found in healthcare outcomes. When talking about the LGBTQ+ community, they noted that an assistant clinical professor at the College of Nursing found that “the group has higher rates of depression and suicide than the general population.” A 2019 article in the Texas Medical Association also stated that LGBTQ+ patients tend to face unique barriers that ultimately put them at greater risk for both mental and physical health problems. Issues can arise from a lack of family support, public prejudice, and also fear of the healthcare system. A new Texas Medical Association Physician Committee is attempting to improve awareness and understanding of these patients while the Texas Medical Association LGBTQ+ Health Workgroup seeks to also raise awareness in hopes of ensuring the patients get the care they need. They reported that all LGBTQ+ groups face high rates of mental illness, HIV, obesity, suicide, and even homelessness while also having the highest rates of tobacco, alcohol, and drug use.

There are issues with the healthcare system that are contributing to these scary facts. An example is that some electronic medical record systems don’t provide the option to record the patient’s desired sexual identity and gender preferences which, in turn, discourages the LGBTQ+ patients from seeking medical help in the first place. The same Texas Medical Association article also claims that many physicians would like to treat LGBTQ+ patients but hesitate because they fear they lack the training to do so. I understand where the physicians are coming from as they might fear calling a patient by the wrong pronouns, for example, but I don’t think physicians should be hesitant to the point they don’t treat a member of the LGBTQ+ community if they comprehend that LGBTQ+ people are just like any other patient they treat, human.

An article in The Texas Signal stated that this past May, the United Nations noted that worldwide, the LGBTQ+ community has been severely impacted by COVID-19, particularly HIV-positive and trans people. These people don’t just have to deal with the lack of access to healthcare or disruptions to medication and treatments, but, because of the pandemic, there have been more complications including an elevated risk of domestic and family violence, social isolation, increase anxiety, scapegoating, societal discrimination, and unfortunately, so much more. To make matters worse, there is no statewide protection. LGBTQ+ Texans are disproportionately threatened in housing, employment, and healthcare, but a positive thing that has risen from the pandemic is that some State Representatives are pushing for an anti-discrimination bill. This could make a significant difference in the red state if the Representatives continue to have the support that have now.

In 2015, The New York Times claimed that Houston was one of the largest metropolitan areas with the lowest rates on LGBT residents (3.3%). In 2018, Houston Public Media wrote that Houston lags behind other major Texas cities (e.i. Dallas, Fort Worth, San Antonio, and Austin) as Houston was the only major city in Texas that didn’t get a perfect score on the annual Municipal Equality Index by the Human Rights Campaign. It scored a 70 out of 100 in “LGBT- friendliness” largely because the city of Houston does not have citywide nondiscrimination protections in employment, housing, and public accommodations since Houston did pass a law that protected LGBTQ+ people in 2014 but was repealed by voters a year and a half later.

Though I will admit that health disparities seem quite prevalent for the Houston LGBTQ+ community, there are many programs that give hope!

 

Legacy Community Health- LGBTQ+ Services

Legacy Community Health offers a large variety of LGBTQ+ services to Houstonians. They are a full-service, federally qualified health center that identifies the unmet needs and gaps in health-related services. They formed in 2005 as a result of a merging of two leading Houston area community organizations (Montrose and the Assistance Fund). Currently, they are a nationally recognized leader in HIV/AIDS primary care, prevention, and treatment as they treat LGBTQ+ patients with dignity, respect, and compassion. The LGBTQ+ services at Legacy Community Health include HIV/AIDS screening and prevention, HIV/AIDS treatment (which includes primary healthcare, case management, counseling, educational workshops, financial assistance, and wellness services), Transgender Specialty Care (which includes individual and family therapy psychiatric evaluations and care), vision tests, and social services that assist transgender patients in areas such as school advocacy, housing, financial, employment, and legal needs. They even have a body-positive wellness center! As a bonus, Legacy claims to provide care to anyone in the community regardless of their ability to pay as they are a safe, judgment-free, patient-centered environment. Great!

Aside from LGBTQ+ services, Legacy treats a variety of other patients with services such as chronic disease management, behavioral health, dental care, endocrinology, pediatrics, pharmacy, OB/GYN and maternity, and vaccines, etc. But guess what? It doesn’t stop there! Legacy has always tried to go above and beyond that even on the onset of the pandemic, Legacy clinics in Montrose, Fifth ward, and Southwest became the first three testing sites in all of Houston!

 

Planned Parenthood

In Houston, I was able to find 4 Planned Parenthood locations that provide LGBTQ+ services. The first location is the Prevention Park Health Center that is currently only offering services through Telehealth. The second location is the Southwest Health Center who is also only offering services through Telehealth. The third location is Northville Health Center who is offering in-person services and lastly, the Northwest Health Center that currently only offers Telehealth. When clicking on the LGBTQ+ services, the first, second, and fourth locations offer services referral specifically for clients who identify as LGBTQ+ while the third location is the only location that offers gender-affirming hormone therapy. If one has already started hormone therapy, the center can be utilized for ongoing care and monitoring. I’m sure many people have heard of Planned Parenthood but, after exploring their entire site, it became even more evident to me that it is a program worth fighting for! #ProtectPlannedParenthood

 

The Montrose Center

Compared to the general population, LGBTQ+ people face greater health disparities so this center has embraced an integrated care model with one-stop access to a number of services. The MontroseCenter offers behavioral health and support services, adult primary care and psychiatry, and free wellness programs. Unlike Legacy and Planned Parenthood, the Montrose Center is completely dedicated to the care of the LGBTQ+ community. The center is viewed as “home” to dozens of LGBTQ+ -affirming social and civic organizations that many rent a space at the center to hold meetings and events. The Montrose Center has a variety of services that make them stand out. For example, WAY OUT Recovery. WAY OUT recovery is an affordable outpatient substance-use treatment tailored to the LGBTQ+ and HIV-positive communities. In other words, The Montrose Center is directly addressing the issue that I mentioned earlier. That issue is that there is a significantly higher percentage of LGBTQ+ people who engage in addictive drugs and alcoholism when compared to the general population. Another unique service is SPRY, also known as Seniors Preparing for Rainbow Years. SPRY is for adults in the LGBTQ+ community of ages 60+. They do community outreach, counseling, social and recreational activities, and more. Isn’t that exciting? I didn’t even know that was a thing!

The Montrose Center doesn’t stop there. There is an array of counseling services such as LIFE Counseling, HIV/AIDS Counseling, Group Therapy with specific themes, and EMBody Integrated Care which stands for Empowering Mind & Mody. For the Transgender community specifically, there are support services such as professional counseling and support groups (one for adults and one for the youth of ages 13 to 20). Aside from that, they even an anti-violence program serving LGBTQ+ survivors of domestic violence, sexual assault, and trafficking as well as survivors of hate crimes. Last but not least, the center has an AssistHers program which provides a network of support to the LGBTQ+ identified women and non-binary individual living with chronic illness or disability as well as advocating for necessary healthcare and social service resources. Isn’t this place just awesome?

 

Lesbian Health Initiative of Houston, Inc.

Although there are many more programs and clinics that provide services, I wanted to provide this last resource, the Lesbian Health Initiative of Houston (LHI). LHI is a nonprofit dedicated to eliminating barriers to healthcare while promoting health and wellness for LGBTQ+ identified women and transgender men through collaborative and integrated education access and advocacy programs. LHI is partnered with the Montrose center, especially when at capacity. They have an access program that provides funding and support for LGBTQ+ healthcare clients by delivering health insurance education and enrollment assistance. They also hold Health fairs with screening and education events held twice a year. Though it seems to me like their site hasn’t been updated in a while, I managed to find their Twitter handle where they seem to be posting daily, so if you have Twitter, make sure to give them a follow @LHIHouston.

 

Find a service near you!

As mentioned earlier, the resources I listed in this blog post are not the only places that provide LGBTQ+ friendly services so if you want to explore more on your own or if you do not live in the Houston area, here is a link to a provider directory where you can search for a primary care provider, specialist, therapist, dentist, and other health professionals. The directory is free and does not require registration. Personally, I prefer OutCare. The link I provided lets you select out of the 50 states so use it however you wish. OutCare has identified LGBTQ+ healthcare resources in all the states and you can find resources including primary care, mental health services, youth groups, shelters, support groups, STI testing, etc. They recognize doctors and healthcare providers that fulfill 5 criteria showing that they are culturally competent in care, treatment, and services of the LGBTQ+ population. The 5 criteria are, creating a welcoming environment for LGBTQ+ person, facilitate disclosure of sexual orientation and gender identity but aware that disclosure of coming out is an individual process, feel culturally competent to provide appropriate care for LGBTQ+ persons, avoid assumptions of sexual orientation and gender identity, and lastly, provide informatization and guidance for specific health issues facing LGBTQ+ person. For more resources already tailored to Houstonians, check this link.

 

I believe Houston still has a long way to go in terms of providing equitable healthcare to the LGBTQ+ community but, with more vocal generations emerging, I know people will continue to fight for justice and equality until needs are met!

 

Annear, Brent. “Texas Physicians Push to Improve Health Care for LGBTQ Patients.” Texmed, 3 Sept. 2019, www.texmed.org/Template.aspx?id=51425.

“Are You SPRY?” The Montrose Center, 24 Jan. 2020, www.montrosecenter.org/services/spry/.

“EMBody Integrated Care.” The Montrose Center, 19 July 2019, www.montrosecenter.org/services/behavioral-health/embody-integrated-care/.

“Find an LGBTQ+ Friendly Doctor or Healthcare Provider Near You.” OutCare, 17 Sept. 2020, www.outcarehealth.org/outlist/.

“GLMA Home Page.” GLMA- Provider Directory, www.glma.org/index.cfm?fuseaction=Page.ViewPage.

“Health Resources.” Pride Houston, Inc., pridehouston.org/outreach/health-resources/.

Hennie, Matt. “Two Houston Hospitals among Best for LGBT Care.” Project Q Atlanta, 22 Oct. 2014, www.projectq.us/two-houston-hospitals-among-best-for-lgbt-care/.

“Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) Center of Houston.” The Montrose Center, 8 July 2019, www.montrosecenter.org/.

“LGBT Services Houston TX: Specialty Care: Legacy.” Legacy Community Health, 21 July 2020, www.legacycommunityhealth.org/services/lgbt-services/.

“LGBTQ Services in Houston, TX – Gay, Lesbian and Bi Sexual Help.” Planned Parenthood, www.plannedparenthood.org/health-center/texas/houston/77081/southwest-health-center-2293-91652/lgbtq.

“LHI.” Lesbian Health Initiative of Houston, Inc., 2016, www.lhihouston.org/.

Martin, Florian. “Houston Lags Behind Other Major Texas Cities in LGBT-Friendliness.” Houston Public Media, 12 Oct. 2018, www.houstonpublicmedia.org/articles/news/2018/10/12/307944/houston-lags-behind-other-major-texas-cities-in-lgbt-friendliness/.

Montoya Coggins, Jessica. “For LGBTQ Community, COVID-19 Exposes Health Disparities in Texas.” The Texas Signal, 8 June 2020, texassignal.com/for-lgbtq-community-covid-19-exposes-health-disparities-in-texas/.

“Northville Health Center of Houston, TX.” Planned Parenthood, www.plannedparenthood.org/health-center/texas/houston/77037/northville-health-center-2494-91652.

“Northwest Health Center of Houston, TX.” Planned Parenthood, www.plannedparenthood.org/health-center/texas/houston/77040/northwest-health-center-4042-91652.

“Prevention Park Health Center – Family Planning of Houston, TX.” Planned Parenthood, www.plannedparenthood.org/health-center/texas/houston/77023/prevention-park-health-center-family-planning-2291-91652.

“Southwest Health Center of Houston, TX.” Planned Parenthood, www.plannedparenthood.org/health-center/texas/houston/77081/southwest-health-center-2293-91652.

“WAY OUT Recovery.” The Montrose Center, 14 Feb. 2020, www.montrosecenter.org/services/addiction-recovery/way-out-recovery-program/.

What Factors Determine Access to Healthcare Resources in Houston?

In my last blog post, I discussed what factors influence the health of Houstonians. This time, I will present some factors that determine who has access to certain healthcare-related resources and who does not.

Before I dive in, I would like to mention a few statistics that will help you get a better sense of the overall access to health in Houston. In 2017, Harris County indicated that 24.3% of adults were unable to afford to see a doctor sometime in the past 12 months. Unfortunately, it seems like this percentage has only continued to increase since 2014. When people do not have the financial means to see a doctor, there is a high chance they are not receiving proper medical services allowing a greater opportunity for adverse health outcomes, conditions to go untreated or undetected, and missed diagnoses. Without the proper financial means, one is less likely to get routine checkups and screenings and end up seeking treatment for illnesses once it’s a bit too advanced which, unfortunately, causes it to be more costly and difficult to treat. Low-income people are less likely to have insurance as well which often results in more ER visits rather than seeks a primary care physician.

For the same year, 67.9% of adults had a routine check-up in the past year. Routine check-ups are essential to maintaining good health but, although the percentage is 0.2% higher than the 2016 percentage indicating an increase, Houston’s percentage remains lower than the country’s value (70.6%).

The state of Texas is also one of only 14 states that chose not to expand Medicaid even under the Affordable Care Act (ACA) despite strong support from Texans. Because of this, many uninsured people have had to remain uninsured due to the high cost of insurance. According to understandinghouston.org, in 2017, 20.4% of the population in Harris County had no health insurance. When compared to the percentage for the entire state of Texas (17.3%) and the country’s percentage (8.7%), Houston has a significantly higher percentage of its population that is uninsured. An even more shocking fact is that the uninsured rate amongst children is more than double the national average. A total of 184,301 children in Houston didn’t have any type of health insurance coverage in the year 2017 meaning that the rate of uninsured children (those under 19) was about 11% while the US average was only at about 5%. According to understandinghouston.org, Texas has the highest number of uninsured children in the country with Hispanic children having the highest uninsured percentage (15.9%). Almost three times the rate of White children!

The fact that the percentages vary depending on one’s racial/ethnic group speaks a lot for Houston. Recall that in my previous blog post, I mentioned how diverse Houston is. Well, regardless of Houston’s diversity, Blacks and Hispanics still have lower health insurance coverage and access to primary care. For those who are uninsured, the uninsured rate amongst all Hispanics is 42.8%, nearly four times that of Whites (11%), while Blacks have an uninsured rate of 21.5%. Because it is estimated that there are about 400,000 undocumented people living in Houston, this, in part, explains why there is a high uninsured rate in the area as undocumented immigrants are ineligible for either Medicaid or Marketplace coverage.

This leads to the next determining factor that I would like to discuss.

In general, people who are in the country illegally are barred from enrolling in Medicaid or Medicare and cannot buy insurance through the Affordable Care Act marketplace since it is publicly subsidized. Though it is still possible to be insured if you are undocumented (assuming you can afford unsubsidized insurance), it doesn’t come easy as undocumented people oftentimes work jobs that don’t pay well enough to cover such high costs. Because of a lack of health insurance, most end up using emergency rooms for non-emergency care. When you break this down, one quickly realizes that many rather avoid going to the doctor than receiving a big hospital bill. But why is this? Well, undocumented people live with the constant fear that they will be asked for citizenship documentation, making them less willing to access services and programs for which they might be eligible for. But don’t worry, it isn’t the end of the world! Those who have access to health care tend to do so at federally funded health care centers which are required to treat anyone, can adjust costs, and doesn’t ask for citizenship documentation. If you or someone you know can’t afford or doesn’t qualify for health insurance, use this site as it provides you with services without the need for insurance. They can provide COVID-19 testing, STD testings, physical exams, urgent care, preventative care, discounted laboratory testing, and much more at a location near you! There are also free and income based clinics in the Houston area, so click here to learn more. For immigrant families specifically, AccessHOU is a database of resources working with immigrants in the greater Houston area. It helps you search through hundreds of agencies and programs that can provide help for legal reasons, health, education, food, housing, employment, and more.

When it comes to children, there are a bit more opportunities.

A larger percentage of children in Houston have health insurance compared to adults. In 2018, it was concluded that 86.0% of children compared to 68.9% of adults had insurance. Health insurance is especially important for children since, in order to stay healthy, children need to have regular checkups, dental and vision care, and medical attention for illness and/or injuries to prevent serious illness development. 

Children from low-income families may be eligible for Medicaid and the Children’s Health Insurance Program (CHIP). CHIP is primarily designed for families that earn “too much” money to qualify for Medicaid but not enough to afford private health coverage. For Texas residents specifically, the Texas Children’s Health Plan, which offers low-cost health coverage for children from birth through the age of 18, is also an option. According to texaschildrenshealthplan.org, the most a family will pay is $50 per year for all children that qualify but they claim that most families pay $35 or less per year. Aside from this, one must also pay additional co-payments on some of the services offered. Some benefits include doctor visits, dental care and teeth cleaning, prescriptions, eye care and glasses, hospital care, hearing testing, x-rays, etc. What determines whether a family qualifies depends on the number of children you have and the amount the family earns. To check if you qualify you can check this income chart. Some other determining factors for the Texas Children’s Health Plan include being a Texas resident and a US citizen or a legal permanent resident. Because it does look into legal status, this, unfortunately, leaves out a large portion of Houston’s population. Also, because Texas did not expand Medicaid regardless of the Affordable Care Act as previously mentioned, the state has seen virtually no change in Medicaid and CHIP enrollment since 2013. 

The factors that determine someone’s access that I mentioned in this post are very interconnected. A Houstonian can have multiple factors that prevent them from being able to have certain access such as being low-income, being undocumented, and a victim to health disparities while another can only have limited access for one reason. Regardless of the individual circumstances, the main components are whether the person has insurance or not, their legal status, race/ethnicity, age, and income. This is in no way claiming that these are the only factors that determine who has access or not. But there is always a silver lining.

Houston has been attempting to address the high percentage of uninsured people which has led to The Harris Health System which provides access to quality health care for Harris County residents, regardless of their ability to pay. The system includes three hospitals, twelve community health centers, a dental center, and an AIDS clinic, as well as several school-based clinics. It is nice to see there is a variety of resources made available in this system alone and hopefully more people become more aware of such opportunities. There is also the Harris County Public Health and Environmental Services (HCPH), a county health department that also provides public health care services ranging from nursing, dental health, health education, nutrition, and more! It even has a jurisdiction that provides services to about 4.7 million people! There are also programs like Doctors for Change that serve as an educational resource and forum where healthcare providers, students, and community members can advocate for improvements to the health care system in Texas. Check them out here. Lastly, I would also like to shine attention to HCA- Houston Healthcare as they provide over 2 billion dollars in charity care annually! Hopefully, there’s at least one resource here that can help!

 

Sources:

“About Us.” HCA Houston Healthcare, hcahoustonhealthcare.com/about/index.dot.

“Access to Care.” Doctors for Change, 4 Aug. 2020, doctorsforchange.org/access-to-care/.

“Access to Health Care in Houston.” Understanding Houston, 2020, www.understandinghouston.org/topic/health/access-to-healthcare/.

“Adults Unable to Afford to See a Doctor.” Houston State of Health, Mar. 2019, www.houstonstateofhealth.com/indicators/index/view?indicatorId=53.

“Adults Who Have Had a Routine Checkup.” Houston State of Health, Jan. 2020, www.houstonstateofhealth.com/indicators/index/view?indicatorId=3645.

“Adults with Health Insurance.” Houston State of Health, Jan. 2020, www.houstonstateofhealth.com/indicators/index/view?indicatorId=8287.

“Children with Health Insurance.” Houston State of Health, Jan. 2020, www.houstonstateofhealth.com/indicators/index/view?indicatorId=2732.

“CHIP.” CHIP | Texas Children’s Health Plan, 2020, www.texaschildrenshealthplan.org/what-we-offer/chip.

“Health.” Back to Www.houstontx.gov, 2020, www.houstontx.gov/abouthouston/health.html.

“Houston TX Free & Income Based Clinics.” Clinico, 2020, www.freeclinics.com/cit/tx-houston.

“Our Services- We Care for Your Entire Family.” Access Health Clinic, 2020, www.accesshealthclinictexas.com/services.html.

Uhler, Andy. “Here’s How It Works If You’re Undocumented and Need Health Care.” Marketplace, 9 July 2019, www.marketplace.org/2019/07/09/heres-how-it-works-if-youre-undocumented-and-need-healthcare/.

Factors Influencing the Health of Houston, TX

Community Overview:

My community, Houston, TX, is known for its large and diverse population. As of 2020, the population stands at around 2.33 million people, making it the largest city in all of Texas and the 4th most populous city in the United States. According to worldpopulationreview.com, Houston has a population density is of 3,657 people per square mile and its racial composition is as follows: 57.63% White, 22.54% Black or African American, 10.50% Other Race, 6.89% Asian, 2.07% Two or More Races, 0.32% Native American, and 0.06% Native Hawaiian or Pacific Islander. The average household income for Houston is about $81,995 and the city has a poverty rate of 20.57%.

Houston is extremely multicultural as there are 145 different languages spoken and a third of Houstonians older than five speak a language other than English at home. When ranking the cities that have the largest Hispanic population, Houston ranks 3rd in the US with about 41.4% of its population being Hispanic, according to an article in usnews.com. It is also estimated that there are about 400,000 undocumented people living in the Houston area alone and, the median age in Houston is 32.9 years, indicating a young population.

The majority of Houston is contained within Harris County, although Houston also extends slightly into the Fort Bend and Montgomery counties. Harris County is home to approximately 4.7 million residents, including me!

Because Houston is such a large city, there are many factors that influence the health of the community, and each factor affects people differently. Some of the determinants of health that I will mention in this blog post are education, financial security, the Houston environment, and access to food.

Education:

The city of Houston has countless educational opportunities. There are about 25 independent school districts with the largest being the Houston Independent School District (HISD) as it has 288 schools within the district providing over 13,000 teacher jobs and educating over 210,000 students. I personally went to the Spring Branch Independent School District (SBISD) which is a significantly smaller school district in Houston. SBISD only has about 44 schools, 4 of them being traditional high schools.

The greater Houston area has 14 major institutions of higher learning and more than 60 degree-granting colleges, universities, and technical schools. Rice University and the University of Houston are tier-one research universities in the Houston region.

As mentioned earlier, the majority of Houston is contained in Harris County. I mention this as some of the following data only takes into account Harris County while others do view the city of Houston as a whole. I will note the differences.

As of 2017, the high school dropout rate for Harris County and the Houston area is 7.8% while about 17.1% of adults haven’t finished high school. This means the region is behind both the state and national averages as it was reported that for the first time in US history, 90% of the population that was 25+ in 2017 completed high school. This is a large factor that can influence the health of the community as the level of education can often determine what opportunities are open to a person such as what jobs they can have and how much their income will be. Although Houston has numerous school districts that provide an adequate education to a large number of students, 61.6% are economically disadvantaged causing the majority of the students enrolled in public schools to qualify for free and reduced lunch but, according to understandinghouston.org, with the growing Hispanic and economically disadvantaged population, there have been more opportunities and programs arising to allow students from various backgrounds to succeed.

Financial Means:

Moving onto financial security, from the measurement period of 2014-2018, there seemed to be 32.4% of children living below the poverty line in Houston. This is a big factor that influences the health of the community since compared to their peers, children living in poverty are more likely to have physical health problems as well as behavioral and emotional problems. With the increase of health issues, it usually means more money is needed for medical attention which is exactly what people living below the poverty line lack. In the city of Houston, 1 in 5 Hispanics and Blacks live in poverty with the percentages being 20 and 22 respectively. As mentioned earlier, the average household income for Houston is about $81,995, and the city’s poverty rate is 20.57%.

Environment:

Houston is a large city and with large cities comes low walkability. When there is low walkability, it means that if you need to go to work, get groceries, go to school, etc. you will need a car, if not, you will have to rely on public transportation. In Houston, the public bus transportation is known as METRO and, due to the pandemic, people are required to wear face at all times. Other safety measures have been implemented as well such as no longer being able to board from the back door and extra busses have been added to encourage social distancing. With there being little to no places one can simply walk to, it means traffic becomes a big problem both for Houston residents and the environment. From the  2014-2018 measurement period, it was concluded that the mean travel time to work in Houston is 27.4 minutes and it seems to be increasing. Lengthy commuting times can contribute to health problems such as headaches, anxiety, and increased blood pressure plus it increases expenses which can lead to financial stress.

Aside from this, Houston rates first in total park acreage among US cities with more than one million residents. Of the 50 largest parks located in US cities, 4 of them are in Houston. Those parks are Cullen Park, George Bush Park, Lake Houston Wilderness Park, and Bear Creek Pioneers Park. As of April 2020, in Harris County, it is estimated that about 90.6% of individuals live reasonably close to a park or recreational facility allowing them to have access to several exercise opportunities. Regular physical activity can benefit health as it can lead to weight control, muscle and bone strengthening, improved mental health and mood, and a greater life expectancy. Exercise reduces the risks of serious cardiovascular diseases, diabetes, and even some cancers.

Food:

Lastly, I would like to talk about access to food. As of 2015, the percentage of individuals with low access to a grocery store in Harris County is 18.1% but it does seem to follow a downward trend. The accessibility, availability, and affordability of such food options increase the chances of having a balanced and nutritious diet. Low-income and underserved areas often have a limited number of stores that sell healthy food therefore by having grocery stores in close proximity, it can decrease the chances of consuming readily available food from convenience stores and fast-food restaurants. Also in Harris county, 14.8% of the population experienced food insecurity at some point in the year 2018. Food insecurity is associated with chronic health problems including diabetes, heart disease, high blood pressure, obesity, mental health issues, etc. This percentage is most likely due to poverty and unemployment levels since there are countless areas that can provide food but not everyone has the economic needs to get the food they need.

A problem that I believe can also be contributing to this percentage is the lack of knowledge about such programs. The State of Texas has a social service hotline that is available 24/7, 365 days of the year. One can dial 2-1-1 and find information about resources in the local community including where to find food, housing, childcare, crisis counseling, substance abuse treatment, etc. One can either call or click on this link. If you don’t know where to start, there is also the option for a guided search. To conclude this blog post, I would also like to provide a link to an interactive map of various food access-related services in Houston. It is important to note that the data was collected between 2016-2017 (prior to Hurricane Harvey) so there is a possibility that some locations are no longer available but I feel it can be essential information, especially during COVID-19. Feel free to click on the Houston Area Food Access Map tool and apply layers of what you want to see.