How have we responded to the COVID-19 Pandemic?

Currently, a large portion of the world is still being affected by the scary and deadly virus that is COVID-19. As of right now, we are approaching the 10-month mark since the reporting of the first US case in Washington State. Unfortunately, it seems like the number of COVID-19 cases is beginning to rise once again.

Although I live in Houston, TX, I study at Union College located in Schenectady, NY. I, along with everyone else at my school, was obligated to leave campus immediately after the school had its first confirmed COVID-19 case on March 12th. There was a wave of anxiety and fear that spread amongst everyone. I flew back home on March 15th after packing up all of my belongings, finding last-minute storage, and switching my spring break flight to a sooner date. I remember arriving in Houston at around 2 am completely exhausted. I felt an immediate sense of relief once I saw my parents and embraced them as we knew things were beginning to get worse in NY. Soon NY became the epicenter of the COVID-19 pandemic. Since my flight on March 15th, I have remained at home.

Today, November 11th, I woke up to a headline that stated that Texas is now officially the first state in the US to surpass 1 million COVID-19 cases, a devastating new record. Experts claim that the US is entering the “worse period” since the onset of the pandemic as there has been a week-long streak of 100,000 daily cases and record hospitalizations. You would think that things would be getting better by now but, from the data, it seems to me that the US is losing its grip on the pandemic once again. It is evident that things are becoming much more difficult to control as people are tired of being stuck indoors. I know I am but, regardless of this, my health and that of my family is a priority to me. Focusing back on Texas, Harris County (where Houston is located) ranks first amongst all other Texas counties when it comes to the number of COVID-19 cases. An article in Independent, claims that if Texas was a country, it would be ranked the 10th highest amongst other infected nations. Yikes!


Action Taken at a State Level (March- July):

I have compiled a few of what I believe are important points, announcements, declarations, orders, headlines, etc. and organized them chronologically. I use this approach to demonstrate the response to the COVID-19 pandemic over time in relation to health care and to my community. I will begin by mentioning that the first case was announced in Texas, more specifically in the Greater Houston area, on March 4th.

On March 10, Governor Greg Abbott and the Texas Department of Insurance (TDI) announced that they asked health insurers and health maintenance organizations to waive costs associated with testing and telemedicine visits needed for the diagnosis of the virus. This was an effort to ensure no Texan is denied access to testing resources. A few of the specific requests made included requesting insurers to waive co-payments, co-insurance, and deductibles for testing, waive consumer cost-sharing, facilitate telemedicine, cover necessary medical equipment, supplies, and services, and waive penalties restrictions as well as claim denials for necessary out-of-network services.

March 13– Governor Abbott declared a State of Disaster for all counties in Texas. He also promised to “ramp-up” testing and urged that there is no need to panic-buy. At this point, there were more than 30 confirmed cases and over 50 Texans pending test results.

The next day, Governor Abbott directed the Texas Medical Board and the Texas Board of Nursing to fast-track the temporary licensing of out-of-state physicians, physician assistants, certain retired physicians, nurses, and other license types to assist in Texas’ response, all which was now possible due to the State of Disaster declaration. With this, now there was an increasing supply of health care professionals available to provide in-person and telemedicine help across the state. Out-of-state physicians were now able to obtain a Texas limited emergency license or hospital-to-hospital credentialing through this period. Over time, Abbott continued to loosen restrictions on requirements in other areas such as long-term care, pharmacists, and more in an effort to get more hands on deck.

March 17– Abbott held a call with hospital CEOs and representatives across the state to provide updates on care capacities. The Governor and hospitals discussed the supply, staffing, and bed capacities of hospitals to ensure that health care providers have the support they need to assist patients. They were also able to discuss strategies that would further increase these capacities including a temporary waiver for hospitals to increase unused bed capacity without having to submit an application or deal with associated fees. At this point, the state’s COVID-19 count was 64 cases.

On that same day, Abbott waived some regulations for telemedicine. Patients with state-regulated plans could now make telemedicine consultations that would be paid the same way/amount as in-office visits for insurance purposes. Doctors were now eligible for payment from insurance plans regulated by the Texas Department of Insurance for visits conducted over the phone instead of in-person at the same rate they would receive for in-person visits. As a reminder, Texans covered by CHIP or Medicaid would not be charged co-pays for tests or telemedicine consults. Patients that are covered by Medicare or large employer plans still had to check with their own health plan administrators to determine their specific benefits.

March 19– The Commissioner of the Department of State Health Services, John W. Helllerstedt, M.D., issued a Public Health Disaster Declaration.

March 20– Governor Abbott directed the Texas Department of Criminal Justice (TDCJ) to temporarily suspend inmate fees for health care services related to COVID-19. While incarcerated Texans within TDCJ facilities were never denied access to health care due to inabilities to pay, the temporary waiver was implemented to encourage timely reporting of COVID-19 symptoms. The number of cases for the state was now 194 with Harris County being the county with the largest concentration of cases in the whole state (24 cases).

March 21– There is a continued need for health care professionals, more specifically nurses, so now Abbott allowed temporary permit extensions to practice for graduate nurses and graduate vocational nurses who still had not taken their licensing exam. Students who were in their final year of nursing school could now meet their clinical objectives by exceeding the 50% limit on simulated experience and, nurses who were retired or had inactive licenses could now reactivate them.

March 25– Abbott allowed certain health facilities that were still under pending licenses status or had been closed for no more than 36 months to become active under a hospital with an existing license. The was no longer a mileage restriction which allowed hospitals to operate additional facilities that were more than 30 miles away from the main location. This was great because more buildings could now provide space for patients!

April 2- An Executive Order is put in place and it requires all Texans to stay at home except to provide essential services or to do essential things (ex. Go grocery shopping).

April 6–  Governor Abbott announces the initiative to increase in-home child care access for frontline workers. offered 90 days of free premium access to its services and also provided specific portals for frontline workers in Texas.

April 27– Abbott announced the first phase of a three-phase plan that would “safely and strategically” open up Texas. Under Phase I, certain services and activities were allowed to open with limited occupancy. The Texas Department of State Health Services (DSHS) issued minimum standard health protocols for all businesses and individuals to follow. All retail stores, restaurants, movie theaters, malls, state museums, and state libraries were permitted to reopen starting on May 1st with a limited capacity of 25%. Within shopping malls and museums, the food-court dining areas, play areas, and interactive displays still had to remain closed. Local public museums and libraries had to get permission from the local government. Bars, barbershops, gyms, and hair salons had to remain closed.

May 7th– Oh no, a controversial confinement issue! A Dallas judge sentences a hair salon owner, Shelly Luther, to jail for violating the state’s emergency order on May 5th alongside a $7,000 fine. Public outcry led to Abbott modifying his Executive Order from April 2, eliminating jail time as a punishment for disobeying orders. Barbershops were allowed to open the following day.

May 18– Under Phase II, restaurants could now increase their occupancy to 50%. Additional services and activities that remained closed under Phase I could now open. Bars, child care centers, and other businesses still had to have 25% capacity.

May 29- Protests began to take place in Houston, where George Floyd grew up from the age of 2. This made many people worried about the containment of the virus but many people also believed it was crucial to protest as it was an unjust killing that should not be tolerated. #BlackLivesMatter

June 3– Under Phase III, the final phase, all businesses in Texas could now operate at up to 50% capacity, with very limited exceptions. Businesses that previously have been able to operate at 100% capacity could continue to do so, and most outdoor areas were not subject to capacity limits. This phase was effective immediately. Was this a smart choice? Personally, I don’t think so because the announcement came just one day after the state saw its largest single-day increase in cases since the start of the pandemic. The Office of the Texas Governor even wrote that between May 26th and June 2nd, there were over 45% of new cases coming from jails or prisons, meatpacking plants, and nursing homes. At the moment of Phase III, there were 1,487 Texans hospitalized due to COVID-19, 20,679 active cases, and about 45,858 Texans recovered.

But guess what? The reopening did not last!!

June 26- Abbott rolled back phase III of the reopening strategy and stated that restaurants had to return to 50% capacity from 75% and bars were completely shut down again. That very day, I received a Public Safety alert on my phone alerting me that COVID-19’s threat had elevated to severe for Harris County. Here’s a screenshot I took of the alert 🙂


July 2– Abbott issued a statewide mask order in counties with 20 or more positive cases. It required people to wear masks when in public. This was a huge step as many conservatives were against the idea of a mask mandate and the governor himself resisted it for months.


What about Houston specifically?

When people were becoming more informed about COVID-19, only a few expected it to reach the point that we are seeing now. Interestingly enough, as I was doing my research for this blog post, I found an article titled “Why Houston is uniquely situated to be better prepared for the coronavirus threat”. Even though the article was published back in January and there were still no confirmed cases in Texas, the article seemed to claim that if it were to reach Houston, we were going to be more than prepared without really having to do anything abnormal. When reading the article, they kept referring to the coronavirus as a “flu-like virus” which I believe downplays the severity. They also mention the Strategic National Stockpile that apparently is kept in various places around the country as a precautionary measure for a pandemic. The article even boasts the fact that Houston is considered a home to Galveston’s Center for Biodefense and Emerging Infectious Diseases as it is one of only a handful of high-level containment laboratories in the entire country. It is a bit disappointing to see that instead of preparing for the virus, it sounded like many were sitting down thinking nothing big was going to happen in Houston. I believe it’s better to prepare for the worst rather than pretending nothing will happen.

When things started to take a turn for the worse, there was significant clash between the City officials in Texas and the State’s government. City officials including Harris County Judge, Lina Hidalgo, a democrat, can be quoted saying that she “had the authority and [She] did require masks in public months ago… We had great compliance because law enforcement would show up and educate and folks would get it”. Hidalgo had issued a mask order on April 22nd but, 5 days later, Governor Abbott used an Executive order to prevent local governments like Harris County from issuing fines even though, at the time, there were more than 25,000 confirmed cases according to an article in The Hill. Because of Abbott’s Executive order, Hidalgo claims that all she is able to do now is issue recommendations.

Steve Adler, Austin’s Mayor, also claimed that Governor Abbott has been saying people should wear masks because it is one of the most important things a person can do right now, yet he took away the authority of cities to impose mandatory mask orders. Consequently, more people stopped wearing protective masks. What this health crisis seems to really emphasize is the constant battle between conservatives who dominate the state legislature and the liberals who run the state’s largest cities, includes the city of Houston.

A Business Insider article also shined a light on the local vs state issues that result from different views on how to control the outbreak. Houston Mayor, Sylvester Turner, blamed Abbott’s decision to strip his authority as the reason the city cases were getting out of control. Houston’s cases skyrocketed in June and July as well as statewide after Abbott reopened the state’s economy on May 1st, “ending one of the nation’s shortest stay-home orders.” Local officials were prohibited from mandating masks and imposing fines for not complying. Turner, along with other Texas mayors teamed up to request Abbott to allow them to put in-place face mask mandates but the idea was dismissed. It wasn’t until 2 weeks later that Abbott issued his one statewide order. Many are angry at the limitations as they know many more lives could have been saved if strict measures were implemented from the beginning. From the beginning, Turner thought Abbott’s idea to reopen was bad and a premature decision. He believed it would simply wipe “away all the gains that [was] achieved”. Turner noted that more Houstonians contracted and died of COVID-19 in July than in March, April, May, and June combined.

When it comes to the great city of Houston, there is already a timeline that is extremely detailed and constantly being updated. This is quite helpful for anyone who wants to know exactly what is going with the pandemic in Houston, TX. The first post of the timeline was made at noon on March 9th and posts have been made practically every single day after that. Some days even have multiple updates! I find the updates extremely reliable as they go in-depth using names, quotes, and statistics all while being appropriately dated and time-stamped. Feel free to check it out in your free time (heads up it’s a long read if you are thinking of checking things out from the beginning). Here’s the link!


Check these resources out!

Though this blog has been full of information as I wanted to cover the handling of the pandemic from the beginning, I would like to include a few more resources that one could check out and see how the COVID-19 cases are looking in Houston.

Currently, Houston is still a Level 1 (Severe) location even though we are reporting fewer cases compared to June and July. To see Houston’s curve, check out the Harris County/Houston COVID-19 Cases Dashboard. You can tailor the data depending on what you would like to see. Some options are seeing cases by race/ethnicity, zip code, age, sex, etc. Personally, I believe this Vulnerability Map is much cooler and informative. You are able to see much more including the active COVID-19 cases per 10,000 Population. You can input different layers into the map such as “Socioeconomic Social Vulnerability Score”, Health risks such as lack of health insurance, the prevalence of Asthma, the prevalence of smokers, what percent of populations are Black, or what population percentage is Hispanic. A plus to this map is that all layers are depicted in different colors so feel free to overlap them and try to spot out any trends!

Now to end on a positive note, please watch the following inspirational video about Houston. Houston has gone through significant natural disasters yet we have always found a way to unite and prevail together. I am confident when I say we definitely plan to follow this approach to get through the pandemic because we are #HoustonStrong.



Blackman, Jeremy, and Jeremy Wallace. “Gov. Abbott Expands Reopening as Texas Sees Record Number of New Cases.”, Houston Chronicle, 3 June 2020,

“COVID-19 Cases by Super Neighborhood – Houston.” ArcGIS Web Application, 2020,

Garcia, Julie. “Why Houston Is Uniquely Situated to Be Better Prepared for the Coronavirus Threat.”, Houston Chronicle, 27 Jan. 2020,

Hardin, Kristy. “From Harvey and Imelda to Coronavirus- Is Houston Prepared From Past Events?” Versa Creative, 29 Apr. 2020,

“Harris County/Houston COVID-19 Cases.” ArcGIS Dashboards, 2020,

Lamm, Stephanie. “Reopening Texas during COVID-19.” The Houston Chronicle, The Houston Chronicle, 2 Oct. 2020,

Moritz, John C. “Texas Coronavirus Updates: How the State Is Handling the Outbreak.” Caller Times, Corpus Christi Caller Times, 13 Mar. 2020,

“News.” Office of the Governor | Greg Abbott, 2020,

Relman, Eliza, and Rhea Mahbubani. “Houston Mayor Says the City’s Coronavirus Crisis Could’ve Been Avoided If Texas’s Governor Hadn’t Obstructed Local Efforts to Control the Outbreak.” Business Insider, Business Insider, 7 Aug. 2020,

Wilson, Reid. “Texas Cities Say State Is Making Pandemic Worse.” The Hill, 27 June 2020,

Woodward, Alex. “Texas Becomes First State in US to Reach 1 Million Coronavirus Cases.” The Independent, Independent Digital News and Media, 11 Nov. 2020,

Wray, DiannaCatherine Wendlandt, and Catherine Wendlandt. “Here’s What You Need to Know about the Coronavirus in Houston.” Houstonia Magazine, Houstonia Magazine, 2020,

End-of-life Care Options in Houston- Hospice

The ability to feel such a range of emotions is what makes us human regardless if what you are feeling is happiness, sadness, anger, disgust, fear, disappointment, etc. But when it comes to the topic of terminal illness, it is fair to say that you feel an array of emotions with the most prevalent being fear and overwhelming sadness. As humans, we are aware of the fact that all life must come to an end but, when we know that time is right around the corner, especially when one is diagnosed with a terminal illness, it is hard to live life without thinking of such a diagnosis. But what do you do when you or a loved one is facing a life-threatening illness? In this blog post, I will talk about some of the options that are available for someone who is terminally ill and is residing in Houston.

Though there are several ways people cope with such life-changing news, I am not here to tell you what the right way to react is as there is no such thing as a “right way”. You can cry, try to not think about it, or swing into action. Whatever you choose to do that helps you cope and grief, I am here for it.


What is end-of-life care and what do I need to do?

A prevalent issue when it comes to moving forward with the knowledge of a terminal illness is sorting out advance directives that ensure a person’s healthcare wishes and end-of-life care are met. It is best to fill out the forms before it comes to this terminal stage. Trust me, it is better to have the uncomfortable conversation of end-of-life care sooner rather than when you feel like you are running out of time. One common advance detective is determining a healthcare proxy or healthcare power of attorney which designates someone to act on the behalf of the ill person when necessary. The other is having a living will which sets the medical wishes to help guide care once a person is unable to make decisions.

When it comes to end-of-life planning, it, unfortunately, is more complicated and stress-inducing than what I believe needs to be. Death is a heavy subject alone but the idea of having to sort many things out before a person passes can make the whole process worse. First, everyone must have a clear idea of the patient’s preferences when it comes to treatment during this stage of their terminal illness. This includes the caregivers, the family members, and anyone else involved. One should have conversations that mention the topics of hospice care, palliative care, spiritual practices, memorial traditions, and more. One must also think about their financial means. Do you have health insurance? If so, will it cover most, if not all, end-of-life care? Do you feel comfortable being a healthcare proxy or comfortable with whom you’ve assigned? My point here is that when it comes to a terminal illness and end-of-life care, communication is key!


What is Hospice Care?

Hospice encompasses physical, emotional, and spiritual needs. This care can take place at one’s personal home, a nursing home, an assisted living center, or at a hospice residence but, aside from the several options is physical locations, they all typically have a multidisciplinary team that includes doctors, nurses, aides, social workers, counselors, therapists, volunteers, etc. Hospice care offers symptom relief, pain control, and patient-family support. When one is dealing with a terminal illness, it is important to understand that hospice care provides comfort care for the person but doesn’t include attempts to cure the person.


Finding locations in Houston:

I was able to find a National Hospice Locator already tailored to Houston, TX. There were about 53 results but, what I love about this locator is that you can add multiple criteria that then allows you to see a more condensed list. This, in turn, allows you to find a Hospice care option much more easily for either you or your loved one. For example, the first criteria tab is labeled “Innovative Practices” and you can select yes or no for questions and characteristics like “Medicare Certified?”, “Pediatric Services”, “Faith Based”, “75+ Certified RNs” and much, much more. Other tabs allow you to select hospice care based on how many patients are served at a time which helps indicate whether it is a large or small locale. You can also check for Accreditation and Memberships, whether it is nonprofit or for-profit, and the type of hospice program (freestanding, hospital based, home health based, or nursing facility based). Here’s the link!

When you scroll to the bottom of the page, it provides all the hospice sites shown on the map in a list form with the location’s name, address, and phone number. If you click on a specific location found in the list, it would take you to view all the criteria specific to the selected hospice location as well as their website link. In other words, one is clearly able to see how a place measures up to most, if not all, questions and concerns you may have to help you determine if the place is the right fit.


If you are looking for options other than Hospice, here is another directory by the National Hospice and Palliative Care Organization (NHPCO). This directory can be used for any location in the US but, what I wanted to bring up is that when one types “Houston”, a lot more results showed up compared to the National Hospice Locator. This option could be helpful if you are planning ahead and have more time to explore all or if you want to see Palliative care or Bereavement Services aside from Hospice.



Towards the end of my second blog post, I briefly talked about the Harris Health System which is a system that helps provide access to quality care for Harris residents. They have expanded their end-of-life services by offering Hospice care to their patients at Ben Taub Hospital, Lyndon B. Johnson Hospital, and the Quentin Mease Hospital (now an outpatient facility). This is great news as back in 2017, Harris Health treated 150 terminal oncology patients despite being eligible for hospice care according to Harris Health News. It also stated that about 40% of the terminally ill patients died within 30 days after admission into the ICU. Now, patients can be transferred to either an inpatient hospice facility or a home hospice. By expanding their end-of-life care, there is now more affordable access for eligible patients. To be eligible, one must meet the indigent financial requirements set by their financial assistance program. There are other hospitals that offer hospice such as MD Anderson Cancer Center specifically for patients with cancer.



The University of Houston has a Houston Public Media service where I found an article titled “Patients Want To Die At Home, But Home Hospice Care Can Be Tough On Families” where it highlights the option to allow patients to pass while at home rather than being in a hospital. The article talks about how the For-profit hospice industry has grown yet, not many family members are aware that they still have to do a lot of the physical and emotional work that ensures someone a “good death at home”. The article brings up how a Kaiser Family Foundation poll indicated that 7 out of 10 Americans prefer to die at home. I urge people to do their own research and, as a family, decide whether at-home services is truly what they want.


Can’t decide?

If you are struggling to decide, there are places you can go to in Houston that have different levels of care such as Accredited Healthcare of America. They offer routine home care, continuous care, inpatient care, and inpatient respite care. Check to see what each type of care breaks down into! A similar breakdown is seen in Star of Texas Hospice and Seasons Hospice & Palliative Care of Texas-Houston. What I think makes Seasons stand out though is that they also offer programs such as Open Access which allows patients experiencing intense psychosocial issues to have hospice services earlier, Namaste Care which uses sensory activities for stimulation, relaxation, and comfort for those with dementia, Music Therapy which uses music to console and comfort patients even when they are no longer conscious or speaking, Palliative Care for clinical symptom management, and Cardiac Care for health disease management led by a board-certified cardiologist. They accept Medicare, Medicaid, and the majority of private insurance plans. But guess what? Even if you don’t see your insurance provider in the list offered at the bottom of their page, in many cases Seasons is able to advocate for their patients and secure insurance coverage for them! They are here to help!


Farmer, Blake. “Patients Want To Die At Home, But Home Hospice Care Can Be Tough On Families.” Houston Public Media, University of Houston, 24 Jan. 2020,

“Find a Care Provider.” NHPCO, 10 Aug. 2020, “Finding Care at the End of Life.” Houston Hospice | Accredited Healthcare of America, 8 Feb. 2016,

“Harris Health Expands End-of-Life Services by Offering Hospice Care.” Harris Health System,

“Harris Health Home.” Home, 2020,

“Houston, Texas Hospice Care.” Hospice Analytics,

“Our Services.” Star of Texas Hospice, 15 Oct. 2016,

“Seasons Hospice & Palliative Care of Texas-Houston.” Seasons Hospice & Palliative Care, 6 Feb. 2020,

Wayne, Melissa, et al. “Late Stage and End-of-Life Care.” HelpGuide, Sept. 2020,

“When a Loved One Is Terminally Ill.” HelpGuide,

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,

“Are You SPRY?” The Montrose Center, 24 Jan. 2020,

“EMBody Integrated Care.” The Montrose Center, 19 July 2019,

“Find an LGBTQ+ Friendly Doctor or Healthcare Provider Near You.” OutCare, 17 Sept. 2020,

“GLMA Home Page.” GLMA- Provider Directory,

“Health Resources.” Pride Houston, Inc.,

Hennie, Matt. “Two Houston Hospitals among Best for LGBT Care.” Project Q Atlanta, 22 Oct. 2014,

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

“LGBT Services Houston TX: Specialty Care: Legacy.” Legacy Community Health, 21 July 2020,

“LGBTQ Services in Houston, TX – Gay, Lesbian and Bi Sexual Help.” Planned Parenthood,

“LHI.” Lesbian Health Initiative of Houston, Inc., 2016,

Martin, Florian. “Houston Lags Behind Other Major Texas Cities in LGBT-Friendliness.” Houston Public Media, 12 Oct. 2018,

Montoya Coggins, Jessica. “For LGBTQ Community, COVID-19 Exposes Health Disparities in Texas.” The Texas Signal, 8 June 2020,

“Northville Health Center of Houston, TX.” Planned Parenthood,

“Northwest Health Center of Houston, TX.” Planned Parenthood,

“Prevention Park Health Center – Family Planning of Houston, TX.” Planned Parenthood,

“Southwest Health Center of Houston, TX.” Planned Parenthood,

“WAY OUT Recovery.” The Montrose Center, 14 Feb. 2020,

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, 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, 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, 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!



“About Us.” HCA Houston Healthcare,

“Access to Care.” Doctors for Change, 4 Aug. 2020,

“Access to Health Care in Houston.” Understanding Houston, 2020,

“Adults Unable to Afford to See a Doctor.” Houston State of Health, Mar. 2019,

“Adults Who Have Had a Routine Checkup.” Houston State of Health, Jan. 2020,

“Adults with Health Insurance.” Houston State of Health, Jan. 2020,

“Children with Health Insurance.” Houston State of Health, Jan. 2020,

“CHIP.” CHIP | Texas Children’s Health Plan, 2020,

“Health.” Back to, 2020,

“Houston TX Free & Income Based Clinics.” Clinico, 2020,

“Our Services- We Care for Your Entire Family.” Access Health Clinic, 2020,

Uhler, Andy. “Here’s How It Works If You’re Undocumented and Need Health Care.” Marketplace, 9 July 2019,

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, 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 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.


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, 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%.


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.


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.

Sept 15, 2010: My First Entry

Image: brain word-cloud



consideration, contemplation, idea, impression, meditation, observation, opinion, rumination, view, cerebration, cogitation, deliberation, imagination, musing, speculation, pondering, conclusion, consideration, examination, experience, information, inspection, investigation, knowledge, measurement, note, perception, ascertainment, recognition