The Commission questions what Central Health is doing to tackle persistent differences in access to healthcare

Tuesday, January 9, 2024 by Nina Hernandez

The Austin/Travis County Public Health Commission heard key findings from Central Health’s 2022 Demographic Report at its Jan. 3 regular meeting.

Central Health updated the report in February 2023, finding that Austin’s high cost of living and affordability crisis has become a regional crisis affecting Travis and surrounding counties.

Austin is a key point of access to health care, affordable housing, public transportation and social services, while families in poverty are increasingly concentrated along the Interstate 35 corridor. But access to care continues to be a major barrier for Central Health patients , regardless of that person’s proximity to care.

The report found that homeless people, who make up 8 percent of Central Health’s patients, are twice as likely to experience chronic illness as the general population. The report found that health equity issues occur most significantly in East Central Austin and among black patients. Race and ethnicity are more likely than location to be a factor in disparities in access to care.

As of 2022, more than 23,000 families in poverty live in Travis County. Central Health projects an increase of 1,799 families by 2027. About three-quarters of families living in poverty live along the I-35 corridor. The data shows that 4,335 families living in poverty live in East Travis County, another 17,081 families living in poverty live along the I-35 corridor, and only 2,239 families in poverty live in West Travis County.

“It’s not going away,” said JP Eichmiller, director of strategy and information design at Central Health. “Poverty will remain and continue to grow at a rapid pace.”

For the presentation, Central Health highlighted three focus areas: North Central Austin, Oak Hill and East Central Austin. In North Central Austin, also known as the Rundberg area, Central Health found the highest total number of families in poverty, enrollees and patients. The district also has the lowest median income and more than 5,200 unserved enrollment. For Oak Hill, which is the only new focus area in the 2022 report, Central Health found a 21 percent increase in poverty.

In East Central Austin, Central Health found the highest percentage of families in poverty and lower than expected enrollment. Additionally, 1 in 20 patients received all care in an emergency setting.

“The number of families in poverty within these nine focus areas that we’ve identified is four times the number in Travis County overall,” Eichmiller said. “Poverty and enrollment do not always coincide. There are areas where we have high numbers or high rates, but we see less enrollment than other areas. Spanish is the predominant language spoken in these focus areas – about twice the national average. Also, the majority is Hispanic in those areas.”

He continued, “The median income is about $34,000 lower in these areas than overall, nearly half of adults have a high school education or less, and people living in these areas are much less likely to have vehicle access.’

Regarding chronic conditions and disease prevalence, data from Austin Public Health shows that chronic diseases account for 3 out of 5 deaths in Travis County residents. The analysis found that 40 percent of Central Health’s patient population had a diagnosis of at least one chronic condition in the past three years, and enrollees had an average of at least two and a half chronic conditions to treat. The top four conditions are cardiovascular disease, hypertension, behavioral health, and diabetes.

In response to questions from the commission about what was being done to address the disparities identified in the report, Central Health Vice President Monica Crowley said the county looked at identifying moderate to significant gaps across the continuum of care. This led to new clinics in Hornsby Bend and Del Valle, as well as continuing the design of a community health center in Colony Park.

“We also found that there are areas of significant gaps where we are meeting less than 50 percent of the need for certain services,” Crowley said. Central Health will continue to “focus on specialist care services that are significantly underserved in a number of different areas across the county. Some areas that lack almost 100 percent, such as care services for people who do not have a safe place for treatment or preparation for health services.

Central Health is currently remodeling a 50-bed respite center that is expected to open in 2026. It is also working with the city to create additional respite beds at some of the shelter sites the city recently opened in the north, the central and eastern parts of the county.

“And then we’re really focusing on diversion, piloting diversion services and working with the Sobriety Center to expand safe spaces for people who have decided they’re ready to take the next step and enter treatment to have a place where can get some medication-assisted retention therapy while they wait for a treatment bed,” Crowley said.

In addition, Central Health works with Integral Care to provide emergency psychiatric services, including prescribing, 24 hours a day, seven days a week. “So if people are in a mental health crisis, including needing to access substance use medication, there’s a place where they can get those emergency services on a walk-in basis instead of, unfortunately, getting them through the system of criminal justice.’

Photo by Larry D. Moore, CC BY-SA 4.0, link.

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