Harris County, Texas

Population and Demographics

Population: 4.3 million

SOURCES:
U.S. Census Bureau; photography courtesy Flickr user RockinRita, CC BY-NC-ND-2.0.

Community Context and Challenges

• Black residents face the highest unemployment rate in the county (10%), while Hispanic residents experience lower educational attainment and health care coverage.
• Among Hispanics, 39% are uninsured, compared to 11% of white and 21% of Black residents; this may be because many non-U.S. citizens cannot receive public insurance or subsidized coverage through the Affordable Care Act’s insurance marketplace.
• In 2010, cost prohibited 32% of Hispanic residents and 30% of Black residents from seeing a doctor, compared with only 11% of white residents.
• Approximately 18% of residents don’t have consistent access to healthy food; 22% of children eat fast food at least three times a week, 77% lack sufficient physical activity, and one in three are overweight or obese.

SOURCES: 
U.S. Census Bureau. (2014). 2010–2014 American Community Survey 5-year estimates; Texas Behavioral Risk Factor Surveillance System (BRFSS) (2010).

Taking Action

Through progressive collaboration across sectors, organizations have addressed some systematic factors that bear on health and well-being.

Several major initiatives are in place to nurture partnerships across sectors, provide opportunities for civic engagement, and share information and resources for improving the health of all Harris County residents.

NOTE: 
These baseline reports, created in 2016, track community programs and initiatives in their early stages and measure initial progress only. Future reports will provide more in-depth insights and analysis into this community's efforts to build a Culture of Health.

Questions for Consideration

Despite significant political and structural challenges, Harris County is making progress in “turning the ship” toward health equity through innovative initiatives led by multi-sector partnerships. Additional surveillance, data and information gathering, analysis, and reporting will examine the progress and impact of these initiatives on the health and well-being of Harris County residents, especially at-risk Hispanic and Black residents.

The following questions could provide insights into the degree to which meaningful change is taking place and can be extended and sustained:

• How are the various initiatives aligning their missions and collaborating with each other, and how are underserved groups involved in decision making?
• How are local initiatives, particularly Healthy Living Matters, mobilizing support for their policy priorities among influential sectors, such as health care and education?
• Who is benefiting from the initiatives, and who is not? How are the initiatives addressing inequities among Hispanic and Black residents?
• How is Harris County measuring and evaluating the impact of completed and ongoing initiatives to address systematic drivers of obesity and related chronic illnesses?
• In what ways have grassroots accomplishments, such as the BUILD Challenge, improved the social and economic environment?
• What evidence is there that the initiatives are improving the health and well-being of Harris County residents? For instance, what are the trends in access to healthy foods, physical inactivity, and obesity prevalence?