Economic Stability
Who is at most risk for economic instability in Texas? Why?
Although there is no exact answer to this question, patterns in healthcare imply that people of color are especially at risk for economic instability and inequalities in the healthcare system. Especially due to the political landscape of Texas, people of color are increasingly at risk for inequalities that are present in the economy. This ultimately leads to poorer healthcare among people of color in Southern states. Texas’ location along the border can also have an effect on the percentage of people of color who experience economic stability in the state.
How might Texas’s low public education teacher salaries create negative health issues for both the teachers and students?
The low wages Teachers in Texas receive push onto them the negative health outcomes that come with low socioeconomic, and even onto their students. According to the national education association, Texas teacher salaries are $7,500 less than the national average. Low-income living brings with it high-stress exposure, which leads to a weakened immune system as well as risk factors for subpar health like hypertension, weight gain, and mental health struggles. These things can lead to teachers being sick more throughout the year, taking them away from the students, or even spreading illness onto their students. Not only is this an issue for current teachers, but this factor of low pay deters people who are interested in education from becoming an educator. This is creating a shortage of teachers and resources and worsening the quality of the public education system in Texas.
(https://www.texastribune.org/2022/07/25/texas-teacher-shortage/)
How does the political landscape in Texas shape healthcare options for different Texans?
Despite the large increase in over 4 million people over the last decade, Texas is still regarded as one of the worst states when it comes to accessibility to healthcare. Texas has the highest uninsured rate in the country, and fewer of its residents report having a regular source of health care. Texas also has the largest number of residents who said they skipped health care they needed because of cost, and health insurance costs take a bigger share of people’s incomes in Texas than in almost any other state. Because of its conservative nature, Texas is one of 14 states that still have not expanded Medicaid under provisions of the Affordable Care Act, leaving millions of working people uninsured to this day.
How does the built environment influence health?
The built environment can have an influence on people’s activity levels, access to healthy food, social interactions, and contact with nature. These factors can also negatively impact mental health. Environments such as overcrowded homes can put people at higher risk of infectious diseases. Those with higher Socioeconomic Status are more likely to be able to live in a healthier and safer environment. Low-income housing can contain many toxins such as lead and asbestos, as well as higher exposure to industrial pollution, noise pollution, and higher rates of violence.
How does Texas as a social context shape health outcomes for different groups of people?
Generally, the social makeup of a community or a state, such as Texas, appreciably affects an individual’s health outcomes. For example, in Texas, “Black and Hispanic children are much more likely to be growing up… concentrated (in) poverty” where their “families are more likely to lack health insurance” (Turner). Therefore, their health outcomes will be considered negative compared to their white counterparts. More specifically, the largest disparities between Black and Hispanics, and Whites are “health status, disease prevalence, and premature death” (Turner). These differences have existed for decades, yet they have been exacerbated after COVID-19, as the initial contraction and death rates were disproportionately minorities. To showcase the disparity, “if Black and Hispanic populations in Texas were hospitalized for COVID-19 at the same rates as non-Hispanic Whites, there would have been 24,000 fewer hospitalizations in Texas through September 2020” (Turner) Therefore, there is a clear health disparity for minority Texans compared to White Texans.
How does economic instability relate to food insecurity in Texas? How does this impact healthcare?
Economic instability and food insecurity both significantly impact health care and the access of those groups that are significantly at risk. Populations that are not economically stable often live in food deserts where there is limited access to healthy, higher-quality foods. Therefore, those who cannot afford a more healthy lifestyle are more at risk for future health problems. Households in Texas are particularly prone to food insecurity along with many other Southern states. This could largely be in effect by Texas’ location along the border and the migrant families traveling into Texas. There is a larger portion of poverty-ridden families in Texas which greatly affects the state’s overall access to quality healthcare. The relative isolation of many Texan families could also have an effect on the high rates of poverty and hunger in the state. Along with poor geographic regions come economic hardships, limited access to healthy foods, and, overall, restricted access to quality medical care.
How do programs like National School Breakfast and Lunch programs improve the health of Texas students that come from families of low socioeconomic status?
Programs such as the National School Breakfast and Lunch programs provide free meals for students at school for both breakfast and lunch. For families that live in food deserts and/or struggle to put food on the table, this is a major benefit. The free meals help ease the worries of parents trying to provide for their children and save them money that can be allocated to other things. With the money saved, families can afford to see doctors, treat illnesses, and improve their health. As well, with one less thing to worry about, stress exposure is lessened which can also improve the health of the families.
How is reproductive healthcare considered in state policy in Texas?
While there are many different studies done in regards to how Texas ranks with reproductive healthcare, a common occurrence is Texas being within the bottom of the pack. In 2019 for example, Texas ranked dead last in health insurance coverage for women between the ages of 19 and 64. In general, about 23% of women in Texas are uninsured, about double the national rate. Since Texas is regarded as one of the most gerrymandered, conservative states in the nation, it should be no surprise that abortion was one of the first laws overturned and banned after the fall of Roe v Wade a year ago. Therefore, any policy regarded under reproductive healthcare is likely to receive little notice in favor of a more pro life approach on the state level.
How do state environmental policies shape climate-related health threats in Texas?
State environmental policies aim to create laws that protect and regulate certain areas such as water and air pullution, chemical and oil spills, and wildlife protection. Climate threats like hurricanes and wildfires can be very disruptive to the environment and people’s communities. Environmental policies should help to maintain a livable and healthy quality of life for people who may now be displaced or exposed to health threats. However, state environmental policies can often make it difficult for Texan residents to endure and out-last climate-related threats. For example, during the winter freeze in 2021, Texas policies did not properly account for the power grid to handle winter weather. The Austin water system also had to issue a boil notice. This caused the freeze to be a huge health threat for people without power or clean water. With better policies for renewable energy and clean water, Texas could have been better prepared.
How do language or citizenship barriers shape health outcomes in our state?
It is no denying that language barriers, specifically English proficiency, in Texas appreciably affect health outcomes. For immigrants, their health outcomes are considerably worse than American-born, native English-speaking citizens. Health clinicians are taught to communicate with patients in exclusively English, therefore, for immigrants, the direct effects of that are “worse health outcomes, reduced access to health information, and decreased satisfaction with care” (Ortega). This will, in turn, also affect their actual health experience. Throughout the United States and Texas, immigration status results in vulnerability to inadequate health care due to limited English proficiency resulting in complete dependency on publicly funded health care, which is lower quality than private health care. This is both a state and federal issue, as every single state in the United States suffers from an unconscious, internal xenophobia that appreciably affects immigrants’ healthcare experience and outcomes (Ortega).
What is the poverty level in Texas and how does that affect access to quality healthcare?
According to recent data, the Texas poverty level is ranked 38th in the United States at 17.2%. About 28.1 million people living in Texas have an income that is below the poverty level. These statistics are relatively high compared to more Northern and Central States. This is mainly because of the geographical location of Texas and how it is located next to the border. It is easy to say that Texas has the highest poverty rate of any large, industrial state. This further explains the limited access to high-quality healthcare for economically insatiable families - the majority of which are families of color.
For Texas’s large population of undocumented immigrants, how does the education system benefit their health?
Texas’s large population of undocumented immigrants benefits from the fact that Texas provides eligible undocumented residents, access to in-state tuition and state financial aid. Access to receiving education gives an opportunity for a better life of higher socioeconomic status, and in turn, creates improved health outcomes for the immigrants and their families. Within lots of education programs, there are some provided health resources such as free checkups which allow the opportunity for people to analyze their health at a time at which they might not have otherwise.
(https://www.higheredimmigrationportal.org/state/texas/)
What about gender-affirming care in state policies?
Earlier this year, Governor Abbott issued a directive defining certain gender affirming services for youth as child abuse, and calling for investigation of and penalties for parents who support their children in taking certain medications or undertaking certain procedures. In addition, health care professionals who facilitate access to these services could also face penalties and a range of professionals in the state would be mandated to report known use of the specified gender affirming services. While other states with proposed policies to limit youth access to gender affirming care include penalties for parents, no other state implemented policy that ties the parental role to child abuse as the Texas directive did. However, early September an Austin Judge called for the overturning of this policy, yet further struggles for the fight for gender affirming care still persist to this day.
Who is most vulnerable to climate-related health threats in Texas and why?
Minorities and those with low-SES are most vulnerable to climate-related health threats. Black and Hispanic people have much higher rates of poverty and living in poverty or having low-income has been linked to many health problems along with a higher death rate. When minorities or low-SES individuals encounter climate-related health threats, it is much harder to gain access the resources needed to recover. In Texas, a very common climate-related threat is extreme weather. This can be both from high temperatures causing heat exhaustion or from severe storms. Those with fewer resources such as low-SES individuals have a more limited ability to combat those climate extremities.
How does an individual’s community/where one lives shape their health outcome? Does it affect accessibility?
An individual’s community/where one lives substantially shapes their health outcomes. This was seen the most during the COVID-19 pandemic, as the allocations of the vaccine were given based on communities’ location. Wealthier, white communities received the vaccine first, leaving communities with people of color/minorities no access to vaccines. The (Alabama) state supply had only parsed them out to White communities and left none for Black communities. However, this general racial inequity in vaccination distribution happened all over the United States, including Texas. As one would expect, this significantly shaped their health outcome regarding COVID-19. The racial gaps in vaccination contributed to racial gaps in COVID death rates. However, what began as a travesty exposing vast inequality in the health care system based on communities/where one lives turned into a success story. With affirmative action policy, President Biden was able to swing the pendulum in the opposite direction, and by the end of the pandemic, the racial gap had completely closed. In fact, minorities living in communities that didn’t initially receive the vaccine had a smaller contraction and death rate than their White counterparts (Leonhardt).
How does socioeconomic status relate to race in Texas, and how does this affect health outcomes?
As we know socioeconomic status often intersects with other aspects to compound for health effects. Race is extremely correlated with SES and is very important in explaining much racial and ethnic variation in health. Poverty rates are especially high in families headed by single women, particularly if they are Black or Hispanic. This can be seen widely across the state of Texas. The high percentage of Hispanic households in Texas, due to its location along the border can explain the low socioeconomic status of these families. Black and Hispanic families are much more likely to be growing up in poverty-ridden communities where their access to high-quality health care is very limited. In Texas, specifically, 40% of the population is Hispanic, and 23% of that population claims that they are not in good health. It is very clear that there is an obvious relation to SES and race in the state of Texas, which ultimately results in a downfall in access to quality health care among the populations at risk.
In areas of low socioeconomic status, how does the public school system benefit the students’ health?
Areas of low socioeconomic status are of low income and very often described as “violent” or “unsafe”. Living in dangerous areas promotes a sedentary lifestyle as a protective measure, but this comes with negative health consequences. Lack of exercise can lead to weight gain, mental health issues, and poor cardiovascular health, not to mention lots of housing in these areas are unsanitary and promotes disease along with a plethora of other health risk factors. The public education system gives opportunities for exercise in safe school environments such as joining clubs or participating in sports creating an outlet for physical activity. A more active lifestyle is a healthier lifestyle. As well, having the ability to try new things and activities improves the mental health of students and their overall quality of life.
(https://www.hhs.texas.gov/sites/default/files/documents/sept-2022-tshac-agenda-item-6.pdf)
How do social, cultural, political and economic factors shape access to high-quality health care in Texas?
Compared to men, women use more health services, are more likely to take prescription medication, and are more likely to experience problems paying medical bills or forgoing needed health care because of the cost. In Texas, three in ten women are low-income, almost one in five are uninsured, and the state has not expanded Medicaid. People of color in Texas are more likely to be prescribed prescription drugs and are likely to be delayed treatment compared to White individuals of any gender.
Does the built environment promote health or demote it?
The built environment for low-SES individuals oftentimes does not promote healthy habits or spaces. Poorer areas are disproptionately built near highways and industrial areas which means there are less recreational and green spaces. This also leads to limited transportation options because many low income people cannot afford cars. Walking or traveling long distances on public transportation can expose people to more health risks. This was especially true during COVID-19. The built invironment in low-SES areas also has more tobacco and alcohol advertisent which promotes very unhealthy habits that can have long-term health effects.
How does one’s socioeconomic status positively or negatively affect their health care outcome?
Socioeconomic status is the umbrella under which every issue stems from. It is intricately connected with race and immigration status, all of which palpably affect health care outcomes. As one could imagine, private health care in the United States is significantly better than federal health care. Both the quantity and quality of care for private health care insurances gives their patients better results, minimizing illness. Countless studies have shown that SES and health outcomes are directly and intricately correlated. The higher one’s SES, the higher their health outcomes. This is true for Texas and the United States as a whole. Moreover, those with more financial resources can have more agency over their individual behaviors that would positively affect their health outcome. Because they have more money than those with low SES, when they are purchasing food, they can afford organic, non-processed food that has great nutritional value (National Library of Medicine).
What policies will help populations at risk recover from economic instability in Texas?
In Texas, opportunity isn’t the same for everyone – despite our state’s wealth. Texans are working hard to support their families and contribute to our state, but millions lack access to affordable health care, healthy food, a quality education, and good jobs. Although Texas boasts one of the largest economies in the country, approximately 15% of Texans were living at or below the federal poverty line in 2018. Hispanic and Black Texans are far more likely to experience poverty than White Texans, and the uninsured rate for colored populations is significantly higher. What can we do to change this? Starting with improving the state’s health care, expanding health care converage eligibility and fully funding state wide health systems is crucial. Increasing wages, ensuring paid leave, expanding child care access, and reforming unemployment insurance are all crucial in the labor system. Finally, it is important that we work together to make the state of Texas a more fair and just system for all.
What major issue arose for education during the COVID pandemic lockdown for low-income families and can in turn promote future negative health outcomes?
During the pandemic, education access became a large issue for low-income families as schools turned virtual. Lots of low-income families did not have the resources for their children to access virtual classes, and many were not in convenient living situations for them to participate in class. This has pushed lots of these students away from education and we have seen a large increase in people not getting their high school diploma or GED. Without basic education, it becomes increasingly hard for individuals to improve their socioeconomic status and experience the health benefits that come with a better life.
Compare Federal health care v state health care. How does Texas rank amongst other states with health care access and quality?
Overall, Texas ranks fourth from the bottom, across all measures, ahead of only New Mexico, Nevada, and Alaska in regards to health care access. Texas also does the worst job in the nation at caring for Hispanics and is only somewhat better with African-Americans of similar measures. Even the rich within the state aren’t much better, as Texas ranks 41st in healthcare for high-income individuals as well. This is in large part due to the high rate of residents of all ages lacking health insurance and the limited access to certain types of health care. The uninsured rate is double the national figure and higher than that of any other state.
How does food insecurity relate to the built environment and how does Texas’ food insecurity compare to other U.S. states?
Food insecurity is the lack of availability for fresh produce and healthy food options around your geographic location. A built environment can create an environment that has high levels of food insecurity. Food insecurity is most prevalent in low-income communities and this makes it difficult for low-income individuals to live healthy lifestyles. On a map showing counties with people who have no car and no supermarket within a mile, we can see how these areas are in the South which includes Texas (SES and Health lecture, slide 34). In another graphic showing the prevalence of food insecurity in 2019-2021 (SES and Health lecture, slide 35), Texas is one of the states where food insecurity is above U.S. average.
From a social perspective, how is having a tight-knit community efficacious for health care outcomes?
Surprising to many is the effect of having an extremely tight knit community on health care outcomes. Whenever people think of factors that contribute to positive health care outcomes, at the top of the list are accessibility to quality health care insurance and SES. Very few people would contribute the effect of having a tight knit community efficacious to health outcomes, however, it does positively and appreciably affect said outcomes. For example, Janny Scott writes in a New York Times piece about the health outcomes of three different people suffering from the same ailment – a heart attack. One is wealthy, the other is middle class, and the last is a poor immigrant. Not shockingly, the wealthiest person, Mr. Miele, was a part of a tight knit community whose support was as efficacious as the health care treatment itself. His wife and friends completely took over everything around home and at work, giving him more time to relax and recover after his heart attack. Just as effective as any medicinal or pharmaceutical solution was the social solution of having a tight knit community who was willing to pick up the slack after his heart attack. (Janny Scott).