A realistic framework for advancing health equity in Houston

An honest conversation about health equity in Houston can start in Settegast where after more than a century of disinvestment and discriminatory land use, the neighborhood suffers inordinately high rates of asthma, obesity, and diabetes. That conversation expands beyond Settegast and across Harris County where we see a 19-year difference in life expectancy between the healthiest and unhealthiest ZIP codes.

Houston is working to break the cycle. We are confronting our city’s health disparities and historical injustices. We are aiming to make informed, intentional investments in infrastructure, services, and resources. But there is more work to be done. The work involves using maps and location-based data to systematically address the social determinates of health laid out by the US Department of Health and Human Services.

1. Ask the important questions

We are the nation’s fourth-largest city and home to the largest medical complex in the world. Yet, on a neighborhood-by-neighborhood level, our people experience shockingly disparate access to healthcare and healthy food, and many live with inadequate infrastructure and increasing environmental hazards.

Why? What are the factors contributing to ongoing social vulnerability? Where do our most vulnerable residents live, work, shop, play, and receive services? When we seek answers to these heavy questions, when we look at the health impacts of historical planning decisions, we can more clearly see where to prioritize efforts.

2. See all the data

It’s one thing to have information—studies, reports, and figures on spreadsheets. It’s quite another to see that information as data on a map of our city.

In a report, we can see that nearly half of Houston’s Latino community does not have health insurance. In a report, we can see that Black women in our city are 3.5 times more likely to die in childbirth than white women.

On a map, we can see the spatial relationships that drive these health inequities. We can see those social determinates of health—like violence, racism, polluted air and water, a lack of recreational spaces or nutritious food, a lack of opportunities for education or employment. We can see exactly where and how these key factors impact the health of our communities.

Maps can help us understand complex issues in new ways. The most powerful maps come from geographic information system (GIS) technology. Houston city leaders already use GIS to study housing equity and Houston Public Works uses it to manage operations. These interactive smart maps bring together data, imagery, dashboards, and other storytelling tools. They show the locations of patterns and trends—and most importantly, gaps—in health equity.

3. Enact real solutions

A shared view of Houston’s health equity, with data points on a map, shows us more than gaps. It shows us where to connect people with resources, where to upgrade infrastructure, and where to mitigate environmental hazards such as pernicious flooding.

Equity upgrades look like the construction of Navigation Esplanade and the rehabilitation of Guadalupe Plaza Park in Second Ward, new home construction in Fort Bend, and workforce development in Gulfton. These are important projects, but there’s so much more to be done.

Deeper analysis of our city’s data helps us examine health equity block by block, to guide planning and policy decisions. We can prioritize resource allocation according to hyperlocal needs. We can employ broader communication via shared maps to attract community partners and funding. As more data inputs stream in, we can add those to the map to inform policy and program adjustments.

4. Report progress

If equity work is to have lasting impact, it must be consistently monitored. We must report and show progress, then reevaluate policies and programs. Here again, we can bring technology to bear—data-driven GIS dashboards and maps available to officials and the public.

Modern enterprise technology systems like GIS allow us to communicate real-time and near real-time data collected by staff, community members, or other partners. They give insights into outcomes and key performance indicators, like where and by how much rates of chronic disease or infant mortality have improved in neighborhoods like Settegast. Or, where we have made improvements to housing, transit, and environmental infrastructure inside and outside the Loop, and how people are benefiting.

In this way, maps become storytelling mediums to record our lived experiences and communicate with decision-makers and the broader community. They tell the story of historical injustices in our city that continue to drive health outcomes. They also guide our work to design a more equitable city, to improve access to essential services and resources for all Houstonians.

Read the free ebook, Local Health Departments Advance Health Equity with GIS, to learn how other leading cities are using technology to work toward health equity.