Greater Houston Community Foundation (Foundation) launched Understanding Houston in November 2019, marking nearly five years of insights into our region. The last five years have been quite a journey, and many of you have been along for the ride, and we are grateful for our partners and supporters who have supported us throughout this endeavor.
Measuring what matters to do what matters
Using the data from Understanding Houston, we have learned a lot together about Houston’s three-county region.
We know more needs to be done to build trust amongst residents and boost civic engagement in our region. Less than half of Harris County residents think “Most People Can Be Trusted,” and while voter turnout hit record numbers in the 2020 presidential election, our region and state still lag U.S. voter participation rates.
Our diversity is a point of pride with Fort Bend County’s demographic composition being just about evenly split among the four largest racial/ethnic categories, but we still see disparities across income, home ownership, educational attainment, and health.
Houstonians are struggling. Renters are increasingly burdened by the rising cost of housing, incomes have stagnated, and more than 1 out of 3 households in the region is not able to afford their basic needs despite working full-time.
We have shared this type of data — and more — far and wide. Over 150,000 users have visited the understandinghouston.org website and we’ve provided data briefings to over 3,700 individuals. But Understanding Houston was never meant to be only about collecting data and learning. The purpose was always meant to inform action by measuring what matters to do what matters.
Our First Three Years
Start-Up
Year 1
Engage
Year 2
Catalyze
Year 3
Build new tools
Engage community leaders across three counties to inform the project
Aggregate credible data and build the website
Launch November 21, 2019
Build capacity and convene
Host educational opportunities across sectors
Offer nonprofit partners data capacity building
Convene to identify key focus issues for collaborative action
Take action and iterate
Deepen learning through community engagement and discussion on focus issues
Develop and begin executing on key actions
Update website and reflect
Community Impact Fund
How did we evolve from Understanding Houston, a data indicators project, to action? Greater Houston Community Foundation’s Community Impact Fund. The Community Impact Fund will be a catalytic force for philanthropic impact – making a meaningful difference in the lives of Houstonians through three pillars of work that speak to data, collaboration, and lasting impact.
Understanding Houston was the first initiative that started and shaped the Foundation’s Community Impact work. By grounding ourselves in our region’s strengths and challenges through the data and community engagements, we were able to make decisions around how we should deepen our impact and show up for Houston.
This learning journey, expedited by a global pandemic and a grueling winter storm shortly after, prompted the Foundation to proactively step into a space we had already been leading in reactively. The Greater Houston Disaster Alliance officially launched May 2023 in partnership with United Way of Greater Houston and city and county leadership. This initiative allows us to strengthen our role as philanthropic first responders to support disaster recovery and partner in new ways to increase our region’s resiliency in between times of disaster.
Finally, our newest initiative, High-Impact Grantmaking where we partner with community to leverage collaborative, catalytic grantmaking to improve economic mobility for our neighbors. Through Understanding Houston data trends and engaging over a hundred community leaders, we solidified economic mobility as a priority and a paramount concern for Houston. Dive into our journey from going to 200+ indicators to one issue area of focus.
Engage in the Journey
If you want to stay informed on all our Community Impact initiatives, subscribe to the new, quarterly Insider Update newsletter. For all our data lovers out there, do not worry — while the Understanding Houston newsletter will be switching to a quarterly cadence, it isn’t going anywhere. We will continue to share data insights and trends, articles that dive into relevant and complex issues, and other resources for further learning.
So please stay with us on this evolving journey as we transition from “Measuring what matters to do what matters” to “Doing what matters by measuring what matters,” because the ride isn’t over!
I’ve been the Pastor of Olivet Baptist Church, located in the Fifth Ward since 2004. Approximately 10 years ago, our church formed a nonprofit, Olevia Community Development Corporation, to take an active role in our community by developing people, property and resources within the Fifth Ward, a consistently under-resourced minority community since its beginning in 1866.
What the study found was a “silent crisis”: 32% of Harris County adults are functionally illiterate, meaning more than one in every three residents do not have the literacy skills they need “to successfully perform their role on the job, in their family, or in society.” The study’s conclusion: Houston needs to act strategically and proactively to address the pervasive, multifaceted, complex nature of low levels of adult literacy.
Greater Houston’s population of more than 6.2 million is among the most diverse in the country, with a quarter of residents born outside of the U.S. and 145 spoken languages here. In Harris County – there is no racial/ethnic majority – though 44% percent identify as Latino, 19% percent as Black, and 7% as Asian American. Our region’s diversity is a strength — one that brings together different experiences, perspectives, and ideas.
However, we also have challenges. Consider the finding that Black and Latino adults in Harris County are 3 times more likely than white adults to have low literacy skills,1 and that 94% of adult learners in Harris County are people of color, with the vast majority (greater than 85%) being Black or Latino.2 This report found that the issues of illiteracy are rooted in systemic injustices which go unnoticed in our collective consciousness.
Why illiteracy matters
The economic disparities in neighborhoods of color in Houston directly relate to overall educational attainment and literacy, by extension. In particular, poverty is closely intertwined with illiteracy. According to one national study, 43% of adults with the lowest literacy skills live in poverty, compared to 4% of those with the highest literacy skills.3
In Fifth Ward, the median income is $38,000 (less than half the state average), 37% live below the poverty line, and 32% of adults have not completed high school. For comparison, about 17% of adults in Harris County have not completed high school and 15% live in poverty.
What the study points out — and what we know from living, working, and ministering in the Fifth Ward — is that children of parents without a high school diploma have a much higher likelihood of also not finishing high school, which establishes a recurring pattern, often spanning multiple generations. With more than one million functionally illiterate adults in Harris County, the implications are dire.
In fact, low literacy rates challenge the well-being and prosperity of families across our region and prevents many adults from reaching their fullest potential in life and the pursuit of the American Dream. When fewer of us do well, that threatens our region’s overall economy and social vitality. The literacy report found that Harris County’s economy could grow by $13 billion if adults with the lowest level of literacy increased their skills just by one level – that translates to a 3.3% increase in GDP. Further, research has shown that adults with low literacy tend to have worse outcomes in health, job opportunities, and economic stability. If low literacy rates in our region continue, we will not have the skilled workforce we need to support tomorrow’s economy, which could negatively impact our region’s growth and prosperity.
Libraries as one tool in the fight
Libraries are champions in the fight against illiteracy as they tend to offer a diverse range of approaches for both children and adults, are generally accessible in neighborhoods, and are free to all. One of the many solutions to tackling adult literacy is to fund more robustly community library programming. This literacy programming should include classes in ESL, workforce development and training, financial literacy, health literacy, and digital literacy. As Edward Melton, Director of the Harris Co. Library System, shared with us recently, “You can’t just build a library and believe people will come. You must have literacy programming dedicated to the needs of the immediate community.”
Recently, we at the Olevia CDC have been working on the development of a library in the Fifth Ward as none exists for the 17,000 people who live in this neighborhood directly adjacent to and northeast of downtown Houston. The City of Houston Library in the Fifth Ward was located next to the Fifth Ward Multi-Service Center, but it received extensive damage from Hurricane Harvey in 2017 and has been closed since.
This void has left the community without a valuable and needed resource for its citizens both young and seasoned for the past six and a half years. That means the following services are not being provided for Fifth Ward residents: programs and events such as story time for children, book clubs, and author talks. Along with missing traditional library services, neighborhood libraries also offer unique resources such as free access to online learning platforms, free tax preparation for seniors, access to free legal aid, health fairs and screenings, food giveaways, and so much more.
In addition to providing basic services, the Olevia CDC’s library project is primed to be a destination space for the community and the neighborhood as it will utilize a historic building to create an innovative reading space. We partnered with the University of Houston Gerald Hines College of Architecture and the Design Build Master’s Classes to complete a structure that will fit within an existing unused donated structure.
While books and literacy are paramount, we also plan to provide e-books via mobile devices, establish a community garden, host indoor and outdoor performances, an onsite coffee shop, spaces to hold community events, such as weddings, birthday parties, author book signings, Houston sport and entertainer celebrity reading literacy nights, corporate sponsored literacy events and much, much more. We intend for literacy and fun to be interconnected and highlight the true benefits of literacy.
Join the fight
As the Houston community begins to address this silent literacy crisis, it is clear from the Literacy Blueprint report that investing just $2,200 per year in adult education “can raise an adult learner up two grade levels.” By improving adult literacy rates through education and skills training, a greater number of Houston’s most marginalized, including those in the Fifth Ward, will be able to advance economically, support their families, and play a positive role in our society.
There are many ways to join the fight against illiteracy in our region. I encourage you to see how you can get involved in your local library system — such as Harris County’s or Houston’s — to read to children or tutor. You can also join the literacy movement or volunteer in some other capacity. To learn more about our efforts in the Fifth Ward, including our efforts to build a new library, please visit us at Olevia Community Development Corporation.
End Notes
1 Program for the International Assessment of Adult Competencies (2017) 2 Houston-Galveston Area Council (2021) 3 Kirsch, I., et al., Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey. (Washington, D.C.: Office of Educational Research and Improvement, U.S. Dept. of Education, 2022) 61.
Since its launch in 2019, we have been asking how we can improve Understanding Houston — not only the site, but also the overall initiative: How can the site be easier to navigate? How can the site help you quickly find what you are looking for? How can our events be more engaging or useful? What else do you want to see from Understanding Houston?
In search of answers, we conducted three Data Dives, two Visioning Labs, dozens of post-event evaluations, hundreds of conversations, and a biennial survey.
Through this discovery, we heard that the site was not intuitive to navigate; few people were aware of our blog page; the site was not fully accessible; and users wanted more background and context with which to interpret the data but also fewer indicators. (We also heard that Understanding Houston presents data in compelling, interactive visuals; provides analysis in clear, accessible language, and is aesthetically pleasing.)
Throughout 2023 we have been working with our incredible partner, Baal & Spots, to build and enhance UnderstandingHouston.org, and we are thrilled to finally reveal the refreshed website!
Here are five ways Understanding Houston has improved, informed by your feedback and suggestions.
1. Popups and Navigation
Each time you open Understanding Houston in a new browser, little popups will take you on a quick tour of the homepage (if you do not want to see them again, select the appropriate box). The popups will guide you through the homepage, the new navigation, the new “Explore the Data” button, the blog page, and more.
Additionally, the navigation headers have been renamed and reordered for clarity. The “Explore the Data” button now appears first. We have also made it easier to learn who we are, what we do, and how to get involved by registering for events or subscribing to the newsletter. Finally, the blog page is now called “Articles & Reports,” the search bar is more prominent, and it is easier to find information on upcoming and past events, including presentations and photos through drop-down menus.
2. Explore the Data
We are proud to host a new Explore the Data page that presents all topics and subtopics in one place for convenience. From this page, simply click on the cover photo or topic name to visit one of the nine topic-level pages and read the summary report. Users can also view all subtopics to directly find what you are looking for or to get a sense of how the data are organized. In this update, we refined the 300+ indicators to about 200 based on feedback and use and combined and refined subtopic pages — the result of which can be seen in this one high-level page.
3. Enhanced Blog
The blog page formerly known as “Community Voices” has been renamed “Articles & Reports.” The articles can be filtered by one of the nine topics by selecting the issue in the drop-down menu. With over 80 articles to choose from, we know there is a lot to explore. To help focus, the top five most read articles will appear in a carousel format, with all articles in reverse chronological order below, denoted by the “Most Recent” header. Scroll down the page to load more articles or use the search tool in the upper right corner to find one you are looking for.
4. Improved Accessibility
We are proud to share that Understanding Houston is more accessible now. We have tweaked our color combinations and fonts to ensure that all users can fully enjoy and utilize the website. Screen readers can read each page’s content, including charts, and we are working to complete adding alt text to all relevant images.
5. More background, context and analysis
You asked for more historical background, situational context, and deeper analysis from Understanding Houston, and we aimed to deliver! Throughout the site you will find deeper dives and more holistic analysis of outcomes across indicator, and we disaggregated more data by race/ethnicity, gender, and income where possible. For example, we took a deep dive into the racial characteristics of poverty, analyzed housing cost trends before and after the pandemic, dissected disparate outcomes in maternal and child health, and more.
Approaching our Fifth Anniversary
We have made significant updates to the website, but many parts of the site you love have not changed. You have always been able to interact with the charts on the website and download them for use. Users can still change views by filtering the data in the legend or selecting different buttons or drop-downs in the top right corners. And, you can still jump to the indicator of interest by selecting it under “The Data” header on the left of each subtopic page.
As we move toward our fifth anniversary in November 2024, we will continue to improve, following your suggestions and input. Understanding Houston’s second biennial Impact Survey is now live! We encourage all users and visitors to complete the 10-minute survey for a chance to win a $1,000 donation to your favorite local nonprofit. We will continue to update the site with the most recent data and to convey the initiative’s next phase of work.
Once again, we extend our deepest gratitude to and appreciation for Baal & Spots who has been an incredibly talented and supportive partner to us since Understanding Houston’s inception.
Every November 11th, cities, towns, and communities across our country come together to pay tribute to the brave men and women who have served in the armed forces. Veterans Day is a solemn occasion, a day when we pause to reflect on the sacrifices made by our military personnel and express our gratitude for their unwavering dedication to protecting our freedoms.
At its core, Veterans Day is a reminder of the profound debt of gratitude we owe to those who have served in our country’s defense. It’s a day to acknowledge the immense sacrifices that veterans have made for the greater good. These sacrifices extend far beyond the battlefields; they encompass time spent away from loved ones, physical and mental challenges, and the burden of carrying the responsibility for the nation’s security.
The essence of Veterans Day
One of the most important aspects of Veterans Day is the opportunity it provides for Americans to connect with veterans and gain a deeper understanding of their experiences. Through conversations, events, and ceremonies, Americans can hear firsthand accounts of the challenges veterans faced and the resilience displayed in the vein of defending the greatest country in the world. These stories remind us that freedom is not free; it has been safeguarded through the courage and valor of our veterans.
Nearly 220,000 veterans live in Houston’s three-county region. About 7% of Montgomery County’ population are veterans — the largest proportion of veterans in the region, compared to 4% in Fort Bend and Harris counties. On average, men, Black, and white people are most likely to be veterans.
Veterans Day also serves as a reminder that even after a soldier, marine or airman takes off the uniform there are a litany of ongoing challenges that veterans may encounter upon returning to civilian life. Transitioning from military service to civilian life can be daunting, and many veterans face difficulties such as finding employment, accessing healthcare, or coping with post-traumatic stress.
According to the Department of Veterans Affairs, 29% of veterans who served in Operation Enduring Freedom or Operation Iraqi Freedom will experience post-traumatic stress disorder (PTSD) at some point in life, though these statistics are likely underreported since many returning veterans may not report PTSD symptoms or may not be screened at all. By recognizing and supporting our veterans, we can work together to address these complex challenges and ensure Veterans receive the care and opportunities they deserve.
Veterans Day is also an opportunity to extend our gratitude and support to the families who play an integral role in supporting and encouraging our military community. It is important to remember that no veteran serves alone. Spouses, children, and parents of veterans have also made sacrifices — enduring long deployments and the anxiety of worrying about their loved one’s safety — and they often have to endure PTSD or other mental health battles alongside their loved one.
Yet, despite these challenges, there is also great honor in their sacrifice. Being in the army taught me that a kid from a small town who is willing to raise his hand and take the oath to defend and protect our country would not only learn about military tactics, see the world, and be a part of experiences that are not possible as a civilian, but that anything is possible if you believe in yourself. The leadership, problem-solving skills, resilience, and team-building skills I gained through my service were life-changing. There is no doubt that the military is not for everyone, and the voluntary military system is a great one but, in FY 2022 the Army missed its recruiting goal by 25% (~15,000 active-duty soldiers), and as a society, we should carry some of the responsibility for this staggering number.
A society united in respect
Imagine a country in which veterans were put on a pedestal like professional athletes or looked up to and idolized like movie stars and musicians. Imagine what might happen to a 16 or 17-year-old who is trying to figure out what to do when she turns 18, so she looks to Brig. Gen. Smith in the Space Force as a hero and decides on a career as an Intelligence Analyst. Imagine a kid who is about to graduate high school but has no idea what his purpose in life is but decides to don the uniform of this country. Imagine not only what these choices would do for those individuals but also what might happen if the men and women of our armed forces were viewed as “influencers” and how that might re-center our societal priorities to “Be all you can be.”
While I am an optimist at heart, even I know a complete re-prioritization of values is nothing that can happen overnight, and a societal shift of putting the men and women who bravely defend our way of life in the same day-to-day conversations as celebrities and professional athletes is unlikely.
But this is H-Town. As the fourth largest city in America, Houston, we may have a problem, but we have influence. We have the ability to make changes so that Veterans Day can extend beyond November 11th.
This does not mean more parades or showering veterans with gifts or handouts, frankly most veterans (me included) would be adamantly opposed to this type of thing. What I’m talking about is making a conscious effort to learn about what our men and women in uniform do for this country and share that knowledge into normal day-to-day conversations (and social media posts!) with our friends, family members, work colleagues, and children. This is a powerful way in which we can all act individually and collectively to shape the future and honor the sacrifices made by our nation’s veterans and active-duty service members.
Leading by example
So, on this Veterans Day, attend the parades, thank those veterans you know for their service, and come together in your community to recognize the courage, sacrifice, and dedication of our veterans. But as Houstonians, let us make a commitment to find our own individual ways to elevate the sacrifices made for this country into the other 364 days of the year. This is Space City — anything is possible.
There is more to economic security than living above the poverty line.
Across Greater Houston, more than a million households struggle to make financial ends meet. Among those households across Fort Bend, Harris and Montgomery counties, about 306,000 live below the Federal Poverty Level (FPL). However, this common economic measure only describes part of the economic reality in our community. The Asset Limited, Income Constrained, Employed (ALICE) data presents a more accurate picture of the economic reality across our community, especially regarding the number of households that are economically challenged.
What is ALICE?
According to the 2023 ALICE report for Texas by United For ALICE, 700,000 households across Fort Bend, Harris and Montgomery counties, or 31%, experienced ALICE in 2021 – they worked hard but couldn’t afford the basic necessities of life. The ALICE Report draws attention to the huge but often hidden segment of our community that is struggling to make ends meet, beyond those living on incomes below the FPL.
The ALICE data takes into consideration the ALICE Survival Budget, which is a bare-bones, real-world, conservative estimate for what it takes to make ends meet. It includes actual costs, such as housing, utilities, child care, food, transportation, health care, and a low-cost smartphone, and it changes based on the county of residence and size and composition of the household. Noticeably missing from the ALICE Survival Budget is the ability to save for emergencies or a rainy day. Individuals and families experiencing ALICE often feel the stress of living paycheck to paycheck and are one emergency away from financial hardship.
The ALICE Survival Budget highlights how a single adult in Harris County, for example, needed an annual income of $32,328 to afford the basics in 2021, while a family of three (one adult with one preschooler and one school-aged child) needed $61,548. In contrast, the FPL for a single adult was $14,583 and for a family of three was $24,860 in 2023 – a 121% and 148% difference, respectively. The individuals and families who earn above FPL but still can’t afford everything are often not eligible for assistance programs, public benefits, and other supports.
Comparison of itemized budgets for one adult versus one adult with a school-aged child plus pre-schooler in Harris County.
Households experiencing ALICE typically spend more than half of their income on housing and transportation, leaving less money for other essentials. The local cost of rent represents the greatest expense for a family of three in Harris County, averaging $1,208 per month. The same size family in Fort Bend would need $1,574 per month for housing and $1,334 in Montgomery County. The average monthly cost of transportation was $364 for the same size family across all three counties.
The ALICE data also reveals disparities and challenges faced by different groups of households in our community. By race and ethnicity, 43% of Black and 45% of Hispanic households were experiencing ALICE across Fort Bend, Harris, and Montgomery counties in 2021, compared to 25% of white households.
By age of head of household, those with a head of household under 25 years old or over 65 years old had the highest rates of financial hardship, with 40% and 42% experiencing ALICE respectively across the three counties.
By household composition, single-parent families with children were more likely to experience ALICE than married-parent households or single/cohabiting households without children. Single-female-headed households with children experience ALICE at 35% and single-male headed households with children experience ALICE at 45% across Fort Bend, Harris and Montgomery counties.
We see the number of those experiencing ALICE growing across communities. You can dive into the ZIP Code level data for prevalence of those experiencing ALICE and living below the FPL. For example, when reviewing ZIP code level data, 77417 in Fort Bend County has 6,923 households experiencing ALICE, an increase of nearly 5% since 2018. In Montgomery County, zip code 77306 has 2,139 households experiencing ALICE, up 14% from 2018.
What’s important about being able to look at the ALICE data from this lens is that households of all ages, genders, races, and ethnicities, living in rural, urban, and suburban areas, are impacted by financial hardship.
ALICE and COVID
What’s important about being able to look at the ALICE data from this lens is that households of all ages, genders, races, and ethnicities, living in rural, urban, and suburban areas, are impacted by financial hardship. The ALICE data shows that financial hardship is not a temporary or isolated problem, but a persistent and widespread issue that affects households across our community. It also shows that the COVID-19 pandemic exacerbated the situation for many ALICE households. They faced employment shifts, health struggles, and disruption to day-to-day life activities.
Throughout 2020 and 2021, there were various temporary pandemic supports that provided a much-needed cushion for these struggling households, such as a range of direct assistance programs, including pandemic-specific unemployment insurance, economic impact payments, expanded Child Tax Credit (CTC) and Child and Dependent Care Tax Credit (CDCTC), and emergency rental assistance. The temporary relief mitigated the pandemic’s negative financial impact on ALICE households, avoiding what could have been a deeper economic crisis overall.
When combining the households that are living below the federal poverty level and experiencing ALICE, over a million households are forced to make difficult choices and risky tradeoffs every day across our area. This requires them to make tough choices, often forgoing basic necessities such as healthy food and health care which is why sufficient incomes matter for everyone.
How to Use ALICE Data
The ALICE data also highlights the opportunities and solutions that can help households achieve financial stability and well-being. United Way of Greater Houston is using the ALICE data to guide the Integrated Client Journey, which consists of a network of over 100 funded nonprofit partners that coordinate services to support those that identify as ALICE. The vision is that these organizations work together to help individuals and families to reach financial stability, ensuring that individuals and families in our community have the opportunity to thrive and to prosper.
We invite other service providers and community stakeholders to explore and use this data to gain a deeper understanding of the realities many of our neighbors are facing and how we as a community can lift up those struggling to make ends meet. To learn more about ALICE data visit https://unitedwayhouston.org/what-we-do/employed-but-in-need/.
Banner photo: Carrie Rai, FBCHHS Performance and Innovation Specialist
This article is the first of a two-part series that describes the community engagement plan and process to create Fort Bend County’s first Community Health Assessment and Health Improvement Plan since 2007.
In the summer of 2022, Fort Bend County Health & Human Services (FBCHHS) completed its first Community Health Assessment (CHA) in 15 years. The Centers for Diseases Control and Prevention (CDC) defines a CHA as “an assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. The ultimate goal of a community health assessment is to develop strategies to address the community’s health needs and identified issues.”
The CHA process was a collaborative effort, led by FBCHHS. The process of collaboration and community engagement began with identifying stakeholders from a variety of sectors within the community and the creation of the CHA Committee.
The committee was comprised of FBCHHS divisions and leadership and division representatives alongside community stakeholders representing primary health care, mental health, hospitals, private philanthropy, local government, non-profits, the faith community, academia, transportation, and public safety.
The committee was integral in guiding the process of the CHA, providing input for and reviewing the methodology, data, analysis, as well as determining the types of secondary data to collect, and what questions to ask in the survey and the key informant interviews. The CHA committee also made suggestions about who to interview and how to administer the survey.
More than 150 Fort Bend County leaders, residents, stakeholders and health champions and over 70 organizations attended the community input sessions throughout the CHA and community health improvement planning process. Additionally, FBCHHS conducted 25 key informant interviews and administered 845 surveys. These activities provided a platform for diverse agencies, community members and perspectives to be shared to generate inclusive, cohesive and attainable health improvement goals.
Event photo from The Big Picture – Fort Bend County
Community Health Priorities
FBCHHS used the Kaiser Permanente National Community Benefit decision-making criteria for the identification and prioritization of health needs. Quantitative data was compared against the following benchmarks: the state of Texas, U.S. as a whole or the top 10% performing U.S. counties. A health issue was identified when there was poor performance across the comparative benchmarks. Health issues were also identified through thematic analysis of qualitative data from input sessions and Key Informant interviews. Community health need priorities were determined when the same health issue was identified in both the quantitative and qualitative data.
According to the 2022 County Health Rankings, Fort Bend County ranks fourth in the state for best overall health outcomes. However, the CHA data illustrates areas for improvement among vulnerable populations that have disproportionate health outcomes. Black and Hispanic populations, people without health insurance, and people with low-income have poorer health outcomes. These groups struggle to access services, contributing to health disparities.
Source: Kaiser Permanente National Community Benefit, August 2015
While there are several areas where Fort Bend County could see improvement, residents, community leaders and stakeholders identified five top community health priorities.
Mental Health
Like physical health, mental health is critical to our overall well-being. Good mental health affects our thoughts and behaviors, helps us maintain fulfilling relationships, enables us to cope with change and adversity, and ultimately supports our contributions to society. Mental health is also closely connected with physical health. Poor mental health may lead to behaviors that harm physical health (e.g., alcohol and other substance use, lack of exercise, etc.), and having poor physical health can negatively affect our mental health. About one in four survey respondents stated that their mental health was not good for one to five days out of the past 30, and 46% said mental health has been a problem in their household.
About one in seven survey respondents stated that there was a time in the past year that someone in their family needed mental health services but couldn’t receive them — either because they couldn’t afford to pay (34%) or the wait times were too long (27%). Overall, one-third indicated that mental health services are missing in the community. The data from surveys reflect mental health access challenges we see in Fort Bend, specifically. Within Houston’s three-county region, Fort Bend has the highest ratio of residents to mental health care providers, though there has been improvement since 2017.
Housing
Affordable, safe, and stable housing is a basic need, and unsafe or unstable housing threatens our health, well-being, and economic security. At the same time, the cost of housing is the single largest expense for most households, and it has become increasingly unaffordable in recent years. The U.S. Department of Housing and Urban Development considers affordable housing as not more than 30% of income. If a household spends 30% or more of their income on housing costs, they are “housing cost burdened.” Households that spend 50% or more of their income on housing costs are “severely cost-burdened.”
Renters are much more likely to be burdened by housing costs than homeowners. In 2021, more than 45% of renters were cost-burdened compared to 25% of homeowners; and 22% of renters were severely cost-burdened compared to 11% of homeowners. While the share of homeowners who are cost burdened has fallen since 2010, renters are more likely to be cost burdened now than a decade ago. Additionally, a person would need to work 3.2 full-time jobs at minimum wage to afford a two-bedroom rental property at Fair Market Rent in Fort Bend County. Fort Bend County’s population has already increased 41% over the last decade and is expected to increase an additional 15% to nearly 1 million by 2030, according to the Texas Demographic Center’s recent projections. Given these data, it is not surprising that one-third of survey respondents indicated affordable housing is missing in Fort Bend and more than half of Key Informant interviewees cited the issue as their top concern.
Obesity
Obesity, defined as having a body mass index (BMI) of 30 or more, is a complex health condition affecting both adults and children. Obesity increases the risk for health conditions such as coronary heart disease, type 2 diabetes, cancer, hypertension, and more. Obesity is found to take more years of life than diabetes, tobacco use, hypertension, or high cholesterol.
Nearly 30% of adults in Fort Bend County are classified as obese, according to County Health Rankings, and the disease was the top health issue identified among survey respondents. While not the only related triggers, poor eating habits and lack of exercise can contribute to obesity. About 40% of survey respondents are concerned with poor eating habits and 39% are concerned with a lack of exercise.
Cardiovascular Diseases
Heart disease was the fifth most-cited health issue by survey respondents and Key Informants with more than one in seven identifying the diseases as a health concern. White and Black residents of Fort Bend die from heart disease at significantly higher rates than Asian and Hispanic residents, according to the Centers for Disease Control and Prevention’s WONDER data tool.
The National Center for Health Statistics shows that three out of 10 deaths in Fort Bend County are attributed to heart disease and stroke. However, we know that many patients with heart disease also suffer from other chronic conditions, including lower respiratory diseases, diabetes, and kidney diseases, which comprised an additional 6% of deaths in 2020.
Maternal Health/Prenatal Care
Babies who are born in good health and who continue to thrive with positive experiences, tend to grow into healthy and productive adults who sustain our population and contribute to our economic vitality. Of course, a newborn’s health depends not only on the mother’s health during gestation but also her state of health before pregnancy. Early prenatal care is defined as pregnancy-related care beginning in the first trimester (1-3 months) and has been viewed as a strategy to improve pregnancy outcomes for more than a century.
In 2020, the rate of women who receive late (after the first trimester) or no prenatal care in Fort Bend County (30%) is three times that in Texas (10%) and five times the rate in the U.S. overall (6%). Between 2019 and 2020, Fort Bend saw an unprecedented 10-percentage-point decline in the proportion of women who received early prenatal care — a drop we didn’t see in neighboring counties despite the pandemic. Black and Latino women in Fort Bend had the lowest rates of early prenatal care, which is not surprising because a lack of health insurance is the largest contributor to women delaying or not accessing prenatal care, and women in those groups have the lowest rates of health insurance coverage.
Community Mobilization for Change
Through the CHA organizations, community members, and other stakeholders are able to evaluate the health of communities, factors that contribute to health challenges in Fort Bend County, existing community assets and resources to improve the community’s health can also be identified. The Community Health Improvement Plan (CHIP) contributes to the advancing of strategies to shorten the gap to accessing services, resources, and disparities faced with the top five community health priorities. The CHIP brings focus to the health issues identified in the CHA and allows communities, municipalities, jurisdictions, and community partners to actively collaborate and create a united plan to improve the health of Fort Bend County.
Healthy communities do not happen on their own, but through the efforts of community mobilization, local government support and key stakeholder contributions. Key stakeholders include local elected officials, hospital partners, FQHCs, foundations, non-profits, religious organizations, school districts, HOAs and many others. The shared goal is always to increase the quality of health across Fort Bend County.
We invite you to join us in reducing the gap for accessing services and or providing resources for the community members to meet the needs identified from the top five health priorities. FBCHHS Office of Communications, Education and Engagement is available to present to your organization or business about the CHIP to bring further awareness on how your organization or business can aid the community members of Fort Bend County.
On January 25, 2023, in partnership with Montgomery County Community Foundation, we hosted our first event of the year: The Big Picture | Montgomery County. The room was full with over 75 leaders across various sectors, including Judge Wayne Mack, Justice of the Peace, Precinct 1, Montgomery County, who assembled the Behavioral Health and Suicide Prevention Task Force in 2020. At this event, Understanding Houston shared key data highlighting Montgomery County’s strengths and challenges, and participants were able to react and respond to the data – the findings of this activity are below.
The program began with Julie Martineau, President & CEO of Montgomery County Community Foundation and member of Understanding Houston’s Advisory Committee. Julie shared how critical it is to use data in decision-making.
“Data is key to understanding what is happening in our community, where we’ve been, where we are right now, and where we are going. The change makers of Montgomery County are the people who can make an impact and use data to measure whether it is working or not.“
Julie Martineau, President & CEO, Montgomery County Community Foundation
Julie explained how Montgomery County Community Foundation works for the present and future well-being of Montgomery County, while Greater Houston Community Foundation works throughout Harris, Montgomery, and Fort Bend counties. Because of this overlap, there is often powerful cross-collaboration between the two foundations.
Julie shared how Understanding Houston is a resource for independent and accessible data that organizations, community and civic leaders, and other residents should use to measure progress and effect change.
Exploring the Trends and Data
Montgomery County has grown significantly, but wages have not kept up
Montgomery County’s population has grown nearly five times in just 40 years, numbering more than 620,000 according to the 2020 Census. Job growth was double the rate of the state and nearly quadruple the rate of the country, while GDP growth over the last two decades consistently outpaced Fort Bend and Harris counties, the state, and the nation.
While GDP grew 82% between 2010 and 2021 in Montgomery County, median household income grew only 7% during the same period. Not only have incomes stagnated, but income inequality has not improved in Montgomery County.
Nearly half of all income in Montgomery County went to 20% of the highest-income households, while just 3% of all income went to the bottom 20% of households. While the income gap between white and Hispanic households decreased by 22% between 2010 and 2021, the gender pay gap increased by 41% for the same period, and Hispanic households still earn about two-thirds of what white households earn.
Montgomery County’s poverty rate has increased recently, contributing to growing inequality. The percentage of children under five living in poverty increased from a decade-low of 12% in 2017 to 24% in 2021.
Nearly 1 in 5 children under the age of five in Montgomery County lives in poverty.
Households that live above the poverty line but earn less than what it takes to meet basic needs are called ALICE (Asset-Limited, Income-Constrained, Employees) – also known as the working poor. Combining households in poverty and ALICE, nearly two out of every five households in Montgomery County struggle to afford basic necessities like rent, transportation, and food.
Rent has increased and consumes a larger portion of incomes
In Montgomery County, rent increased 22% between 2010 and 2021 compared to an 8% decrease in housing costs for homeowners; the percentage of renters that spend at least 30% of their income on housing is double that of homeowners. Some individuals and families will move farther from city centers to access more affordable housing, which can translate into higher transportation costs.
Montgomery County residents typically spend 53% of their income on housing and transportation alone. On par with L.A. County residents (52%) – a place infamous for its expensive housing market and long commutes.
While a higher percentage of households in Montgomery County are homeowners (75%) compared to the state (63%) and the nation (65%), the homeownership rate in Montgomery County has not seen any improvement over the last decade.
Considering rising rents, homeownership appears to be increasingly out of reach for many first-time homebuyers. This is problematic because home ownership is still one of the most effective ways to build wealth and improve economic mobility.
Where we can afford to live determines more than housing costs
Where we live determines more than just our housing and transportation costs. It also affects our environment, including the air we breathe and the temperature we feel.
In Montgomery County, ozone levels were rated “F” by the American Lung Association – the same rating for Harris County. Montgomery County experienced 523 days of extreme heat, defined as 95°F or higher, during the 2010s decade. This extreme heat was a 231-day increase – the equivalent of nearly two-thirds of a year – compared to the previous decade.
Poor environment and lack of health care access contribute to poor health
Over 90,000 Montgomery County residents under the age of 65 do not have health insurance coverage and do not have adequate access to primary care physicians. There is only one primary care physician for every 1,674 residents compared to one for every 1,319 residents in the U.S. overall.
Clinical guidelines focus on the role of primary healthcare in obesity prevention, and obesity rates in Montgomery County have been up 14 percentage points since 2011. In just a decade, the percentage of residents living with obesity in Montgomery County went from being the lowest in the three-county region to the highest.
One out of three adults in Montgomery County are living with obesity.
Adding to healthcare challenges, Montgomery County has less mental healthcare availability than the state, and Texas ranks last across all states in access to mental health treatment. Montgomery County has only one mental health provider for every 1,069 residents.
Even more concerning, Montgomery County has consistently had the highest suicide rate in the region over the past two decades, and suicidal thoughts for young adults between 18 and 25 in the Houston area have nearly doubled. Research has shown that recent years have been especially difficult for youth and young adults due to social isolation caused by the COVID-19 pandemic and several subsequent traumatic events in recent years.
Educational outcomes suffered from the impacts of the pandemic
The pandemic delayed the opportunity to see the full impact of House Bill 3 (HB3), which was signed into law in 2019. HB3 required all pre-K programs to be full-day, which has added benefits over shorter-day programs. Montgomery County saw a 16-percentage point increase in the rate of pre-K students enrolled in full-day programs between 2018 and 2020, despite still having the lowest rate.
A higher percentage of Montgomery County kindergarteners assessed are considered kinder-ready (57%) compared to Fort Bend (54%) and Harris (45%) counties. However, not all kindergarteners in Texas are assessed equally. Only 31% of Montgomery County kindergarten students were assessed, compared to 96% in Fort Bend County and 90% in Harris County. This rate has been consistently decreasing in Montgomery County compared to a consistent increase in the neighboring counties.
If we look at a group of Montgomery County eighth graders and their educational journey through higher education, many do not ultimately earn a higher education degree or certificate. For every 100 students enrolled in eighth grade during the 2011-12 school year, 80 graduated from high school, 50 enrolled in a Texas higher education institution, and only 22 earned a credential or degree by the time they turned 25. Among economically-disadvantaged students, only 10% earned a degree or certificate compared to 30% of their wealthier peers.
Place-based disparate outcomes
Montgomery County’s economy has grown significantly, but that growth has not translated into growing wealth and prosperity for all residents. Income inequality has not improved, the poverty rate has increased, and nearly two out of five households struggle to afford basic needs. This inequality exacerbates the disparate impacts of rising rents, worsening environment, and low access to healthcare, which play a role in the vastly different outcomes we see for residents. According to research from Opportunity Atlas, one’s childhood zip code can tell a great deal about expected outcomes within each county.
On average, a child from a low-income family who grew up in Conroe earned a household income of $24,000 as an adult, whereas a low-income child from The Woodlands earned $53,000. About 38% of women who grew up in low-income families in a neighborhood in Conroe became teenage moms compared to 5% of low-income women from a neighborhood in The Woodlands.
“[The] community is not fully informed about what is truly happening in rural parts of [the] county. It’s easy in The Woodlands to be isolated from the poverty.“
Anonymous Participant
These problems cannot be solved alone. Cross-sector conversation and collaboration are required for Montgomery County to truly be a place where all its residents have the resources and opportunities they need to prosper.
Results from the Group Discussion
Given that many often need more time or capacity to converse and collaborate with those outside their organization, attendees were given time to reflect on how the data may align with what they see in the communities they reside, work in, and serve. Attendees reported that:
Many Montgomery County households struggle to afford basic needs, and there are disparities between neighborhoods regarding health, access to services, income, and housing.
There has been an increase in mental health issues among Montgomery County residents, youth and young adults in particular, and it is difficult to access mental healthcare.
Residents are often underinsured or uninsured, and there is a high use of emergency room services in place of primary/preventative care.
There is a severe lack of affordable housing.
Realizing that the county-level averages provided in the presentation can mask differences across various communities, attendees were asked how the data may need to align with what they see in the more granular communities they reside, work in, and serve. Attendees reported that:
Even though the data shows more access to mental health providers than primary care physicians in Montgomery County, mental health seems more difficult to access than primary/preventative care.
Schools in the south of the County appear to have better student outcomes than the county-level data show.
Access to health care is not a pressing issue within specific Montgomery County communities, likely due to new hospital facilities.
They do not see a reduction in the income gap between white and Hispanic households through the community they serve.
Given time limitations, not all quality-of-life indicators from the website were included in the data presented. Some issues attendees noted that were not in the presentation but were pressing challenges in the communities they serve were:
The lack of resources available to support individuals with autism spectrum disorder and with intellectual or developmental disabilities.
The lack of resources and services for the growing numbers of older adults (age 65+).
The income gap between white and Black households.
Lack of public transportation.
Food insecurity and food deserts.
Based on the most common themes discussed, mental health and poverty, the rest of the session was dedicated to discussing potential projects and ideas for collaboration around these two issues. Some of the suggestions that came out of the discussion were:
Mental Health
Partnering with local colleges to better prepare and increase the workforce of mental health practitioners.
Funding for mental health provider salaries to increase the workforce.
Establishing Community peer support groups.
Differentiating between mental illness and mental health and collaborating to utilize alternative services to help with mental health, such as community, exercise, animals, nature, etc.
Leveraging telehealth to circumvent obstacles such as transportation.
Poverty
Increasing the minimum wage to something that accurately reflects the cost of living.
Creating mixed-income communities to ensure affordable housing is available in high-opportunity areas.
Providing more mentorship to students, including expanding career and technical education (CTE) opportunities, local trade school resources, and removing barriers for individuals to further their education.
Greater Houston has gained a reputation for being generous. Historically, our region has often topped lists in national studies measuring total philanthropic assets, percentage of income given to charity, and overall financial health of nonprofit charity organizations. Our expansive, rich nonprofit sector enriches our communities and our local economy and is one of the largest contributors toward this reputation for generosity. Other likely contributors also include the national headlines of collective action after crises like Hurricane Harvey and Winter Storm Uri as well as the COVID-19 pandemic.
Uplifting stories of community resilience are valuable, but are also often anecdotal. How generous are we really, and in what ways? Where can we improve our generosity? Let’s unpack the data on generosity in Houston, and whether or not the headlines and human interest stories match the reality.
Houston bands together post-disaster
The greater Houston region is no stranger to natural disasters. Fortunately, when disasters do strike, Houstonians step up. Total giving after Hurricane Harvey reached nearly $1 billion, the most on record after any disaster. Notably, and in the spirit of regional generosity, donations after Harvey were marked by a broad, grass-roots donor base. The Hurricane Harvey Relief Fund administered by Greater Houston Community Foundation, for example, received an average donation of $100 from around 127,000 donors.
Some residents, however, are impacted more severely by disasters and are less likely to receive adequate recovery assistance. On a macro level, research indicates that federal disaster recovery and assistance policies place vulnerable groups at a disadvantage, making it more difficult for them to access resources or assistance. In Harris County, researchers have estimated that natural disasters can widen the Black-white wealth gap by an average of $87,000.
Another way to measure regional post-disaster generosity is through post-disaster contributions (both donations and volunteer-hours) at local mainstay charities. In 2020, following the onset of the COVID-19 pandemic, the Houston Food Bank reduced their volunteers by 85% due to new safety protocols — and yet, that year, over 537,000 hours of service were contributed by 88,000 volunteers. The Food Bank also saw a 468% increase in financial donations in the first half of 2020 and took in $455 million in donations the following year.
Organizational impact and limited access
Communities banding together to volunteer their time and donate money require more than just individual effort. For generosity to take place in any meaningful way, and for individual efforts to combine to affect positive change and address real issues, there need to be organizations, like nonprofits, to facilitate giving, organize communities and ultimately connect seekers with resources and services.
Although Greater Houston has a sizable, flourishing nonprofit sector that includes about 15,660 public charities, residents in each of the region’s three counties has relatively low access to public charities, with fewer nonprofits per 10,000 residents than both the state and the nation.
Compared to the population, the region’s nonprofit sector doesn’t look so robust. While 15,660 isn’t exactly a dearth of nonprofit charities, the comparison does tell us that our region’s nonprofits risk being overwhelmed during times of crisis when demand is at its highest.
Who gives and how in Houston
About half of the residents in Greater Houston donated $25 or more to nonprofit organizations in 2019, which was similar to the national average (51%), and higher than the state average (45%). This puts Houston squarely in the middle of the other measured large metropolitan areas, and behind San Francisco, Atlanta, Chicago and Austin.
Between 2011 and 2018, residents of the three-county region gave an average of $4.4 billion dollars per year, which accounts for nearly a quarter of all donations made by Texans. This impressive number has dipped along with the national average since 2018, likely due to a change in federal legislation that almost doubled the required deduction amounts for charitable donations.
The more money someone has, the more ability they have to contribute, therefore contributions by residents do scale with income, but those are not the only factors that impact donations. Among the three counties, there are large differences between the average contributions made by households that earn $200,000 or more, with high earners in Fort Bend County giving about half ($20,100) of the yearly average of those in Harris County ($38,661).
Large donations are, however, not the only factor in measuring a people’s or a region’s generosity; there are many ways in which residents can be generous.
Between 2012 and 2020, at least half of the residents (anywhere from 50-54%) in the three-county region reported having volunteered at least once in the last year. Between 2020 to 2021, that number went down by 14 percentage points, with only 40% of Harris County residents having volunteered in the last year. This follows a national trend, with many Americans reducing or completely stopping previous volunteer activity due to the COVID-19 pandemic, according to a survey conducted by Fidelity.
The Corporation for National and Community Service measured cities’ generosity using the above five metrics, which included volunteering, doing favors for neighbors, doing something positive for the neighborhood, participating in local groups or organizations and donating $25 or more to charity. All individual efforts — with the exception of lending a neighbor a cup of sugar or the like — require facilitation from a nonprofit charity organization or another local group.
Houstonians are generous, with potential to grow
One thing is certain: our residents will never want for inspiration. The national stories about Greater Houston’s generosity, tales of community resilience, civic engagement and personal sacrifice, while maybe anecdotal, get at what is essentially the truth about many communities in the region. Although not everyone will participate, those who do will continue strengthening their communities with dedicated and richly rewarding work.
Our region is certainly generous, although it has plenty of room to grow. And while generosity may have its genesis in individual efforts, it requires widespread, organizational oversight to thrive. Therefore, our substantial nonprofit sector must also have room to grow, if we want our region to truly thrive. We can take comfort in knowing that we’ve got both the residents and the resources to take generosity to unknown heights, and make an even greater impact in the future.
We live in eventful times. The past few years have been replete with once-in-a-lifetime events, including the many impacts of the COVID-19 pandemic, historic natural disasters and a variety of galvanizing political issues in between. While reactions to these events run the gamut, their impacts have been widespread in our digitally connected world, contributing to increased engagement throughout and between communities nationwide.
Not only did more Houstonians come out to vote in 2020, many Houston-based civic and social justice organizations worked to support our residents. After all, civic engagement is more than just voting — it’s volunteering, communicating with elected officials, donating to causes and even having difficult conversations with friends and loved ones.
Engaged communities help one another, cultivate trust among residents and ensure all voices are heard. Not only can positive engagement result in the betterment of one’s community, it can also improve feelings of connectedness and reduce individual loneliness. Houston may be turning out to the polls, but how do we fare in other areas of civic engagement, and how do we compare to the rest of the nation? Let’s take a closer look.
How and when Houston votes
Voter registration rates are high and rising in the three-county region with Fort Bend (95%), Montgomery (93%) and Harris (89%) counties all significantly ahead of the state (72%) and national rates (73%). With each Houston-area county’s registration rate almost 20 percentage points higher than the national rate, it’s easy to think that Houston is especially engaged, but registering to vote is only the first step toward electoral participation.
Voter participation among those who have registered in the region, is still far behind the national rate, despite significant upticks in the three counties during the 2020 election.
Fort Bend County has the highest turnout rate among those who registered at 74%, yet is still almost 18 percentage points behind the national average of 92%. Although registration rates and turnout rates were both notably high for the 2020 election, the disparity between turnout among those registered in the region and the nation was not.
If the voting-age population is consistently registering to vote, what could stop them from casting a ballot? Some argue that a lack of competitive races in the more visible governmental offices dissuades Texans from casting a ballot. In the 2018 primaries, 83% of voters did not cast a ballot, and one of Texas’ U.S. Senate seats — in a state with an estimated population of 28 million residents in 2018 — was secured with fewer than 775,000 votes.
Research suggests that offering early voting is a viable way to increase voter turnout, but the Houston region’s voters already vote early. While early voting has recently become more popular all over the nation, voters in the Houston area choose early voting at a rate higher than the national average. More than half of the votes were cast during the early voting period for every election in the past 12 years in the three-county region, with early votes representing 88% of all votes in 2020.
Research has shown that Americans are more likely to vote if they know and understand the process, if the rules and regulations are easy to navigate and if they believe their vote “matters.” According to the Cost of Voting Index (COVI), Texas has not kept pace with many common reforms to voting processes like absentee voting and online voter registration, making it one of the most difficult states in the nation for a resident to cast a ballot. Texas was 50th on the 2020 COVI but has since risen to 46th, mostly on the strength of a full 13-day early voting period.
Charitable giving and volunteering
Public charities don’t just help those in need through acts of service and donations, they also give residents a platform for contributing to and engaging with causes that matter to them. The Houston region has a robust nonprofit sector (over 15,660 nonprofit public charities in 2020), and although many charitable organizations serve the region, the number of charities per 10,000 residents is lower in Greater Houston than in the state and nation.
Nonprofit organizations operate largely on individual philanthropy, and Houstonians are no strangers to charitable donations. Charitable donations are an important component of engagement; when people feel engaged in their communities, they are more likely to contribute to its improvement. Nearly half of Greater Houston residents claimed to have donated at least $25 to charitable organizations in 2019, which puts Houston somewhere in the middle of other major metros with a higher percentage of residents donating $25 or more a month than in New York City and Los Angeles, but less than in Austin, Atlanta and Chicago.
Much like having a significant nonprofit network, a community with a strong contingency of volunteers is likely to stay supported and engaged. Residents of the nine-county Houston Metropolitan Statistical Area (MSA) volunteer less frequently than others at the state and the national level. About 30% of people who volunteer across the state and the nation do so less than once a month, compared with 38% of volunteers in the Houston MSA. In keeping with national trends, volunteer rates in Harris County fell 14 percentage points (54% to 40%) from 2020 to 2021, likely due to the COVID-19 pandemic.
Civic and social engagement
In addition to financial contributions made through charities, residents also provide direct service in their communities as members of civic organizations. Membership in civic and social organizations (which include non-profits, charities and advocacy groups) is another way to engage with a community and increase social connectedness. Social connectedness is the experience of belonging within a social relationship or network, not just within personal relationships, but within professional and community networks and beyond. Similar to the region’s large nonprofit network, Houston’s coalition of civic social organizations lags significantly behind the state and nation in the number of organizations per 100,000 residents.
In 2019, the three-county region had 3.2 civic social membership organizations per 100,000 residents. Texas, in comparison, had 5.2 per 100,000, and the U.S. 7.8 per. While it doesn’t nullify the stark contrast in access to these organizations, the number of organizations in the region has been rising, while those in the state and nation have been falling.
Actions may speak louder than words, but communicating with elected officials past election day is an important component of the democratic process. Unfortunately, it’s one many Houston-area residents don’t take advantage of.
In 2019, 6.5% of residents in the Houston MSA reported contacting their public officials at least once per year. Though marginally higher than the state rate of 6.4%, the Houston MSA does lag behind the national average of 9.3%. Although reaching out to elected officials does not always translate into legislative action, elected officials who do not hear from their constituents are deprived of the opportunity to understand how their policy ideas may affect our communities.
Why being engaged matters
Active participation in one’s community promotes deeper connections between residents and is the first step in creating a region that provides everyone the opportunity to reach their full potential. But without important information about the region’s different communities, we lack the full picture of what our residents are facing. The U.S. Census recently reported that they likely missed more than a half-millionTexans during the 2020 count, representing an immense amount of people that were left unaccounted for, and therefore not advocated for.
Census data is used to shape infrastructure and policy at every level of government. A study found that the 2010 Census was used to direct $101.6 billion toward federally funded programs at state and local governments, businesses, nonprofits, hospitals and households. Census data determines the number of funds allocated to everything from creating opportunities for jobseekers to deciding how relief funds will be distributed in the event of a disaster.
The issue of undercounting on the Census is an issue of underrepresentation, as the groups who are considered hard to count, and therefore the most likely to be systematically undercounted, include people of color, immigrants, refugees and people experiencing homelessness.
Houston is engaged, but more work remains
Comprehensive civic engagement requires not just individual, but organizational effort and attention. Having more Houston-area voices heard in our elections and other civic processes helps ensure that our region can achieve its full potential, and hearing from a more diverse set of perspectives ensures that more diverse needs are met.
Not all elections are nationally publicized, but they are all important. Though the 2022 midterms have some highly watched races on the ballot, it will be just as important that residents vote in subsequent, less visible elections. After all, our region is more than just its mayor and governor — it’s our judges, council members, school boards, sanitation leaders, local ordinances and so much more. Whether this year’s election is your first or your 51st, we encourage you to check what’s on the ballot and engage thoughtfully. Every vote, volunteer hour and voice matters — don’t let yours go unheard.
On October 6, 2022, Fort Bend County residents convened at Long Acres Ranch in Richmond, TX, to learn, engage, and explore ways to solve some of the county’s most significant challenges. At this event, Understanding Houston shared key data highlighting Fort Bend County’s strengths and challenges. Guests also heard from representatives from Fort Bend County Health & Human Services (FBCHHS) about significant findings from their recent Community Health Assessment. This event was unique as it was the first time Understanding Houston partnered with a county department for a presentation.
Fort Bend County Health & Human Services Team
Painting the Picture
The program began with Steve Maislin, President and CEO of Greater Houston Community Foundation, who shared an overview of the Foundation’s work and how it was established in 1995 to inspire and create meaningful change with our donors and for our community. In addition to being the Houston region’s hub for all charitable solutions, the Foundation is well-positioned to help its donors identify and invest in a validated network of agency partners throughout the Greater Houston region.
The next speaker was Dr. Jacquelyn Johnson-Minter, Director of FBCHHS. Dr. Minter shared how FBCHHS is the principal agency for protecting the health of Fort Bend County residents and providing essential human services. Dr. Minter emphasized the importance of the cross-collaboration needed for their ongoing response in addition to the emergency relief they provide during times of disaster. She conveyed that no one person or entity can solve the problems outlined in the forthcoming presentation alone, and this event was designed to help share the data needed to ignite cross-sector collaboration to address significant regional challenges.
Guests also heard from Rocaille Roberts, Program Officer at The George Foundation, where she helps to oversee how The George Foundation partners with the community to impact Fort Bend County and its residents positively. She encouraged everyone in the room, in their professional and personal life, to be open-minded about what resources we can all leverage to make an impact, as we all need to collectively think outside the box. She also shared how data helps their foundation make strategic choices about what issue areas to prioritize.
Sharing the Data
Population Growth
This leads us to the data shared by representatives from Understanding Houston. First, Nadia Valliani, Director of Community Philanthropy, began by grounding the conversation in the county’s population growth and change over time. Fort Bend County’s population has grown over 500% in the last 40 years.
Fort Bend County’s population has grown over 500% in the last 40 years.
Along with large population growth, there has also been a dramatic change in who makes up Fort Bend’s population. International migration is a large contributor to Fort Bend’s population growth, with one out of three residents being foreign-born in 2021, the highest rate in the three-county region, which includes Harris and Montgomery counties. Additionally, Fort Bend’s population has shifted from majority-white to an almost completely equal distribution of each major racial/ethnic group. Valliani shared how population growth is a significant strength as it helps to expand the economy and workforce. However, if not planned for properly, population growth can put stress on our infrastructure and environment. While the region’s diversity is a point of pride as it is an asset and opportunity to lead the country, diversity does not automatically mean inclusivity.
Fort Bend’s population has shifted from majority-white to an almost completely equal distribution of each major racial/ethnic group
The data shows that economic opportunity and prosperity are not shared among all residents in Fort Bend County. While the median household income in Fort Bend County, at $97,210, is higher than in Texas and the U.S., Fort Bend has larger income disparities by race/ethnicity. The income gap between white and Hispanic households in Fort Bend County was nearly $42,000 in 2019, according to data from the Federal Reserve. In Fort Bend County, income has grown by about 7% in the past decade compared to 15% for the nation and 21% for Texas. Fortunately, fewer people are living in poverty, but there are racial/ethnic disparities here as well. About one in 10 Black and one in 14 Hispanic residents in Fort Bend live in poverty compared to one in 20 white residents, according to data from the 2019 American Community Survey.
Fort Bend County is one of the most diverse and wealthy counties in the nation, but wealth has not grown meaningfully for all. This has wide-ranging implications contributing to gaps in housing affordability and health outcomes.
Residential Infrastructure and Health
Next, we heard from Chelsea Cheung, Senior Data and Learning Analyst. Cheung shared how the rising cost of housing has disproportionately impacted renters. She revealed how homeownership can be critical to wealth creation and upward mobility, as that wealth can be passed on to future generations. A higher percentage of Fort Bend County residents are homeowners compared to the state and nation; and while homeownership disparities exist by race and ethnicity in Fort Bend County, the disparities are smaller when compared to Texas and the U.S. However, median home values rose 62% between 2010 and 2019 in Fort Bend County, nearly double the national increase of 34%. For the same time period, the median monthly costs for homeowners with a mortgage increased by 4% compared to a 21% increase for renters. In Fort Bend County, nearly one in five renters spend more than half of their income on housing alone. For Fort Bend renters with stagnant wages who face soaring rents, the cost of achieving the American dream has increasingly become practically unachievable.
In Fort Bend County, nearly one in five renters spend more than half of their income on housing alone.
Cheung then addressed how where we live affects our environment and, by extension, our health and the health services available. Unfortunately, Texas has had the highest percentage of residents without health insurance in the United States for the last decade. In 2019, about 41,000 residents between the ages of 19 and 64 in Fort Bend County were uninsured, with one-third of Hispanic adults younger than 65 in Fort Bend being uninsured. In 2020, half of all deaths in Fort Bend were caused by heart disease, cancer, and COVID-19. In addition, in 2019, over 25% of Fort Bend County residents 18 and older reported no leisure-time physical activity in the past month, and over 15% rated their health as poor or fair. With more than a quarter of adult residents in Fort Bend County living with obesity, it is time to look at increasing access to and uptake of healthier options for residents.
Cheung then spoke about mental health and prenatal care. In Fort Bend County, the number of pregnant women who received early prenatal care declined 10 percentage points in just one year between 2020 and 2019, a decline not seen in Harris or Montgomery counties. In addition, Fort Bend County has the highest ratio of residents to mental health care providers in our three-county region and compared to the state and nation. This shortage of mental health providers is especially problematic because over one in 10 Fort Bend residents reported experiencing at least two weeks of poor mental health within a one-month period in 2019.
Identifying Community Priorities
The final speaker was Carrie Rai, Performance and Innovation Specialist from FBCHHS, who shared an overview of their recent Community Health Assessment. This Community Health Assessment is the first in Fort Bend County in 15 years. In addition to using data from various sources like Understanding Houston and local hospitals, they also collected their own data by conducting 25 key informant interviews and distributing 845 surveys to community residents.
Through their research, FBCHHS collected data on health outcomes related to health care, health behavior, social and community factors, and the physical and built environment. While they learned that Fort Bend County performs well in several areas, there were a few areas that were flagged as community priorities, including mental health, obesity, heart disease, housing affordability, and prenatal care access.
Mental Health
Rai shared that 37% of survey respondents had at least one day of poor mental health in the past month, and 46% indicated that mental health had been a problem within their households this past year. She also shared that suicide rates in Fort Bend County vary by race and ethnicity, with the highest rates of suicide being in the white population. These high rates of poor mental health are complicated by the shortage of mental health providers in Fort Bend County, as there is only one mental health provider for every 1,210 residents compared to a ratio of one mental health provider for every 760 Texans. Their data also showed that 14% of respondents needed mental health services but did not receive them. When asked why they did not receive mental health services, 34% said they could not afford to, and 27% said it took too long to receive services.
Obesity
While Fort Bend County has lower obesity rates than other counties in the region, it is still a top health issue, as nearly 30% of Fort Bend County residents are obese. In addition, results from the Community Health Assessment indicated that 40% of survey respondents were concerned with poor eating habits while 39% were concerned with lack of exercise. Only 8% of survey respondents are consuming enough fruits and vegetables, and 60% are not getting enough exercise.
Heart Disease
Heart disease is the leading cause of death in Fort Bend County. Breaking it down by race/ethnicity, according to CDC WONDER, the Black or African American and white populations in Fort Bend County had the highest rates of deaths related to heart disease in 2020. Heart Disease was the fifth most cited health issue by survey respondents and key informants.
Housing Affordability
Housing in Fort Bend County is another area of focus due to affordability challenges. In 2022, County Health Rankings found that the Fair Market Rent (FMR) is $1,208 in Fort Bend County, whereas, across Texas, the average FMR is $1,172. In addition, 32% of survey respondents and 55% of key informants said that affordable housing is a resource/service that is missing in Fort Bend County.
Prenatal Care Access
The last priority issue Rai shared was about prenatal care, which has been viewed as a strategy to improve pregnancy outcomes for more than a century. Fort Bend County has higher rates of low birthweights than the national goals set by Healthy People 2020. In addition, in Fort Bend County, there has been a 10-percentage point drop in women who receive prenatal care from 2019 to 2020, and in that same time period, the percentage of pregnant women receiving no prenatal care in Fort Bend County increased more significantly compared to the state and the nation.
Paving a Path Forward
In closing, Rai shared how the data collected by FBCHHS reflects similar data to what was presented by Understanding Houston. She shared that as a health department, they share this information to get feedback on how the community should work together to address these priority issues.
Attendees then broke into smaller groups where members of the FBCHHS staff facilitated discussions. Each group picked one of the five priority topics to brainstorm solutions around. All discussions and data shared within each group were logged by an FBCHHS staff member. Information was also shared about ways different people or organizations can participate in addressing these priorities.
If you are interested in learning more about the data presented or attending an upcoming program, please contact understandinghouston@ghcf.org.
