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.
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.