Quantifying the Struggle to Live Here

This map of the county shows high and moderate concentrations of families in poverty. (Photo by Screenshot via Central Health)

A new demographic report from Central Health illustrates the barriers low-income residents of Travis County are facing as they try to access healthcare in the wake of the COVID-19 pandemic.

Central Health, the public hospital district that primarily serves low-income residents of Travis County, has produced Demographic Reports on its patient population and the state of healthcare for low-income residents since 2015. In the years since that first report was released, the landscape of poverty and need in the county has shifted significantly.

“Low-income has become redefined,” said JP Eichmiller, Central Health’s director of strategy and information design. “I think the low, middle, upper-income have completely been transformed since 2015. Just regionally, even five years ago, I believe… about 30 percent of the housing in the region was below $250,000. And now that’s down to less than five percent.”

That’s had a major impact. In the past, Eichmiller said, poverty in Travis County was mainly concentrated in places like ​​Pflugerville, Manor, and Hornsby Bend. But the 2022 demographic report, the first conducted since the onset of the pandemic, found that there is now significantly more poverty in the I-35 corridor neighborhoods in Austin itself, ranging from Del Valle and Montopolis in the southeast part of the city to St. John’s and Windsor Park in the northeast.

“We are seeing that even though Austin is becoming less and less affordable, it’s becoming even more the key access point for healthcare, affordable housing, transportation services and other social services,” said Monica Crowley, chief strategy officer at Central Health. “So even though it is more expensive, Austin and Travis County is where people are able to receive help.”

People living in East Central Austin are most negatively affected by health inequities, but the report found that race and ethnicity, more than a person’s zip code, is the top factor driving health inequities. Black patients were 30% more likely to have cardiovascular disease, and 40% more likely to have hypertension than Central Health’s overall patient population, while Latino patients were 10% more likely to have diabetes. No matter where people live, and no matter their proximity to a hospital or clinic, simply accessing care in a timely manner was a major barrier for low-income residents. Consistent care is a necessity for many Central Health patients, 40% of whom had at least one chronic condition. And that rate was up to twice as high for the houseless population.

Central Health is aiming to offer more direct health services of its own instead of contracting with other providers in the coming years, a change that Crowley said will allow the organization to offer more specialty care. She also hopes that, even if they won’t expand Medicaid, the state legislature will look at making small changes to better the care landscape – like letting new mothers stay on Medicaid for 12 months after giving birth instead of just two. “Anything along those lines is helpful,” Crowley said.

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