Community Participation Report

Community Assessment Neighborhood Meetings*

Executive Summary
As a follow-up to the “Hearing Community Voices” meeting, a series of meetings was conducted to learn how residents from around Bexar County feel about the health of their neighborhoods. Nine meetings with 13 to 28 participants collected ideas from community residents in response to the question, “What would it take to make your community a healthier, safer, better place to live?”

Findings from neighborhood meetings confirm that residents of Bexar County view community health in the context of the Determinants of Health Model. Participants in neighborhood meetings were asked to provide input based on their knowledge of what would make their community a healthier, safer, better place to live. Five classifications of responses were identified:

• Infrastructure and environment
• Community programs
• Education
• Crime and safety
• Healthcare facilities

Infrastructure and environment responses are mostly about making the physical environment more suitable to the needs of people living in communities. Participants indicated that good streets, sidewalks, streetlights, and parks help them feel safe and good about the communities in which they live. They want community centers and libraries. It is not surprising that residents also want to have quality places to shop, places to take their families for healthy meals, and venues for entertainment. Many of the suggestions about improved consumer opportunities came from meetings held in the south and west areas of the county. Many participants from all over the county indicated that improved public transportation would improve the quality of life in their community.

Ideas classified as community programs are connected to infrastructure and environment. Closely coupled with suggestions for community centers and parks is the desire for programs that support communities. Many of the suggestions offered are intended to enhance the social environment in the community. These included ideas, such as after-school programs, parenting classes, child care, and adult daycare. Many of the suggestions are aimed at increasing access to recreational facilities that improve opportunities to exercise. Participants indicated an interest in having more sports fields, walking trails, skate parks, and bike trails. An exercise-friendly environment could be an important step toward supporting an increase in physical exercise. This could contribute to a change in attitudes and behaviors of a population that is burdened by problems related to being overweight.

There also are links between participants’ ideas about education and their concerns about infrastructure and community programs. Many participants supported having community centers that offer educational programs. There was significant support for libraries that, in addition to housing educational materials, often have programs and classes that help local residents increase their knowledge. Participants in neighborhood meetings indicated concern about in a wide variety of topics that impact the vitality of communities, including life skills, strengthening families, health and nutrition education. Some of the educational topics were aimed at developing individual capacity and many indicated interest in improving the quality of life in communities.

Statistical reports from the 2006 BCCHA clearly indicate that health in Bexar County would benefit from more primary prevention efforts. Community leaders and policy makers can encourage residents to take initiative to improve both their own physical condition as well as that of their neighborhood by supporting efforts to improve the infrastructure to meet the needs and desires of the people who live in their jurisdictions.

The methodology designed for these meetings focused on how to make the community healthier, safer, better. Had the question been to identify needs, problems, and health concerns, results may have been different. In addition to collecting information about how people would like to see their neighborhoods improved, the design was developed to help participants think about how they can contribute to their communities. These results suggest that many of the participants have an understanding that there is a benefit from people working together for mutual good and that social interaction can be a catalyst to strengthening the resources already available.

Crime and safety are always concerns in communities. What is interesting is that in these community meetings, suggestions about making their communities healthier, safer, better places to live contained far more ideas about the infrastructure, community resources and education than were given for crime and safety. An increased enforcement of speed limits and greater police presence were major suggestions in this classification, but there were also many ideas that involved the community, such as neighborhood watch. Other thoughts offered about making neighborhoods safer included things like more street lights, crosswalks and school crossing signs. Local newspaper reports tend to focus on violent crime, drive-by shootings, drug-related crime, and burglary and theft, yet when thinking how to make their neighborhoods healthier, residents do not rank these topics as a large concern. While participants want to live in a safe neighborhood, they are also interested in providing programs for people dealing with problems.

Healthcare as a classification ranked fifth as a priority to make neighborhoods healthier, safer, better places to live. Not surprising is that concerns about healthcare ranked first for the “over 65” population. Participants wanted improved access to health services, more access to health specialties, pharmacies open in off hours, and wellness centers. Suggestions in this classification also included retirement homes and drug rehabilitation centers. Education about health, exercise, nutrition and other topics related to health also connected to community interest in health. The fact that interest in health and related topics is important to participants but falls far below other concerns that they felt would improve their sense of living in a healthy community is consistent with the Determinants of Health Model. Most people live their day-to-day lives with the assumption that they are vital and healthy. It is only when their physical condition prevents them from conducting their lives in a reasonable way that most people’s thoughts turn to the healthcare system. When they need it, they expect that a good reliable and accessible system will be available to them.

Overall the findings from the neighborhood meetings are consistent with the results of the “Hearing Community Voices” meeting. Information collected in the neighborhood meetings provided more detail about interests and concerns from residents from across Bexar County that can be useful in making this a healthier, safer, better place to live. These are issues that must be addressed systematically and with consistency. It will take time to work with residents to develop healthier neighborhoods. Using the words of San Antonio’s City Manager, Sheryl Sculley, “this is a marathon, not a sprint.⁸⁷”