Building and Advancing Coalition Capacity to Promote Health Equity: Insights from the Health Equity Collective's Approach to Addressing Social Determinants of Health.

This article presents the structure and function of the Health Equity Collective in developing a systemic approach to promoting health equity across the Greater Houston area. Grounded in Kania and Kramer's five phases of collective impact for coalition building, The Collective operationalizes its mission through its backbone team, steering committees, and eight workgroups; each has goals that mutually reinforce and advance its vision. To date, Phase I (generating ideas), Phase II (initiating action), and Phase III (organizing for impact) have been completed.

Leveraging a health information exchange for analyses of COVID-19 outcomes including an example application using smoking history and mortality.

Understanding sociodemographic, behavioral, clinical, and laboratory risk factors in patients diagnosed with COVID-19 is critically important, and requires building large and diverse COVID-19 cohorts with both retrospective information and prospective follow-up. A large Health Information Exchange (HIE) in Southeast Texas, which assembles and shares electronic health information among providers to facilitate patient care, was leveraged to identify COVID-19 patients, create a cohort, and identify risk factors for both favorable and unfavorable outcomes. The initial sample consists of 8,874 COVID-19 patients ascertained from the pandemic's onset to June 12th, 2020 and was created for the analyses shown here.

Population-Based Estimates of SARS-CoV-2 Seroprevalence in Houston, Texas as of September 2020.

Background: In contrast to studies that relied on volunteers or convenience sampling, there are few population-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence investigations and most were conducted early in the pandemic. The health department of the fourth largest US city recognized that sound estimates of viral impact were needed to inform decision making.

Methods: Adapting standardized disaster research methodology, in September 2020 the city was divided into high and low strata based on reverse-transcriptase polymerase chain reaction (RT-PCR) positivity rates; census block groups within each stratum were randomly selected with probability proportional to size, followed by random selection of households within each group.

Understanding Associations Between Hurricane Harvey Exposure and Mental Health Symptoms Among Greater Houston-Area Residents.

Objective: Hurricane Harvey made landfall on August 25, 2017 and resulted in widespread flooding in Houston and the surrounding areas. This study aimed to explore the associations between exposure to Hurricane Harvey and various mental health symptoms.

Methods: Self-reported demographics, hurricane exposure, and mental health symptomatology were obtained from residents of the greater Houston area through convenience sampling for a pilot study, 5 months after the storm from January 25-29, 2018 (N = 161).

Differences in nativity, age and gender may impact health behavior and perspectives among Asian Indians.

Objective: Identify health perspectives among Asian Indians in greater Houston area, to guide a tailored community wide survey.

Design: Four focus groups of different ages, gender, and nativity were conducted at which participants were asked for their opinions about specific health topics. Key informant interviews were conducted with ten community leaders to validate focus group responses.

Chronic Health Conditions, Physical Activity and Dietary Behaviors of Bhutanese Refugees: A Houston-Based Needs Assessment.

Bhutanese refugees resettling in the U.S. face many challenges including several related to health and health care.

A1C Testing and its Sociodemographic Predictors: Implications for Diabetes Self-management Programs.

Background: One of the Healthy People (2020) goals related to the glycated hemoglobin (HbA1C) test is to increase the percentage of adults (aged 18 years and older) with diabetes who have had an HbA1C test at least twice in the past 12 months from 64.6% percent in 2008 to 71.1% by 2020.

Characterizing urban vulnerability to heat stress using a spatially varying coefficient model.

Identifying and characterizing urban vulnerability to heat is a key step in designing intervention strategies to combat negative consequences of extreme heat on human health. This study combines excess non-accidental mortality counts, numerical weather simulations, US Census and parcel data into an assessment of vulnerability to heat in Houston, Texas. Specifically, a hierarchical model with spatially varying coefficients is used to account for differences in vulnerability among census block groups.

Do people become better prepared in the aftermath of a natural disaster? The hurricane Ike experience in Houston, Texas.

Objective: Despite large-scale efforts and expensive public education campaigns mounted by the government at all levels in the past decade, the improvements in disaster preparedness among the US Gulf Coast residents have been ineffectual at best. Some factors that contribute to better preparedness are past experience, awareness of what to do in a disaster scenario and availability, and access to informational and supportive resources. We examine whether an experience of a natural disaster brings about changes in preparedness and access to resources.

Determinants of fruits and vegetables consumption among persons with doctor-diagnosed chronic diseases.

Objective: The objective of this study was to examine the factors associated with fruits and vegetables consumption pattern among persons with doctor-diagnosed chronic diseases.

Method: The authors examined cross-sectional, random-digit-dialed health survey data collected in 2008 in Houston, Texas, a city with a diverse ethnic population. The survey sample, which was designed to represent all households with telephones, was drawn using standard list-assisted random-digit-dialing methodology from telephone exchanges that serve the study area.

Disparities in fruits and vegetables consumption in houston, Texas: implications for health promotion.

Background: The consumption of the recommended amount of fruits and vegetables is believed to help prevent nutrient deficiency disorders and lower the risk of several chronic diseases. Information on the disparity of fruit and vegetable consumption may be useful in designing targeted health promotion programs for increasing fruit and vegetable consumption. The objective of this pilot study was to examine disparities in fruit and vegetable consumption among Houston residents based on sociodemographic characteristics.

Disaster preparedness of linguistically isolated populations: practical issues for planners.

In the absence of culturally and linguistically appropriate disaster preparedness plans, several linguistically isolated and culturally diverse population groups are disproportionately disadvantaged in the United States. The communication gap poses challenges to emergency preparedness planners and response personnel in predisaster communication and postdisaster response efforts. Houston Department of Health and Human Services aimed to develop practical recommendations for local emergency response personnel so as to improve dissemination of emergency information and equitable delivery of services to linguistically isolated communities in the greater Houston area.

Prenatal Care Barriers in an Inner-city Neighborhood of Houston, Texas.

The objective of this qualitative pilot study was to explore barriers to prenatal care among women (aged 17 to 30 years) with pregnancy experience who resided in an underserved and predominantly African American neighborhood in Houston, Texas. The authors conducted 5 focus group discussions with, and collected demographic information from, the 32 participants. Discussions were audiotaped, transcribed, and analyzed manually.

Community-based participatory research in disaster preparedness among linguistically isolated populations: a public health perspective.

Working with linguistically isolated immigrants on public health issues poses a set of methodological challenges unique to this population. We used community-based participatory research (CBPR) techniques to investigate the disaster preparedness needs of four linguistically isolated population groups in Houston, Texas (Vietnamese, Chinese, Somali, and Spanish-speaking) in partnership with community-based organizations and community researchers. As a local health department conducting CBPR, we witnessed various challenges, including: engaging and using interpreters versus using community researchers; translating focus group questions from English to other languages; recruiting participants from linguistically isolated populations; and handling issues of community power, data collection, and data reliability.

CAN DO Houston: a community-based approach to preventing childhood obesity.

Background: Comprehensive, community-based efforts may reduce rates of childhood obesity.

Community Context: Almost half of the children in Houston are overweight or obese, even though Houston has many available resources that support good nutrition, physical activity, and prevention of weight gain among children.

Methods: We used existing resources to implement a community-based, childhood obesity prevention initiative in 2 low-income neighborhoods in Houston.

Self-reported health, functional status and chronic disease in community dwelling older adults: untangling the role of demographics.

Self-reported health, a widely used measure of general health status in population studies, can be affected by certain demographic variables such as gender, race/ethnicity and education. This cross-sectional assessment of the current health status of older adult residents was conducted in an inner-city Houston neighborhood in May, 2007. A survey instrument, with questions on chronic disease prevalence, health limitations/functional status, self-reported subjective health status in addition to demographic data on households was administered to a systematic random sample of residents.