Mayor Ivy Taylor

2017 Candidate Questionnaire

2017 Mayoral/City Council Candidates

Health Care Questions

Ivy Taylor

1.   Despite affecting everyone in this community, "community health and wellness" has not been a big priority at City Hall. "Community health and wellness" had one third of the ranking that "streets" received in community input via SpeakUPSanAntonio. Yet it impacts our well being, workforce, economic development and the prosperity of San Antonio.

What health-related areas do you think deserve increased attention, priority, and local resources, and, if elected, how would you elevate the discussion of these health issues at City Hall and lead effective action to improve health and healthcare in our community?

1        Teen pregnancy, obesity and subsequent diabetes rates, and access to healthy food. From my experience with the Mayor’s Fitness Council -- which have already focused on communications, community, health care, and healthy schools -- and the San Antonio Business Group on Health, I would also include teen pregnancy. 

2.  Bexar County is the primary source of funding for indigent health care in our area through the Bexar County Hospital District and University Health System. How would you, if elected, promote cooperative efforts to increase services and access to care for the citizens of San Antonio?

Through a close working relationship with Bexar County Judge Nelson Wolff, I have coordinated on several efforts, including the creation of the Criminal Justice Coordinating Council (CJCC). This joint effort focuses on several issues such as reintegration and mental health in the criminal justice system. If re-elected, I will explore the feasibility of additional services and access to care for the citizens of San Antonio. 

3.  The disparity of health care between our poorest and wealthiest zip codes/districts is quite striking (Bexar County Health Collaborative 2016 report). How would you, if elected, reduce health disparities and improve health outcomes for our lower income communities/citizens?

1        I consider education to be the great equalizer, and, long term, I see the issue of health disparities and improving health outcomes as no different. By improving educational outcomes for our most vulnerable populations, the disparity between the poorest and wealthiest zip codes could be reduced. In the short-term, I think community-wide education efforts to inform lower-income citizens of existing programs is a step in the right direction. 

4.  San Antonio has a high incidence of obesity and diabetes mellitus and has been ranked as high as second in the nation for obesity in recent years. Past city efforts attempting to improve these rates, such as trying to reduce the prevalence of sugary drinks in our community, have been met with controversy. What ideas do you have to reduce the incidence of these chronic health issues?

1        Again, I believe education is key in reducing the incidence of these chronic health problems. Although the city has some jurisdictional responsibility, just as much if not more lies with the food and grocery industries. As someone who lives in the East Side, I can tell you from firsthand experience the difficulty it can be in buying healthy food in certain parts of town, also known as food deserts. Just as it shouldn’t matter which zip code you live in to determine your educational outcomes, it also shouldn’t matter when it comes to having access to healthy and nutritious food. 

5.  According to the CDC, child abuse and neglect are serious problems that can have lasting harmful effects on its victims. The goal in preventing child abuse and neglect is clear — to stop this violence from happening in the first place. What local policies, resources and efforts will you support to promote safe, stable, nurturing relationships and environments for all children and families?

1        Promoting safe, stable, nurturing relationships and environments for all children and families is something that comes in all shapes and sizes. At the municipal level, the city of San Antonio promotes via delegate agency funding many programs that promote these causes. Mentorship in particular has been a focus of mine, whether as a Big Sister in Big Brothers Big Sisters, or through my efforts with My Brother’s Keeper, which seeks to improve outcomes for boys and men of color in our community. 

CD 8 Manny Pelaez

2017 Candidate Questionnaire

2017 Mayoral/City Council Candidates

Health Care Questions

Manny Pelaez, District 8

1.   Despite affecting everyone in this community, "community health and wellness" has not been a big priority at City Hall. "Community health and wellness" had one third of the ranking that "streets" received in community input via SpeakUPSanAntonio. Yet it impacts our well being, workforce, economic development and the prosperity of San Antonio.

What health-related areas do you think deserve increased attention, priority, and local resources, and, if elected, how would you elevate the discussion of these health issues at City Hall and lead effective action to improve health and healthcare in our community?  San Antonio is woefully low on the list of cities that are considered walkable. Except for a small handful of walkable pockets and parks, San Antonio offers very little for citizens who want to bike, walk, jog, and play outside.  Social scientists now know that where a person lives is inextricably tied to how a person lives and that person’s health.  I, and many others, are alarmed at San Antonio’s health problems that have direct relationships to how our city is laid out, developed, and planned. I am particularly alarmed by city planner’s refusal to embrace walkability as a best-practice for future development.  We need city council leadership that is willing to admit something very difficult to admit: That we’ve been doing it all wrong.  If elected I will make walkable communities the topic of a long and difficult discussion with planners, developers, neighborhood associations, the medical community, schools, VIA, and opinion leaders. I will force a long overdue conversation about changing the way we have allowed San Antonio to develop. We can no longer apply the car-centric model of planning and thumb our nose at science. 

2.  Bexar County is the primary source of funding for indigent health care in our area through the Bexar County Hospital District and University Health System. How would you, if elected, promote cooperative efforts to increase services and access to care for the citizens of San Antonio? I am the General Counsel for Family Violence Prevention Services, also known as The Battered Women & Children’s Shelter. I have first hand experience and expertise in delivery of services to vulnerable populations. I also have hands-on experience with creating coalitions between government and private organizations for the purpose of  The county and city governments have done significant work in bringing private institutions to the table to help address problems related to indigence; San Antonio can and must do more. Other cities, such as San Diego and Chicago, invest much more (per capita) in time and money creating opportunities for NGOs, hospitals, medical schools, and private practitioners to leverage their own expertise in helping the communities address problems like diabetes, cancer, infectious disease, alcoholism, child abuse, and mental health.  We must look to those cities that are being bold in this regard and we must not be shy from adopting their strategies.  Also, we must be more demanding of ourselves and hold each other more accountable.  I plan on creating an incentive program so that the city will reward medical students, dental students, and nursing students for their pro-bono community service. My aim would be to inculcate in them a desire to keep serving after they graduate. 

3.  The disparity of health care between our poorest and wealthiest zip codes/districts is quite striking (Bexar County Health Collaborative 2016 report). How would you, if elected, reduce health disparities and improve health outcomes for our lower income communities/citizens? See answer to question #1.  I believe that walkability and transit is also directly related to making it more difficult for people to access resources, go to school, travel to and from work, and traverse the city to visit their doctors.  There is no debate that access to resources and access to school, work, and healthcare are essential to bridging the gap between poverty and thrivability.  A quick look at the poorest neighborhoods in San Antonio reveals to any observer that those neighborhoods were not built or designed with access in mind.  In order to ameliorate our poor citizens' lack of access we must commit ourselves to a transit system that is efficient and sustainable. To that end, I will work with VIA, the Metropolitan Planning Organization, the Advanced Transportation District, the Economic Development Foundation, schools, and the healthcare industry leaders to recommit ourselves to the most basic of principles: That a world-class city seeking to progress and evolve must not leave its vulnerable populations behind.  

4.  San Antonio has a high incidence of obesity and diabetes mellitus and has been ranked as high as second in the nation for obesity in recent years. Past city efforts attempting to improve these rates, such as trying to reduce the prevalence of sugary drinks in our community, have been met with controversy. What ideas do you have to reduce the incidence of these chronic health issues? First, we need city leadership that is willing to face controversy head-on. Effective leadership requires us to be unafraid of critics and those special interests that make money from selling products that imperil our citizens’s health. (eg. smoking in restaurants, vape shops, etc). Second, we know that prohibition and heavy-handed regulations rarely work.  But, we certainly know that incentive programs DO work.  As such, I will push city council to consider tax and fee abatements to restaurants and hotels that demonstrate adoption of healthy menus. I will push our council to adopt tax and fee abatement for large employers that institute healthy lifestyle programs that result in their workforce’s weight loss or achievement of other healthy lifestyle metrics. These are not innovative and unique programs - - they already exist and have proven effective in other cities.

5.  According to the CDC, child abuse and neglect are serious problems that can have lasting harmful effects on its victims. The goal in preventing child abuse and neglect is clear — to stop this violence from happening in the first place. What local policies, resources and efforts will you support to promote safe, stable, nurturing relationships and environments for all children and families? Child abuse, domestic violence, substance abuse, and mental health are enmeshed and should be approached with a no-silos strategy.  I have dedicated my career to domestic violence and child abuse prevention. In my work with the Rape Crisis Center, the Battered Women & Children’s Shelter, the criminal courts system, the jail system, and the Texas Family Violence Council I have come to realize that San Antonio is in the throes of an epidemic of violence and abuse.  Thankfully, our local judges, law enforcement, district attorney, and County leaders have dedicated mountains of resources, time, and effort to address the problem of abuse and violence. But more can be done.  We must bring churches, schools, and doctors to the table. Oftentimes, teachers, doctors, and pastors are the first to see the signs of abuse. City Council must create a network of advocates and watchdogs.  Doctors, teachers, and pastors must be given quick and easy-to-access resources to help them respond to concerns of abuse.  We must also work together to help each other track at-risk citizens to make sure that  someone is always watching and so that they do not get lost because of a lack of interconnectedness between those of us that care.  

International Day of Yoga - June 17, 2017

Mayoral candidate Ron Nirenberg

BCMS QUESTIONNAIRE

Ron Nirenberg April 2017

Despite affecting everyone in this community, "community health and wellness" has not been a big priority at City Hall. "Community health and wellness" had one third of the ranking that "streets" received in community input via SpeakUPSanAntonio. Yet it impacts our well being, workforce, economic development and the prosperity of San Antonio.

As a city we must address the social determinants of health, particularly in those areas of San Antonio with the greatest health disparities.

An individual’s health and wellness is directly linked to the quality of their environment. Safe communities mean safe streets that lead to healthier communities.

Sidewalks, well-lit streets, no stray dogs, and slower residential traffic all lead to people walk more in their neighborhoods, and regular walking can improve myriad health outcomes. But since 2010, the neighborhood walkability score decreased from 44 to 34 for the city overall. We must improved street and sidewalk infrastructure in these neighborhoods, while we also focus on neighborhood crime prevention.

What health-related areas do you think deserve increased attention, priority, and local resources, and, if elected, how would you elevate the discussion of these health issues at City Hall and lead effective action to improve health and healthcare in our community?

As a city we need to focus on healthy families and safe communities. Improved infrastructure such as sidewalks, parks, well-lit streets, streets without stray and dangerous dogs mean families can walk and play. They can participate in community activities and engage with neighbors. Such physical activities lead to safer and healthier communities.

In San Antonio, obesity and diabetes continue to be significant problems. While 14.2 percent of the Bexar County population diagnosed with diabetes, the burden is much higher in the near east, south, and near west sides.

Long-running programs like the Mayor’s Fitness Council have called attention to the importance of a healthier lifestyle. However, city leaders must become more active in public health groups such as the Bexar County Health Collaborative (BCHC) and other non-profits targeting specific diseases in the city.

We must coordinate with SAMHD to develop task forces to focus on specific public

health concerns, such as the opioid epidemic, which has impacted all socioeconomic groups. We will also work with community partners to develop a Public Health Advisory Committee to advise and make policy recommendations.

Finally, we should encourage local non-profit public health organizations through financial support and collaboration with city agencies to address specific health issues. This includes areas where needs are acute but also places where prevention will be needed as the city grows. And we will make community health data more accessible on the city’s website so that citizens can take ownership and track our progress as a community.

Bexar County is the primary source of funding for indigent health care in our area through the Bexar County Hospital District and University Health System. How would you, if elected, promote cooperative efforts to increase services and access to care for the citizens of San Antonio?

The City of San Antonio will work closely with Bexar County to evaluate current systems. We will work with VIA to improve transportation to clinics through frequent bus service in high need areas at the most needed times.

We will also work with SAMHD and the county to establish a system of community health workers (CHWs) in areas of greatest health disparity. This system is very common in the border regions of Texas and in San Antonio, the organizations serving the AIDS community utilize CHWs, and we will prove up the community cost effectiveness of this preventative approach versus dealing with the negative outcomes only when it is too late.

School based clinics in high need areas - such as those located in Harris and Hidalgo counties - provide basic health services to students and their families. In Harris County, the Baylor College of Medicine is part of the partnership. In San Antonio, we have indigent health clinics staffed by UTHSCSA medical students at Haven for Hope. The new medical school at UIW/Brooks City Base is establishing an “Adopt a Family” Program.

Some San Antonio school districts have school based clinics - though budget cuts have closed many - so the City should work with these institutions to enhance health care, cost effectively.

The disparity of health care between our poorest and wealthiest zip codes/districts is quite striking (Bexar County Health Collaborative 2016 report). How would you, if elected, reduce health disparities and improve health outcomes for our lower income communities/citizens?

First, we must recognize the social determinants of health, particularly in those areas of San Antonio with the greatest health disparities. For the city’s part, this means equity

for all parts of our city - particularly those most challenged - when we invest in infrastructure of service. An individual’s health and wellness is directly linked to the quality of their environment. Safe communities mean safe streets that lead to healthier communities.

Utilization of care is also a significant challenge. Clinics exist, but getting to them is difficult for many reasons. Community Health Workers (CHWs) and school based clinics can help residents understand their needs and direct them to the right resources.

By improving communities through safer streets and access to healthier foods, we improve overall quality of life, and this should also be a call-to-arms for partners in the public and private sector.. For example, HEB partnered with the FQHCs to provide nutrition education and information to promote healthier eating for pregnant women. The goal was to reduce the rate of gestational diabetes through a change in lifestyle. The City should convene interested businesses and organizations that can take on active roles in providing education and resources for these purposes.

San Antonio has a high incidence of obesity and diabetes mellitus and has been ranked as high as second in the nation for obesity in recent years. Past city efforts attempting to improve these rates, such as trying to reduce the prevalence of sugary drinks in our community, have been met with controversy. What ideas do you have to reduce the incidence of these chronic health issues?

We must ensure that health data and experts are driving the community health conversation, not politics. We will collaborate with Bexar County and with school district SHACs (School Health Advisory Councils) to include plans that limit sugary foods and drinks at school and educate residents about overconsumption of sugar. And by improving communities through better parks, safer streets, and increased walkability, we will encourage more physical activity among the general population. This promotes healthy living and decreases the risks of obesity and diabetes.

Nutrition education must also be incorporated into the area science curricula. For example, SAMHD and the BCHC can work directly with school districts to incorporate curriculum that shows how healthy food and drink choices - as opposed to increased sugars in processed foods and drink - have a positive impact on the body.

As a city, we can promote gardening, sustainability programs in the schools. COSA should partner, including through land use policy, with non-profits like Green Spaces Alliance, to provide long-term programs in the schools with greatest need. For example, Bonham Academy, a land-locked school, managed to find space to create garden beds, setting them up in a tiny space between the portable classroom buildings.

According to the CDC, child abuse and neglect are serious problems that can have

lasting harmful effects on its victims. The goal in preventing child abuse and neglect is clear — to stop this violence from happening in the first place. What local policies, resources and efforts will you support to promote safe, stable, nurturing relationships and environments for all children and families?

First, we must ensure that Community Safety Net programs, such as those that provide services to victims of child abuse and neglect and family violence, are not stripped of needed funding during the city budget process. In addition, we should continue to enhance the delegate agency funding process to recognize the continuum of care that will comprehensively deal with perennial challenges like homelessness. For example, data shows that the vast majority of our homeless population are victims of domestic abuse, struggle with addiction, or have untreated mental health issues. So when set goals for addressing homelessness and allocate funding accordingly, we should also consider and support organizations that deal with these associated challenges.

In addition, the City must work with local and state leaders and agencies to track data and effectiveness of our strategies. Our local legislative agenda should seek to partner with area delegations that improve transparency and access to information needed by health practitioners and and city and county officials.

Finally, city policy and investments should reflect a focus on children and the impact to the next generation. We should fully support and join in with the Bexar County Children’s Agenda recently launched by ReadyKidSA, a coalition of organizations devoted to ensuring that area children grow up healthy and educated for the future.

This means ensuring equity of services and infrastructure on all sides of town so that no matter where families are raised in San Antonio, they can thrive in a safe, affordable and high quality community.

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