Houston Endowment Funds Research on the Uninsured

Collaborative project supports local response to health care challenge

It’s a huge problem, understood mainly in general terms – 1.1 million people in the Houston metropolitan area lack health insurance, nearly a third of all residents.

Charles Begley, Ph.D.

A new research center in The University of Texas School of Public Health is leading local efforts to understand the details of this issue and helping policymakers address the challenge under a $485,429 grant from the Houston Endowment over the next three years.

“We have severe problems providing health care to the uninsured in Houston, but exciting and interesting things are happening locally, and we are right in the middle of it,” said Charles Begley, Ph.D., codirector of the School of Public Health Center for Health Services Research.

The center is the focal point of the Houston Health Services Research Collaborative, which is funded by the Houston Endowment grant and includes participants from virtually every institution interested in the issue.

Begley, a professor of management, policy and community health, says that intense interest – by Harris County, the City of Houston, the Greater Houston Partnership, Texas Medical Center institutions and a variety of other organizations – is what’s exciting about tackling this daunting issue.

“There are things going on. There is recognition of the problem, there’s openness about our inadequacies and the issues, and a willingness to make some changes,” Begley said.

The research collaborative will focus on three major tasks during the next three years:

Identify and study six local issues related to the uninsured.
Develop and maintain a database to monitor the overall problem, including improvement in access to care and health status of the low-income uninsured population.
Provide technical assistance to community leadersfor proposals to the federal government to fund programs for the uninsured.

Step one is under way with the help of a 19-person advisory council. Topics will include surveying the uninsured to get a better idea of their circumstances and where and how they get health care. Compiling a solid inventory of primary care capacity in the community, both public and private, is planned. Monitoring emergency room use for primary care also is likely to be studied.

Accurate information will be important to cooperative local efforts, which will require better coordination and better use of resources to succeed, Begley said. A push is under way to improve coordination of health services among Harris County Hospital District, city and county health departments, the Mental Health and Mental Retardation Authority, and the UT Harris County Psychiatric Center. Harris County Commissioners Court created a council for that purpose in January.

Center researchers also worked with the Greater Houston Partnership Public Health Care Task Force, which issued a report last October calling for an integrated health care delivery system, building greater capacity for community-based care and increasing the number of insured residents through a variety of means.

By Scott Merville, Public Affairs