New nonprofit coalition will aim to break cycles of disease, starting in South San Antonio

A new, cross-sector nonprofit coalition will bring people together to address health disparities in South San Antonio.

Dr. Lyssa Ochoa, vascular surgeon and founder of the San Antonio Vascular and Endovascular Clinic, the only Medicare-accredited surgical center on the South Side, is spearheading the effort and plans to file paperwork to create the nonprofit by the end of the year.

The coalition needs funding first, then will challenge developers, nonprofits, schools, city and county government to sign onto the effort to create an ecosystem for health.

The cross-sector coalition will define a master plan beginning on the South Side, which has areas affected by economic instability that creates psychological and physical stress, plus physical inactivity. 

It will also make an effort to fulfill the need for hospital beds for the underserved South Side.

Health care is a big part of the coalition, but it’s not all of it, Ochoa said.

With health disparities causing a 20-year difference in lifespan on parts of the South Side compared to parts of the North Side, the coalition will help create healthy neighborhoods physically, but also economically and through community.

“That’s what it’s going to take to change what’s going on in these neighborhoods,” said Ochoa, whose SAVE Clinic serves 6,000 patients a year for artery or vein issues. 

The coalition, which is in the process of identifying board members and target grants, would work on the social determinants of health, ensuring access to parks, healthy foods, health care, Wi-Fi, good air quality and transportation in neighborhoods.

Right now, some San Antonio families live in scarcity and in stressed situations, often involving domestic violence issues, higher rates of uncontrolled type 2 diabetes, obesity and higher rates of diabetic amputations, Ochoa said.

The data reported by Metropolitan Health District reflects the issues are prominent. Social determinants of health affect underserved areas, like zip codes 78221, 78214 and 78235 on the South Side. Barriers in education, like access to early childhood education, leads to unhealthy diets, due to food insecurity or food deserts. 

Without access to social support, or quality and affordable health care, people living in these neighborhoods suffer from diabetes and cardiovascular issues, like hypertension, hypercholesterolemia, diabetes, obesity and thrombosis, leading to mortality. And diabetic amputations, the highest portion of which happen on the South Side of San Antonio. 

Diabetic amputations are usually a sign of higher risk of mortality within a population, and it’s preventable, Ochoa said. Data shows that people, including uninsured populations in underserved areas, need access to care to treat uncontrolled diabetes, she said.

“We can control diabetes,” Ochoa said. “Our diabetic patients, by the time they have bad circulation, they’ve already had damage to the nerves in their feet, where they don’t feel very well and they have numbness. They may step on something and not even notice.”

According to the San Antonio Metropolitan Health District, lower limb amputations due to diabetes in Bexar County are higher than the statewide average.

Diabetes amputations by zip code in Bexar County show that the South Side, West Side and East Side have had more diabetic amputations than the rest of the county.

Bexar County’s East and Southeast sides also have higher rates of pre-diabetes diagnosis and heart attacks, combined with higher rates of diabetic amputations. This happens when uncontrolled, type two diabetes causes buildup of cholesterol and plaque inflamed and clog arteries.

Public Health frameworks, like the one Ochoa is organizing, are recommended for reducing health inequities, according to the 2022 Community Health Needs Assessment, the most recent report available.

“We don’t have to fix every single problem,” Ochoa said. “But we have do is get the dedication of our communities of our leaders, our education partners, workforce partners, developer partners, that we all want better for our families, and we want better for their children.”

An ongoing challenge is breaking generational patterns, she added.

“I literally have patients in their 40s … like ‘Well, I knew I was gonna end up like this, because my father did, my uncle did, my grandfather did. All of them had amputations and are on dialysis,'” Ochoa said. “So they have a life where what they foresee in their future is one that is not a happy future. They expect this to happen to them. So how do we change that vision for their futures?”

But a much bigger issue in South San Antonio is that there aren’t enough primary care doctors — or hospitals — to meet the patient population’s needs.

Since the closure of Texas Vista Medical Center, only one hospital remains on the South Side — which will be the case for at least three more years. University Health is the planning to bring Palo Alto Hospital to the South Side. 

The Baptist Health System, CHRISTUS Health and Methodist Healthcare have said there are no plans to open additional hospitals on the South Side in the coming decades. 

But even with 166 more beds coming to the South Side in 2027, it’s not enough, Ochoa said. The South Side will still have only .37 beds per 1,000 population, compared to more than 2.94 beds per 1,000 people on the North Side. 

In perspective, that means there are only 100 beds per 713,254 people, the estimated population living on the South Side. On the North Side, there are 4,196 beds per a 1,426,509 population, according to 2023 data by University Health System. 

Mission Trail Baptist Hospital CEO Erik Frederick said beds at the only hospital on the South Side stay full, including the ones in medical surgical and critical care, and in the telemetry unit for patients with cardiac services.

“The majority of our blue-collar workers in San Antonio come from the South Side,” Ochoa said. “They’re the ones that clean up after us after we do surgery in the operating room, they’re the ones that take care of us in hotels, they wash the dishes in restaurants we go to.

“They really are the foundation of San Antonio,” Ochoa said.

In a statement, CHRISTUS said it will continue to “assess the needs of the women and children of our community,” and will grow with those needs. 

There are no plans to expand Mission Trail Baptist Hospital or open another location on the South Side in the coming decades, its CEO said. Instead, it will focus on improving and upgrading. Frederick said that last year, the hospital got two new robots for surgery and urology worth $1.5 million, completed a $1 million design plan to expand operating rooms and cardiac cath labs with more capacity, and got new CT machine replacements worth over $1 million and a new MRI scan.

“The fact that there’s overwhelmingly so many more resources of health for acute, preventative or primary care on the North Side compared to the South Side [gives] these communities who already have disadvantages … more burden on them by not giving them the access to acute care. How can we ever expect them to overcome the challenges of poverty?” Ochoa said.