The Health Collaborative

Tuesday, January 13, 2015

Improving the Health Status of the Community by Supporting Family Health and Fitness

Diana Guzman is a changed woman. Beginning with Zumba classes offered by Project Measure Up (PMU), a program of The Health Collaborative (THC), she lost 68 pounds and improved her health. She was able to attend close to home — at the Scheh Center in the Harlandale Independent School District. As she starts her third year of free classes, she is down 68 pounds and has gone from a size 26–28 to a size 10. Her blood pressure is lower, too. The pain she felt in her feet and knees is gone. Now she walks five miles a day.

“Project Measure Up is fantastic,” says Guzman, 46. “They motivate me and help me do my best.”

PMU is designed to decrease weight problems in youth and families. It is a team effort that includes all THC member organizations, schools, volunteers and families. From January–October 2014, PMU served 10,475 people at 36 locations in San Antonio, Harlandale and Northside Independent School Districts and other sites in Bexar County.

“Diana is a great example of The Health Collaborative’s work,” says Elizabeth Lutz, THC Executive Director. “We are working to improve health, not just for Diana, but for the many families in Bexar County who can make better choices for themselves.”

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Rita Hernandez leads a PMU Zumba class.

As an emergency room tech for 10 years, Rita Hernandez saw families in need, families who did not have the resources for exercise classes or nutrition counseling. As a result, their health was suffering.

Hernandez was already offering free fitness classes through her own organization, Inspiration 4 Life, when she became a master trainer for the Zumba classes THC was offering at local high schools. She joined a creative roundtable that included THC and the school districts.

“We wanted to change lives,” Hernandez says.

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PMU participants celebrated family fitness with a Zumbathon last May.

Guzman and Hernandez exemplify the work of THC, a small but cutting-edge nonprofit organization that brings together public and private partners to improve community health in Bexar County through collaborative means. Priority issues of The Health Collaborative include family health and wellness, health literacy, and youth mental health.

THC is committed to the importance of a comprehensive community health assessment every three years; to taking a leadership role to evaluate, develop, fund and implement programs and projects to improve community health; and to ensure that healthcare resources are used effectively to meet community needs.


Collaboration has been key to the success of THC.

“Most practicing physicians agree that in a community as large and diverse as San Antonio and Bexar County, health improvement for any population can only come through collaborative means,” says Charles Kight, THC Board Chair. “Such collaboration must involve physicians, other providers, patients and potential patients, payers and representative community leaders and stakeholders.

“These efforts are best informed by local research that documents our community’s conditions and provides a first-hand understanding of the challenging question: ‘What makes us sick?’”

Bexar County Community Health Assessment

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Elizabeth Lutz, THC Executive Director, and Charles Kight, Board Chair

THC began informally in 1997, when the Bexar County’s major healthcare organizations put aside their competitive business practices to conduct a comprehensive health needs assessment. This has become the Bexar County Community Health Assessment that directs planning and programming for health for three years at a time.

“Over the years, we have learned that the prevalence and severity of disease is rooted in both medical and non-medical factors,” Kight says. “Non-medical factors, also called ‘social determinants,’ include a population’s income, education, environment and behavior. Here in San Antonio, culture plays a significant role as a social determinant. With the impact of these social determinants in mind, THC serves as a forum to investigate ‘What makes us sick?’ and act on the follow-up question, ‘What works for health?’ Based on evidence, we can determine which policies and projects can be launched and sustained to make our community a healthier place to live, learn, work and play.”

With the community health assessment in hand, THC collaborates to produce a Community Health Improvement Plan (CHIP) for Bexar County, providing goals and strategies to improve health in San Antonio and Bexar County. The process includes planning and research conducted over 24 months with the participation and input of more than 85 agency partners and community stakeholders.

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THC releases the 2014 Community Health Improvement Plan to community leaders.

As a result of this effort, CHIP focus areas are healthy eating and active living, healthy child and family development, safe communities, behavioral and mental wellness, and sexual health. For each area, the CHIP provides medical and non-medical determinants, objectives, targets, strategies and partners/resources with time frames.

“We encourage healthcare professionals to review the health assessment and health improvement plan at, to use it to identify barriers that they and their patients face, and to share it with colleagues,” Lutz says. “Most of all, we ask them to use it as a vehicle to become part of the effort to improve health in our community.”

“As a critical project and resource of the Health Collaborative, the San Antonio Health Literacy Initiative (SAHLI) is crucially important in raising awareness about one of today’s most under-recognized and serious healthcare issues — the illiteracy of individuals at all socio-economic levels when it comes to health care. SAHLI addresses the problems of healthcare illiteracy in different ways, reaching out to patients, physicians and other health care professionals.”
— Adam V. Ratner, MD, Chairman, The Patient Institute

In addition to providing valuable data and references for local impact, THC is also an engaged community partner, offering year-round programs for families:

THC-Cover Shot 250Youth Mental Health. Young Minds Matter focuses on helping parents recognize youth mental-health issues and reducing the stigma attached to mental health problems through education, outreach and awareness of resources. YMM is led by the Youth Mental Health Council, a multidisciplinary group of community members with representatives from local agencies and organizations involved in supporting healthy young minds.

Several years ago, the YMHC began working with local pediatricians to reduce the stigma associated with youth mental health and provide resources for physicians and patients. This effort resulted in the Community Health Bridge (CHB), an online directory of more than 500 resources available in and around Bexar County. Since one need often leads to another, a range of services are included in the CHB, from family mental health services and counseling to housing and grocery assistance.

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Keynote speaker Dean Schillinger, MD, addresses the 10th annual Texas Health Literacy Conference, presented by THC.

San Antonio Health Literacy Initiative (SAHLI). “Can you hear me?” is a phrase readers probably recognize from television. Health literacy is more than hearing; it is about understanding. A person who is health-literate is able to hear, communicate, process and understand basic health information and services to make appropriate health decisions. The Institute of Medicine estimates that nearly half of all American adults, 90 million people, have difficulty understanding and acting on health information. THC has one of the country’s top programs on this issue, the SAHLI.

SAHLI offers year-round programming to increase health literacy in San Antonio. In addition to presenting the annual Texas Health Literacy Conference, which brings the nation’s top experts on health literacy to San Antonio each year, SAHLI offers ongoing health-literacy training and online resources for healthcare professionals.

ImmuniZe San Antonio (IZSA). IZSA is Bexar County’s immunization collaborative of more than 40 volunteer organizations and individuals working to increase immunization rates in San Antonio. Often, people may think about immunization as something children need for school. But it is much more. IZSA presents an annual provider conference that updates physicians, clinics and other organizations in Bexar County on the importance of immunizations throughout the lifespan, on current immunizations rates in Bexar County, and on best practices for community protection.

Physicians interested in the work of THC are encouraged to contact Robert Ferrer, MD, THC 2015 Vice Chair and 2016 Chair-Elect at


“The Health Collaborative [THC] has had a tremendous impact on the health of the community. THC is the data brain that drives strategic alliances among public and private health systems, businesses, school districts, and others that facilitate policy changes resulting in healthier behaviors. THC is the advocacy center that provides support and guidance to organizations that are trying to create healthier work environments. University Health System is a member of THC because we advocate and support community health improvement.”
— Theresa De La Haya, RN, MPH, Senior Vice President, Community Health and Clinical Prevention Programs, University Health System

“Methodist Healthcare Ministries is proud to be a part of The Health Collaborative because we share a commitment to improving the health of those least served, and because they have effectively built a bridge among healthcare providers and advocates that has made us a more cohesive community. Together, we are expanding access to quality care for all in our community.”
— George Thomas, Chief Operating Officer, Methodist Healthcare Ministries of South Texas, Inc.

“As the landscape of healthcare changes, population health will become of central importance. This is a very good thing! We must move from a reliance on the costly, acute-care settings to a proactive focus on health, prevention and wellness. This, while challenging for our healthcare systems, is in the best interest of patients.
“The Health Collaborative is a vital partnership of healthcare leaders in our community who are committed to this transformation for the betterment of all San Antonians. CHRISTUS Santa Rosa, the oldest healthcare institution in San Antonio and a leader, partner and advocate in working to build healthier communities, is proud to be a part of this collaborative.”
— Dennis Gonzales, PhD, Vice President, Mission Integration, CHRISTUS Santa Rosa Health System

“Since 1903, Baptist Health System has been involved in the community, caring for the health and spiritual needs of people in San Antonio, South Texas and beyond. We are dedicated to continuing our strong tradition of providing quality, compassionate health care that puts people first. This mirrors the mission of The Health Collaborative [THC], which is to improve the health of our community.
“Serving as a member of THC’s board allows Baptist Health System to share ideas with those members of our community who are dedicated to making San Antonio a healthier place to live.”
— Beth Davenport, Manager, Community Health Screening, Baptist Health System

For additional information on THC programs, visit, or call THC at 210-481-2573. For information on the importance of collaboration in improving community health, please see the “Collaborating for Community Health” section in the November 2014 issue of Health Affairs.