TX RPC Health Policy Resources

The Texas Research-to-Policy Collaboration Project has developed resources available to policymakers with the intent of providing facts and evidence on health-related topics.

Since the start of the COVID-19 pandemic, Texas legislators have expressed needing access to accurate information in a timely manner from experts in the field. As a result, the Texas Research-to-Policy Collaboration (TX RPC) Project has created multiple reports/one-pagers related to public health topics of interest expressed by Texas legislators. If you would like to request information, please complete this form.

If you intend to share information from these TX RPC Project reports or overviews with your constituents or media, we ask you to please reference this project as the source if possible: The Texas Research-to-Policy Collaboration Project is conducted by the Michael & Susan Dell Center for Healthy Living at the UTHealth School of Public Health in Austin.  Questions or inquiries should be directed to: TXRPCNetwork@uth.tmc.edu

Public Health Outcomes of Healthcare Access

The TX RPC Project worked with Dr. Katelyn Jetelina from The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Dallas to create this data brief on public health outcomes of healthcare access. This brief highlights the problem with healthcare access, as well as health and economic outcomes associated with healthcare access.

This report was released on June 9, 2020. It was updated on January 4, 2021.

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Frontline Workers during the COVID-19 Pandemic

Characteristics of frontline workers during the COVID-19 pandemic in specific Texas legislative districts and in Texas overall were developed into data briefs by a TX RPC Network Member.

Calculations are based on labor data from the American Community Survey. 

Key Takeaways:

  • 18.1% of the workforce in Texas (2.7 million) are in a frontline industry.
  • Women represent 63% of Texas frontline workers, despite representing 46% of the general workforce.
  • Among frontline workers in Texas,
    • 30% are over the age of 50
    • 9% live below the poverty line
    • 27% live below the <200% poverty line

This report was released on July 7, 2020. It was updated on November 23, 2020.

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Comparison of COVID-19 cases and deaths in nursing homes and long term care facilities

Data briefs that describe and compare general population COVID-19 cases and related deaths in nursing homes and long term care facilities within specific legislative districts and in Texas overall were developed by a TX RPC Network Member.

Estimates were generated using COVID-19 case and death data from the New York Times database, population statistics from the American Community Survey, and nursing home and assisted living facility COVID-19 data from the Texas Department of State Health Services.

Key Takeaways:

  • As of June 25, 2020, approximately 39% of statewide COVID-19 related deaths (2,292) occurred in nursing home residents (883).
  • The statewide COVID-19 related death rate in nursing facility residents is ~120 times greater than the COVID-19 related death rate in the total population of Texas.

This report was released on July 1, 2020.

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Considerations for Reopening K-12 Schools during COVID-19

In response to COVID-19, most K-12 schools cancelled in-person classes starting in mid-March. On March 19, 2020, Governor Abbott issued an executive order closing all Texas schools; schools completed the 2019-2020 school year through remote learning. In July, the Texas Education Agency released school reopening guidance that included flexibility at the local level to delay start dates and optional online-only delivery for the first several weeks of the 2020-2021 academic year. 

Key Takeaways:

  • School administrators and staff, parents, policy makers, and public health professionals are concerned about the unknown health consequences of resuming in-person instruction at the start of 2020-21 school year.
  • Distance learning creates practical and economic challenges for parents, as working parents, particularly essential workers, need to either miss work or find childcare alternatives when schools are closed for in-person instruction.
  • The benefits of in-person instruction are significant, however, reopening schools during the COVID-19 pandemic may result in serious health consequences for school staff, students, and families.

This report was released on August 21, 2020.

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COVID-19 Impact of Working from Home on Mental Health

Following the March 13, 2020 U.S. national emergency declaration concerning COVID-19, Texas Governor Greg Abbott issued stay-at-home orders to slow and contain the spread of the coronavirus on March 20, 2020. As a result of physical distancing, large numbers of non-essential employees have started working from home. Individuals working and sheltering at home for extended periods face challenges of social isolation and loneliness, which can result in increased risks of depression, anxiety, suicidal ideation, and substance use.

Key Takeaways:

  • In April 2020, nearly half of U.S. adults (45%) reported anxiety, fear, and stress compared to 33% in 2018, prior to the COVID-19 pandemic.
  • Severe economic uncertainty resulting from decreased work hours, furloughs, and unemployment has increased the risk of mental health issues and substance use disorders.
  • An April 2020 poll about COVID-19 and mental health found that:
    • 52% of Americans feared job loss,
    • 45% worried about income loss due to workplace closure or reduced hours, and
    • 59% worried about long-term negative impacts on their investments.

This report was released on August 25, 2020.

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COVID-19: Impact of Pre-Existing Health Conditions in Adults

Studies have found adults with underlying medical conditions—or pre-existing conditions such as chronic kidney disease, obesity, diabetes, hypertension, and asthma—who contract COVID-19 have a higher risk for more severe illness, including hospitalization, admission to intensive care units (ICU), and death. COVID-19 hospitalizations were up to 6 times higher and deaths 12 times higher among patients with reported pre-existing conditions compared to patients with no reported pre-existing conditions between January and May of 2020.

Key Takeaways:

  • Based on strong evidence from multiple studies, the list of pre-existing conditions that put individuals at increased risk for severe illness include: serious heart conditions (heart failure, coronary artery disease), chronic kidney disease, chronic obstructive pulmonary disease (COPD), obesity, sickle cell disease, solid organ transplantation, and type 2 diabetes.
  • Among COVID-19 hospitalizations, the three most common underlying conditions are hypertension (57.7%),  obesity (47.8%), and metabolic disease (42.9%).

This report was released on October 9, 2020.

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COVID-19: Impact of Pre-Existing Health Conditions in Children

Though data on pediatric cases (≤18 years) of COVID-19 are limited, early studies indicate that severe complications from COVID-19 appear to be less common among children compared to adults. Children with underlying medical conditions—or pre-existing conditions such as obesity, diabetes, asthma, chronic lung disease, and immunosuppression—who contract COVID-19 have a higher risk for severity of illness, hospitalization, admission to pediatric intensive care units, and death.

Key Takeaways:

  • Among 121 childhood deaths related to COVID-19, 75% had an underlying health condition.
  • In the U.S., among 246 pediatric COVID-19 hospitalizations with information on underlying medical conditions, 52.7% had at least one pre-existing condition, the most common being obesity (44.5%),  asthma (14.0%), and neurologic conditions (13.2%).
  • Children with underlying conditions that pre-dispose to possible severe disease should not be exposed in face-to-face school participation.

This report was released on October 9, 2020.

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COVID-19: Impact of Adult Obesity on Health Outcomes

Adults with obesity are at increased risk for severe illness, invasive mechanical ventilation, hospitalization, and death due to COVID-19. Prevalence of obesity and deaths from COVID-19 are substantially greater in the United States compared to other countries. 

Key Takeaways:

  • Obesity is a stronger predictor of severe COVID-19-related illness than cardiovascular or pulmonary disease.
  • Many adults have difficulty maintaining a healthy diet and exercising, which are important precursors to maintaining a healthy weight gain, during stay-at-home orders.
  • Black and Hispanic populations are disproportionately affected by chronic diseases (including obesity), increasing their risk for worse outcomes from COVID-19. 

This report was released on October 13, 2020. It was updated on January 14, 2021.

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COVID-19: Impact of Childhood Obesity on Health Outcomes

Though COVID-19 infections remain low in younger populations, children with obesity are at greater risk for hospitalization and mechanical ventilation from COVID-19. Recommendations include supporting telemedicine to coordinate care for youth with obesity,  strengthening school- and community-based efforts to promote healthy eating and physical activity, and reinforcing COVID-19 prevention efforts in childcare centers and schools.  

Key Takeaways:

  • Texas has the 5th highest rate of adolescent obesity and 12th highest rate of childhood obesity.
  • During stay-at-home orders, youth have reported more physical inactivity, sedentary behavior, and consumption of unhealthy foods and sugar-sweetened beverages - all of which increase risk for weight gain.
  • Severe obesity is an even higher risk for COVID-19 complications among children. 

This report was released on October 13, 2020. It was updated on January 20, 2021.

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SNAP Utilization and Eligibility in Texas and Texas Legislative Districts

This data brief describes and compares Supplemental Nutrition Assistance Program (SNAP) utilization and eligibility in Texas, Texas House Districts (HDs), and Texas Senate Districts (SDs).

Key Takeaways:

  • In Texas, 1,751,810 households containing 3,941,165 individuals received SNAP benefits in August 2020.
  • The average monthly SNAP benefits in Texas were $261 for eligible households ($116 per eligible individual).
  • Compared to August 2019, in August 2020:
    • 468,214 more individuals received SNAP benefits in Texas, an increase of 13%.
    • In Texas SDs, this increase ranged from 6% to 26%.
    • In Texas HDs, this increase ranged from 6% to 30%.

This report was released on October 19, 2020.

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Impact of COVID-19 on Food Insecurity

Food insecurity among adults and children has increased during the COVID-19 pandemic due to rising levels of unemployment, poverty, and limited access to school nutrition programs because of school closures. Current models predict that 54 million Americans (16%) will experience food insecurity in 2020 compared to 37 million Americans (11.5%) in 2018, an increase of 17 million food insecure Americans due to COVID-19.

Key Takeaways:

  • Food insecurity among Texans has doubled from December 2018 (about 13%) to April-June 2020 (about 28%)
  • At the current projected levels of 28% food insecurity in Texas, the annual estimated healthcare costs associated with lack of access to food in Texas will be over $11.1 billion.
  • Approximately 30.9% of Texas children are projected to be food insecure in 2020, compared to 21.6% of children in 2018.

This report was released on December 3, 2020. It was updated on April 6, 2021.

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Data Brief: Food Access in Texas and Texas Legislative Districts

Eating a healthy diet can be a challenge for people with limited income and/or limited physical access to supermarkets, grocery stores, and other sources of healthy and affordable food. This data brief describes and compares the number of individuals at risk of low food access in Texas, Texas House Districts (HDs), and Texas Senate Districts (SDs).

Key Takeaways:

  • Approximately 2,403,438 (9%) individuals in Texas have both low income and low access to healthy food sources, as of 2015.
    • In Texas SDs, this proportion ranges from 3% to 23.3%.
    • In Texas HDs, this proportion ranges from 0.2% to 34.6%
  • The Food Access Research Atlas data is available for specific census tracts (neighborhoods) and can now be viewed by Texas Senate and House districts.

This report was released on January 11, 2021.

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Comparing COVID-19 Vaccines: Pfizer/BioNTech vs. Moderna

This graphic describes and compares the Pfizer/BioNTech and Moderna vaccines, and is available in English, Spanish, Vietnamese, and Mandarin. It can be downloaded and distributed to the public free of charge.

Key Takeaways:

  • Both vaccines are mRNA vaccines, meaning they provide "instructions" for our cells to make a piece of protein that is found on the surface of the virus that causes COVID-19. Our body recognizes this protein as "foreign" and will build an immune response that protects us from COVID-19.
  • To gain maximum protection and ensure "memory" immunity, you must get the second dose.
  • Vaccine side effects are a sign that the immune system is responding as it should and do not mean that the vaccine is unsafe.

This graphic was released on January 25, 2021.

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Supplemental Nutrition Assistance Program (SNAP): Vehicle Value Limits

In Texas, approximately 79% of Supplemental Nutrition Assistance Program (SNAP) recipients live in households with children, and more than 27% live in households with seniors or people with disabilities. Currently more than 3.4 million Texans use SNAP, representing 1.6 million households. More than half of all SNAP recipients in Texas live in families in which at least one member works full time. While each state determines the eligibility requirements for its residents, the federal government provides 100% of SNAP funding. Administrative program costs are split equally between the federal government and the state. SNAP is a proven program to combat food insecurity and poverty, and improve child outcomes. 

Key Takeaways:

  • Texas is one of four states that does not exempt the value of at least one vehicle in determining SNAP eligibility. Thirty-seven states exclude the value of all vehicles owned by the applicant.
  • Vehicle asset limits prevent many otherwise eligible applicants from qualifying for SNAP benefits.
  • The vehicle asset limit increases the workload of state employees who determine SNAP eligibility because they must collect vehicle ownership information from each applicant and research the FMV of each vehicle.
  • Due to a lack of wide-spread public transportation in Texas, most people in Texas require a reliable vehicle to get to work. Texas ranks 15th in terms of states with longest commutes to work (over 26 minutes).

This report was released on May 11, 2021. It was updated on May 18, 2021.

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Supplemental Nutrition Assistance Program (SNAP): Work Requirements

The Supplemental Nutrition Assistance Program (SNAP), is a federally funded program that provides benefits to certain low-income individuals and families, to enable them to supplement their food budget. Currently more than 3.4 million Texans receive SNAP benefits, representing 1.6 million households. In Texas, approximately 79% of SNAP recipients live in households with children, and more than 27% live in households with seniors or people with disabilities. More than half of all Texas SNAP recipients live in families in which at least one person is working full time. While each state determines the eligibility requirements for its residents, the federal government provides 100% of SNAP funding. Administrative program costs are split equally between the federal government and the state. SNAP is a proven program to combat food insecurity and poverty, and improve child outcomes. 

Key Takeaways:

  • SNAP recipients subject to the foregoing work requirements are prohibited from voluntarily quitting a job or reducing their hours.
  • SNAP recipients must provide proof of identity and work eligibility through proper documentation when requested.
  • Unemployed able-bodied adults (18-49 years old) without dependents can receive benefits for up to 3 months every 3 years.

This report was released on May 11, 2021. It was updated on May 18, 2021.

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Public Health Experts are Needed in Policy Work Groups, Task Forces, and Advisory Committees

Approximately 80-90% of a person’s health outcomes are due to social determinants of health, such as where one lives and works. These foundations of health are especially important when predicting health outcomes for diverse populations, women, and children.  Public health experts examine “upstream” issues like structural and systemic factors that contribute to the overall health and wellbeing of a person.  Public health experts’ approaches to health tend to be proactive to reduce the burden of chronic disease, costs, and to improve life expectancy and quality of life for everyone.  Public health experts add value to policy work, task forces, and advisory committees because they can provide timely recommendations based on the essential components of public health service. 

Key Takeaways:

  • Public health researchers and experts focus on the social determinants of health, which are particularly important in predicting health outcomes for women, children, and Black, Indigenous, People of Color (BIPOC). 
  • Seven in 10 voters indicate public health departments are important to create a healthy community.
  • Public health experts are uniquely situated to provide timely recommendations based on the essential components of public health service.

This report was released on May 17, 2021. It was updated on May 19, 2021.

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