City health improvements impressive, precarious

San Antonio’s reputation as a city full of overweight people with Type 2 diabetes who never exercise might — might — change for the better over the next 35 years.

“In 2050 San Antonians will be thinner, there’ll be less diabetes, fewer amputations and less kidney disease,” said Vincent Nathan, interim director of the San Antonio Metropolitan Health District. “Things won’t be perfect, but the future looks brighter.”

The growing economy in Texas as a whole and in South Texas in particular — until recently spurred on by the boom in the oil industry — is good news for the health and well-being of its residents.

“As San Antonio and Austin continue to merge along the (Interstate) 35 corridor, it means improvement in health, wealth and diet and gives local governments the ability to put more resources into health care,” said Steve Murdock, director of the Hobby Center for the Study of Texas at Rice University and a former state demographer. “We’re already seeing improvements in those areas in San Antonio — in fact those improvements are better there than what we’re seeing in the rest of the state.”

And by 2050 many of those should be established as a part of society, according to Dr. Robert Ferrer, a professor in the department of family medicine at the University of Texas Medical School.

“I think we’ll see more physical activity in 2050, more cyclists in street clothes, more recess in schools and more people heeding the messages about what food is and isn’t,” he said.

The 20- and 30-year-olds of 2050 will be healthier because of policies put into place today.

“Pre-K for SA, for example, is an educational program, but it will have big health benefits because it will help teach kids how to take better care of their minds and bodies,” Ferrer said.

Expect to see a continued increase in life span and all that entails, said Dr. Fernando Guerra, who headed Metro Health for 13 years before retiring in 2010.

“Living longer is good, but that also means dealing with an array of chronic diseases, such as dementia, hypertension, stroke and cardiovascular disease,” he said. “Fortunately, I think we’ll make advancements in how we serve this aging population.”

Of course, there’s no guarantee that these positive predictions will come to fruition. They could easily be knocked off track.

A drastic downturn in the economy, for example, or a long-term decline in the oil industry could halt the improvements already underway.

“We’re already seeing the effect of this downturn in West Texas and other areas where fracking has been an economic driver,” he said.

From 2010 to 2050, the percentage of Bexar County’s population that is Hispanic will increase from 58 percent to 66 percent, according to Murdock. Meanwhile, the percentage of non-Hispanic whites will decline from 30 percent to 14 percent. (African-Americans will drop from 7 to 6 percent of the population.)

“In other words, the majority of population growth in Bexar over the next 35 years, while not in the minority statistically, will be among those who tend to have less access to health care, poorer diets and other trends working against them,” Murdock said. “So much of this region’s success in improving the health of its citizens will be tied to the success of its minority population.”