Urban Myopia: Confronting homelessness in the hinterlands of Houston, Texas

Community clinics are the cornerstone of several new public health strategies including integrated mental health care and rapid-response homelessness intervention. But, a poorly designed system that does not keep up with changing neighborhoods threatens the success of these initiatives. As more interventions are built around Federally Qualified Health Care Providers (FQHCPs) we must ask where are they and whom do they serve? In Houston, for example, the largest share of current unmet need for FQHCPs is in suburban and rural areas. Young Hispanic families are buying property in inexpensive, mid-century planned subdivisions while traditionally poor black populations continue to migrate out of the city center, settling in run-down edge cities. Thus, the several un-served pockets of “slumburbia” demand a more regional and responsive approach to planning. Using data from the Collaborative Psychiatric Epidemiology Surveys I build a p-median location allocation model to locate five new hypothetical community clinics to address the current gaps in service.