At a City Council meeting in August 2017, Christine Drennon spelled out in stark terms how decisions made a century ago had left San Antonio one of the most economically segregated cities in the country.

As the city began to grow in the early part of the 20th century, inner-city neighborhoods were developed to segregate different races and ethnicities, explained the geographer from Trinity University. These neighborhoods were later redlined by banks, creating dense communities with poor housing stock and little infrastructure. Today, those same communities on the East Side and West Side of the city have life expectancy rates that are as much as 19 years less than in affluent enclaves in the northwest.

“We may have changed the rules about redlining and property, but we never re-did the landscape,” Drennon says.

“We make sure that if it’s a mental health issue or a substance abuse issue, we do everything we can for you to get treatment and not be incarcerated for that,” says Gilbert Gonzales, director of behavioral and mental health in Bexar County, which includes the city of San Antonio.

For police, the starting point is training. Every officer must receive 40 hours of crisis intervention training—more than the 10 hours required by the state. “Whenever the worlds of the police and people who are in crisis collide, it’s usually a bad outcome,” says San Antonio Police Chief William McManus. Training has been “a game changer,” he adds, by giving officers better understanding and techniques for responding to situations.

The region also has a new routing system—dubbed the Law Enforcement Navigation Center—to steer 911 calls for mental health emergencies. Before, an officer would take a person who needed to be held for observation to the nearest emergency room or, as a last resort, to jail. Now, the individual goes directly to an open bed at a facility with psychiatric services. Eventually, responders will be able to know very quickly through an online portal the name of a person’s doctor or whether someone was just treated or discharged from a facility.

Stevens, a 10-year veteran of the mental health team, said because of the new routing system, officers this past July diverted about 800 patients from emergency rooms to mental health facilities. After the 911 call to help the woman hearing voices, he was able to bring her directly to the closest behavioral health center.  

The San Antonio Police Department estimates that it saves about $10 million a year in jail and emergency room costs by diverting people to immediate care.

A key link in the chain of care is the 10-year-old Restoration Center, an around-the-clock facility for mental health emergencies that is supported by the county hospital, nonprofits, and government agencies. Located west of downtown, the facility has a sobering center for people who have been arrested for public intoxication, a drug detox unit, and an inpatient psychiatric unit that can evaluate and stabilize a person within 72 hours. For patients who want to take the next step and enter rehab, treatment is available next door at Haven for Hope, a 22-acre campus providing services like medical care, job placement help, and housing to individuals and families experiencing homelessness.

“The nice thing about working in San Antonio is that everybody wants to help,” Gonzales says, with the focus being, “How do we get together to solve a problem?” 

In essence, the museum has “game-ified” a health survey, says Bryan Bayles, the Witte’s curator of anthropology and health who created the exhibit. Although unorthodox, the information and results provide yet another window into communities.

“We don’t have this data any other way,” says Bridger, who leads the Metropolitan Health District. “Now we have it by ZIP code. We can map it and target our intervention.”

San Antonio’s Culture of Health journey is informed by data and focused on tracking progress. Partners connect across sectors—like a museum supplying information to the city’s health department—and engage in rigorous efforts to collect, share, and analyze data to make informed decisions about how they assess needs, deploy resources and measurably improve health outcomes.

A centerpiece of this collective action is the nonprofit SA2020, which tracks progress in 11 categories affecting the quality of life in San Antonio—everything from education to community safety, health and fitness, family well-being, and economic competitiveness. In 2010, then Mayor Julian Castro posed a  question to the city: What do you want your hometown to look like in 2020? The answers informed a set of shared priorities that can be tracked year-to-year through 61 indicators, showing just where the city is making progress, stalling, or falling behind.

“It’s like holding up a mirror and reminding everyone where we wanted to go and where we’re currently situated,” says Molly Cox, president of SA2020. Of the indicators, 70 percent are moving in the right direction. “We can use this to move the needle on things the community said was important.”

A partner organization, Community Information Now, shares that trove of material and crunches even more numbers—such as life expectancy estimates by ZIP code—in order to equip communities with better tools for making informed decisions.

With schools, the P16Plus Council of Greater Bexar County brings school districts to the table with universities, nonprofits and businesses to set goals, identify resources and measure results around the “cradle to career” progress of children. Excel Beyond the Bell comes under the umbrella of the nonprofit council and works with 43 after-school programs—groups like Big Brothers Big Sisters, the YMCA and Boys and Girls Clubs—to coordinate activities and measure results.