A new health assessment conducted by Rice University’s Kinder Institute for Urban Research and the Institute for Health Policy at UTHealth Houston School of Public Health has identified significant gaps in access to mental health services and prenatal care in Fort Bend County. The findings come despite the county’s overall strong economic indicators.
The survey, which included responses from 3,440 residents, was commissioned by Fort Bend County Health and Human Services. It found that while Fort Bend County’s population has grown rapidly—reaching nearly 1 million in 2024—the number of residents living in poverty also increased. Median household income rose from about $76,000 to $105,000 between 2010 and 2023, but those living below the poverty line grew from around 53,000 to more than 80,000 during that period.
“Since Fort Bend is a relatively prosperous county, statewide, it is easy to overlook pockets of unmet health needs that can remain invisible,” said Stephen Linder, PhD, professor and director of the Institute for Health Policy at UTHealth Houston School of Public Health. “This survey helps identify health care needs and shows which groups in the population need the most help from local health care providers.”
Half of those surveyed reported needing mental health care within the past year; less than half (49%) said they could always access these services. About 13% rated their mental health as poor or fair. Access varied across age and ethnic groups: young adults ages 18-29 experienced nearly six days per month of “not good” mental health compared to fewer days among older groups. Hispanic residents reported five such days on average compared to 3.3 days for Asian and white respondents.
Prenatal care also emerged as a concern. Thirty percent of respondents needed prenatal care in the previous year; only 46% were always able to obtain it while more than one-third (36%) said they were never able to access this care.
Cost was cited as the leading barrier to accessing healthcare by 41% of respondents. Other barriers included lack of insurance coverage (31%), inability to get appointments (27%), and being too busy or unable to take time off work (22%).
Most residents—about 88%—reported having some form of health insurance. Employer-provided insurance accounted for over half of this group. However, one in eight residents remained uninsured; this was more common among younger adults and Hispanic residents.
Physical health indicators showed that most people rated their health positively but over half reported having at least one chronic condition such as hypertension or high cholesterol. Residents with higher educational attainment generally reported better physical and mental health outcomes.
Housing instability and food insecurity were also highlighted as important factors affecting well-being. Around one quarter worried about paying for housing either sometimes or often; about one in six had fallen behind on rent or mortgage payments within the past year. Food insecurity affected nearly a quarter of Black respondents and almost one-fifth of Hispanic residents.
More than three-quarters expressed interest in receiving education on topics like nutrition, wellness, stress management, and mental health from county programs.
The report recommends expanding access to mental health services along with prenatal and primary care initiatives as well as programs targeting food insecurity and housing instability.
“This data validates what we see as boots on the ground and supports our current strategic priorities. It provides a clear roadmap for action, allowing us to collaborate with community partners to build a healthier and more equitable Fort Bend County,” said Letosha Gale-Lowe, MD, director of Fort Bend County Health and Human Services. “It pinpoints where we must focus our collective efforts to ensure that our county’s prosperity translates into lasting health and well-being for all residents.”
According to Dan Potter, co-director of the Houston Population Research Center at the Kinder Institute for Urban Research: “This is the largest survey sample we’ve ever had representing Fort Bend County. This allows Fort Bend leaders to hear from a wide range of communities all across the county, from the urban to the suburban to the rural.”
The panel will continue surveying participants over time on topics related to community needs throughout Greater Houston.
The Institute for Health Policy at UTHealth Houston School of Public Health specializes in community assessments for local authorities while maintaining publicly accessible data files online free-of-charge.
