 Good evening. We are a small, compact group, a good group. I welcome you to this community meeting on issues of health in your community. My name is Steve Blanchard. I'm the chair of the Bear County Health Collaborative, which is sponsoring this. And the collaborative are the major hospital systems in the city, the YMCA, a part of the medical school, the county, quite a, quite a, and a university, quite a composite of organizations. And I'm sorry? Is there a mic? I have no mic. Oh, is it not on? I think this is just going to Clayton. Yeah. Well, it's the first time I teach at a university. It's the first time anybody's ever accused me of not speaking loud enough. So we'll raise the voice, eh? Can you hear me now? Anyway, I welcome you to this evening's community meeting to listen to your voice on issues of health in your, in your community and perhaps any strategies you might have for improving community health. I am, my name is Steve Blanchard and I'm the chair of the Bear County Health Collaborative, which is comprised of the major health hospital systems in the city or in the county, the YMCA, medical school, the county, and a number of, a number of other organizations. And we do this every periodically, about every three years, do an assessment, work with the community, understand from your standpoint what the issues are that you confront every day in terms of your own health and improving your health. And we have with us tonight that will help us to facilitate the discussion, a group that we've been out of Boston we've been working with now for, well, we began with them in 2010. This is actually, I think, the fourth or fifth assessment we've done. We started in the first one in 1998. But anyway, health resources in action and I'll introduce you to my Tokayo. It's got the same name as I do. Steve Radini here in a minute and he'll get that portion of the conversation started. But I want to say something about what's going to, what's going to become of, of our having listened to your voice. I can give you a pretty concrete illustration. Steve and I met with Mayor Castro a couple of days ago and his and with one of his assistants. And they're very open and listening to the conversations that we have as they are listening to the to the community all the time anyway. But they're particularly interested in terms of SA 2020 and issues of community health. So the kinds of things that we talk about end up in a report, but it doesn't go on a shelf. It ends up in a report becomes an action document for improving community health and becomes a part of the decision making that happens at the municipal government and at the county government and in our own Metro health department, which is also part of the part of the board. You might remember or maybe you don't. But a year or two ago, there was a half a billion dollar bond issue that went out and some of it had to do a good piece of it had to do improvement of parks, getting better lighting on the street corners and all of that. Because a lot of what we already have learned over the years, and perhaps you'll talk about tonight, is that we know we need to exercise. Voila, here we are in the YMCA. We know that we need to exercise and but neighborhoods need parks and lighted streets. The mayor and others in the municipal government listen to those voices, not just the ones here, listen to those voices, generated that bond to improve parks and lights. So even though what we talk about tonight, you won't see change tomorrow. You will see change over the next year or two on issues that you present in the conversation this evening. So again, we're informal and very eager to listen to what you have to say. And Steve Rodini, please, come on down. And that's what they say on the TV. Yeah, come on down. Yeah, this is the price is right. This is this is Steve Rodini. He's the Vice President of Health Resources in Action. He's a group out of Boston. Several of his colleagues are in the back that will be helping in small groups. We go back a number of years now. And Steve is good at what he does. And I welcome him here this evening and introduce this is Steve Rodini. And here's the community and and here's the group. Thank you very much. Yeah. Thank you. Alright, so before we get started, I'd like to go. Can you hear me? I'd like to hear your name. And why are you here? And there's no wrong answers. I'm thinking you have a lot of other options tonight. Maybe you came for the free food. Maybe you came for the enlightening conversation. But I'm curious to hear why you're here. So if anyone wants to start, you know, it might be good and face that way only because at least for this moment so people can hear who you are. Okay. Okay. This is one of the options. Okay, an honest woman. Thank you. We'll take it. Okay. You're in the same. What's the class? It's not with Dr. Blanchard is it? Okay, just checking. All right. Great. Glad you here. Okay. Good. Okay, we got a theme going. Volunteer. Okay. Out of where? Okay, great. Okay, what's the class? Okay. Okay, wonderful. Great. Okay. You're not here. You're not here because of a class though. Okay, I didn't think so. Good. Good. Okay. No. Well, thank you. Absolutely. It's been an interesting week last week. So thank you. Thank you. But that's important. It is good to be here. I might have to leave because of professional opportunity. Okay. Not at all. Thank you. I'm also a board member of the health collaborator. And I'm delighted to be here to listen to this presentation this evening about a very important subject and that's our health and what's going on with that in our community. Great. Thank you. I'm sorry, but well, I'm not I'm glad we're doing this but it's this doesn't have an amplifier. So what it's catching is people's voices that will be on okay, we're live streaming there and recording this so your voices will be so you're on TV. Yeah. So I think we should just pass this around. Make sure to get your good side spoken yet. Oh, has everyone already spoken? No, no, we're right here. Please. Well, hi, I'm Beth Davenport. I'm also a member of the health collaborative board. In addition, I am the manager for community health screening programs. So I have a lot of interest in this question tonight. Well, really good to have you. Nice to meet you. Hi, I'm Mercedes and I'm here for service hours. You hear what? For service hours. Okay, so okay, that's a theme tonight. That's good. You're here for your service hours. Hi, I'm Avery and I'm here for volunteer hours. Okay. Alrighty. Let me guess. And I'm here for service. Okay, good. All right. Well, let me do I don't need to use this. Do I? Well, I'm recording over there. It's not broadcasting. Okay. No, you don't need that. Okay. Okay, I'll just put it right here. So what I wanted to do is, as Pilar and some others identified, we really wanted to ask you some questions about health and how you think about health. So there are no right or wrong answers here. And really what we want to do is we as we develop the information for this assessment for the county, we want to get your opinion. So even though you're here for volunteer hours and you may be observing, we'd also like you to participate. We'll do that in small group and we'll do it in large group. So I guess the frame I would like to use as we think about what impacts your health is to think about some a frame that researchers use out there in terms of thinking about four major things that impact your health. One is to think about your lifestyle and the choices you make in terms of your lifestyle, but also the things around your environment that also impact your lifestyle. So if there's a grocery store in your neighborhood, that might impact your health. If there's not a grocery store in your neighborhood, that might impact health. If you go to the grocery store like me and you start in the sweets or chips section that could impact your health. So the idea there is that there are things in the in the in your in lifestyles or lifestyle choices that can impact your health. Before I go on to the next one, I just wanted to ask you what other types of things related to lifestyle? Can you provide as examples? Yes, hold that thought. We're going to come because that's going to be a specific area. But as we think about lifestyle in terms of how you live your day to day life, what are things that can impact your health? I'm not dressed to be on television. I believe I believe that consistency is very important. So if we're gun hold to start an exercise program, a diet program, this and that, we have to be consistent and then we have to be gentle with ourselves. We can't expect change instantly. It's not hatch match and dispatch. It takes time, but it consistency, even if we exercise for instead of two hours at the gym, if we just park our car somewhere, you know, further down, and we walk. And instead of, you know, and we think throughout the day, what am I intending? I'm sorry, I'm getting nervous here. What am I intending to to get out of life? Yep. Well, the body is a wonderful mechanism. It needs to move. We either use it or you lose it. So I think that consistency is very important. Once we set our goals, you have to have a game plan. Whether it's budget, whether it's schoolwork, whether it's health or the council visit. But for yourself, you have to do it for yourself, because we only have one life. And that's ours. Right. Well, what I'd like to do is even take a step back from what you were saying, is that some people may choose to be active. Some people may not. They may their their choice may be to go home and kind of sit on a couch and watch TV all night. So that's another choice that you're making. Other people, there are communities we work in, where people talk about the fact that they would rather have their children stay at home because it may not be safe outside. So unfortunately, those are choices that some people have to make because of the environment in which they live. Is there another example in terms of kind of thinking about what influences your health based on lifestyle choices? Yes. Please say that. In this particular community, access to good medical care. So did everyone hear the notion of access to good medical care? How does that impact your health? Exactly. Exactly. So if you don't know you have high blood pressure, you could be doing things that are contributing to unhealthy lifestyle. In other situations, if you have access to screening, you might be able to figure out sooner rather than later what you need to be doing. And in other places, you might get education even before you get the onset of high blood pressure to prevent that from coming in. So you're absolutely right. Yes. I think an important step to take in any community of this size is to make medical facilities accessible in all neighborhoods. The east side does not have the transportation of the south highway revenue, does not have the transportation or the means to take the bus or take the taxi and go to the medical center. Great. You have to bring the clinic in the neighborhood. So this is another piece, though, around lifestyle. So people who may be living in the east side may not have transportation options to get to the facility. So it's another piece around lifestyle. So that's one area. Are people getting this idea of how lifestyle, your choices and your environment influence your health? Yes, no, maybe. Shake your head one way or the other. Tell me you're breathing. Okay, good. So the next area, did you have a question? Also, what you eat. Give me an example. Well, how common I mean, you can just walk to Birking and if you're busy work, you don't want to go home and cook for the kids. Yes. So did everyone hear this? It's some of it is about what you choose to eat in terms of lifestyle choices. Interestingly enough, I worked in a public school in a city where when we were talking to young kids about the use of forks and knives, the teacher said, don't worry, they don't use forks and knives. They don't know those kids haven't been introduced to that because everything they eat, they eat with their fingers. So what's that telling you about that particular community? That some of those kids, all they're eating is fast food. So whether it's a chicken McNugget or it's a burger or fried chicken. So the fact that they're not using utensils gives you a quick sense of what it is they may be eating and it may, probably in most cases, may not be healthy. So yes, food is also an issue. So that makes sense as one area. So the next area that also influences health is the environment. What is it about the environment from your thinking has an impact on your health? What I'm going to do is just ask if we can get some others, okay? I'll come to you. What other things, what are the things in the environment that would impact your health or affect your health? Think about your own day-to-day life. I'm looking at you but I won't call on you. Well what does that mean? Okay, so great. So that environment in terms of your home environment. So it may be what people are choosing to do in that home environment. Going back to what's being served at the table in terms of whether it's fast food or something else. What else about environment? So that's great. Family. What else about the environment? Anybody? No, go ahead, go ahead. Like people who smoke or if you're around friends that say a little louder. Like people who smoke or people who like to drink. So people who smoke. What does that mean if you're around a bunch of people who smoke? What's that? You may not see anything wrong with it but what if you say it a little louder? Second-hand smoke. There was a time where people didn't think second-hand smoke was an issue. Now we have come to realize that second-hand smoke is an issue. Do you now know there's another thing that people are talking about? They're calling it third-hand smoke. There's an issue around third-hand smoke. That's what they're saying. So smoking, that's another thing in terms of the environment. Anything else related to the environment from folks we haven't heard from? Yes, well go ahead. Safety? Say it a little louder. Right. How many of you have heard that or think about that? If your environment is not safe, you may not want to be going outside to go jogging or running. We did a conversation, what was it about two years ago, and a woman said she didn't feel safe walking around in that neighborhood. Anything else? I'll come back. Okay, so that's another area. So as you think about this, we've got lifestyle. We've also got environment. The next area that we can think about is genetics. So do you want to give us an example since you... Yeah. So that's another area that influences health. It's your genetics. You could be from a group of people that suffers particular types of diseases. It could be a racial thing. It could be an ethnic thing. You could also be from a family that has a higher blood pressure. I live in a family where, on my mom's side, everyone of her siblings and parents passed before they were 60 due to high blood pressure. So that means something about what we have to think about in terms of our consumption of salt and paying attention to hypertension. Any other genetic things? Anyone else? You all have been very quiet. You know I'm going to pick on you before the night's over. So think now. Any other things around genetics? Well let me ask you, does that make sense? So as we think about what influences health, we've got lifestyle choices. Again, personal choices, but also what's going on in your surroundings. We've got the environment. We've got genetics. The fourth area is health care or medical care or medical. So that's a fourth area that can impact your health. And as Beth brought up, that you may have better health status if you have access to these services. Whether they are intervention services or prevention services. So those are the four areas that we can impact, that influence or impact your health status. What I want you to do is turn around and talk to folks in your group. And I'd like you to identify what you see or some of the key factors or key issues in one or many in any of those areas. So what I'd like you to do is think about those four areas. And I'd like you to turn around with other folks at your table and talk about or identify a few key issues that you would like to talk about, okay? Yeah, so you four could do a circle. If you two want you could join this group. And again, there's no right or wrong answer. They're going to just talk about key issues, but I don't need you right now. I'm going to facilitate this. I'm going to call you in a minute. So can I interrupt for one second? What I'd like you to do is talk, but in the end, come up with one or two issues that you want to talk about in terms of key, kind of key priorities or health issues in any one of those areas. Would you like me to? And come up with a list of one or two. Okay, thank you. Thank you. If you all wouldn't mind, if you think about what did you talk about and kind of list out two or three areas that you think are priority areas as it relates to the broader community, that would be helpful. We're going to then come back and share and then we're going to break you up into groups to talk further. Okay, let's see what you got for all these folks who are here because of volunteer hours. It's not a bad way to spend volunteer hours, right? Okay, we'll make it painless. Yeah, so since we talked about lifestyle, what is it? What's the priority? Like, if you had to spend some time and energy on that, what do you want to address? Like what particular area of lifestyle? So put that down. So put it down as, you know, physical activity and then some of the reasons behind it and that could be a priority area that you want to address. Okay, so that may be one area then also decide is there something else in the lifestyle area or is there something in the one of any of the three other areas we talked about. Again, the reason why we're doing this is we want you to list it, we'll hear what people say and then you're going to stop it. Okay, so these are our main things. They get little squiggly stars. Squiggly stars. Perfect. So what within those have we discussed? Because I think we're going to try to report. Well, in the environment we discussed the whole safety issue about being able to go work outside or run or jogging or if you don't feel safe you're not going to go outside. In your neighborhood? Or even if there was a gym around the area like if you didn't feel safe like driving or even walking and then we discussed also how if there's a lot of fast food around the environment then a lot of you're going to go choose that over anything else because that's all it's all hard. If you're on your way home and there's a drive through, it's easier. And more so with lifestyle we talked about your nutrition choices, your food choices, whether you want to make a workout or not or make that time, like work out as a family or individually. I think we all, I mean more people. I think we mainly focus on with lifestyle, your nutrition choices or your food choices, except for our lifestyle it's probably the one you can control. Least will power. It's your most mobile behavior. Most mobile behavior, lots of good way to learn. All right Dr. Sosa. That stuck with me for my glasses. I wish I could always use those words all the time. And then I'd say think of them as they're another issue. Maybe health class, foundation to health class. I never thought school health would be useful, but I use it every day. Yeah, I've been learning that. Especially for me, health and personal health. Oh yeah. I took personal health with what? Lowell? No, I took the other one. The one that taught adolescents and health. She's not there anymore. Oh goodness. I had Dr. Shapiro for adolescents. No, I had her too last semester. This was a trick. Off topic. I had to take the last semester with you. Okay, so I have three points for lifestyle and only two for environment. To address the changes, how would we make the environment better? Would that just be like... I think we have to implement policies for other city councils or advocate for... So you all, you can think about another one or two of these. And come up with some bigger ideas and then we'll talk about them more in depth. Yeah, interesting. So what do you have? Oh, neighborhoods. Would you circle that as one of your areas? This is coming up. It's like cops or the neighborhood on patrol. Anything like that. Anything about... So you all are saying that lifestyle those things are the... you have the highest control over. Which do you think has the most impact strategies that address lifestyle or the environment? Lifestyle. I think that's what we've learned in our classes that we've taken. I thought that's what I've learned so far as lifestyle out of the classes I've taken for health. That's what I've learned the most. Modifiable in the most. Control over as an individual. Yeah, that's the one that mostly influences you and your family and your choices, I guess. That whole saying you are what you need. I think... So I think we're mentioning policies or advocate for different policies. Do you see that as impacting more than just you as an individual? I think it just impacts your whole area your whole community as a whole. If people start seeing more people I know whenever I pass by areas I see people running or working out It motivates you to want to do the same thing too. I should be there. I want to do that. I want to go for a run later. This is a nice weather to go for a run. It looks like a nice place to go running. I know with me it motivates me to go for a trail or something but if I see it's a nice area and it's safe then I'll go. Or if I see a lot of people in that area it will make me want to go. Key concepts these are these two like stellar environments. These people are not as fortunate as you and I professionals and educated at the best places. But their needs are the same. It's a distribution of wealth. Take this YMCA which is in this affluent neighborhood and place it on the east side and go to these places and if the kids are interested in soccer have the soccer instead of the basket. Let's identify that as an issue for here in terms of this notion of the equitable distribution of resources. I love it. Totally. You would enjoy talking to him. In your neighborhood you would know John Rawls from Harvard University. Absolutely. But not Nasik, not entitlement. Great. I feel like that helps a lot. I feel like that helps a lot too but then another issue that I hear that a lot of people say I want to be healthier especially college students but it's so expensive and I think that's another issue is that I know in Brazil the healthier food is a lot cheaper versus here where it's a lot more expensive. But I think that's also a big issue too is affordability on eating healthy food. I know organic food and college budgets. It's not the best thing. Do you think college students are actually focused on what they're eating? I think the whole freshman 15 or when you move out mom's not cooking anymore so you have to learn how to cook on your own. I think they don't know how to plan their day. Exactly. I think you learn as you go through college and you realize after maybe gaining some weight it's not for me. I need to change my behavior or something. And some others just don't care but I think that's another issue too is education on health. People not knowing how badly eating something so often could lead to something. Our communities don't know that so I know that's another issue too. Wow. Long issues. It's easy to get negative but there's ways to address it. There's ways to address it. To bring it back to you you're talking about the individual issue of making a healthy choice for meals but that's a policy decision of the restaurant that's serving that now so those are some environmental ways of addressing and impacting a lot of people to make your choice as an individual healthier. That's true. And it's been getting better. It's been getting better. That's another issue. For Mr. Clark. Is that Dr. Clark? It looks like another. Where? It looks like if it's not. I don't know. He's too tall. No, it's not Clark. His eyes are too big. He's a professor scope. Yeah. It's weird to see a professor outside Clark. I have not seen anyone yet but when I do see Clark he's like Hi Maritza. Hi. Didn't know you knew my name. He's like how are you? You know my name. So what are some other barriers to you as students to being healthy? Besides affordability I would say time management. Because you're just so busy with school and you just want to go home and you don't want to work out or you're just so tired. You really want to go for a run or study or should I take the time to cook? Yeah. And you think those are the same issues maybe the family space that are. Time management is a huge issue for kids. Because some parents just want to go home to work and just lay back and not do anything and they're like oh on the way let me pick up some food for the kids Alright folks let's come back just for a minute. What I'd like you to do is one person in each group is just tell us the highlight in terms of what are the two or three priorities around health that you've identified. What I'd like the rest of you to do is listen because there's a lot of overlap in what you identified and what people then do is break off into maybe four potentially five groups probably four groups to talk about some of these in each group. So which group would like to volunteer in those groups? We can actually do five groups usually. We've got five groups so we may have five areas. Who wants to start? Please. Would you mind standing up so everyone can hear? What are the major health priorities areas? I don't have cards because people watch them all the time from their jobs. And then they end up going to an emergency room because they don't have actual positions. How will there be more than half of the cost of going to an emergency room? Yep. Yep. I really feel that. So that's one priority area. Awareness of resources. Good. Another one? Safety. Because you don't feel safe. Was there another one? If not, that's okay. We have a few other groups. So we've got two things that have come up. Safety and believe it or not that's actually almost come up in every group that I've seen. And then the awareness of resources. That came up with safety. Raise your hand. So you don't have to repeat that when we come to your group. That will be one area we talk about is safety. Another is awareness of resources. Let's pick another group and are there other things that came up that you haven't heard? Yes. What came up in your group? I think one of the biggest ones was health literacy. Because I think it's really important first of all diseases and all that stuff. They don't really know what it means. They don't know how it's to be treated. And then the other aspect is the whole insurance issue. They don't really know a lot about different policies. They don't really know where to contact. How to get insurance. Where their insurance can be used. Stuff like that. We also talked about the access to healthy food and that kind of goes along with transportation. So maybe around this area and this community there's whole foods down the street. There's whole sections that like HEB's that are just devoted to organic living and healthy life styles. Lots of different places like that that in other communities they would have to take the bus pay several different fares just to get over to that and haul the groceries back. Because they don't have access to those healthy foods. And then we talked about the importance of self esteem a lot. So some people they might just be like oh I'm overweight I'm feeling bad about themselves they don't really know how they can better their lives. And then we also brought up the fact that the doctor or the hospital somebody said the people that are taking care of you often you notice they might not have the best healthy habits either. So it's kind of like how do you take that advice and interpret it into something you can use if the people giving it to you aren't really reflecting it very well. Could you do me a favor because I'm never going to remember all those good things. Would you circle the few that came up so the self esteem is one that way I can come back when we bring it go to the group. Either way and you also said health literacy the self esteem and then you had access to healthy foods and that kind of goes with the transportation. Please circle that, that's great and did I miss one? Those are so far, okay. So we've got a few. Now again for those folks who've also talked about any of those what I'm doing that up now what I'd like to hear are there any other priorities that you've talked about. Oh and who talks, oh you did safety. You did safety and and awareness, okay. What did you have over here? What we focused on was lifestyle and by food choices we mean the actual person making the decision I'm going to make healthy food options. That is the easiest thing to modify but at the same time what they were saying it's the easiest thing to ignore also. So especially on college campuses what we were focusing on getting those students to realize their food choices are going to impact them in the long run. Once they realize that I've gained the freshman 15 then they start addressing their food choices so before it becomes an issue they need to address that and then our other one that we picked were the student barriers in the environment obviously their budget to get healthy foods and then time management to actually put in the effort to cook meals. So yours was really around healthy food. Was there anything else you wanted to add? So can we think of that as a big broad priority area? Anything else? The other unique thing is physical activity opportunities. Okay so why don't we think about healthy eating active living, physical activity. Okay great. So those are two other areas. How about you all? I think they just did everything you did. So here we have access to resources, we got safety, we got physical activity and lifestyle. Anything else you want to add? I didn't mean to steal your thunder. Okay, alright. So would you do me a favor? Well I'll look at these that way I'll remember. Who didn't go? Oh you didn't go. What were the big areas? Certain types of insurances aren't taken always at specific doctors causing people to go to other doctors and then the whole referral system for people becomes very confusing. Medication management just medical record management all together becomes an issue and the students brought up a good point. Some of them that are coming into San Antonio with insurances that are outside don't have access to medical care even though they have medical insurance. So there's a huge increase in cost for their medicine. Increase in cost of out-of-pocket medical expenses if you're working, families are working with in-network versus out-of-network physicians and then with a whole affordable care act coming into place giving everyone free healthcare but at the same time having a shortage in the medical workforce to be able to provide the service to families. So that was an issue on ours and it was sort of touched in a different, a couple of different ones but this was specifically targeting about the healthcare system. Everything else was relevant. Great, so we got everybody? Let's figure out how to do this. So who's interested in talking about issues around safety a little bit more? Raise your hand. Who's interested in dinner? Just checking. How about safety? Even though that came up in many of the groups. You want to do safety? So over here at this table we'll have folks who are interested in talking about safety. How about access to resources? We got two, anyone else? Okay, how about we keep the access to resource folks here? How about physical activity options? How about healthy eating, active living together as one group? Heal issues together as one group? I know I was thinking that but there are a lot of folks here. I'm curious to know what everyone else wants to do. How about healthy eating? Okay, so back there. Anyone who wants to talk about healthy eating? Back here. Physical activity? Maybe, I wonder if we have enough. Should we break it up? Sure. Why don't we do the physical activity folks here? So healthy eating, physical activity, safety, and what was this one? Thank you. Awareness and access to resources. Now the rest of you who haven't signed up for things, what are you doing? Safety? Is there another area that you wanted to do that we didn't identify? There was transportation, there was self-esteem. Anyone want to do that? You do? Okay, self-esteem, self-image is over here. You could be a group of one. That's okay. There's power of one. Exactly, right? Thanks for coming. So, remind me. Okay, and you'll facilitate. Okay, you're in good hands. You're in good hands. This is active living? You're in good hands. Safety? Oh, I should get them a pad, huh? Can I grab a piece of paper too for this group? Excuse me. Oh, this is... You do? Wonderful. Oh, got it. You know why we're just recording some of this, okay? I'll get you a marker. You're a good husband. Exactly. I had a lot of fun last night. That was a good place. Zombie mode, you have all these different types of runs. It's like a social thing. People are actually getting into it. That's really neat. 5K runs have become a social thing. It's a cool thing to do. It is a cool thing to do. Which is good. But those cost money. The people that are going to be in it are going to be like... Exactly. People can afford to pay the entry fee, whatever it might be. Is it usually $15, $20, $25? Sometimes more. Really? I know that. Do I really want you to pay to run 5K and get a t-shirt or do I just run in my notebook? Yeah, I really like the t-shirt. Some of them are like, can you get a beer afterwards? Yeah. But it is fun from a social perspective. It's neat that it's encouraging people to get out there and do something. What are other positive things that you see going on in terms of physical activity in the community? Well, like what they did with Cecilia a couple of weeks ago. And that's free, right? Yeah. It just seems like you go out there and you realize how easy it is to just get involved. With things like that. If not that hard, just pick a date and a time and everybody will go. Yeah. How many of you heard of or were able to go to Cecilia? So it was this outdoor, they closed down part of the Broadway and you can ride your bike. You can walk, you can run. You can roll your blade. And there's lots of boots that have yoga and CrossFit. Also so different. Simba. Yeah. So Cecilovia is kind of in the why actually sponsors it. It used to be something that the city got into funding from a grant to do. And then they were able to transition over the why. The way why was able to keep it going. Otherwise it might have just happened once or twice. So Cecilovia is another example of something positive. Any other things you guys can think of? Well like, all that I, you know, in my social group, we all have kids and we put all of our kids in sports. And so our weekends are like sports oriented. The summers are only time off if not basketball, baseball. It's just non-stop year round. So it seems like, you know, we're becoming more conscious. But I mean it's only certain areas and certain groups obviously. But becoming more conscious about how important it is to start at an earlier age. To have your kids be active. And not just to be active but to realize that there's fun ways to be active. You know, like it doesn't mean you have to go run on the treadmill for 30 or 45 minutes. And that's the only way you're going to get fit. There's other ways to do it. And it just seems like now more so like team sports is like a big, yeah. A big thing. Especially with San Antonio getting all of the new teams, like the new Scorpion soccer team and the new indoor football. I think it's going to go up. And it also seems like around Olympics time, like everybody wants to do something. Everybody wants to do some gymnastics and swimming now. You know, because it's only Olympics. And it's more, you know, like, it's more public, you know, as far as like, you know, like, look what they're doing. You know, a lot of people are involved. Or it seems like a lot more people are getting involved in team sports and intramural. What are some of the challenges when you think about physical activity and how important it is in this community for people to be physically active? The money, like you said, like even if you play for like, I know the YMCA is a lot of people's cheapest option. But I've noticed throughout the years, like it keeps getting more and more expensive. Yeah, so like from when I was little, it was really reasonably priced. But like for my little sister, she wants to do all these different sports. And it's like, no, you have to pick one because it's too expensive. So it's expensive to be involved in some of these organized sports activities or gym memberships. Gym membership is special. Getting involved in physical activity programs. What are some other challenges? Yeah, like, no, I was telling them earlier. I just did this research project where I gave everybody a survey to see what their various challenges was. And the number one, two and three were lack of willpower, time and energy. You know, especially as you get older, you start feeling it. You have less energy. Like, I think about what I could do 10 years ago and I'm like, my gosh, I can't do that even if I try. In a way that I could keep up all of this and still be like, okay, and be able to go out, you know. So now it's like, people make all these excuses. It's so much easier to not do it than to say, look, I'm going to make time. I'm going to, you know, try to get up and use what little energy I have in the morning to do a little bit, you know. And, you know, it's that willpower. It's hard to get going, especially like if you see like your kids sleeping. It's much easier to be like, God, I just want to, I'm just going to go back to it. You know, so it's like, I think that the most of it is like the time. Time, you know, to really have time to exercise. And the thing about that is that people don't realize, and I think this is what like where we can focus to is like making people realize you don't have to do like 30, 45 minutes or 30 to an hour of intense workout at a time. You can just put it up, you know, like if you have during your lunch breaks, you know, you'll walk up and down the stairs at work. Or, you know, just do, yeah, just do simple things like that, that it can add up. When people think of like after workout, they think I have to make an hour and a half of my entire day just for that. You know, I'm not going to have the energy to do it. Others just do it in no way. But if people need a little bit more that they can do it like in spurts, it'd be a little bit more like, oh, I can do it. You know, that's something I can do. It doesn't seem something so out of reach, you know? What do the rest of you think about in terms of challenges or related to physical activity or being physically active? What do you see as some of the challenges? It's kind of stuff that she's already gone over personally with me. I would say it's time. Time? I take 15 hours as far as school, at least per semester. I work at least 35 to 40 hours a week. I'm in a sorority for when I've got a lot of volunteer hours outside at least one step. And it's just time. At the time, like I leave my apartment at like 6.30 to 7 in the morning at the day. By the time I'm home, I start. So you're one of those people who when you say, I don't have time, you really mean you don't have time. A lot of people are like, I just don't want to make the time. Right. I mean, as far as that, I mean, I've had friends who are like, hey, I'm fine. I'm fine. I'm fine. It's a place for me to do it because I will if you find it. But for me, since there's a lot of time for working here, there's lifestyle choices that I make. Whereas, as far as elevators, there's no shuttles on campus, things like that. Like he said, small steps that you can take if you feel like you don't have that hour or eight going out. Which keeps you active. Right. At least walking. Yeah. And I'm kind of worried, you know, like I parked at the very top of the hill. I have to walk up and down to get to class and things like that. What about you guys? What are some of the challenges that you see? Pretty much the same things. Yeah. I think we all have like a little bit of time at least to work out. Because my dad, he works out during commercials. Like in his bed, he'll just crunches. He'll just, he actually just brought a dog just so he'll go around because he doesn't like being by himself. He's a counter survivor and he lost a lot of weight. He looks really young because he's 50 and he lost a lot of weight and he got really healthy. He made it. That's how he did it because he just wanted to. So, did he lose a lot of weight because of the cancer? Did he lose a lot of weight when he realized he really wanted to? That was a way to... No, I guess because he really wanted to live. He just didn't want to leave. So after the cancer, he started gaining a lot of weight and the doctor told him, well, you want to get better, you have to do this. And he did it. So he'll try to do different things, just little small things. Like walking up to stairs at the house and then coming back. Stuff like that. So I think we do all have time. Well, in that example, you walk instead of, you know, drive or you use the stairs instead of elevators. And I know during it, while you're watching a show, it's like, oh, I just did like my playing spot. Swatching during a commercial. You get your reps in and you go like that. But somehow... Sometimes too, like even running around my one year old, I'm like, okay, it looks great. You know, and we're like, let's go back and forth. And then, you know, like, we're just, we do things. And like, I feel like then, like afterwards, I'm like, I feel like I just got a workout. You know, and it's like, I realize that, you know, just little things like that are like, not, you know, they're not going to substitute a good solid workout. No. It's better than just sitting there watching him play. It makes a difference. You know? It's sort of essentially makes a difference between someone who has an active lifestyle versus a really sedentary lifestyle. Because you're active. You might not be, like said, going and running for 30 minutes, but you're an active person. I'm going to my older son's baseball game. Running after him is definitely a workout because he's like running everywhere. And I'm like trying to watch and trying to go get him, you know. And it's like, it's keeping me young. So what are the resources available to all of you in the neighborhoods and your communities? Well, I know. I was telling them at the other table, I've lived like, you know, where Woodlawn Lake is. So in that community, like we used to just be able to walk like a minute tops because we lived down the street to Woodlawn Lake and we were on the track. But if you tried to do it in the, if you were a little bit further in and you tried to do it in the neighborhoods, you probably wouldn't feel safe. And like the neighborhood that I'm at now is right across the street from UTSA. And it's, I've known the community for a long time. It's mostly like older people and stuff. So I feel safe even to run at night if I have to or to run early in the morning when it's so dark if I have to. And there's people always in the community. So I don't feel like I'm ever alone because other people are always running. Folks out there. Also. So that's for those two communities that I pursue. What other resources do you guys see out there? Well, for me, I think we are very lucky. Him and I, we, we go to TAMUSA. And we're at the Brook City Bays Campus and TAMUSA has a contact with the Brook City Gym and we have free membership there. We just have to take our IDs. So I know like I see him at the gym like all the time like we're in between classes or you know whatever because it's just, it's there. And I've made it to where I'm like, okay, if I have a break, I'm going to go. The bad thing is like around this time when everything's due between the boys like you don't, you know, you don't make the time to go do it because it's like that one time I used to have is like, you need to do something. So. And then these resources you guys can think of. So gyms related to school. Yeah. Well, see in my neighborhood, like it's, I feel like I can walk out at any time. At any time. It's a huge difference that you think when you feel safe in your neighborhood versus not. Like I'll take the baby. We'll get him the mail. You know, even if you get the mail, like it's like I never drive to get it. Like we walk to the mail. But I know it's not like that for everybody. Right. So for you guys it sounds like the resources are pretty effective. Maybe like if more places had open gym nights, like there's YMCA's like all over, but people can't necessarily come in and play basketball because they don't have a membership. Right. So maybe if there was open gym nights, like more often, then, you know. It would encourage for me to try and get membership. To try and get membership or at least to come. Or like a friend of mine made a good comment. Like some of the neighborhoods where there's not a lot of access, two things that people have access to in those neighborhoods are schools and churches. You know, if you get something with the school, you know, it's a public thing. Yeah, nobody wants to stay afterwards. You know, I get it to like make sure that nobody messes with anything. But if the gym at the school could be open, you know, for basketball. Like every night, not have like limitations or you know, things like that, that wake people in the community. You know, if kids go to school, you're going to be advised. You know, it's not going to be too much of a struggle together. And you know, even at like programs, like to be implemented like at churches, you know, to make them more aware and tell them, hey, you know, we're going to all get together at this school, at this night to do like a Zumba class or something like that, you know. So use existing facilities. Because they're there, they're just closed, you know. Could you jot that down as an idea? Exactly how he was waiting for that. Use existing facilities for physical activity groups. So as you think of... What resources for activities are needed in your communities? What's missing? Well, in my community, I don't... I think we only have one YMCA and it's really small and it's mostly just for childcare. So you need more places that you can go and... We have one like right next to the park and that's the basketball court. But it's not open all the time. It's mostly closed or it's only during school hours I'm sure if you had a YMCA that had a pool like this one, like with that slide and things like that, I mean, people would go like awesome along. Like in my hometown, like the main thing there it's Boys and Girls Club. Like when I went to elementary, the bus will pick you up there from the Boys and Girls Club dropping off there, you would exercise and your friends would pick you up afterward. That's all I did during elementary. We also had a swimming pool at my elementary. We had to learn to swim and it was actually required. But yeah, we had stuff like this and when I moved over here to San Antonio where I live, it's not like that. I don't even think I've ever seen a Boys and Girls Club in my community. Yeah, I know the only Boys and Girls Club that I've ever seen is by UTSA and that's not where most of the San Antonio population lives. I would say, like, we're just talking physical activity. I mean, as far as physical activity goes to, I think it also goes back to the environment because it has to be fully erased. So I mean, as far as me, even though I'm really, really busy, I was raised not taking care, not, I mean, parking far away and not... You were raised, though. Right. So your family heard something that I... Just came up. Right. On my own. Like, my mom, you know, does the same thing. We probably go to Rochester, we park far away, and it's no easier to put this time around to provide a spot right in front of the walk. And so... Driving for 10 minutes. For a 10 minute walk? For 10 minutes? Yeah. So it's kind of just something that needs to be instilled in these two years. Yeah. That's true. I sit around everyone. So I tell them, we gotta run. Like, everywhere we go, take quick spreads. Like, just run. Yeah, and I... I babysat for a while, and I would just babysit. I babysat. Mm-hmm. Let's go for a walk. Let's go to the playground. Let's go to two-year-olds. They live in a hard house, go to your gym, and things like that. Take a walk and things like that. Do you think of any other things that would be nice to have, or anything else you want to share related to kind of this whole concept of physical activity? Well, like, in some communities, I think that it was as developed, like, as far as, like, you know, they had the proper lighting and the proper sidewalks, you know, because people... And even, you know, like, the bike lanes. So now, can you write that one down to sidewalks? Like, the bike lanes? Lighting. Lighting is really important. Because, like, there's... I mean, there's some areas, even, you know, up north, it's not just, like, one area. But where there isn't enough of that. And if somebody does want to go out for a bike, you know, it's dangerous. Yeah. I think there should be, like... Maybe, like, security guards are ventures. Y'all have been to a running trail that's kind of scary to go to at night. If it was lighted, or if there was maybe security that was supposed to ride a bike through it. Or the more people that are out there may be safe for the rail. Exactly. I think that there should be, like, in different communities, there should be suggested, uh, trails. Like, not trails, but, like... Routes. Routes. So, like, you know what roads, so, like, if there was, like, a little board, like, how they do at the trails, they have those little boards that say the different levels. And how far. But in a neighborhood, in a neighborhood, it would be just as easy to do that and make sure that you're listing, like, the streets that are the most lit up, or, um, the different lengths that you could take, like, take a ride on Green Glen, take a left, and then that's a line. I mean, you could even form walking groups or exercise groups that way. And you would be like, oh, I'm gonna go do that long loop, and I'd love it. Just groups, period. Groups is the best way to get... Look at all this. You guys ready? Yep. So one person, I just need to, kind of, share some thoughts from the group. Okay, in a minute? Mm-hmm. Who'd like to do that? Okay. So, shall we start? Can I talk about... You ready? Yeah. Who's going, you? Would you just, again, remind people what your name is? Okay, just say it to the group, and then a few observations. Okay, folks. Here we go. We're gonna start back here. We gotta volunteer. So again, if you wouldn't mind sharing your name with the group. Can people hear you? Okay, good. Things we highlighted. A few things we highlighted were, um, the stray dogs that apparently are running around the east side. Um, the gang activity. Um, the... the streets that need to be cleaned up. And a lot of people don't want to go outside to exercise or just leave the house in general to go to the grocery store, walk to work, or even drive wherever they need to go. So they stay in their house, and they live a more sedentary lifestyle. Um, so we would like to increase the security in our communities by... what does that say? Oh, creating more gated communities and creating safer park environments. Um, also fixing the streets, especially on the east side. Um, providing family appropriate activity centers, and also age appropriate activities. That was a big thing. Um, that are either free or, like, low cost. Uh, changing fast food to healthier options or healthier restaurants. That families can sit down and go to and have family bonding time instead of it all being a separate type of thing. Um, a neighborhood watch program possibly being implemented. Uh, cleaning up the appearance of our neighborhoods with adding some greenery and cleaning up the streets. And building of community sites such as libraries, which would improve the aesthetics of the community, as well as provide more resources and access to resources that are free to the public. Okay, great. Well, thank you very much. How about a hand for Ivory? Thank you. Another group. So, all right. Again, your name? My name is Ali and I'm a program coordinator with the Health Collaborative. Um, so I want to start off by saying I notice Ivory mentioned the east side. Um, but we're in the north side. One thing I notice in our discussion is every time we were talking about what we wanted to see, it was for other areas. Not necessarily the north side. Our conversations kept going what other areas need. So, I just want to point that out. Um, so, a negative part of self-esteem is the self-fulfilling prophecy. You know, like if you think you're fat and you're never going to mount anything, you know, you're never going to want to better yourself. Lack of self-esteem as a barrier to accessing resources. If you don't have a good self-esteem, you know, oh, I'm fat, I'm never going to be able to work out. You're never going to get a gym membership by healthy groceries. A positive part of self-esteem is, um, as a role model, you know, if you have good self-esteem and you can be a role model, you know, hey, I lost 300 pounds, you can do it too. You know, acting like a role model. Um, showing your struggle into success, being authentic about it as well is really important. Um, being supportive, supportive environments. What I made is, you know, for instance, walking into the Y, it's kind of, I was kind of intimidating, you know, seeing everyone pump in the iron, so you have to be supportive and have a supportive environment. Um, and then some things that we said is like, uh, the YMCA has group involvement, um, churches. There's a lot of churches around in the area. The schools, a lot of the schools have like, you know, basketball courts and playgrounds outside that the kids can access after hours. Um, we want to see encouraging individuals to reach out to their highest potential. Um, other things that we talked about were more, uh, that we want to see in this area though, is, uh, more open, uh, community spaces. Um, for instance, Parliar said the, uh, the park, what is it, McAllister Park? There's a park there, but it's always packed. So, maybe more open community spaces. Um, also one thing we talked about is community swimming pools. Not a lot of the communities in this area have swimming pools. And even some of the ones that are there, you have to pay for. So that's something that we would like to see, um, mobile health clinics, um, you know, owning your health and having the resources to make those decisions. Um, uh, more accessible day care centers. And our point with that one is like, you know, say you're a single mom and you know you need to work out or lose weight, but then you have, oh, I have a child. What do I do with my child? I can't go work out. So that, um, then awareness around resources available throughout San Antonio, um, and not stigmatizing choices of those without resources. Which means not saying, oh, people in the west side are fat because they go to the doctor or whatever. You know what I mean? And that was, you want to add anything? Did I hit everything? Good, okay. All right, nice work. Thank you. All right. Another group. All right. So what we addressed was, um, awareness of resources. And what we thought of, she brought up a great idea was contacting churches. Since majority of the ethnicity here is Hispanic, so high percentage. And most of them end up going to church on Sundays. So we thought maybe we could provide screenings there, more events, and maybe develop resource booklets. Because a lot of them are, oh, you can go on the internet, access a public library. Not everybody has time for that. But everybody has time for church, especially if you're that family-oriented with religion. So I believe on Sunday the churches did hand out those booklets, or if we developed booklets that had, you know, all these events, access to medical services, or free clinics, free screenings, that would be great to know. And, um, I also talked, we also mentioned, um, mass transit. Maybe they developed a relationship with the buses. Most of the people that go on buses are the poor population. And I've seen lots of people that are, you know, reading magazines or listening to their iPod or newspaper. Um, if we also provided, you know, resources there that can communicate with them, that type of population about weekly events, again free clinics, contacts that you can call. Maybe they can contact Health Collaborative if they wanted to and find out more information one-on-one. Um, because nowadays everybody has a cell phone, so they can probably do that. And she mentioned a really great idea about community gardens. I never thought of that, which sounded awesome to basically maybe have community gardens, and if you go, you can grow. If you have time to grow a whole flower bed, why not grow your own vegetables or try to grow it yourself, especially for the senior community that have lots of time on their hands. I mean, they can probably grow for the community and then have days where you can give it out to, you know, an event. And yet, again, people will know about the event because we could provide all the resources of what matters for it. So, um, that's basically all we had. And I talked about college too, like, awareness in college. Not too many students know how bad food is until they do, until they gain weight. Which myself, in my first semester I did horrible, because I didn't know. And now I'm horrified by our food there. We have a cafeteria that doesn't have any type of healthy food. We don't have access to any type of vegetables, and we need to be aware about that too. Maybe have more clinics there about health awareness. We have eye clinics. We have blood pressure clinics. We don't have clinics that talk about healthy food. So, even around that area, and our college is in that area too, but also in other areas just everywhere in San Antonio. So, that's basically all we addressed. That's what I was going to say. So, kind of the low-hanging fruit for these volunteers tonight may go back and talk about what kind of food options. There's a school system. We work with Abby and I in Williamsburg, Virginia in the elementary schools where they're getting elementary school kids to do tasting menus. And what they're trying to do is they're trying to make sure that they don't have to have to have to have to have to have to have tasting menus. And what they're finding is that the kids are invested in the food that is being served to them. There's a greater likelihood they're going to purchase that food. So, good for you all. Maybe this will turn into kind of a movement. You could... So, that's a little bit about awareness of resources and information, right? For them too. Great. Thank you very much. How about a round of applause? Thanks. Great work. We've got some advocates. Alright, one of the other two groups who wants to go? Great. Tell folks your name again. I'll come over here so I can see it. Great. Okay, my name is Zaina. I'm a freshman at Incarnate Word. We talked about physical activity and we did have a lot of positives that we saw in our community. So, we always see people actually going and it's usually more family oriented. So, that's definitely a positive. I was talking about how I noticed this whole 5K fad thing that's going on. So, I don't know, you probably see it on Facebook all the time, all these different 5Ks that you can do, the color runs, all that different stuff. But, the downside with that is that most of them are costing, you know, anywhere from $15 to $50. So, maybe if we had some more free ones, we were talking about the Ciclovilla. So, that's a really good resource. But, we need more of those to get the community, like, up and at it. Let's see. Oh, we talked about cost of gym memberships and physical activity programs being an issue. So, like, you know, little kids love sports. They love to get involved with their friends. But, most of the time, they want to play every single sport that they know of. And, they just can't because it's too expensive for their families and then that becomes an issue. Let's see. We have lack of willpower and time. We're such a busy society that we might not always be able to find the time to actually work out and get our kids active. So, then we would try to brainstorm some ideas on how we could improve the community. And, we thought about using existing facilities for free activity groups. So, think about all the elementary, middle schools, high schools that we have in our communities. They all have gyms. They're playgrounds. Some of them have tracks. But, they're closed most of the time when we could go. So, they're open during school hours, but then they close them. So, maybe if they were open more, they could have more open gym opportunities and get the community involved. And, transportation, it would be a lot easier to get there because you would just go to the elementary school that your children go to. That's right down the street from you. We talked a lot about sidewalks and bike lanes and lighting in the community. So, while people are getting out there, they might not have sidewalks and lighting that would make them feel safer. And then, we thought of the idea of, you know how when you go to like bike riding trails, they have the boards that say the different routes. Well, they could easily do something like that in neighborhoods where they say if you want to run a mile you know, you follow this track. If you're two miles, you can follow these streets. And then, they could put like the safer streets. They would be aware of the ones that people feel more comfortable on. So, they could easily make tracks like that. They could take the more lighted streets into account. Sidewalks, you know, a lot of streets might have potholes and stuff like that. So, they could probably put together some kind of board that informs people this is the best track to run on in this neighborhood. Great. All right, thank you for those ideas. Final group? Great work. We were focusing on healthy eating and I'm Alyssa from the Health Collaborative. Our main focuses were the disconnect between the community, the nutrition educations that are available. The education classes mainly focusing on food safety and food prep because if you are new to cooking fish and chicken and better options then you need to know how to prepare those items safely. And then also moving with the education addressing portions for kids and adults. The difference is between those and then the peer influence because they could have a positive influence like, hey, no, let's not go get seconds. Let's go walking instead after we eat. And then also it could have the negative aspect that encourage the seconds or encourage the empty calories in the drinks and then peer influence can steer in either way with the portion controls as well. And then the barriers that we addressed are definitely access to healthy foods. Most food deserts that we mentioned they do rely on their gas stations to get quick items if they don't have a grocery store close by so they are paying higher prices for those food items and then their options are limited as far as fresh foods and vegetables. Another barrier that we addressed is that they are assuming that those better healthier options are out of their budget range when in fact they are already paying higher prices on processed foods and boxed items when they can just readdress their budget and plan out their meals to include those fresh items. Also another thing that we did mention in other groups is they are unaware of the resources that are available to them to help them plan those meals. We decided that we wanted to see program wise affordability healthy food options advocacy to make those items better. I know what we mentioned was McDonald's automatically salting their burgers so if we could get a policy that addresses that to get them to change that simple thing that would help those people that are watching their sodium intake and those that are unaware that McDonald's would be better. Let's see we also focused on school lunches getting all the districts to kind of be on the same game plan. I know north side or northeast might be a wealthier school district and they might have access to those salad bars and fruit bars or a school garden and some of the other less fortunate districts don't have access to those. They're more evenly so all the kids in San Antonio areas get those same available options and then was there anything else that I needed to let's see definitely promote the nutrition classes that are available already and connecting those with the community. Great, alright well thank you very much. I don't know if you all realize but I know this was for a volunteer effort but you've all become health advocates in your own way so hopefully there's some opportunities here where there may be some things you might do individually but also maybe working within the institutions of your own family there could be potential change so we really appreciate your level of engagement, your thoughtfulness we want to record this information what I'd like to do is turn it over to Steve to kind of do a closing piece and share with you kind of so what are we going to do with this information and how you might want to stay involved. I think before I say anything Steve come here please I think we should I think we should thank Steve for his helping us make the conversations he made it easy we have Abby here and Elizabeth and Catherine back there kind of quiet and Allison over here and back there is Jennifer so I want to thank HRIA Health Resources in Action but most importantly thank you for coming here and giving your voice some very powerful issues were stated and some strategies talking about barriers and ways to get beyond the barriers very powerful stuff and you and I are going to connect on the campus soon and talk about that cafeteria so I think I want to thank you for that I would say at the outset how this will evolve this is not something that will change the world tomorrow the conversations we have now but incrementally we are changing the world and the conversations and the documentation of this it does go into a report but it's not a shelved report it becomes part of an action plan incorporated into ways of it's actually called a community health improvement plan with indicators to see whether we're moving the needle and developing resources to help perhaps with lighting and overcoming some of the barriers to see whether we're actually making a change and like also said earlier Steve and I met with the mayor and his staff over the last couple of days and they're very open very interested very listening to the voice and one of those manifestations was that half a billion dollar bond that came out a year or so ago that began the changes in lighting in neighborhoods improving the parks so we think well half a billion so probably we need another billion to make it work and perhaps that's where we'll all end up doing that but your voice is a part of that whole process so I thank you for taking the time and coming here this evening and engaging us and yourselves in the conversation engaging the community the larger community of which we're all apart so yes ma'am sure it means a lot that you guys were able to share your thoughts a lot of your own personal reflections we had a lot of people that were here tonight that actually are not of San Antonio you're actually coming from Houston or from California or other communities and the information that you brought today your insight that you brought from other communities in how San Antonio can gain from those experiences is really beneficial for us what we're going to do for you is send an email to your professors to let them know exactly what you were a part of tonight and we're also going to provide you guys with a copy of the health assessment report that we did in 2010 and give you an update for the 2013 assessment when it rolls out when you guys see this report and the 2013 assessment and the long term plan behind it it'll be something that you're really going to be proud of because today what you did was empower not just yourselves but you gave voice to a lot of other communities a lot of students that are in the same situation as you guys are that are living in the communities that you are living in and so when you look at this 2013 assessment as it rolls out and we're going to keep you connected with that and keep you aware of that you'll be able to see the long term vision and the part that you guys played today is so so important you guys should be very proud of what you did today and for that we applaud you nice work ok what's next we're done so there is a table full of nutritious sandwiches and carrots and broccoli and squash that I've been eating and other things so thank you again thanks again so now what school are you from I'm from San Antonio you too oh you said an Incarnate I'm Steve Ryan you're from Incarnate Word oh K&M as well ok great so now you're getting credit for this so we'll get a note back to your professor saying great job