July 3, 2025
White Paper: Quality of Life in San Antonio, TX
By: The Better Future Institutes Civic Tech Scholars
5 min read
White Paper: Quality of Life in San Antonio, TX

Insights from Better Futures Conversations: Public Policy and Civic Lab

Session 6 – Quality of Life: Mark Carmona, Chief Housing Officer - City of San Antonio City Manager’s Office, Rita Espinoza, Chief Epidemiologist - City of San Antonio Metro Health Department, Dr. Carol Huber, Deputy Chief Public Health and Equity Officer - University Health System

Better Futures Institute

Introduction

The Civic Tech Scholars, a program by the Better Futures Institute, hosted a panel discussion featuring Mark Carmona, Chief Housing Officer of the City of San Antonio City Manager’s Office, Rita Espinoza, Chief Epidemiologist of the City of San Antonio Metro Health Department, and Dr. Carol Huber, Deputy Chief Public Health and Equity Officer of University Health System. This session focused on Quality of Life, particularly from a public health perspective. Panelists discussed the social and economic factors that impact quality of life in San Antonio and explored how urban planning, public health initiatives, and community engagement intersect to create an equitable and sustainable city. The conversation led to key civic insights and revealed challenges that must be addressed to improve the well-being of all San Antonians.

This white paper reflects the findings from the Quality of Life session in the Better Futures Conversations Series, focusing on the factors that contribute to quality of life in San Antonio, with an emphasis on public health. Key topics include financial stability, housing access, healthcare, and safety. The session highlighted the interconnectedness of these factors and explored avenues for further improvement, such as equitable transit-oriented development, leveraging technology for equitable housing, and addressing the social determinants of health. Promising practices, such as Beat the Heat and housing-first initiatives, are already making an impact, while climate change, accessibility of outreach, and displacement remain critical challenges.

Methodology 

This white paper marks the first step in a collaborative research initiative aimed at gathering resident feedback and stakeholder input from the San Antonio metropolitan area. Small groups during the panel compiled key insights from the discussions, identified promising courses of action for San Antonio’s urban and economic development, and highlighted critical challenges the area still faces in terms of improving the lives of its citizens.

The next phase in this research initiative involves developing a consultation plan to engage San Antonio stakeholders and community members. This plan will include conducting surveys, community meetings, and developing online platforms to gather feedback that will inform future policy recommendations and guide further research.

Key Recommendations:

  • Develop equitable transit-oriented development strategies to ensure accessible and sustainable urban growth.
  • Leverage data science and technology to make housing more equitable and efficient.
  • Focus on addressing the social determinants of health that are most critical to the well-being of San Antonio’s vulnerable populations.
  • Improve outreach and accessibility to ensure that underserved communities have access to the programs and services they need.

Key Themes and Opportunities for Further Exploration

1. Defining Quality of Life

Panelists agreed that quality of life encompasses several interconnected factors, including financial comfort, housing, access to healthcare, safety, and a sense of community for San Antonio residents. A report by the Journal of Epidemiology and Public Health found that living as a couple, level of education, employment, and income were social factors that affected quality of life (2013). However, they also emphasized that quality of life is subjective and can vary depending on individual circumstances and needs.

Key Opportunity: San Antonio can improve the quality of life by prioritizing equitable housing policies and healthcare access. A holistic approach, addressing financial stability, housing, healthcare, and safety simultaneously, will be key to fostering well-being for all residents.

2. Equitable Transit-Oriented Development

One of the most pressing questions raised was: What would equitable transit-oriented development look like in San Antonio? According to the National Association of Realtors, homes within walking distance of a rail station “sell for 17% more than comparable homes in the same neighborhood” (2025).  Transit-oriented development (TOD) integrates sustainable transportation with urban planning to reduce sprawl, increase accessibility, and promote healthier, more connected communities.

Key Opportunity: By integrating transit-oriented development into urban planning, San Antonio can address accessibility issues and reduce socioeconomic disparities. Developing pedestrian-friendly infrastructure and expanding public transit options can improve access to jobs, healthcare, and social services, especially for low-income and underserved communities.

Passengers on the San Antonio VIA Bus (Source: Ashton Rodgers, San Antonio Magazine)

3. Leveraging Technology for Equitable Housing

Equitable housing is a key factor in improving the quality of life in San Antonio, particularly as rising property values and displacement threaten long-term residents. Ways that the city has combated the ongoing housing crisis has been used in the Towne Twin Village, where they have utilized housing data and property values in their “combined Housing First (HF) and Permanent Supportive Housing (PSH) model” that has been “highly successful as well as highly cost-efficient” (2025). In designing data-driven policies, communities such as Twin Towne Village have been able to optimize services and provide housing stability for the homeless San Antonio population. The panel discussed the need to leverage data science and technology to create smart housing policies that are both efficient and equitable. 

Key Opportunity: San Antonio can expand its use of data science and technology to inform housing policies, ensuring that affordable housing is targeted to those most in need. This will help prevent displacement, particularly in areas vulnerable to gentrification, and foster long-term housing security.

4. Targeting Social Determinants of Health

Social determinants of health, such as housing stability, access to nutritious food, and employment, were emphasized as critical to quality of life. The Centers for Disease Control found that the level of education and diagnosed diabetes in adults were highly correlated in each ZIP code of San Antonio. Additionally, there is a strong relationship between the percentage of the population aged 25 years and older without a high school diploma and diagnosed diabetes (2023). The panel discussed the importance of targeting these determinants in San Antonio’s underserved communities to improve overall public health outcomes.

Key Opportunity: By focusing on these social determinants, San Antonio can improve public health and reduce health disparities in marginalized communities. Housing-first initiatives like those championed by Mark Carmona are critical for providing the stability needed to address broader health issues.

Current Solutions in San Antonio

Despite the challenges identified, several promising practices are already making a difference in improving the quality of life in San Antonio:

  • Beat the Heat Campaign: This citywide initiative educates residents about the health risks of extreme heat and provides resources like cooling centers and safety tips. This program is vital as San Antonio continues to face rising temperatures due to climate change.
  • Twin Town Village and Haven for Hope: These programs focus on providing housing-first solutions to combat homelessness. Twin Town Village uses data-driven decision-making to ensure housing stability, while Haven for Hope operates on a model of meeting people where they are, offering outreach to jails, streets, and underserved neighborhoods.
  • Efforts to Cap Housing Prices: There are ongoing efforts to implement housing price caps in areas vulnerable to gentrification, ensuring that long-term residents can remain in their homes despite rising property values.
  • Housing-First Philosophy: Mark Carmona emphasized the need for a housing-first approach, which views housing as a fundamental human right. By providing stable housing, people are given the security they need to improve their health and quality of life.

Critical Challenges

While there are several promising programs in place, there are also significant challenges that must be addressed to improve the quality of life for all residents in San Antonio:

1. Climate Change

The panelists highlighted climate change as a significant threat to public health and quality of life in San Antonio. A report by ClimateCheck found that by 2050, San Antonio is projected to experience an average of about “47 days per year over 100.8 degrees Fahrenheit” (2025). Rising temperatures not only exacerbate health risks but also make it difficult to promote urban density and sustainable transportation options, such as walking and biking.

Key Challenge: San Antonio must integrate climate resilience into its urban planning and development strategies, focusing on heat mitigation, green spaces, and sustainable transit options to combat the negative effects of climate change on residents' quality of life.

2. Outreach and Accessibility

Despite the presence of many promising social programs, community outreach and accessibility remain critical challenges. While broadband access in San Antonio rose from 80% in 2019 to 82% in 2023, according to a survey reported to the San Antonio Report, this slow growth only scratches the surface of providing full accessibility of resources to San Antonians (2023). Many underserved populations, such as the homeless or those without digital access, are not fully aware of the social services available to them, limiting their ability to benefit from existing resources.

Key Challenge: San Antonio must focus on meeting people where they are, expanding outreach efforts, and addressing the digital divide to ensure that all residents can access the resources they need.

3. Displacement and Gentrification

As San Antonio continues to grow, displacement and gentrification threaten to erode the city’s cultural fabric and displace long-standing residents. According to the UTSA School of Architecture and Planning, the Dignowity Hill neighborhood on the east side that has been experiencing gentrification has seen home values rise from $69,000 in 2015 to $271,000 in 2021 (2023). Rising property values and the influx of new residents can push out low-income communities, especially in historically affordable neighborhoods.

Key Challenge: San Antonio must develop tools and policies to protect vulnerable communities from displacement. Tools like the Displacement Input Tool, which helps identify areas at risk of gentrification, are vital for ensuring that economic growth does not come at the expense of the city’s most vulnerable residents.

Gentrification has been well apparent in areas of San Antonio, such as Denver Heights (Source: San Antonio Business Journal)

Recommendations for Improving Quality of Life in San Antonio

1. Develop Equitable Transit-Oriented Development Strategies

Invest in transit-oriented development that prioritizes accessibility, pedestrian-friendly infrastructure, and public transit. Expanding green transportation options and promoting urban density will improve the quality of life while reducing San Antonio’s carbon footprint.

2. Leverage Technology for Equitable Housing Solutions

Expand the use of data science and technology to create smarter, more equitable housing policies. This can help reduce displacement, target subsidies more effectively, and ensure that affordable housing is available to those who need it most.

3. Address Critical Social Determinants of Health

Target key social determinants of health, such as housing stability, access to healthcare, and income inequality, that are most critical to improving quality of life for vulnerable populations. A housing-first approach should remain central to public health efforts.

4. Increase Outreach and Accessibility

Expand outreach efforts and address the digital divide to ensure that underserved communities have access to the programs and resources they need. Partnerships with nonprofits, community organizations, and faith-based groups can help extend the reach of public programs.

5. Implement Policies to Prevent Displacement

Use tools like the Displacement Input Tool to identify areas at risk of gentrification and develop policies that protect low-income residents from displacement. Incentivizing the development of affordable housing in high-demand areas can also help maintain San Antonio’s diversity and cultural richness.

Conclusion

San Antonio’s future depends on its ability to enhance quality of life through equitable housing, sustainable transportation, and resilient urban development. By addressing the challenges posed by climate change, expanding outreach, and leveraging technology, San Antonio can build a more inclusive, sustainable, and vibrant community. The insights from the Quality of Life session provide a roadmap for tackling these issues and ensuring a better future for all residents.

References
Castañeda, A. (n.d.). Visualizing the landscape of gentrification pressures: UTSA professor to develop national dashboard to make visible trends of neighborhood change. UTSA Today. https://www.utsa.edu/today/2023/08/story/professor-develops-dashboard-to-track-neighborhood-changes.html 
ClimateCheck. (2025). San Antonio, Top Climate Change Risks. https://climatecheck.com/texas/san-antonio
Kivits, J., & Guillemin, F. (2012, October 26). Social Determinants of Health-Related Quality of Life. Journal of Epidemiology and Public Health. https://pdf.sciencedirectassets.com/276878/1-s2.0-S0398762013X00082/1-s2.0-S0398762013002927/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEAUaCXVzLWVhc3QtMSJHMEUCIQCSgOv3%2BX%2FsFFv2h%2FQVrv0NU30sFU1343qBbwMSLz4ZKAIgO4SVjd3iWmc4RgVRBK7xtv4sruCCSnB6XlUlfm2 
The Real Estate Mantra: Locate Near Public Transportation. (n.d.). National Association of REALTORS®. Retrieved June 11, 2025, from https://www.nar.realtor/research-and-statistics/research-reports/the-real-estate-mantra-locate-near-public-transportation 
SA Forward. (2023). Social Determinants of Health. https://dashboards.mysidewalk.com/city-of-san-antonio-strategic-health-plan-dashboard-5bbc32e941c7/social-determinants-of-health 
Towne Twin Village – Housing First Community Coalition. (n.d.). Housing First Community Coalition. Retrieved June 11, 2025, from https://housingfirstsa.org/towne-twin-village/ 

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