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How Nitya Capital is mixing health care and housing - Houston Chronicle

Starting next year, tenants at one west Houston apartment complex will spend mere seconds to get to their medical check-ups.

Real estate developer Nitya Capital is adding a preventive health care clinic to its Bella Vista Apartments off Dairy Ashford and Westheimer roads. The goal, partner Vivek Shah said, is to give back to the community by improving its health.

The clinic is funded through donations from Karya Kares, Nitya Capital’s nonprofit arm, and will be open to everyone regardless of whether they live in the apartment complex. The Texas Medical Board approved the clinic’s license the first week of December, and Nitya Capital plans to open the doors to the Karya Kares Healthcare Clinic at the end of January.

The clinic is just a first step toward improving the community’s access to health care. Staffed by volunteer doctors and nurses, the clinic initially will open one or two days a week with limited services, such as basic check-ups, blood pressure monitoring and screenings for diabetes, hypertension and other chronic diseases.

The clinic is not replacement for primary health care, but provides the avenue for doctors and nurses to refer patients to physicians who can give them the care they need. If the screenings identify a cluster of similar conditions, such as respiratory illnesses, it will bring in volunteer specialists, such as a pulmonologist.

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“We want to truly improve the quality of people’s lives,” said Shah.

Eliminating barriers

Offering free medical services would eliminate a barrier that keeps many from seeking help — cost — said Dr. Parin Shah (no relation to Vivek Shah), who sits on the clinic’s board of directors. In Houston, nearly one in five people are uninsured, leading many to put off routine care that can avoid more serious health problems down the road.

Parin Shah, who was previously an emergency room doctor at Houston Methodist Sugar Land Hospital, said most cases he saw in the ER were linked to untreated chronic illnesses, such as obesity and heart disease.

“What we find in the emergency room is patients that don't always have access to health care and use our emergency room as a safety net,” he said.

Chronic illnesses account for nearly 75 percent of health care spending in the United States, according to the Centers for Disease Control and Prevention. By addressing and identifying problematic lifestyle choices, such as diet, the Karya Kares Healthcare Clinic board and volunteer medical staff hope to reduce the number of people who develop more serious and illnesses later in life.

People who earn less are more likely to have poor health compared to high earners with better health insurance plans and access to high-quality medical care, according to a 2016 study from the CDC. The average resident living in apartments of Nitya Capital, which specializes in affordable housing, earns about $45,000 a year, compared to the median household income in Houston of about $52,000.

“That demographic is really underserved in many ways across the health care spectrum,” said Vivek Shah. “It would be a net benefit, but it's like, how do we get there from the system we’re in?”

Getting the execution right

The Karya Kares Healthcare Clinic will not be the first time that housing and health care mix. In cities across the country, nonprofits have tried to provide free or affordable health care by bringing mobile clinics to low-income communities.

In theory, an affordable clinic is a good idea, said community health experts. Combining it with affordable housing eliminates the barrier of finding transportation to the doctor’s office and paying for the services.

“Housing is health care,” said Elena Marks, president of the Episcopal Health Foundation, a Houston-based community health nonprofit.

But cost isn’t the only problem for low-income communities. People who live in those neighborhoods are at higher risk of developing chronic diseases such as diabetes and hypertension not only because they may not be able to afford fresh fruits and vegetables, but also because they may not have easy access to them. Environmental factors, such as pollution and crime, can also adversely affect their health.

To succeed over the long term, clinics need to address social and environmental factors and provide consistent care over time that comes with knowing and understanding patients. Plenty of mobile and free clinics have been introduced to low-income communities, but they rarely offer the continuity of care that they might receive with a doctor at the county’s safety-net hospital system.

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“The issue that comes up here is what's the extent to which those challenges are acknowledged and addressed by the clinic,” said Dennis Andrulis, a senior researcher at UT-Austin’s Texas Health Institute.

Long-term aspirations

Vivek Shah acknowledged the clinic is only a stepping stone to addressing large inequalities in health care. The development company’s goal, Vivek Shah said, is to introduce a clinic that will be open seven days a week, staffed by its own doctors and nurses and offering a wide range of medical services. It hopes to shift from just the basics to more complex care as it expands its patient base.

The clinic at Bella Vista apartments is a start.

“You have a lot of people that may not be able to afford any kind of health care, or that are intimidated or scared to go in to get a checkup,” Vivek Shah said. “And so, we're trying to really enhance the access here where people feel very welcome.”

gwendolyn.wu@chron.com

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