Health report ranks Texas 34th in nation
State’s high rates of uninsured residents, diabetes stand out
If Texas were a patient, it would have to be hospitalized — and the lack of insurance might be a problem.
A new state-by-state health report found the state ranks worst in the nation when it comes to the percentage of uninsured residents. For the number of diabetes patients, it ranks 40th.
Texas also is notable for its severe shortage of mental health care providers.
The state ranked 34th overall in the annual America’s Health Rankings, released by the United Health Foundation, the charitable arm of Minnesota-based insurer UnitedHealthcare. The healthiest state in the country is Vermont, according to the report. Mississippi came in last.
Dr. Rhonda Randall, chief medical officer at UnitedHealthcare, said researchers crunched health, environmental and socioeconomic data to determine national health benchmarks and state rankings.
Texans suffers from an outsize rate of diabetes, with nearly 13 percent of adults in the state affected. Colorado ranked No. 1, with only 7 percent of its adult residents living with the chronic disease.
Diabetes is the nation’s seventh-leading cause of death, the Centers for Disease Control and Prevention reports.
Within Texas, Bexar County stands out. It consistently has a
higher rate of diabetes-related amputations compared with other parts of the state, said Golareh Agha, who leads a team of data analysts and chronic health epidemiologists at the San Antonio Metropolitan Health District.
“It is a really big problem,” she said.
Shortage of providers
Another concern, she said, is that the state ranks 49th in the nation in the number of mental health providers for every 100,000 people.
Texas has 111.8 providers per 100,000 residents. Massachusetts, which ranks first in this category, has 2.5 times as many per 100,000 people. Included in the count are psychiatrists, psychologists, licensed clinical social workers, counselors and therapists who treat mental health and alcohol and drug abuse.
The shortage in Texas could get a little worse with the recent closure of Nix Health System in San Antonio, which eliminated 164 psychiatric beds.
One of the few bright spots in the report: Texas’ high school graduation rate was fourth in the nation. Nearly 90 percent of its students earned diplomas.
Agha, however, said the graduation rate could mask broader problem with educational attainment in some parts of Texas. Census data show 18 percent of San Antonio residents lack high school educations, resulting in limited job skills and lower-paying employment.
According to the Census Bureau, South Bexar County has a higher percentage of residents with no more than a high school diploma or GED than does the rest of the country.
San Antonio also has a lower percentage of residents — 25.7 percent — who have earned a bachelor’s degree or higher when compared to the state as a whole and the country, Agha said.
The report, available at AmericasHealthRankings.org, says Texas ranks last in the country when it comes to public health policy.
Its authors cite lax enforcement of vaccination laws, low public health funding and a lowest-inthe-nation rate of health insurance coverage.
Texas ranked 41st among the 50 states in rates of child immunization, 40th in public health funding per capita and 50th in the percentage of residents without insurance (17.5 percent), the report said.
In Massachusetts, less than 3 percent of residents are uninsured.
Experts say insurance is critical to help people receive the preventive care needed to maintain good health. Compared with insured adults, those without coverage have worse health outcomes, higher rates of mortality and more emergency room visits.
Baptist Health System spokeswoman Patti Tanner said the hospital operator has made efforts to avoid unnecessary ER visits by connecting uninsured patients with primary care providers. Those efforts are subsidized by the private hospital chain, which is part of Dallasbased Tenet Healthcare Corp.
She said that in 2019, Baptist helped more than 4,000 uninsured patients make visits to primary care doctors.
National concerns
The report also found suicides, drug deaths and chlamydia still are on the rise in America.
The suicide rate increased 4 percent nationally in the past year, responsible for 14.5 deaths per 100,000 people. The suicide rate in Texas is 13.8.
Chlamydia is a commonly diagnosed sexually transmitted infection in both men and women and can cause permanent damage to reproductive organs. The highest rate of new cases is in Alaska at 802 per 100,000 people. In Texas, the rate of 535 new cases of chlamydia per 100,000 residents is just over the national average.
Drug deaths are reaching alarming rates nationally — up 37 percent since 2016, largely because of opioids. The state with the worst rate of drug deaths was West Virginia, with more than 48 per 100,000 residents. Texas’ rate was 10.3.
Although the rates of smoking, children in poverty and infant mortality have continued to decline nationally, other health conditions are drawing the attention of public health experts.
Obesity now affects 31 percent of adults in the U.S., up from 12 percent in 1990, when the United Health Foundation first started tracking public health data. Texas fares even worse, with almost 35 percent of adults considered obese.
The rankings, which were compiled with assistance from experts at the American Public Health Association, highlights two national successes: a 45 percent decrease in smoking among adults and a 43 percent drop in infant mortality since 1990.
Texas’ rate of smokers, 14.4 per 100,000 people, is much lower than most other states’. The report found that more than a quarter of West Virginia adults reported smoking at least 100 cigarettes in their lifetimes and said they smoke daily or on some days.
Another improvement noted by the researchers was a 50 percent decline in violent crime nationally since a peak in 1993. But in Texas, the number of murders, rapes, robberies and aggravated assaults per 100,000 people is still higher than the national average.
Randall said the report revealed a troubling trend in the rate of cardiovascular-disease deaths. Deaths caused by serious heart conditions had been decreasing for years, but she said unhealthy behaviors are pushing the mortality rate up again.
Risk factors that contribute to cardiovascular diseases include smoking, hypertension, high cholesterol, physical inactivity, obesity, diabetes, poor diet and excessive alcohol use.