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Texas gets a “D-” on rural health report card

Rural Health Quarterly's rural health rankings by state. (Rural Health Quarterly)

When it comes to rural health care, Texas gets a grade of “D-.” That’s according to Rural Health Quarterly's (RHQ) 2017 Rural Health Report Card, published last month by Texas Tech University’s F. Marie Hall Institute for Rural and Community Health.

RHQ's report card ranks states according to three metrics: mortality, quality of life and access to care. This is the first time that states’ rural health has been ranked in a national context like this. For Texas, it’s not pretty. The Lone Star state came in 36th out of 47 states (New Jersey, Delaware and Rhode Island were left out of the analysis due to lack of rural counties.)

RHQ Editor-in-Chief Scott Phillips says the findings weren't a big surprise. “Since 2013, nearly 10% of all the rural hospitals in the state have closed," he said. "And Texas has the highest rate of uninsured residents in the nation. So, those two things alone suggested that we might run into some trouble when we crunched numbers, and indeed we did.”

Texas received low scores for its high rates of death from heart disease and stroke. The state also earned an “F” in “access to care," failing in metrics including access to primary care, mental health care, dental care, and the rate of uninsured.

Access to health care is an especially big problem in the Western half of Texas. According to Phillips - and depending on where you draw a dividing line across the state - 78 of the approximately 108 counties in the Western half of the state are rural. Within those, 64 are designated as “health professional shortage” areas, which means they don’t have enough physicians to serve the population. About one out of five of these counties doesn't have a physician, one out of five doesn't have a pharmacy, and almost one-third have no hospital, according to Phillips.

Not only is emergency medical care unavailable, so is preventive health care. "If you have to take a day off of work and get a full tank of gas, and make a vacation of it, those sort of important checkups and such might not happen," says Phillips.

According to the report, New Hampshire ranked first in the country for rural health, thanks to an abundance of rural doctors and a relatively low rate of uninsured. Vermont and Connecticut were runners-up. Rural Health Quarterly plans to publish these report cards at the end of each year.