TEXAS RANKS NEAR THE BOTTOM FOR HEALTH, BUT THE PROBLEM ISN'T SICKNESS. IT'S ACCESS.

Texas ranks near the bottom nationally for overall health - not because residents are uniquely unhealthy, but because getting care here is harder and more expensive than in most states.

The state ranked 40th out of 50 in the 2025 America's Health Rankings Annual Report, which evaluates nearly 100 measures tied to health outcomes, access to care and everyday living conditions.

While Texas performs reasonably well in some outcomes, the report found the state consistently lags in insurance coverage, provider availability and affordability, dragging its overall ranking down.

Getting healthcare in Texas is hard

One of the biggest red flags is access to health care. Texas ranked dead last for "clinical care," driven by an uninsured rate of 16.7% (about double the U.S. rate) and shortages in provider access. The state has 225 primary care providers per 100,000 people, the worst in the county; and for mental health providers it's 188.1 per 100,000, only second behind Alabama.

The report also found 17.4% of adults said they needed to see a doctor in the past year but couldn't because of cost, which is also second to last. The national average is 11.5%.

The report also spotlights a rural health gap that's easy to miss in statewide averages. For example, multiple chronic conditions (three or more) were reported by 14.5% of adults in rural Texas versus 9.8% in metro areas. Several conditions follow the same pattern in the report's rural/metro breakdown, including things like heart disease and diabetes

Texas ranks low on everyday wellbeing

On the "everyday life" side of things, Texas ranked 42nd in social and economic factors. The report points to high food insecurity at 16.9% of households, placing the state 49th. While high school completion is lower, with 86.7% of graduating, landing another 49th place.

Civic measures are soft, too: voter participation scored a 46th place with the most recent presidential election cycle seeing 52.5% turnout. Texas' voter participation fell from 63.9% to 57.9% between 2020 and 2024.

Not a total downer for Texas

Texas scored relatively well on homelessness (8.9 people per 10,000; No. 8 overall) and housing with lead risk (8.0% of housing stock; No. 5). It also ranks 19th in the share of electricity generated from renewable energy (29.3%).

While Texas is still middling on drinking-water violations (No. 41), the report saw a notable improvement: violations fell 26% between 2023 and 2024.

Texas ranked No. 19 on the report's "health outcomes" category, helped by measures like lower drug death rates and a relatively low premature-death racial disparity ratio. But the picture gets more complicated when you zoom in: obesity is still high (35.6% of adults; No. 32), and teen births run well above the national rate (19.4 per 1,000 teen girls; No. 43).

Even with some high standings in some metrics, the generally low scores around access and in other everyday health measures dragged Texas down into the bottom 11.

Texas vs. U.S.: How the healthcare numbers compare

See Texas' overall performance in notable categories reviewed in the study compared to the overall U.S. averages. (Not all data from the study is reflected. The full list can be found in the report.)

Social & economic factors	Texas	United States
Firearm deaths per 100,000 population	15	14
Homicide deaths per 100,000 population	6.8	6.7
Occupational fatalities per 100,000 workers	4.9	4.7
Public health funding dollars per person	$78	$124
Food insecurity (% of households)	16.9%	12.2%
Fourth grade reading proficiency (% of public school students)	27.5%	30.5%
High school completion (% of adults age 25+)	86.7%	89.9%
High-speed internet access (% of households)	94.9%	94.6%
Voter participation (% of citizens age 18+)	52.5%	58.8%
Physical environment
Air pollution (particle micrograms per cubic meter)	9.4	8.8
Drinking water violations (average per community)	2.6	2.5
Water fluoridation (% of population in community systems)	70.7%	72.3%
Renewable energy (% of total energy)	29.3%	21.9%
Homelessness (people per 10,000 population)	8.9	22.6
Housing cost burden (% of households)	33.3%	32%
Housing with lead risk (% of housing stock)	8%	16.1%
Clinical care
Avoided care due to cost (% of adults)	17.4%	11.5%
Dental care providers per 100,000 population	55.6	66.3
Mental health providers per 100,000 population	188.1	362.6
Primary care providers per 100,000 population	225	291.4
Uninsured (% of total population)	16.7%	8.2%
Cancer screenings (% of adults ages 40-75)	60.2%	64.5%
Childhood immunizations (% of 3-year birth cohort)	66.8%	66.9%
Dental visit (% of adults)	58.1%	67.5%
Flu vaccination (% of adults)	36%	41.3%
HPV vaccination (% of adolescents ages 13-17)	52.2%	62.9%
Dedicated health care provider (% of adults)	76%	83.9%
Behaviors
Exercise (% of adults)	30.9%	30.4%
Fruit and vegetable consumption (% of adults)	8.8%	7.4%
Physical inactivity (% of adults)	25.1%	21.8%
Chlamydia cases per 100,000 population	491.9	492.2
High-risk HIV behaviors (% of adults)	6.1%	5.9%
Teen births per 1,000 females ages 15-19	19.4%	13.1%
Insufficient sleep	36.9%	35.5%
E-cigarette use (% of adults)	7.9%	8%
Smoking (% of adults)	10%	11.6%
Health outcomes
Drug deaths per 100,000 population	18.6	31.4
Excessive drinking (% of adults)	17.8%	17%
Non-medical drug use (% of adults)	15.2%	16.8%
Obesity	35.6%	34.2%

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2026-02-09T12:05:42Z