The F. Marie Hall Institute for Rural and Community Health has devoted extensive resources to understanding the demographic, economic, and health care infrastructure issues of rural Texas, and rural West Texas in particular.
It is important for community leaders, educators, policy developers, economic development professionals, and rural advocates to be aware of the needs facing rural communities as well as the opportunities that abound.
West Texas and much of rural America demonstrate four prevalent population trends:
- The rural population as a whole is growing slowly, but its relative share of the overall total population has dropped markedly.
- The rural population is declining in West Texas counties not adjacent to metropolitan areas.
- The demographic profile of West Texas is changing dramatically.
- Declines in population are associated with factors of economic hardship that are worsening.
|Per Capita Income||% Poverty, All Ages||% Poverty, with Related Children||% Poverty, over Age 65|
|West Texas Border||$18,823||25.7%||30.7%||26.2%|
Source: Most recent data available. Income information from the Bureau of Economic Analysis, 2002 data. Poverty data from the U.S. Bureau of the Census, 2000 Census.
Source: The Texas Challenge in the Twenty–First Century: Implications of Population Change for the Future of Texas prepared by the Center for Demographic and Socioeconomic Research and Education. http://www.txsdc.tamu.edu/
Limited Access to Health Care
Limited access to care is exhibited by the fact that, in West Texas, there are 27 counties that have one or no physician. Nine counties have no primary care physician, no nurse practitioner and no physician assistant. An additional 37 counties have no hospital, and 19 have no pharmacist. Fifty–four counties are designated as primary care health professional shortage areas, and 80 are classified as medically underserved and have limited access to public health services. As in much of the nation, public health infrastructure has declined in recent years. The Texas State Office of Rural Community Affairs has determined that 75% of rural Texas hospitals reported financial losses for the past year.
|Ratio of primary care doctors||Ratio of physician assistants||Ratio of nurse practitioners||Ratio of pharmacists||Ratio of RNs||Ratio of LVNs|
|Texas, 2005 (2000)||68.5 (56)||14.7 (11.9)||17.7 (24.4)||73.7 (74.1)||628.6 (603.4)||269 (280.9)|
|West Texas, 2005||41.7||16||13.4||50.9||364.5||424|
|West Texas Border, 2005||25.7||15.2||18.4||64.1||230.7||161|
Source: U.S and Texas data from HRSA Bureau of Health Professions (most recently reported, 2000), West Texas and West Texas Border data from Texas Department of State Health Services, 2005.
Health Care and Economic Development
Health care is a major economic driver in rural areas. In communities that still have a local hospital or nursing home, health–related businesses are often the larger employers. One rural physician can generate more than five full–time jobs and $233,000 in local economic activity. For every health care dollar generated locally, an estimated 1.5 dollars are brought into the community economy. Therefore, out–migration from rural counties is a major contributor to loss of revenues, and 70 to 80% of out–migration is due to availability of care issues (Texas Department of Health, 2001; Texas State Office of Rural Community Affairs, 2001).
Throughout West Texas, low population density is a challenge; it is difficult to maintain health care services if there is not enough population to support a physician's practice. While the general population is affected by limitations in access to care, those most impacted are people with special health care needs: the elderly; the poor; the homeless; mothers, children and adolescents; those living with chronic diseases and disabilities; and agricultural workers (Lishner, 1996: Rickets, 1999; US AHRQ 2002).