Public Health & Risk

Texas County Primary-Care Access & Health-Burden Scorecard

Name: Texas County Primary-Care Access & Health-Burden Scorecard
Creator: KYFEX

A county-level targeting index for Texas, fusing adult chronic-disease and social-risk prevalence (CDC PLACES) with federally designated primary-care provider shortages (HRSA). Ranks all 254 counties by combined need so a health department or rural-health office can see where high burden and thin provider supply overlap.

KYFEX·May 31, 2026

Key findings

1
231 of Texas's 254 counties (91%) fall within a federally designated primary-care Health Professional Shortage Area.
2
Adult diagnosed-diabetes prevalence ranges from 9.0% in Travis County to 23.4% in Dimmit County, a 14.4-point spread within a single state.
3
Dimmit County carries the highest combined targeting-priority index (85.2/100), led by its access & sdoh barriers score.
4
The median county uninsured rate (adults 18-64) is 18.0%, and the median adult diabetes prevalence is 14.5%.

How it is built

A Health-Burden axis is built from CDC PLACES crude adult prevalence (diagnosed diabetes, obesity, high blood pressure, coronary heart disease, fair or poor self-rated health, frequent physical distress). An Access & SDOH barriers axis combines uninsured (adults 18-64), below poverty (acs), households without a vehicle (acs) (Census ACS measures join CDC PLACES here). Each measure is min-max normalized across the state's counties to 0-100, then averaged within its axis. A Provider-Shortage axis scales each county's worst designated primary-care HPSA score against the HRSA 0-26 severity scale. The combined Targeting-Priority Index is the equal-weighted mean of the three axes. PLACES values are model-based estimates with confidence intervals (carried per county), not direct counts. Scores are relative WITHIN Texas: a 100 marks the worst county in the state on that axis, not a national benchmark.

Health-burden axis

Diagnosed diabetesObesityHigh blood pressureCoronary heart diseaseFair or poor self-rated healthFrequent physical distress

Access & SDOH barriers axis

Uninsured (adults 18-64)Below poverty (ACS)Households without a vehicle (ACS)

Top 50 counties by targeting priority

Higher scores mean greater relative need within Texas. Showing the 50 highest-priority of 254 counties; the full ranking is below as CSV or JSON.

#	County	Priority	Burden	Access	Shortage	Diabetes	Uninsured	Top driver
1	Dimmit	85.2	88.9	97.6	69.2	23.4%	41.1%	Access & SDOH barriers
2	Jim Hogg	79.0	83.5	64.9	88.5	22.8%	40.6%	Provider shortage
3	Brooks	77.8	66.1	82.7	84.6	19.8%	37.8%	Provider shortage
4	Zapata	77.0	73.5	84.3	73.1	20.8%	42.8%	Access & SDOH barriers
5	Starr	76.8	71.0	82.4	76.9	20.0%	43.5%	Access & SDOH barriers
6	Zavala	75.9	84.4	70.3	73.1	22.6%	42.4%	Health burden
7	Presidio	69.5	77.3	69.8	61.5	22.2%	34.8%	Health burden
8	Duval	68.4	61.7	66.5	76.9	18.8%	35.4%	Provider shortage
9	Pecos	64.7	49.6	59.8	84.6	16.5%	31.1%	Provider shortage
10	Willacy	64.2	64.0	59.5	69.2	18.8%	40.8%	Provider shortage
11	Maverick	63.7	56.6	61.3	73.1	17.8%	38.8%	Provider shortage
12	Hidalgo	63.4	53.9	59.5	76.9	17.4%	37.4%	Provider shortage
13	Frio	63.2	45.5	63.4	80.8	15.3%	37.0%	Provider shortage
14	Jim Wells	61.4	56.4	54.7	73.1	18.0%	32.9%	Provider shortage
15	San Augustine	61.0	85.0	51.9	46.2	20.9%	17.5%	Health burden
16	Reeves	60.9	54.6	55.0	73.1	17.6%	37.3%	Provider shortage
17	Live Oak	60.8	54.6	47.1	80.8	16.2%	25.3%	Provider shortage
18	Webb	60.4	45.6	54.9	80.8	16.1%	36.2%	Provider shortage
19	Cochran	60.3	68.0	55.2	57.7	18.6%	32.3%	Health burden
20	La Salle	60.3	47.6	52.5	80.8	15.5%	39.7%	Provider shortage
21	Shelby	60.1	57.8	41.7	80.8	16.4%	18.9%	Provider shortage
22	Newton	59.6	73.6	36.0	69.2	18.6%	16.2%	Health burden
23	Hudspeth	59.4	45.6	51.9	80.8	14.3%	38.6%	Provider shortage
24	Swisher	58.8	55.9	51.2	69.2	16.6%	26.5%	Provider shortage
25	Jefferson	58.6	48.1	39.3	88.5	15.6%	18.9%	Provider shortage
26	Culberson	58.3	64.0	45.5	65.4	19.3%	31.3%	Provider shortage
27	Cameron	58.1	50.9	57.9	65.4	18.3%	35.9%	Provider shortage
28	Terry	57.0	53.9	48.0	69.2	16.4%	29.2%	Provider shortage
29	Menard	56.3	59.1	28.9	80.8	17.6%	20.5%	Provider shortage
30	Crosby	56.2	57.3	46.0	65.4	17.1%	27.2%	Provider shortage
31	Uvalde	55.7	45.9	48.1	73.1	15.7%	28.5%	Provider shortage
32	Gonzales	55.6	51.6	49.9	65.4	16.0%	25.8%	Provider shortage
33	Matagorda	55.3	51.1	41.7	73.1	16.4%	22.6%	Provider shortage
34	Hall	55.3	59.6	29.5	76.9	17.5%	21.3%	Provider shortage
35	El Paso	55.2	34.1	47.0	84.6	15.4%	29.0%	Provider shortage
36	Real	55.1	64.6	31.5	69.2	18.3%	18.3%	Provider shortage
37	Hale	54.7	47.4	43.6	73.1	15.6%	28.9%	Provider shortage
38	Nolan	53.6	56.7	46.4	57.7	16.5%	22.9%	Provider shortage
39	Limestone	53.4	53.3	29.9	76.9	16.1%	18.1%	Provider shortage
40	Liberty	53.1	43.3	35.2	80.8	13.9%	23.8%	Provider shortage
41	Wilbarger	53.0	55.9	37.7	65.4	16.5%	21.3%	Provider shortage
42	Trinity	52.8	55.8	37.1	65.4	16.4%	14.5%	Provider shortage
43	San Patricio	52.4	47.5	40.6	69.2	15.4%	24.9%	Provider shortage
44	Bailey	52.3	46.4	60.6	50.0	15.5%	30.2%	Access & SDOH barriers
45	Camp	52.2	54.1	41.0	61.5	16.1%	19.8%	Provider shortage
46	Upton	52.1	54.0	40.9	61.5	16.6%	27.2%	Provider shortage
47	Atascosa	51.9	46.3	40.1	69.2	15.4%	27.4%	Provider shortage
48	Polk	51.8	51.1	27.4	76.9	15.4%	17.3%	Provider shortage
49	Howard	51.6	37.3	36.8	80.8	13.7%	23.5%	Provider shortage
50	Ector	51.6	32.2	41.7	80.8	12.8%	28.0%	Provider shortage

All 254 counties, ranked:CSV JSON

Limitations

Scores are intra-state relative, not absolute or cross-state comparable.
These candidate measures were unavailable for Texas in this release (BRFSS SDOH-module participation varies by state), so they are excluded from the index: Lack of reliable transportation, Food insecurity, Housing insecurity.
PLACES values are small-area model-based estimates with confidence intervals, not direct counts.
HPSA aggregation takes the worst designated primary-care score per county; geographic, population-group, and facility designations are pooled.
Equal axis weighting is a transparent default, not a calibrated policy model.
Socioeconomic measures are ACS 2019-2023 5-year estimates; ACS estimates carry margins of error not reflected in the composite.
This is informational analysis of public data, not clinical, individual, or actuarial advice.

Sources

CDC PLACES — Local Data for Better Health (County Data)
PLACES: Local Data for Better Health, County Data, 2025 release (measure year 2023) · accessed 2026-06-01
HRSA — Primary Care Health Professional Shortage Areas
Shortage Area HPSA detail (Primary Care discipline, designated) · accessed 2026-06-01
U.S. Census Bureau — American Community Survey (5-year)
ACS 2019-2023 5-year estimates · accessed 2026-06-01

Frequently asked questions

What does the Texas county health-access scorecard measure?

It ranks all 254 Texas counties by a combined Targeting-Priority Index that fuses adult chronic-disease and social-risk prevalence from CDC PLACES with federally designated primary-care provider shortages from HRSA, highlighting where health need and thin provider supply overlap.

Which public datasets is it built from?

CDC PLACES county estimates (PLACES: Local Data for Better Health, County Data, 2025 release, measure year 2023) and the HRSA Primary Care Health Professional Shortage Area detail file, both fully open federal sources accessed 2026-06-01.

How should the Targeting-Priority Index be used?

As a transparent first-pass screen for where to focus outreach, workforce, or program resources. Scores are relative within the state and equal-weighted by default; a real engagement would calibrate weights to a program's goals and add socioeconomic and utilization layers.