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
234 of Texas's 254 counties (92%) 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.
This unit has no CDC PLACES estimates in this release, so the Health-Burden axis is empty and the index is the mean of the 2 axes that could be scored rather than all 3: Loving County. CDC states the reason as "Estimates suppressed for population less than 50". It is ranked alongside counties scored on every axis, so the position is not like for like.
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 2026-08-14
HRSA: Primary Care Health Professional Shortage Areas
Shortage Area HPSA detail (Primary Care discipline, designated) · accessed 2026-08-14
U.S. Census Bureau: American Community Survey (5-year)
ACS 2019-2023 5-year estimates · accessed 2026-08-14

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 2026-08-14.

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.