A data-driven focus on Texans’ health

At Texas 2036, we believe reliable, credible data should drive decisions about public policy and the investment of taxpayer dollars. And some of the most compelling, informative data out there about Texas and its challenges relate to Texans’ health. 

Some of the debates surrounding health care policy have become rather familiar, and maybe even a little redundant. For years, there has been talk about whether Texas should expand Medicaid coverage under the Affordable Care Act, for example. Nationally, there has been no shortage of attention spent on how to lower prescription drug prices.

These are all important discussions that will surely continue. But in order to build consensus around the best solutions for our long-term future, we can’t just hop from one isolated policy debate to the next. Instead, we must begin with a thorough understanding of Texans’ health outcomes and disparities. And we must recognize that, even at this time of overwhelming economic success for Texas as a whole, our population continues to struggle with numerous health challenges.

Consider:

• One out of every three adults in Texas is obese, a rate that has tripled since 1990. And 16 percent of children 10 to 17 are obese, which is higher than 31 other states. Obesity is a major risk factor for chronic disease including diabetes, stroke, heart disease, depression, and certain cancers. And more than 75 percent of health care spending in the United States is on those with one or more chronic diseases.

• The percentage of babies born with low birthweight has been increasing in Texas since the mid-1990s and is above the national target set by the US Department of Health and Human Services. African-American babies in Texas experience low birthweight twice as frequently as white babies. Birthweight is an indicator of maternal health and helps predict a child’s future health due to its link to heart problems, intestinal disorders, and obesity.

• Mental health and substance use disorders are now the leading cause of years of life lost due to a disease. In the past three years, the teen suicide rate in Texas has increased 28 percent and is higher than the national rate. In 2017, 16.7 percent of adults in Texas report being diagnosed with a depressive disorder.

• There are wide disparities in health outcomes among Texans based on race, ethnicity, income, and geography. For example, the cancer mortality rate for African-American Texans is 20 percent higher than the rate for white Texans, even though incidence rates among both groups are similar. And the mortality rate in rural areas of Texas is 19 percent higher than the rate in urban counties. In fact, research has shown that life expectancy can vary greatly from one ZIP code to the next, even in the same city or county. For example, according to research from UT Southwestern Medical Center, life expectancy in Bexar County alone ranges from 67.6 years in zip code 78208 to 89.2 years in zip code 78254.

Texas 2036 has compiled a significant amount of data to help shape and drive the conversation around health in Texas. We believe that conversation should focus on helping Texans get and stay healthy. While health insurance and access to health care certainly improve outcomes, personal behaviors and socioeconomic factors drive outcomes as well. 

The challenge is to identify solutions that improve health, whether that means additional investments in physical and mental health care, or greater integration of health-focused activities and services at public schools, or policies that incentivize healthy behaviors and decisions. This quest for such solutions will shape our work and conversations with Texans as we prepare to roll out our Strategic Framework — which will lay out long-term policy goals in health and our five other areas of focus — and advance a policy agenda for when the Texas Legislature meets in 2021.

The future health of our fellow Texans is not about one policy debate or a single statistic. Rather, it’s about a wide-ranging look at how we leverage resources, actions, and strategies to give Texas a healthier — and brighter — future.