Availability of Health Care providers in rural Texas counties

U.S. citizens have access to some of the most advanced health care systems in the world, and Texas is no exception. However, it is widely documented that there are areas of relative scarcity of health providers. These underserved areas have been delineated at the county as well as for metropolitan areas level for many areas in the U.S., including Texas, with a focus on access to primary care physicians (PCPs). However, health and disease treatment is also strongly dependent upon access to other health care providers such as medical specialists (e.g., cardiologists, pulmonologists, and endocrinologists), as well as dietitians and nutritionists, besides PCPs. The need for medical specialists is generally perceived to be more acute in the more rural areas of the state. In this paper we contribute towards a better understanding of health care needs by developing health care availability metrics that include a more comprehensive list of the types of health care providers for the three major disease conditions in Texas, namely cardiovascular, respiratory, and metabolic diseases. In collaboration with healthcare specialists, we develop county-level health provider availability indices and integrate the data in a user-friendly GIS map of health care provision needs and availability that can be used by state, local and private agencies to improve health care provision to underserved areas in particular, but also to all other regions in the Texas. While some urban areas may well be underserved, this paper focusses on rural Texas counties, as defined by the USDA-ERS. Finally, we provide prescriptions for bridging the gap between surplus and deficit areas of health care provision.