Healthcare in Texas

Last updated

This article summarizes healthcare in Texas . In 2017, the United Healthcare Foundation ranked Texas as the 34th healthiest state in the United States. [1] Obesity, excessive drinking, maternal mortality, infant mortality, and vaccinations are among the major public health issues facing Texas. [1]




Obesity has quickly become a major health issue in Texas. [2] In 2017, 33.6% of Texas adults were obese as compared to 29.9% of U.S. adults. [3] [4] In 2000 21.7% of adults were obese and in 1990 only 10.7% of adults were obese. [5] In 2016, 33% of 10-17 year olds in Texas were obese. [5] When separated out by gender, 34.6% of Texas females and 32.8% of Texas males were obese. [4] When separated out by race, 31% of White adults, 41.7% of Black adults, and 37.8% of Hispanic adults were obese in Texas in 2016. [3] Research shows that an increase in household income is correlated with a decrease in obesity rates. [4] In 2014, Comptroller Susan Combs found that there are educational achievement patterns as well - 39% of the Texas population with less than a high school education was obese while only 23% of college graduates were obese. [6] Living in a rural area in Texas is also correlated with higher obesity rates. [4]

Consequences of obesity

Obesity causes several chronic diseases including heart disease and diabetes. [7] The three leading causes of death in Texas - heart disease, stroke, and cancer - are all linked to obesity. [7] Additionally, obesity can cause type 2 diabetes, arteriosclerosis, and hypertension. [7] In 2010, Texas saw 1,261,654 cases of heart disease and is predicted to see 5,688,482 cases in 2030. [5] In 2010, Texas saw 1,962,059 cases of diabetes and is predicted to see 2,851,697 cases in 2030. [5] In 2010, Texas saw 4,300,252 cases of hypertension and is predicted to see 5,689,509 cases in 2030. [5] In 2010, Texas saw 328,379 cases of obesity-related cancer and is predicted to see 810,806 cases in 2030.

Obesity also has substantial impacts on the economy in Texas. Obesity costs Texas businesses $9.5 billion annually. [6] 41% of this is due to obesity-related healthcare costs, 17% is due to absenteeism, and 37% is due to presenteeism. [6]

Obesity treatment

Effective treatment for obesity is known to be expensive and difficult. For childhood obesity, programs tend to focus on creating lifestyle changes including a healthier diet and more exercise. [8] Studies show that obesity treatment for children should aim more at changing the behavior of the family as a whole, especially the parents. [9] Comprehensive weight loss programs for children in Texas have had limited success in reducing weight. For example, only 20% of children finish the Weigh of Life Program and many of them are likely to gain the weight back later on. [10] For adults, surgery is an effective long-term treatment but it comes with several risks and complications. [11]

Obesity prevention

Environmental factors play a large role in obesity rates. [12] Studies have shown that people who live in the same socioeconomic contexts in Texas, regardless of race, tend to have similar rates of obesity. [13] Generally speaking, encouraging healthy habits, raising awareness, and educating people about portion sizes and nutritious requirements can help prevent obesity. [14] Childhood prevention is key - a child who was overweight at 12 years of age has a 75% chance of being overweight as an adult. [14]

Obesity policy
Public School Lunch School Lunch.jpg
Public School Lunch

In 2003, the Texas School Nutrition Policy Launch set nutrition standards with the intentions of discouraging obesity. [5] This policy lowered the availability of foods of minimal nutritional value in schools, limited portion sizes, limited trans fats, and limited fried foods. [5] Texas has also required early childhood education programs to encourage breastfeeding, provide drinking water access, and provide daily physical activity. [5] The state also has a fund specifically for financing healthy food. [5] In 2013, the Obesity Prevention Program was created after merging the Nutrition, Physical Activity, and Obesity Prevention (NPAOP) and Worksite Wellness Programs. [15] This program supports healthy eating, physical activity, and policies that promote healthier lifestyles.

Alcohol use

The most commonly abused substance in Texas is alcohol. [16] The rate of binge drinking in males in Texas is comparable to that of males in the United States. In 2017, 22.4% of adult males in Texas reported binge drinking, as compared to 22.1% of males in the United States. [17] Less than 12% of females adults in Texas reported binge drinking. [17] Alcohol abuse and alcoholism can lead to a variety of health issues including liver damage, heart problems, cancer, and depression. [18] Further, 61% of high school students in Texas have tried alcohol and 17% of Texas high school students had their first drink before the age of 13. [19]

Alcohol policy

The Texas Ignition Interlock Law went into effect during September 2015. This law requires judges to order ignition interlocks for all drunk-drivers with a Blood Alcohol Level of 0.15% or greater. [20] Since the passing of this law, the drunk driving related death rate in Texas has decreased by 8.5%. [20]

Maternal health

Texas has the highest maternal mortality rate in the developed world, and the rate by which Texas women died from pregnancy related complications doubled from 2010 to 2014, to 23.8 per 100,000. A rate unmatched in any other U.S. state or economically developed country. [21] See Maternal healthcare in Texas.

Infant health

Texas has the seventh highest birth rate in the United States, with nearly 400,000 babies born each year. [22] [23] Over half of all Texas births are paid by Medicaid, totaling over $2.2 billion per year in birth and delivery-related services for mothers and infants. [24] Studies have found that infant mortality is usually caused by birth defects, pre-term birth, low birth weight, Sudden Infant Death Syndrome, and pregnancy complications. [25] The average amount spent in the first year of life for a preterm birth with major complications (excluding extreme prematurity) is $19,059, and $4,019 for a preterm birth without major complications compared to $410 for an uncomplicated, term birth. [24]

Rates of infant mortality

For decades the infant mortality rate in Texas was higher than the nationwide rate but that gap has slowly closed. In 2017, the infant mortality rate in Texas was identical to the nationwide rate: 5.9 deaths per 1,000 live births. [26] This rate is not identical across the state of Texas and studies have found significant disparities between zip codes. [27] For example, the 76164 zip code has an infant mortality rate of 12.3 deaths per 1,000 live births while the neighboring 76107 zip code has a rate of 1.8 deaths per 1,000 live births. [27] Additionally, Black families in Texas are disproportionately burdened by these rates. In 2015, the infant mortality rate for Black babies in Texas was 10.9 deaths per 1,000 births. [28] These disparities can be explained by factors such as socioeconomic status, air pollution, and access to health care. [27]

Preterm birth

A birth is considered preterm when it takes place more than 3 weeks before the estimated due date. [29] Preterm birth rates in Texas are consistently higher than the nationwide rate. In 2016, 10.4% of live births in Texas were preterm. [30] The rate for Black mothers specifically was elevated - 13.6%. [31] Numerous factors have been associated with premature birth, including lack of prenatal care,  race, obesity, smoking, and even air pollution. [32]

Low birth weight
Preterm Baby in Incubator Incubator-tahrir.jpg
Preterm Baby in Incubator

A low birth weight is less than 2500 grams. [33] The rate of low birth weight in Texas has always been higher than the nationwide rate. In 2016, 8.4% of live births in Texas had a low birth weight. [33] The rate for Black mothers specifically was 13.5%. [33] Babies of mothers who do not get prenatal care are 3 times more likely to have a low birth weight and 5 times more likely to die than those born to mothers who do get care. [34] As for long-term complications, low birth weight babies are at a higher risk for cerebral palsy, blindness, deafness, and developmental delay. [35]

Prenatal care

Prenatal care is the best way to prevent preterm births and low birth weight babies. [36]   Unfortunately, in 2016 only 65% of pregnant women in Texas had access to prenatal care in their first trimester. [37] Women being unaware of their pregnancies, economic hardship due to inability to work during pregnancy, lack of knowledge or access to health services, and difficulty finding transportation are contributing factors to this alarmingly low rate. [38] Texas has also seen significant disparities in who receives prenatal care - 75% of White women and only 55% of Black women received prenatal care during their first trimester. [37] Although women covered by Medicaid are supposed to automatically transition into the Healthy Texas Women program for postpartum coverage, this transition does not always take place. [39]


In 2017, 67.8% of children age 35 months in Texas completed the recommended vaccination schedule. [40] The highest individual vaccine rate was for the polio virus: 93.1% of children age 35 months in Texas received this vaccine. [40] The lowest individual vaccine rate was for hepatitis A: 62.6% of children age 35 months in Texas received this vaccine. [40] Some children are under-vaccinated due to issues with accessing preventative care, vaccine delivery, or parental choice. [41] The state has started to implement ImmTrac, a free vaccination record system. [42]

Vaccination policy

In 2013, Texas passed legislation that requires employees of child-care facilities to have certain vaccinations, unless the employee objects for reasons of conscience. [43] Texas has allowed for parents to exempt their children from vaccines by citing medical reasons since 1972. Further, Texas has allowed for parents to exempt their children from vaccines on the basis of religious belief since 2003. [44]

Medical research

Texas has many research medical centers. The state has nine medical schools, [45] three dental schools, [46] and two optometry schools. [47] Texas has two Biosafety Level 4 (BSL-4) laboratories: one at The University of Texas Medical Branch (UTMB) in Galveston, [48] and the other at the Southwest Foundation for Biomedical Research in San Antonio—the first privately owned BSL-4 lab in the United States. [49]

The Texas Medical Center in Houston, holds the world's largest concentration of research and healthcare institutions, with 47 member institutions. [50] Texas Medical Center performs the most heart transplants in the world. [51] The University of Texas M. D. Anderson Cancer Center in Houston is a highly regarded academic institution that centers around cancer patient care, research, education and prevention. [52]

San Antonio's South Texas Medical Center facilities rank sixth in clinical medicine research impact in the United States. [53] The University of Texas Health Science Center is another highly ranked research and educational institution in San Antonio. [54] [55]

Both the American Heart Association and the University of Texas Southwestern Medical Center call Dallas home. The Southwestern Medical Center ranks "among the top academic medical centers in the world". [56] The institution's medical school employs the most medical school Nobel laureates in the world. [56] [57]

Legislative responses

The Trust for America's Health ranked Texas 15th highest in adult obesity, with 27.2 percent of the state's population measured as obese. [31] The 2008 Men's Health obesity survey ranked four Texas cities among the top 25 fattest cities in America; Houston ranked 6th, Dallas 7th, El Paso 8th, and Arlington 14th. [58] Texas had only one city, Austin, ranked 21st, in the top 25 among the "fittest cities" in America. [58] The same survey has evaluated the state's obesity initiatives favorably with a "B+". [58] The state is ranked forty-second in the percentage of residents who engage in regular exercise. [59]

Notwithstanding the concentration of elite medical centers in the state, The Commonwealth Fund ranks the Texas healthcare system the third worst in the nation. [60] Texas ranks close to last in access to healthcare, quality of care, avoidable hospital spending, and equity among various groups. [60] Causes of the state's poor rankings include politics, a high poverty rate, and the highest rate of illegal immigration in the nation. [61] In May 2006, Texas initiated the program "code red" in response to the report the state had 25.1 percent of the population without health insurance, the largest proportion in the nation. [62] Research shows that adolescents who see alcohol use in advertisements, television shows, and movies are more likely to start drinking alcohol at a younger age. Drinking at a young age is correlated with long-term alcohol abuse. [63]

Texas Department of State Health Services

The Texas Department of State Health Services manages state government projects in Texas.

The health insurance marketplace for Texas is, which is also the federal marketplace usable by anyone.

Hospitals in Texas

Texas has hospitals serving every part of the state.

Healthcare by region

Dallas, Texas

Dallas, Texas offers healthcare services.

Galveston, Texas

Galveston, Texas offers healthcare services.

Houston, Texas

Houston, Texas offers healthcare services.

Lubbock, Texas

Lubbock, Texas offers healthcare services.

San Antonio, Texas

San Antonio, Texas offers healthcare services.

Related Research Articles

Infant mortality

Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the number of deaths of children under one year of age per 1000 live births. The under-five mortality rate, which is referred to as the child mortality rate, is also an important statistic, considering the infant mortality rate focuses only on children under one year of age.

Maternal death the death of a woman while pregnant or within 42 days of termination of pregnancy

Maternal death or maternal mortality is defined by the World Health Organization (WHO) as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes."

Preterm birth Birth at less than a specified gestational age

Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks' gestational age, as opposed to the usual about 40 weeks. These babies are known as preemies or premmies. Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes or the leaking of fluid from the vagina. Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems and sight problems. The earlier a baby is born, the greater these risks will be.

March of Dimes United States nonprofit organization

March of Dimes is a United States nonprofit organization that works to improve the health of mothers and babies. According to its website, "We believe that every baby deserves the best possible start. Unfortunately, not all babies get one. We are changing that."

Preventive healthcare Prevent and minimize the occurrence of diseases

Preventive healthcare, or prophylaxis, consists of measures taken for disease prevention. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.

Birth weight weight of an organism at birth

Birth weight is the body weight of a baby at its birth. The average birth weight in babies of European heritage is 3.5 kilograms (7.7 lb), though the range of normal is between 2.5 and 4.5 kilograms. Babies of south Asian and Chinese heritage weigh about 240 grams (8.5 oz) less. The birth weight of a baby is notable because very low birth weight babies are 100 times more likely to die compared to normal birth weight babies. As far as low birth weights prevalence rates changing over time, there has been a slight decrease from 7.9% (1970) to 6.8% (1980), then a slight increase to 8.3% (2006), to current levels of 8.2% (2016). The prevalence of low birth weight has trended slightly upward from 2012 to present day.

Healthcare in Cuba highly-ranked system plagued with shortages

The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the health care of all its citizens. There are no private hospitals or clinics as all health services are government-run. The present Minister for Public Health is Roberto Morales Ojeda.

Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to ensure a positive and fulfilling experience, in most cases, and reduce maternal morbidity and mortality, in other cases.

Health is the state of complete physical, mental, and social well-being and a positive concept emphasizing social and personal resources, as well as physical capacities. This article lists major topics related to personal health.

Obesity in the United States is a major health issue resulting in numerous diseases, specifically increased risk of certain types of cancer, coronary artery disease, type 2 diabetes, stroke, as well as significant increases in early mortality and economic costs.

A landlocked sub-Saharan country, Burkina Faso is among the poorest countries in the world—44 percent of its population lives below the international poverty line of US$1.90 per day —and it ranks 185th out of 188 countries on UNDP's 2016 Human Development Index .Rapid population growth, gender inequality, and low levels of educational attainment contribute to food insecurity and poverty in Burkina Faso. The total population is just over 20 million with the estimated population growth rate is 3.1 percent per year and seven out of 10 Burkinabe are younger than 30. Total health care expenditures were an estimated 5% of GDP. Total expenditure on health per capita is 82 in 2014. Despite increased government funding and an effective expansion of proven health interventions, Burkina Faso still faces major challenges in the health sector.Communicable diseases continue to be the primary cause of morbidity and mortality in the country, with malaria being the largest contributor to mortality for children under 5 years of age. In addition, Burkina Faso did not fully meet Millennium Development Goals in child mortality, maternal mortality and sanitation. USAID is contributing to new advances in health by increasing malaria prevention and control and expanding access to improved water resources, sanitation and family planning.

Health in Italy

Italy is known for its generally very good health system and the very high life expectancy, low infant mortality, relatively healthy cuisine and diet, and healthcare system that is ranked 2nd according to World Health Organization and which has the third best medical performance worldwide. As with any developed country, Italy has adequate and sufficient water and food distribution, and levels of nutrition and sanitation are high.

Health care in the United States is provided by many distinct organizations. Health care facilities are largely owned and operated by private sector businesses. 58% of community hospitals in the United States are non-profit, 21% are government owned, and 21% are for-profit. According to the World Health Organization (WHO), the United States spent $9,403 on health care per capita, and 17.1% on health care as percentage of its GDP in 2014. Healthcare coverage is provided through a combination of private health insurance and public health coverage. The United States does not have a universal healthcare program, unlike some other countries.

Research on race and health in the United States shows many health disparities between the different racial/ethnic groups. Different outcomes in mental and physical health exist between all census-recognized racial groups, but these differences stem from different historical and current factors, including genetics, socioeconomic factors, and racism. Research has demonstrated that numerous health care professionals show "implicit bias" in the way that they treat patients. Certain diseases have a higher prevalence among specific racial groups, and life expectancy also varies across groups. This article is directed towards some of the historical and societal factors that impact the health of various minority groups in the United States. Race and health in the United States is a topic that has been researched many times, but the causes of disparate outcomes remain something that can be further explored.

Prenatal care in the United States is a health care preventive care protocol recommended to women with the goal to provide regular check-ups that allow obstetricians-gynecologists or midwives to detect, treat and prevent potential health problems throughout the course of pregnancy while promoting healthy lifestyles that benefit both mother and child. Patients are encouraged to attend monthly checkups during the first two trimesters and in the third trimester gradually increasing to weekly visits. Women who suspect they are pregnant can schedule pregnancy tests prior to 9 weeks gestation. Once pregnancy is confirmed an initial appointment is scheduled after 8 weeks gestation. Subsequent appointments consist of various tests ranging from blood pressure to glucose levels to check on the health of the mother and fetus. If not, appropriate treatment will then be provided to hinder any further complications.

The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. These conditions are also shaped by political, social, and economic structures. The majority of people around the globe do not meet their potential best health because of a "toxic combination of bad policies, economics, and politics". Daily living conditions work together with these structural drivers to result in the social determinants of health.

A high-risk pregnancy is one of greater risk to the mother or her fetus than an uncomplicated pregnancy. Pregnancy places additional physical and emotional stress on a woman’s body. Health problems that occur before a woman becomes pregnant or during pregnancy may also increase the likelihood for a high-risk pregnancy. The NICHD is one of many federal agencies working to improve pregnancy outcome, prevent high-risk pregnancy, and improve health outcomes for pregnant women who are at high risk. The NICHD supports and conducts research on the causes and optimal management of the high-risk pregnancy.

PREEMIE Reauthorization Act

The Prematurity Research Expansion and Education for Mothers who deliver Infants Early Reauthorization Act or PREEMIE Reauthorization Act is a bill that reauthorizes research programs on preterm births that are run by the Centers for Disease Control and Prevention. It also authorizes grants and demonstration programs to be run by the Health Resources and Services Administration that will try to decrease preterm births. The bill passed the United States Senate during the 113th United States Congress.

Maternal healthcare in Texas

Maternal healthcare in Texas refers to the provision of family planning services, abortion options, pregnancy-related services, and physical and mental well-being care for women during the prenatal and postpartum periods. The provision of maternal health services in each state can prevent and reduce the incidence of maternal morbidity and mortality and fetal death.

Maternal mortality in the United States maternal death statistics measured in the United States by state

Maternal mortality refers to the death of a woman during her pregnancy or up to a year after her pregnancy has terminated; this only includes causes related to her pregnancy and does not include accidental causes. Some sources will define maternal mortality as the death of a woman up to 42 days after her pregnancy has ended, instead of one year. In 1986, the CDC began tracking pregnancy related deaths to gather information and determine what was causing these deaths by creating the Pregnancy-Related Mortality Surveillance System. Although the United States was spending more on healthcare than any other country in the world, more than two women died during childbirth every day, making maternal mortality in the United States the highest when compared to 49 other countries in the developed world. The CDC reported an increase in the maternal mortality ratio in the United States from 18.8 deaths per 100,000 births to 23.8 deaths per 100,000 births between 2000 and 2014, a 26.6% increase; It is estimated that 20-50% of these deaths are due to preventable causes, such as: hemorrhage, severe high blood pressure, and infection.


  1. 1 2 "Explore Health Measures in Texas | 2017 Annual Report". America's Health Rankings. Retrieved November 13, 2018.
  2. Texas Department of State Health Services (2006). "Strategic Plan for the Prevention of Obesity in Texas 2005-2010".Cite journal requires |journal= (help)
  3. 1 2 Services, Texas Department of State Health. "Obesity Data". Retrieved October 21, 2018.
  4. 1 2 3 4 "Explore Obesity in Texas | 2017 Annual Report". America's Health Rankings. Retrieved October 21, 2018.
  5. 1 2 3 4 5 6 7 8 9 "State Briefs". The State of Obesity. Retrieved October 21, 2018.
  6. 1 2 3 Combs, Susan (2014). "The Hefty Price of Obesity in Texas". Texas Comptroller of Public Accounts.
  7. 1 2 3 Texas Department of State Health Services (2006). "Strategic Plan for the Prevention of Obesity in Texas 2005-2010".Cite journal requires |journal= (help)
  8. Texas Department of State Health Services (2006). "Strategic Plan for the Prevention of Obesity in Texas 2005-2010".Cite journal requires |journal= (help)
  9. Golan, Moria; Kaufman, Vered; Shahar, Danit R. (May 2006). "Childhood obesity treatment: targeting parents exclusively v. parents and children". British Journal of Nutrition. 95 (5): 1008–1015. doi: 10.1079/BJN20061757 . ISSN   1475-2662.
  10. Texas Department of State Health Services (2006). "Strategic Plan for the Prevention of Obesity in Texas 2005-2010".Cite journal requires |journal= (help)
  11. Waseem, Talat; Mogensen, Kris M.; Lautz, David B.; Robinson, Malcolm K. (October 2007). "Pathophysiology of Obesity: Why Surgery Remains the Most Effective Treatment". Obesity Surgery. 17 (10): 1389–1398. doi:10.1007/s11695-007-9220-1. ISSN   0960-8923. PMID   18000735.
  12. Kumanyika, S; Jeffery, RW; Morabia, A; Ritenbaugh, C; Antipatis, VJ (March 2002). "Obesity prevention: the case for action". International Journal of Obesity. 26 (3): 425–436. doi: 10.1038/sj.ijo.0801938 . ISSN   0307-0565. PMID   11896500.
  13. Bleich, Sara N.; Thorpe, Roland J.; Sharif-Harris, Hamidah; Fesahazion, Ruth; LaVeist, Thomas A. (May 1, 2010). "Social context explains race disparities in obesity among women". Journal of Epidemiology & Community Health. 64 (5): 465–469. doi:10.1136/jech.2009.096297. ISSN   0143-005X. PMC   3099623 . PMID   20445215.
  14. 1 2 Texas Department of State Health Services (2006). "Strategic Plan for the Prevention of Obesity in Texas 2005-2010".Cite journal requires |journal= (help)
  15. Texas Department of State Health Services. "Obesity Prevention Program".
  16. Maxwell, Jane (June 2014). "Substance Abuse Trends in Texas: June 2014". Community Epidemiology Workgroup at UT Austin.
  17. 1 2 "Explore Binge Drinking in TX) | 2017 Annual Report". America's Health Rankings. Retrieved October 4, 2018.
  18. "The Effects of Alcohol Use -". Retrieved October 4, 2018.
  19. "Youth Online: High School YRBS - Texas 2017 Results | DASH | CDC". Retrieved October 4, 2018.
  20. 1 2 "Take Action - Texas | MADD". MADD. Retrieved October 4, 2018.
  21. Redden, Molly (August 20, 2016). "Texas has highest maternal mortality rate in developed world, study finds". The Guardian. ISSN   0261-3077 . Retrieved December 23, 2016.
  22. "Peristats | March of Dimes". Retrieved October 20, 2018.
  23. "Birth Rate per 1,000 Women Ages 15-44". The Henry J. Kaiser Family Foundation. June 1, 2018. Retrieved October 20, 2018.
  24. 1 2 "Maternal Mortality and Morbidity Task Force". Texas Department of State Health Services. 2018.
  25. "What causes infant mortality?". Retrieved October 20, 2018.
  26. "Explore Infant Mortality in TX) | 2017 Annual Report". America's Health Rankings. Retrieved October 20, 2018.
  27. 1 2 3 "Infant Mortality Rates in Texas". UT System Population Health. Retrieved October 20, 2018.
  28. Kormondy, M. (2017). "2017 Healthy Texas Babies Data Book". Texas Department of State Health Services.
  29. Callaghan, W. M. (2006). "The Contribution of Preterm Birth to Infant Mortality Rates in United States". Pediatrics. 118.
  30. Kormondy, M. (2017). "2017 Healthy Texas Babies Data Book". Texas Department of State Health Services.
  31. 1 2 "Texas". State Data. Trust for America's Health. 2008. Retrieved October 14, 2008.
  32. "Premature Labor - American Pregnancy Association". American Pregnancy Association. April 26, 2012. Retrieved October 20, 2018.
  33. 1 2 3 Kormondy, M. (2017). "2017 Healthy Texas Babies Data Book". Texas Department of State Health Services.
  34. "Prenatal care |". Retrieved October 20, 2018.
  35. "Content - Health Encyclopedia - University of Rochester Medical Center". Retrieved October 20, 2018.
  36. "Preterm labor and premature birth: Are you at risk?" . Retrieved October 20, 2018.
  37. 1 2 Kormondy, M. (2017). "2017 Healthy Texas Babies Data Book". Texas Department of State Health Services.
  38. Nepal, Vishnu P.; Banerjee, Deborah; Perry, Mark (October 27, 2010). "Prenatal Care Barriers in an Inner-city Neighborhood of Houston, Texas". Journal of Primary Care & Community Health. 2 (1): 33–36. doi: 10.1177/2150131910385944 . ISSN   2150-1319. PMID   23804660.
  39. Steering Committee for Reducing Maternal Mortality (2018). "Improving Maternal Health in Harris County" (PDF).
  40. 1 2 3 "National Immunization Survey (NIS)". 2018.
  41. Kurosky, Samantha K.; Davis, Keith L.; Krishnarajah, Girishanthy (January 12, 2016). "Completion and compliance of childhood vaccinations in the United States". Vaccine. 34 (3): 387–394. doi: 10.1016/j.vaccine.2015.11.011 . ISSN   0264-410X. PMID   26597149.
  42. Services, Texas Department of State Health. "IMMTRAC". Retrieved October 20, 2018.
  43. "Archived copy" (PDF). Archived from the original (PDF) on November 20, 2018. Retrieved November 19, 2018.CS1 maint: archived copy as title (link)
  44. "Texas Administrative Code". Retrieved November 13, 2018.
  45. "Texas Medical Schools and Hospitals". Texas Medical Association. August 3, 2006. Retrieved April 28, 2008.
  46. "Dental Schools in the United States". Retrieved October 31, 2008.
  47. "Accreditation Council on Optometric Education". American Optometric Association. Retrieved December 26, 2011.
  48. "University Selects Bioscrypt for Biosafety Level 4 Lab". Bioscrypt. October 14, 2004. Archived from the original on November 17, 2007. Retrieved April 29, 2006.
  49. "Biosafety Level 4 (BSL-4) Laboratory". Southwest Foundation for Biomedical Research. Archived from the original on June 29, 2007. Retrieved April 29, 2006.
  50. "About the Texas Medical Center". The Texas Medical Center. Archived from the original on August 10, 2007. Retrieved April 11, 2009.
  51. "Background Statistics > People and Politics (most recent) by state". State Master. May 8, 2008. Retrieved May 8, 2008.
  52. "About MD Anderson". The University of Texas M. D. Anderson Cancer Center. Archived from the original on April 24, 2008. Retrieved April 28, 2008.
  53. "Health Science Center ranks sixth in clinical medicine". XL (7 ed.). University of Texas Health Science Center. April 3, 2007. Retrieved April 28, 2008.Cite journal requires |journal= (help)
  54. "International report gives Dental School high marks". HSC NEWS. Retrieved May 15, 2008.
  55. "Medical center's research ranks high". San Antonio Express-News. Retrieved May 15, 2008.[ dead link ]
  56. 1 2 "About UT Southwestern". University of Texas Southwestern Medical Center. Archived from the original on May 9, 2008. Retrieved April 28, 2008.
  57. "UT Southwestern Fact Sheet" (PDF). University of Texas Southwestern Medical Center. 2008. Archived from the original (PDF) on April 13, 2008. Retrieved April 28, 2008.
  58. 1 2 3 "America's Fittest Cities 2007". Men's Health. 2008. Archived from the original on March 13, 2008. Retrieved April 21, 2008.
  59., Accessed May 16, 2007
  60. 1 2 Perotin, Maria M. (June 13, 2007). "Texas is Near Bottom of Healthcare Rankings". Fort Worth Star-Telegram . Retrieved April 22, 2008.[ permanent dead link ]
  61. Roberson, Jason (December 4, 2007). "Politics, poverty, immigration entangle Texas health care". The Dallas Morning News .
  62. "Code Red: The Critical Condition of Health in Texas". Archived from the original on May 12, 2008. Retrieved April 28, 2008.
  63. Moreno, Megan A. (July 1, 2011). "Media Influence on Adolescent Alcohol Use". Archives of Pediatrics & Adolescent Medicine. 165 (7): 680. doi: 10.1001/archpediatrics.2011.121 . ISSN   1072-4710. PMID   21727285.