2,615. That's the number of people who died in Northeast Texas in 2014 who wouldn't have died if mortality rates in the region were simply the same as in Texas overall. That's 16 percent of all deaths in the region that year.
We don't always think of the region on its own terms, as a distinct part of Texas. If Northeast Texas were its own state, however, it would be the size of West Virginia, and would rank 45th in the nation in overall mortality, sandwiched in between its geographic neighbors Arkansas (44th) and Louisiana (46th). Texas, by comparison, ranks 31st even if you include the Northeast region in its numbers.
An analysis The University of Texas System and UT Health Northeast just published, using data from the National Center for Health Statistics, found that the region has extremely high mortality rates for four of the five leading causes of death: heart disease, stroke, chronic lower respiratory diseases, and unintentional injury (car crashes, for example).
Lung cancer mortality rates are 35 percent higher than the state overall. Suicide rates are 40 percent higher. Stroke mortality rates are so high that if Northeast Texas were a state, it would be dead last in the country, 51st out of 51.
The rates in Northeast Texas are also higher than the Texas average for infant mortality. Half of pregnant women in Northeast Texas do not receive prenatal care in the first trimester, and the rates of smoking during pregnancy are almost three times the state average.
2,615. This number is painful. It becomes tragic when we recognize that it's not just a number. It's mothers, fathers, sons and daughters, newborn babies, neighbors and friends.
There's no quick path to bringing better health to the 35-county region of Northeast Texas, which is home to just over 1.5 million people, over half of whom live in a rural area.
Improving health for the region is possible, however, and it needs to begin from the recognition that the disparity between Northeast Texas and other parts of the state isn't primarily about lack of health care providers or access to insurance. On those metrics the region is in line with the overall numbers for Texas.
Understanding health disparities--whether racial or geographic--requires looking into differences in the conditions in which people are born, live, work, and grow old. Compared to the overall Texas and U.S. populations, median household incomes and education levels are lower in Northeast Texas.
Looked at in aggregate, it's an intimidating picture. However, the data provide direction on where to start. For most of the causes of death for which rates are higher in Northeast Texas, smoking is the key causal factor. In this region smoking rates are 40 percent higher and rates among pregnant women are triple the rates in Texas overall.
Smoking can be a terribly difficult habit to break, but we know that most smokers do want to quit, and there are good ways to help people quit. We also know, from looking at the numbers in Northeast Texas, that demography and geography aren't destiny. Rates of smoking-related deaths vary dramatically from county to county, and experience shows that with the right policies and practices in place smoking rates can come down over time.
Perhaps the most important thing the numbers tell us, though, is that we have to work together. To address the health challenges of Northeast Texas in a meaningful way we'll need a systemic, long-term effort that brings together stakeholders in the region with resources and players at the state level. We'll also need a vision of better health that focuses on prevention, social determinants, and sophisticated population-level analyses of health and illness.
In January of 2017, as the centerpiece of The University of Texas System's commitment to realizing this vision, we will welcome the first class of graduate students to the new School of Community and Rural Health at UT Health Northeast in Tyler.
The school will have a particular focus on the challenges that face rural and underserved populations. Its mission won't be just to train the next generation of community health and public health professionals, but to serve the community directly, and to become a focal point of the kind of systemic effort that's needed to improve health in the region.
But we're just one player. It takes researchers to crunch the numbers and teachers to train the next generation of health professionals, but to truly make a difference it will require the knowledge, wisdom, and energy of local health care providers, officials, educators, and community members.
The numbers are daunting. They're also an opportunity to identify solutions--an opportunity we should seize.