Texas State Highlights

In 2000, the Texas population was 20.8 million and had been estimated to increase by 6 percent to 22.1 million in 2003. ^[2]   The racial/ethnic composition of Texas in 2003 consisted of 53 percent Non-Hispanic Whites, 32 percent Hispanics/Latinos(as), 11 percent Blacks/African-Americans, and about 4 percent Other Races.  With a rate of 104 births per 1,000 women of childbearing ages, the Hispanic/Latino(a) population was the fastest growing race/ethnic group in Texas in 2002 and is anticipated to be the majority population in Texas by 2030. ^[3]   Overall, the population of Texas made up 34 percent of the 65 million people who lived in the four States (Arizona, California, New Mexico, and Texas) that share a Border with Mexico.  While California contributed 55 percent of the population of the four Border States, Arizona and New Mexico accounted for 9 percent and 2.9 percent, respectively.

This report provides information about four regions of Texas based on proximity to the U.S.-Mexico Border.  Texas has a total of 254 counties.  In this report, the regions are classified as counties within 62 miles of the U.S.-Mexico Border (32 counties), the area defined by the USMBHC as Border Counties; counties that are between 62 and 300 miles from the Border (139 counties); and counties more than 300 miles from the Border (83 counties).  Counties within approximately 100 miles of the U.S.-Mexico Border (43 counties) are also included in this report.  These are counties that have been designated by the Texas Comptroller of Public Accounts as counties that are impacted economically by the Border.  In this report, references to the counties within 100 miles of the Border include counties within 62 miles of the Border.  There are no references to the 11 counties that are between 62 and 100 miles from the Border as a separate entity.

Population Dynamics

Geographic Distribution

Estimates for 2000 show that 10 percent of the Texas population lived in the counties within 62 miles of the U.S.-Mexico Border and 60 percent lived in counties between 62 and 300 miles of the Border, for a total of 70 percent of the population in this region.  The remaining 30 percent of the population was located in counties more than 300 miles from the Border .  Of the 32 counties within 62 miles of the U.S.-Mexico Border, four were metropolitan ^[4] and include the cities of:  El Paso (El Paso County), Brownsville (Cameron County), Harlingen and McAllen (Hidalgo County), and Laredo (Webb County).  Two other large metropolitan areas San Antonio (Bexar County) and Corpus Christi (Nueces County) are part of the region designated as counties within 100 miles of the U.S.-Mexico Border.

Race/Ethnicity

Table 2 shows that in 2003, an estimated 2.3 million Texas residents lived in the Texas Border Counties (those counties within 62 miles of the U.S.-Mexico Border ), of whom 84 percent were Hispanic/Latino(a), more than twice the Hispanic/Latino(a) proportion of the State population and the Border States (32 percent Hispanic/Latino(a) each).  In the Texas counties within 100 miles of the U.S.-Mexico Border , 69 percent of the population was Hispanic/Latino(a).  Of the 6.9 million people who lived in the Border Counties of the 4 Border States, 49 percent were Hispanic/Latino(a). ^[5]

Education

Highest levels of education completed in Texas were fairly consistent with the rates across the United States.  In the counties within 62 miles of the U.S.-Mexico Border, 28 percent of the population had completed less than 9 years of education.  The counties within 100 miles of the U.S.-Mexico Border had large populations of people that had not completed high school, 19.9 percent had completed less than 9 years of education and 13.7 percent had completed 9 to 12 years of education (Table 6).

Income ^[6]

The median family incomes in Texas' Metropolitan Statistical Areas (MSA) in 2000 were:  El Paso: $33,410; Laredo: $29,394; and Brownsville - Harlingen: $27,853.  In comparison, the median family income in Las Cruces, New Mexico, was $33,576.  These incomes were much lower than the median family incomes in 2000 for the MSAs of San Diego, California, at $53,438; Phoenix-Mesa, Arizona, at $51,126; and Tucson, Arizona, at $44,446.  The Texas MSAs not directly on the U.S.-Mexico Border, but included as counties within 100 miles of the U.S.-Mexico Border (San Antonio and Corpus Christi), had median family incomes similar to those of Arizona and California.  Hispanic/Latino(a) median family incomes, which were lower in Texas and New Mexico Border MSAs, ranged from $24,500 to $28,500, respectively, compared to higher median family incomes of $31,000 to $34,000 in Arizona and California's Border MSAs in 2000.

Poverty

Table 4 shows that the Texas counties within 62 miles of the Border (47 percent) had a much higher proportion of families living below 150 percent of the Federal poverty guidelines than the State (26 percent), Border States (25 percent), or the U.S. (21 percent) in 2000.  In the counties within 100 miles of the U.S.-Mexico Border, 38 percent lived on incomes below 150 percent of poverty.  The U.S. Federal Poverty Thresholds ^[7] were established as a baseline to develop guidelines for determining eligibility for Federal and State programs such as Medicaid.  In 2000, $ 17,761 for a family of four was established as the poverty threshold.

Source:  U.S. Census Bureau (2000)

Health Access

It is not surprising that with such a high number of people living on poverty wages that 42 percent of respondents to the Behavioral Risk Factor Surveillance System (BRFSS) living in counties within 62 miles of the U.S.-Mexico Border in 2002 indicated that, at the current time, they were not covered by health insurance. ^[8] , ^[9]   Across Texas, 28 percent of the population indicated they were not covered by health insurance compared to 15 percent of the U.S. population (Table 5).

Health Professions Shortage Areas (HPSAs) are the method that HRSA used to identify areas of a State that do not have a sufficient supply of health professionals to meet the health needs of the population.  Sixty-six percent of the population in 2000 within 62 miles of the U.S.-Mexico Border resided in a primary care HPSA, either a single or partial county (Table 65).  While 59 percent (Table 66) of the population within 62 miles of the U.S.-Mexico Border lived in a dental HPSA, 50 percent (Table 67) of Border residents lived in a mental HPSA in 2000.  Statewide, 33 percent of the population lived in a primary care, 24 percent lived in a dental, and 28 percent lived in a mental HPSA.

Source:  Behavioral Risk Factor Surveillance System (2000).

Health Status

Health status indicators for this report are based on the Healthy Border 2010 Goals and Objectives established by the U.S.-Mexico Border Health Commission in 2003.  The Commission is a binational organization dedicated to addressing the pervasive health needs of the U.S.-Mexico Border.

The overarching goals of the Healthy Border Program are:  

1. Improve the quality and increase the years of healthy life, and
2. Eliminate health disparities

The twenty Healthy Border (HB) 2010 objectives fall into eleven principal areas with their specific objectives as follows:

1. Improve access to primary health care
2. Reduce cancer mortality in women through improved screening for breast and cervical cancers
3. Reduce morbidity and mortality from diabetes mellitus
4. Improve water quality through improved sanitation and reduce amount of acute pesticide poisoning
5. Reduce transmission of HIV
6. Improve rates of immunization and reduce rates of infectious diseases
7. Reduce mortality from unintentional injuries
8. Reduce infant mortality and increase the number of women receiving prenatal care
9. Reduce the suicide mortality rate by improving mental health
10. Increase the usage of dental and oral health services
11. Reduce morbidity from asthma

The tables in this report provide detailed information about health status in Texas.  Comparisons to the Healthy Border objectives are used to highlight disparities in health with a focus on the Border Counties (those within 62 miles of the U.S.-Mexico Border ).

Breast and Cervical Cancer

Healthy Border 2010 Objectives for breast and cervical cancer:   To reduce the female breast cancer death rate to 33.7 deaths per 100,000 women ages 25 or more To reduce the cervical cancer death rate to 4.0 deaths per 100,000 women ages 25 or more

• Screening for breast cancer is an important aspect of women's health.  Evidence from the BRFSS in 2002 showed that 75 percent of women living in Texas counties within 62 miles of the U.S.-Mexico Border had a mammogram within the past 2 years ; this was less than the proportion of women living in Texas (79 percent) and the Border States (83 percent) who have had a mammogram within the past 2 years. ^[10]
• The breast cancer incidence rate in the counties within 62 miles of the U.S.-Mexico Border was 38 per 100,000 females; this rate was notably lower than the Texas incidence rate of 53 (Table 7).
• The age-adjusted ^[11] breast cancer mortality rate in Texas counties within 62 miles of the U.S.-Mexico Border was 11.0 per 100,000 population in 2002; this was lower than the Texas rate of 13.8 per 100,000 population (27.6 per 100,000 females) and the Border States rate of 13.3 (Table 7).  The years of potential life lost rate in counties within 62 miles of the U.S.-Mexico Border was lower than the rest of the State at 64 years of life lost per 100,000 population as well as the Border States (72 years per 100,000 population) and U.S. rates (86 years per 100,000 population).  The impact of the number of years of life lost to breast cancer is brought more into focus when the rate is calculated for those most affected by breast cancer:  258 years of life were lost per 100,000 females in Texas in 2002. 
• Regular screening with pap smears helps with early detection of cervical cancer.  Seventy-six percent of women living in the Texas Border Counties had received a pap smear within the past 2 years ; this rate was lower than Texas (81 percent) women and women living in the Border States (83 percent) in general. ^[12]
• In the Texas Border Counties , the cervical cancer incidence rate was 12.4 per 100,000 females; this was higher than the Texas incidence rate of 10.0 per 100,000 females and the Border States incidence rate of 4.5 per 100,000 (Table 7).
• In the Texas Border Counties, the age-adjusted cervical cancer mortality rate at 4.3 per 100,000 females was higher than the Texas rate of 3.2, the Border States rate of 2.6, and the U.S. rate of 2.7 per 100,000 females.

Diabetes Mellitus

Healthy Border 2010 Objectives for diabetes mellitus:  Reduce the hospital discharge rate to 11.2 per 10,000 population for diabetes mellitus Reduce the diabetes death rate to 24.2 deaths per 100,000 population

In 2002, diabetes was the sixth leading cause of death in the United States and Texas. ^[13] , ^[14] Recent studies show that Type 2 diabetes is preventable. ^[15]  Overweight and obesity contribute to diabetes prevalence. ^[16]   Findings from the BRFSS indicate that Hispanics/Latinos(as) have a higher prevalence of diabetes than Non-Hispanic Whites at comparable Body Mass Index (BMI) ranking. ^[17]   Table 8 provides information about diabetes in Texas.

Sources:  Hospital Discharge Data Public Use Data File, Texas Health Care Information Council (2002), and Bureau of Vital Statistics, Texas Department of Health (2002).

• Sixty-three percent of Texas residents were overweight based on Body Mass Index; 37 percent were overweight but not obese, while 26 percent were obese.  There was little variation across geographic areas of the State (Table 9) in regards to being overweight and obese.  However, a larger proportion of adults in the counties within 62 miles of the U.S.-Mexico Border were overweight (43 percent). 
• The reported prevalence of diabetes in the Texas Border Counties was 5.9 percent of adults responding to the BRFSS.  This figure was lower than the 6.8 percent of people living within 100 miles of the U.S.-Mexico Border , the State rate of 7.1 percent, and the overall Border States rate of 7.3 percent.
• Residents of the Texas Border Counties were hospitalized for diabetes- related issues (21 hospital discharges per 100,000 population) at higher rates than all other geographic areas in the State.  Texas residents, in general, were hospitalized at a rate of 16.5 per 100,000 population.  While this was higher than the Border States rate of 14.5, it was lower than the U.S. rate of 20 hospital discharges per 100,000 population (Table 8).
• The diabetes age-adjusted mortality rate was 40 per 100,000 population in the Texas Border Counties and was distinctly higher than the overall Texas rate of 32 deaths per 100,000 population.  Mortality rates for all geographic areas in Texas were higher than the Border States and U.S. rates of 26 and 25 deaths per 100,000 population, respectively.
• Premature death due to diabetes resulted in 80 years of potential life lost per 100,000 population in the counties within 62 miles of the U.S.-Mexico Border . Diabetes years of potential life lost rates in Texas (92 years lost per 100,000 population) were higher than the Border States (73 years lost per 100,000 population) and the U.S. (79 years lost per 100,000 population) rates.  Premature mortality due to diabetes was higher in counties within 100 miles of the U.S.-Mexico Border (97 years lost per 100,000 population) and counties more than 300 miles from the U.S.-Mexico Border (101 years lost per 100,000 population).  This suggests that many people died at a younger age in the Texas counties within 100 miles of the U.S.-Mexico Border and the counties more than 300 miles from the U.S.-Mexico Border as a result of diabetes or diabetes complications.

Both hospital discharge and mortality rates for diabetes in Texas and each of its geographic areas were higher than the HB 2010 goals.

Healthy Border 2010 Objectives for HIV:  Reduce the incidence rate to 4.2 per 100,000 population for HIV

HIV/AIDS

HIV/AIDS, despite recent advances in treatment, is an increasing concern in Mexico and a major cause of illness and death in the United States. ^[18]   While the latest therapies have reduced death rates from AIDS in the Border region, their costs are prohibitive for some segments of the population. 18   Estimates in the United States of the lifetime costs associated with health care for HIV/AIDS have increased from $55,000 to $155,000 or more, contributing to the burden of illness, disability, and death. 18  In this context, HIV prevention becomes even more cost-effective.

• In the Texas Border Counties, the incidence rate for HIV was 8.5 cases per 100,000 population in 2002, while the AIDS incidence rate was 9.1 cases per 100,000 population.  These HIV and AIDS incidence rates were lower than the Texas rates (20 and 13.0 cases per 100,000, respectively) and the Border States rates (15.5 and 11.5 cases per 100,000 respectively).  For the counties within 100 miles of the U.S.-Mexico Border , the incidence rates for HIV and AIDS were 12.9 and 9.8 cases per 100,000, respectively, in 2002 (Table 11).
• The HIV incidence rate in the counties within 62 miles of the U.S.-Mexico Border (at 8.5 per 100,000) was twice the established Healthy Border 2010 objective and the rate for the counties within 100 miles of the U.S.-Mexico Border (at 12.9 per 100,000) was more than twice the objective.

Hepatitis and Tuberculosis

Healthy Border 2010 Objectives for hepatitis and tuberculosis: Reduce the incidence rate to 5.5 per 100,000 population for hepatitis A Reduce the incidence rate to 3.2 per 100,000 population for hepatitis B Reduce the incidence rate to 5.0 per 100,000 population for tuberculosis (TB)

The TB incidence rate in the Texas Border Counties was 12.5 cases per 100,000 population.  This rate was notably higher than the State rate of 7.1 and the Border States rate of 7.8 cases per 100,000 population (Table 12).

In 2002, the Texas Border Counties met the HB 2010 objective for hepatitis A and B.  The TB incidence rate, however, was 2.5 times higher than the HB 2010 objective. 

Sources:  Immunization Division, Texas Department of Health (2002), and Tuberculosis Elimination Division, Texas Department of Health (2002).

Immunization Coverage

Healthy Border 2010 Objectives for immunizations are to achieve and maintain an immunization coverage rate of 90 percent for children 19 to 35 months of age for the following vaccination series:   4+ doses of diphtheria, tetanus, and pertussis or diphtheria and tetanus (DTP) 3+ doses of haemophilus influenzae (Hib) 3+ doses of hepatitis B vaccine (HepB) 3+ does of polio vaccine 1 dose of varicella vaccine 1 dose of measles, mumps, German measles vaccine (MCV)

If children are properly immunized, most childhood diseases could be prevented.  This could result in a significant reduction in the cost of health care.  The only reliable data available about childhood immunization status come from the National Immunization Survey (NIS).  These data were available only for the Nation and individual States.

• The NIS results estimated that 70 percent (plus or minus 4.1 percent) ^[19] of Texas children 19 to 35 months of age had coverage for the prescribed vaccination series.  Nationally, the NIS estimated that 73 percent (plus or minus 1.0 percent) of children in this age group had received this coverage.
• In Texas, Non-Hispanic White children had slightly higher rates of coverage for the prescribed vaccination series (74 percent, plus or minus 7.3 percent) than Hispanic/Latino(a) children (68 percent, plus or minus 5.7 percent).  Data for other race/ethnic groups were not available (Table 13).

Injury-Related Deaths

Healthy Border 2010 Objectives for selected injury-related deaths:  Reduce the mortality rate to 10.0 per 100,000 population for deaths due to motor vehicle crashes Reduce the mortality rate to 10.3 per 100,000 population for deaths due to unintentional injuries for children ages 0 to 4

Injury is identified as the leading health threat in the first 4 decades of life. ^[20] Unintentional injury was the fifth leading cause of death among all persons in Texas ^[21] , the Border States, and the United States ^[22] in 2002.  Most injuries are preventable.  Intentional injury is also among the leading causes of death with suicide being eleventh and homicide being the fourteenth in the United States.   Injuries sustained by violent-intentional or accidental-unintentional means are responsible for more than 146,000 deaths each year nationwide. ^[23]

Source:  Bureau of Vital Statistics, Texas Department of Health (2002).

• The motor vehicle crash age-adjusted mortality rate in the Texas Border Counties was 16.2 deaths per 100,000 population and was similar to the Texas rate of 18.1 (Table 14).
• In 2002, lives claimed by premature deaths due to motor vehicle crashes resulted in the loss of 511 years of life per 100,000 population in Texas counties within 62 miles of the U.S.-Mexico Border .  The Texas rate of 563 years of life lost per 100,000 population was higher than the Border States and the U.S. rates (436 and 466 years lost per 100,000 population, respectively).
• In 2002, there were a total of 247 deaths among children ages 0 to 4 due to unintentional injuries in Texas. ^[24]   Approximately 9.3 percent of these deaths (23 of 247) occurred in Texas counties within 62 miles of the U.S.-Mexico Border .  Hispanic/Latino(a) children accounted for 43 percent of these deaths (105 of 247) statewide.

Mortality rates due to motor vehicle crashes are higher than the HB Objective across Texas, including the Border Counties.

Prenatal Care

Healthy Border 2010 Objective for prenatal care:  Increase the percent of women starting prenatal care in the first trimester to 85 percent

Early prenatal care is important to a healthy pregnancy and is critical in identifying potential problems that may put the pregnancy at risk.  Risk factors and maternal health conditions including pregnancy-related hypertension, gestational diabetes, and cigarette smoking, among others, which can contribute to poor infant outcomes, can be identified by screenings as a part of prenatal care. ^[25]

Source:  Bureau of Vital Statistics, Texas Department of Health (2002).

• In Texas, 81 percent of women received prenatal care in the first trimester in 2002.  The proportion of women receiving prenatal care varied only slightly by geographic area with the Texas Border Counties having the lowest at 75 percent (Table 16).
• Statewide, Non-Hispanic Whites, Asian/Pacific Islanders, American Indians/Alaskan Natives, and Other races had the highest early prenatal care rates (87 percent or more).  Seventy-seven percent of Black/African-American and 76 percent of Hispanic/Latina mothers began prenatal care in the first trimester.
• Blacks/African-Americans and Hispanics/Latinas in Texas fell below the desired goal set out in the Healthy Border 2010 Objective for the proportion of women who should start prenatal care in their first trimester, regardless of geographic area.  In the Texas Border Counties, these rates were 77 percent for Blacks/African-Americans and 74 percent for Hispanics/Latinas.

Prenatal Care - Border Teenage Mothers by Race/Ethnicity

Teenage mothers living in the Texas Border Counties (those counties within 62 miles of the U.S.-Mexico Border ) fell well below the desired goal established in the Healthy Border 2010 Objectives of 85 percent of mothers beginning prenatal care in the first trimester of pregnancy.  In 2002, the proportions of teenage mothers receiving prenatal care in the first trimester were:

• 64 percent of Non-Hispanic White mothers
• 56 percent of Black/African-American mothers
• 66 percent of Hispanic/Latina mothers

Prenatal Care - Texas State Teenage Mothers by Geographic Distribution

In Texas, the proportion of mothers aged 15 to 17 who received prenatal care in the first trimester varied by geographic area:  66 percent of mothers in counties more than 300 miles from the Border , 69 percent of mothers in the counties between 62 and 300 miles of the Border , 66 percent of mothers in the counties within 62 miles of the U.S.-Mexico Border , and 70 percent of mothers in the counties within 100 miles of the U.S.-Mexico Border ( Table 18).

Prenatal Care of Border Teenage Mothers - Comparison of Race/Ethnicity to State

A lower proportion of Non-Hispanic White, Black/African-American, and Hispanic/Latina teenage mothers received prenatal care in the counties within 62 miles of the U.S.-Mexico Border than in the State.

Source:  Bureau of Vital Statistics, Texas Department of Health (2002).

Teenage Pregnancy

Healthy Border 2010 Objective for teenage pregnancy, ages 15 to 17: Reduce teenage pregnancies to 28.0 per 1,000 women ages 15 to 17

• The birth rate for teenage women in the Texas Border Counties was the highest in the State at 56 births per 1,000 females ages 15 to 17.  Statewide, there were 37 births for each 1,000 females ages 15 to 17 in 2002 (Table 17). 

Source:  Bureau of Vital Statistics, Texas Department of Health (2002).

• There was considerable variation in the teenage birth rate by race/ethnicity.  The Hispanic/Latina teenage birth rate was 72 per 1,000 females ages 15 to 17 in Texas, while the rate in the Texas Border Counties was lower at 65 births per 1,000 teenage women.  The teenage birth rate by race/ethnicity in Texas was 14.4 per 1,000 for Non-Hispanic Whites, 50 per 1,000 for Blacks/African-Americans, and 6.1 per 1,000 for Asian/Pacific Islanders.
• Overall, the teenage birth rate in Texas was much higher, regardless of geographic area, than either the Border States or the U.S. at 29 and 18.2 per 1,000 females ages 15 to 17, respectively (Table 17).

Infant Mortality

Healthy Border 2010 Objective for infant deaths: Reduce the infant mortality rate to 4.6 deaths per 1,000 live births

Table 15 shows that in Texas, the infant mortality rate in 2002 was 6.4 deaths per 1,000 live births.

Source:  Bureau of Vital Statistics, Texas Department of Health (2002).

• For Non-Hispanic Whites and Hispanics/Latinos(as), the infant mortality rate was 5.7 and 5.6, respectively.
• The infant mortality rate for Blacks/African-Americans was 13.1 deaths for each 1,000 live births.  This reflects an infant mortality rate that was at least 2.3 times greater than occurred in the Non-Hispanic White and Hispanic/Latino(a) populations.
• The Black/African-American infant mortality rate was consistently more than 2 times that of the Non-Hispanic White and Hispanic/Latino(a) populations across the geographic areas in Texas.

In the counties within 100 miles of the U.S.-Mexico Border , infant mortality rates were higher for all racial/ethnic groups than the Healthy Border 2010 Objective of 4.6 deaths per 1,000 population.

Mental Health

Meeting the mental health needs has been identified as a national priority in the United States.  The National Action Agenda, established by the Surgeon General, notes specific action steps aimed at decreasing the burden of mental illness including promoting public awareness, supporting mental health-related research, improving early assessment, recognition and access to care, and training appropriate personnel to recognize and manage mental disorders. ^[26]

Hospitalizations for psychiatric-related conditions occurred at the rate of 36 per 10,000 population in Texas in 2002 (Table 19).

• At 27 per 10,000 population, the rate for psychiatric related conditions in the Texas Border Counties was lower than in the rest of Texas.
• The rate for hospitalizations for psychiatric related conditions in Texas at 36 per 10,000 population was similar to the Border States rate of 38.

Suicide takes a disproportionate toll in the community as well as on the family and friends of the deceased.  It also results in a significant loss of years of potential life of a productive community member.  Suicide was the tenth leading cause of death in Texas ^[27] and the eleventh in the U.S. ^[28]

• Table 19 shows that the Texas 2002 age-adjusted suicide mortality rate was 11.1 deaths per 100,000 population.  This was similar to the Border States and the U.S. rates (10.9 per 100,000 each).
• In the Texas Border Counties , the loss due to suicide was lower than in the rest of the State as the age-adjusted suicide rate was 6.5 per 100,000 population and the years of potential life lost rate was 145 years per 100,000 population.

• In Texas, suicide resulted in the loss of 260 years of potential life per 100,000 population.

Healthy Border 2010 Objective for oral health: Increase the use of oral care system to 75 percent

Oral Health

"You are not healthy without good oral health," noted Dr. C. Everett Koop, former U.S. Surgeon General. ^[29]   The importance of meeting oral health care needs in communities in the Border Counties, Border States and nationwide is increasing as research continues to link oral health with general well-being.  Oral infection has been associated with the onset and severity of systemic diseases such as cardiovascular disease and diabetes, and negative birthing outcomes. ^[30]   Despite increased use of dental sealants and water fluoridation, preventable oral diseases still afflict many children and adults during their lifetimes, impacting their self-image and quality of life as well as compromising their health and well-being. 30   Disparities in access to preventative and therapeutic oral care are demonstrated by the unmet needs of those with lower income and education levels, underserved populations, and a notable proportion of untreated tooth decay (over 40 percent in persons between 2 and 19 years, and approximately 90 percent of adults) observed in individuals regardless of sociodemographic characteristics. ^[31]   While it is now possible to maintain healthy teeth throughout a lifetime, currently available preventive measures, knowledge, and technologies must be utilized universally by professionals and consumers alike. ^[32]

The HB 2010 Objective for oral health includes these essential services: Treatment of dental cavities Preventive services such as dental sealants Dental restorative treatments such as replacement of permanent teeth Screening and diagnosis of oral and pharyngeal cancers Identification and referral for treatment of oral birth defects, such as cleft lip and cleft palate

Information collected in the Behavioral Risk Factor Surveillance System (BRFSS) results from answers to the question, "Have you visited the dentist or dental clinic within the past year for any reason?"

• Results indicate that, in 2002, Texas residents were well below the HB 2010 goal for oral health (Table 20).  Fewer adults (60 percent) had visited a dentist or dental clinic within the past year than in other Border States (66 percent) or the U.S. (70 percent).
• Residents of the Texas Border Counties and the counties within 100 miles of the U.S.-Mexico Border had lower dental visit rates in the past year for any reason (58 and 57 percent, respectively) than the rest of the State.

Source:  Behavioral Risk Factor Surveillance System (2002).

Healthy Border 2010 Objectives for asthma: Reduce the hospital discharge rate to 5.2 per 10,000 population

Asthma

Of Texas respondents to the BRFSS in 2002, 11.6 percent reported that they had been diagnosed as ever having asthma by a health professional (Table 21).

• The asthma rate was 9.3 percent among residents in the Texas Border Counties.
• The highest prevalence of asthma (11.8 percent) was reported in the Texas counties more than 300 miles from the Border .
• In 2002, the asthma hospitalization rate in the Texas Border Counties was 12.9 per 10,000 population and hospitalizations for asthma occurred at a rate of 12.4 per 10,000 population.  The asthma hospitalization rate (14.3 per 10,000) in the counties within 100 miles of the U.S.-Mexico Border was almost 3 times the Healthy Border 2010 goal.
• The hospitalization rate reflects only cases that were severe enough to be admitted to the hospital, not cases that presented themselves in the emergency department, treated, and released.
• Asthma is a relatively rare cause of death.  The age-adjusted mortality rate in the Texas Border Counties was 0.8 deaths per 100,000 population.  This was lower than the State, Border States and U.S. rates of 1.3, 1.5 and 1.4, respectively.