TXST research identifies real solutions to improve rural healthcare in Texas

Researchers at Texas State University’s Translational Health Research Center (THRC), in partnership with the T.L.L. Temple Foundation, released a new report highlighting major barriers to healthcare access across East Texas and pointing to actionable solutions for policymakers and providers.

For many residents in rural areas, healthcare services remain limited or out of reach. To provide timely evidence for improvements and solutions, researchers surveyed more than 400 residents across 22 rural and remote counties.

The study, “Understanding Health Challenges in Rural East Texas Communities: How Qualities of People and Places Shape Access to Care,” offers community-driven insights into the barriers rural residents face when seeking care. With Texas home to the nation’s largest rural population, these findings provide critical data to shape solutions that improve health outcomes.

Key insights include:

• Barriers hit all groups: Provider shortages, long distances and high costs affect residents across demographics.
• Affordability remains a concern: Nearly half of respondents — even those with insurance — struggle to pay for care. Many also face food, housing and income insecurity.
• Trust is uneven: 85% trust their own providers, but fewer than half trust larger health systems or public health leadership. 

“T.L.L. Temple Foundation’s commitment to improving the health and wellbeing of rural East Texans made this a highly worthwhile partnership for all those involved at Texas State University,” said Melinda Villagran, Ph.D., executive director of THRC.“Our collaborative research resulted in key insights that can help amplify rural voices and address structural issues to lay a foundation for meaningful improvements to the health and healthcare in East Texas.”

The report outlines practical steps forward, including:

• Expanding care affordability through financial support or more flexible payment options, even for those with insurance.
• Supporting transportation, referral and incentive programs that can reduce multiple logistical barriers to care.
• Investing in and supporting local healthcare providers, the most trusted source of care.
• Leveraging community networks to share accurate health information and encourage the timely use of care. 

Russell Hopkins, director of public health emergency preparedness at the Northeast Texas Public Health District, emphasized the importance of the work.

“THRC worked extensively and listened intently regarding barriers of health the population of East Texas faces, accessing care and achieving quality of life,” Hopkins said. “This project shows how much more there is to be done for rural Texas and produces recommendations for how to approach the path to success.”

The T.L.L. Temple Foundation’s commitment to expanding opportunity and reducing poverty, combined with THRC’s evidence-based research, produced a clear roadmap to improve rural healthcare and strengthen communities across East Texas.

For media inquiries or to learn more about the partnership, contact the THRC at HealthResearch@txstate.edu.