Diagnosis: What Is Happening to Texans

Over the next 35 years, demographers project changes in our state's population that will significantly increase the demand for health care and strain our ability to pay for it:

  • Our population will grow rapidly.
    In 2000, Texas was home to nearly 20.1 million residents. By 2010, that number is expected to reach 25.4 million; it could surpass 45 million by 2040. [1]

  • We are getting older.
    In 2000, 9.9 percent of Texans were 65 and older; by 2040, 18 percent of the population will be that old. In 2000, 20.2 percent of the population was 45 to 64; by 2040, 23.6 percent of the population will be in that age range. [2]

  • We are putting on weight.
    In 2000, 3.5 million Texas adults were obese; an additional 5.5 million were overweight. By 2010, those numbers are expected to rise to 5.1 million obese and 6.8 million more overweight. If that trend continues, almost three-fourths of the adult population could be overweight or obese by 2040. [3]

  • Our children are putting on weight.
    Overall, some 35 percent of Texas school-age children are obese or overweight, one of the highest rates in the nation. Among our fourth graders alone, more than one in five are overweight, a rate nearly 50 percent higher than the national average. [4]

  • We are growing poorer.
    The U.S. Census Bureau ranks Texas seventh among all states in the percent of residents living in poverty. In 2000, the share of Texas households living in poverty was 14.4 percent. Forty years later, that figure will grow to 16.6 percent. [5] That 15-percent increase will further strain many Texans' already inadequate ability to pay for their health care.

  • We are becoming less well-educated.
    An ever-growing share of Texas workers will lack high school and college degrees. Because education closely correlates with earnings and eligibility for employee benefits, more Texas households will live in poverty, without health insurance. Both the sheer number and the share of uninsured Texans will increase.

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Medically, these demographics predict an onslaught of preventable disease, particularly diabetes, heart disease, and stroke; the first wave of this onslaught already has arrived.

In 2000, 15,000 of the 944,000 Texans with diabetes died of the disease. Texans as young as 6 years old are being diagnosed with Type II diabetes, a disease that used to be called "adult onset" diabetes. [6] Nationally, Type II diabetes accounts for approximately 45 percent of newly diagnosed cases in children, most of whom are obese. [7]

By 2025, as many as 47,000 Texas children may suffer from Type II diabetes. By 2040, the number of diabetic Texans is projected to exceed 2.4 million. In 2001, 43,192 Texans died of heart disease and another 10,612 died of stroke, both of which are, like diabetes, frequently related to obesity.

In Texas in 2001, the cost of all obesity-related illnesses exceeded $10 billion. That included $4.2 billion in direct health care costs and more than $6.2 billion in lost productivity and wages due to illness and death. If current population growth trends continue through 2040, state health officials predict this cost will nearly quadruple to $39 billion. [8]

Next: What is Happening in Physician Practices

[1] Murdock SH. Institute for Demographic and Socioeconomic Research, College of Business, The University of Texas at San Antonio. The Population of Texas: Historical Patterns and Future Trends Affecting Health Care; Sept. 17, 2005. Accessed October 2005 at http://www.txsdc.utsa.edu/download/pdf/presentations/
[2] Ibid.
[3] Ibid.
[4] Texas Department of Health. Strategic Plan for the Prevention . Department of Health. Strategic Plan for the Prevention of Obesity in Texas; February 2003. Accessed October 2005 at http://www.dshs.state.tx.us/phn/pdf/obesity-plan.pdf .
[5] Murdock.
[6] Texas Diabetes Council. 2004-2005 State Plan.
[7] American Diabetes Association. Type 2 Diabetes in Children. Diabetes Care 2000. 23:381-9.
[8] Texas Department of Health. The Burden of Overweight and Obesity in Texas 2000-2040; June 2004. Accessed November 2005 at http://www.dshs.state.tx.us/phn/pdf/Cost_Obesity_Report.pdf .