Community Context and Challenges

  • Local economic growth has outpaced that of most of the nation—Midland residents have a significantly higher median household income than Texas residents, however stark income disparities exist across sub-populations in the city.

  • One in five adults (21%) in Midland lack health insurance, with 32% of Hispanic residents uninsured, compared to 23% of black residents and 19% of white residents.

  • Factors influencing the high rate of uninsurance in Texas include the state’s refusal to expand Medicaid under the Affordable Care Act and historically low thresholds for Medicaid eligibility; insufficient access to primary and preventative care is also a concern—30% of residents have no doctor or health care provider.

  • The growing population and increased traffic volume has strained decades-old resources and infrastructure, while creating congestion that affects public safety and quality of life.

  • Infrastructure concerns are reflected in health outcomes such as high rates of obesity and physical inactivity; 31% of adults in Midland County are obese, compared with 28% for Texas and 26% of adults report no leisure-time physical activity, compared with 24% for the state.

Community Actions: A First Look

Longstanding initiatives supported by local institutions, businesses, and organizations have offered a range of health and social services to address unmet community needs.

However, evidence of collaboration and coordination among partners, reach of the initiatives to populations especially in need, and the impact on population health are not well-documented and thus difficult to assess.

These baseline reports, created in 2016, track community programs and initiatives in their early stages and measure initial progress only. Future reports will provide more in-depth insights and analysis into this community's efforts to build a Culture of Health.

Going Forward: Questions for Consideration

Midland’s strong business climate and emphasis on economic growth have contributed to prosperity benefiting large sectors of the population. However, the state’s refusal to expand Medicaid under the Affordable Care Act and the modest efforts of Midland’s community stakeholders in addressing significant inequities in access to health care threaten to solidify the already sharp differences in health outcomes among Midland’s uninsured and low-income residents. Additional surveillance, data and information gathering, analysis, and reporting will examine the extent to which ongoing initiatives are coordinated across sectors, help to meet the demand for services, and bridge cultural differences through education and outreach.

The following questions could provide insights into the degree to which meaningful change is taking place:

  • What strategies are being used to identify and assist low-income and minority populations, especially those without health insurance, to access health care services?
  • To what extent does collaboration and coordination exist among Midland’s key organizations, including Midland Memorial Hospital, the United Way, and local business groups, to address gaps in services for the community’s low-income and uninsured population?
  • To what extent is the health department involved in education and outreach to Midland’s Hispanic community? Do other organizations partner in this effort?
  • To what extent are Midland residents limited in obtaining health insurance coverage by their status as legal immigrants or as undocumented immigrants?
  • What impact has the closure of the Planned Parenthood clinic in Midland had on access to reproductive health services? Has the local Federally Qualified Health Clinic been able to fill the gaps in services formerly provided by Planned Parenthood?
  • Given the lack of physicians to treat patients covered by Medicare and Medicaid, what specific strategies has Midland considered to recruit and retain mid-level health physicians, such as physician assistants and nurse practitioners?
  • To what extent are health providers who work in area clinics able to provide education and follow-up to children and adult patients?