Black Health Profile
Black health in Texas
3,829,124
Black residents (ACS)
12.70%
Of state population
Texas has 3.8 million Black residents, the second-largest Black population of any state. The University of Texas Southwestern, Baylor College of Medicine, and UT-Houston anchor the state's academic medicine. Texas has not adopted Medicaid expansion — the largest coverage gap in the nation in absolute numbers. KFF estimates the state's uninsured rate is the highest in the country.
Texas's non-adoption of Medicaid expansion leaves an estimated 900,000 Black adults in the coverage gap (KFF, 2024) — the largest figure of any state.
On the positive side, every US state now has CDC-funded maternal mortality review committees, and most have at least one HRSA-designated federally qualified health center serving low-income Black residents. The ten facet pages below point to state-specific programs and providers.
Key takeaways
- Black residents: 3,829,124 (12.7% of the state).
- Medicaid expansion not adopted — lowest-income adults without dependent children have no direct path to coverage.
- Medicaid does not cover doula services.
- Certified nurse-midwife scope-of-practice recognized by Medicaid.
- 12-month postpartum Medicaid extension active.
Health outcomes & coverage
Ten race-stratified indicators drawn from CDC, Census, KFF, and SAMHSA primary sources. Each page links the underlying dataset, compares to the national average, and frames the state-specific drivers and policy levers.
maternal mortality
Black women in Texas die from pregnancy-related causes at 48.9 per 100,000 live births — 2.6× the US national rate of 19.
Read the maternal mortality breakdown
infant mortality
Black infants in Texas die before age one at 11.6 per 1,000 live births — compared to the US all-race rate of 5.4.
Read the infant mortality breakdown
cardiovascular mortality
Age-adjusted cardiovascular mortality among Black residents of Texas: 353.1 deaths per 100,000 (CDC WONDER, ICD-10 I00-I99).
Read the cardiovascular mortality breakdown
diabetes prevalence
15.6% of Black adults in Texas have been diagnosed with diabetes — compared to the US all-race rate of 11.6%.
Read the diabetes prevalence breakdown
breast cancer mortality
Age-adjusted breast cancer mortality among Black women in Texas: 29.1 per 100,000 (CDC WONDER, ICD-10 C50).
Read the breast cancer mortality breakdown
prostate cancer mortality
Age-adjusted prostate cancer mortality among Black men in Texas: 41.6 per 100,000 (CDC WONDER, ICD-10 C61).
Read the prostate cancer mortality breakdown
life expectancy
Life expectancy at birth for Black residents of Texas: 72.9 years (US all-race: 77.5).
Read the life expectancy breakdown
uninsured rate
16.8% of Black residents of Texas have no health insurance coverage — vs. a US all-race uninsured rate of 8%.
Read the uninsured rate breakdown
Medicaid coverage
About 24% of Black residents of Texas receive Medicaid coverage. Texas is a Medicaid non-expansion state.
Read the Medicaid coverage breakdown
mental health access
60.1% of Black adults in Texas who experienced a past-year mental health need reported not receiving the treatment they needed (SAMHSA NSDU…
Read the mental health access breakdown
Policy context in Texas
Texas has not adopted Medicaid expansion. Low-income Black adults without dependent children earning above state Medicaid eligibility thresholds and below the ACA marketplace subsidy threshold fall into the coverage gap — uninsured by default. Medicaid does not currently cover doula services. Postpartum Medicaid coverage extends for 12 months after delivery, the federal recommended standard.
Texas has not adopted Medicaid expansion. Postpartum Medicaid was extended to 12 months effective March 2024 (HB 12, 2023). Doula Medicaid coverage is piloted in 3 counties via the Healthy Texas Women program; statewide rollout remains under legislative consideration.
Find Black health providers & resources in Texas
Counties in Texas
County-level Black Health profiles for the 4 Texas counties with the fullest race-stratified data and editorial coverage.
Data sources & refresh cadence
- US Census ACS 5-year 2019–2023, Table B02001 (race) & S1903 (income).
- CDC WONDER Multiple Cause of Death (D69) & Underlying Cause of Death (D76), 2018–2022 release.
- KFF Medicaid expansion and state coverage trackers, Q1 2026.
- SAMHSA National Survey on Drug Use and Health, 2022 state annual.
- HRSA NHSC workforce data, 2024.
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