Rural health care is in crisis around the country, but Texas is suffering the most. At least 20 small-town hospitals have closed since 2013.

a Texas Observer Special Investigation
Critical Condition
Clarksville, a town of 3,200 in East Texas, lost its hospital in 2014.
Clarksville, a town of 3,200 in East Texas, lost its hospital in 2014.  Cooper Neill

Rural health care is in crisis around the country, but Texas is suffering the most. At least 20 small-town hospitals have closed since 2013. More than one-fifth of Texas’ 254 counties have only one doctor or none at all. State lawmakers have the tools to slow or reverse the trend, but they’ve mostly neglected to use them. The result? Without nearby medical services, many of Texas’ rural residents end up traveling hours for care—and because of this, people are dying.

Towns are too. Rural communities need health care in order to attract businesses and create jobs. But newly graduated doctors are often averse to working in tiny, down-on-their-luck communities. No doctors means no hospitals, and no hospitals means few businesses. The vicious cycle goes on. Much has been written about medical deserts, but we’ve rarely heard from the people who call them home. This series highlights the stories of rural Texans without access to care—and explores what can be done to reverse this troubling trend. The Texas Observer will continue reporting on rural health care in the coming months.

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Part 1
Without a hospital, the small East Texas town of Clarksville has struggled to retain businesses.
Without a hospital, the small East Texas town of Clarksville has struggled to retain businesses.  Cooper Neill

When a hospital shuts down, everyone in the community loses—the insured and uninsured alike. The hospitals in Clarksville, Gilmer, and Mount Vernon, which closed simultaneously in December 2014, are now in various stages of disrepair. The Clarksville building is a mere skeleton; the steel support beams and concrete floors are all that remains of the three-story structure. It’s an apt symbol for the town of Clarksville, where factories and manufacturers have packed up and moved to other towns with better highway access. Even the Walmart on Highway 82 is vacant. Local public officials say it’s difficult to recruit businesses to set up shop in a town with no functional hospital. In Gilmer, an hour southeast of Clarksville, what was once a hospital is now an empty lot; the building has been ripped out, foundation and all. Read more.

 
 

The closure has reverberated through the community in unexpected ways.
The closure has reverberated through the community in unexpected ways.  Christopher Collins

It’s July 22, and Chillicothe Hospital is closing. Built around 70 years ago, the hospital has been forced to accept fewer and fewer patients because there aren’t enough nurses to see them. This trend is mirrored in the surrounding town of Chillicothe, which has hemorrhaged half its population in recent years. With so few patients to bring in revenue, the hospital can’t make ends meet. Recently, visitors who do come have been met with a paper sign taped to the front door, directing them to the closest hospitals about 20 minutes away. Read more.

 
 

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