What Is Going On With Willacy County Diabetes Deaths? The Rate Is Triple the Nation's and the Worst in the Valley
Willacy County is losing people to diabetes at a rate the rest of the Rio Grande Valley, the state and the country are nowhere near.
From 2022 through 2024, Willacy County recorded 86.4 diabetes deaths for every 100,000 residents, according to Centers for Disease Control and Prevention mortality data published on RGV Health Connect, the regional health data portal run for the Unidos Contra la Diabetes coalition.
Put that number next to everyone else:
Willacy County: 86.4
Cameron County: 59.1
Rio Grande Valley (four-county region): 38.6
Starr County: 31.8
United States: 28.8
Hidalgo County: 28.4
Texas: 25.0
(Deaths per 100,000 population, 2022-2024. Source: CDC data via RGV Health Connect.)
That is exactly three times the national rate. It is nearly three and a half times the Texas rate. And it is three times the rate in Hidalgo County, the Valley's largest county, which sits right next door.
The portal places Willacy in the worst 25 percent of counties in both Texas and the United States on this measure. Hidalgo, by contrast, lands in the best half of counties nationally and in Texas.
A NUMBER THAT KEPT CLIMBING
This is not a one-year blip. The portal's own trend chart for Willacy shows the rate rising in every reporting window:
2019-2021: about 49 per 100,000
2020-2022: about 73
2021-2023: about 73
2022-2024: 86.4
That is an increase of roughly 75 percent in the span of a few years. The portal labels Willacy's diabetes death rate as "worsening over time." Over the same stretch, Hidalgo County is labeled as improving.
One important detail: the portal also marks Willacy's latest number as "stable" when compared only to the period right before it. That is a statistical test, not a reassurance. It means the jump from the 2021-2023 window to the 2022-2024 window, on its own, is not large enough to rule out chance in a small county. The longer trend line is the one flagged as worsening.
HOW SURE ARE WE ABOUT 86.4?
Willacy is small, home to about 20,000 people, according to U.S. Census Bureau estimates. In small counties, a handful of deaths can move a rate a lot. That is why the portal publishes a confidence interval for Willacy's figure: 64.5 to 113.3 deaths per 100,000.
Here is what should stop people in their tracks. Even the lowest number in that range, 64.5, is more than two and a half times the Texas rate and more than double the national rate. The uncertainty is real, but it does not make the problem go away. Any reasonable reading of the data puts Willacy far above the state and the nation.
Based on the published rate and the county's population over the three-year window, The 956 Report estimates the figure reflects roughly 50 deaths, or about 15 to 20 per year. That is an estimate, not an official count. In a county of 20,000 people, that is a funeral every few weeks with diabetes listed as the underlying cause of death.
WHAT THIS NUMBER IS, AND WHAT IT IS NOT
Readers deserve to know exactly what is being measured.
The 86.4 figure is a crude death rate. The portal states plainly that it is not age-adjusted. Crude rates count all deaths against the total population and do not correct for a community that skews older or younger. Because death rates rise sharply with age, the portal itself cautions that comparisons across places should be made carefully.
So could Willacy simply be an older county? Census estimates put Willacy's median age at about 34 years, which does not describe an unusually elderly population. And the older, age-adjusted version of this same indicator, which does correct for age, told a similar story. For 2018-2020, Willacy's age-adjusted diabetes death rate was 50.2, compared with 22.6 nationally and 33.3 for the Valley, and the county ranked in the worst quarter of Texas counties. That age-adjusted series is no longer being updated, so a direct apples-to-apples comparison for 2022-2024 is not available on the portal.
The bottom line: age may explain part of the gap, but the available evidence does not suggest it explains it away.
This is also not a new pattern. Texas Department of State Health Services data compiled for the years 2005 through 2012 already showed Willacy with one of the highest age-adjusted diabetes death rates of any county in the state, 64.7 per 100,000 against a statewide rate of 24.4.
In other words, Willacy has been near the top of this list for about two decades.
THE CONDITIONS ON THE GROUND
Data does not tell us why any individual died. But it does describe the conditions Willacy residents live with, and those conditions line up with what public health researchers know drives diabetes deaths: late diagnosis, poorly controlled blood sugar, missed care and complications like kidney failure and amputations.
No hospital in the county. Willacy's hospital closed decades ago, and local officials have described transporting critical patients roughly 20 miles to Harlingen for care. The nearest acute care hospitals to Raymondville are in Harlingen, about 17 miles away. Primary care is available through community clinics such as Su Clinica's Raymondville location, but there is no hospital emergency room inside county lines.
About one in four residents uninsured. Census estimates put Willacy's uninsured rate at about 26 percent. Diabetes is a disease managed through regular checkups, lab work, medication and supplies. Without coverage, many people delay or skip that care.
High poverty. Roughly a quarter of Willacy residents live below the federal poverty line, according to Census estimates, well above the Texas rate.
High disease burden. An analysis of County Health Rankings data published in 2023 estimated that about 20 percent of Willacy adults have diabetes, ranking it among the counties with the highest diabetes rates in Texas. Across the Valley, the portal reports that about 43 percent of Medicare beneficiaries had diabetes in 2018, compared with about 29 percent statewide, and that nearly 40 percent of Valley adults are sedentary, compared with about 24 percent nationally.
None of these factors alone proves what is driving Willacy's death rate. Together, they describe a county where a chronic, manageable disease too often becomes a fatal one.
WE HAVE SEEN THIS BEFORE
During the COVID-19 pandemic, Willacy County's death toll relative to its population ranked among the highest in the country, according to local officials at the time. The county's then-health authority pointed to the area's high rates of obesity and diabetes as leading factors.
That was a warning. The diabetes death numbers since then suggest it was not fully heeded.
Primary figures come from the "Death Rate due to Diabetes" indicator on RGV Health Connect (rgvhealthconnect.org), maintained by Conduent Healthy Communities Institute using Centers for Disease Control and Prevention data. Rates are crude, not age-adjusted, and cover three-year periods. Willacy's 2022-2024 value of 86.4 carries a confidence interval of 64.5 to 113.3. Historical age-adjusted values come from the same portal's archived "Age-Adjusted Death Rate due to Diabetes" indicator (2018-2020) and from Texas Department of State Health Services vital statistics compiled for 2005-2012. Population, poverty and insurance figures come from U.S. Census Bureau American Community Survey estimates. The estimated death count is The 956 Report's calculation and is not an official figure.
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