In the South Plains region of Texas, rural communities are facing a significant health crisis as they combat the state’s largest measles outbreak in over 30 years. As of early March 2025, the Texas Department of State Health Services reported nearly 200 confirmed cases, raising concerns about public health preparedness and response capabilities.

The Current Situation

Melanie Richburg, the CEO of the Lynn County Hospital District, recalls the improvisation required during the COVID-19 pandemic. Her hospital is once again utilizing makeshift solutions due to the lack of specialized isolation rooms as the measles outbreak continues to escalate. “If we see the volume of patients exceeds the number of beds available at children’s hospitals, we’re going to need a contingency plan,” she stated. Richburg’s alarm echoes through the region, highlighting ongoing shortages in health care infrastructure.

Public Health Infrastructure Challenges

The COVID-19 pandemic has starkly illuminated the disparities between urban and rural health resources across the U.S., with Texas being no exception. Although federal funds were directed to public health districts post-pandemic, rural areas remain under-resourced. Issues such as aging facilities, long distances to care centers, and a shortage of healthcare professionals complicate emergency responses, particularly as the measles virus resurfaces.

According to health officials, at least 198 individuals have contracted measles in Texas since January 2025, resulting in one fatality—the first measles death in the U.S. in a decade. Public health assessments indicate that many of the current cases stem from unvaccinated children in specific communities, revealing gaps in vaccination education and outreach.

Local Response Efforts

In light of this outbreak, rural health authorities have mobilized their efforts to contain the virus. Teams are utilizing various channels, such as social media, to disseminate crucial information regarding vaccination and health safety. Testing facilities have been established despite logistical hurdles. For instance, in Andrews County, local officials are using the old City Hall building for testing, while simultaneously confronting limitations in infrastructure that hinder their response capabilities.

Infrastructure Gaps and Proactive Measures

Currently, 64 Texas counties lack a hospital, compounding the challenge of addressing the measles outbreak. Additionally, 25 counties have no primary care physicians, rendering them especially vulnerable. Some rural hospitals that remain operational are in dire need of renovations and modern facilities. “We have a difficult time in our area finding pediatricians for our newborns,” noted Dr. Sara Safarzadeh Amiri, Chief Medical Officer at Odessa Regional Medical Center.

The need for proactive measures is underscored by the fact that these issues have lingered for years, with many local health departments not having the resources to implement preemptive educational campaigns about vaccinations. “We shouldn’t be doing it during an outbreak,” Dr. Amiri emphasized, insisting that efforts to increase vaccination rates must commence well before health crises emerge.

Funding and Long-term Solutions

Texas has received substantial federal funding to bolster public health infrastructure, including $35.5 million in 2020 for upgrades and an additional $221 million through the CDC’s five-year Public Health Infrastructure Grant. These funds are critical in addressing immediate needs but do not completely compensate for years of underinvestment in public health.

Despite this influx, systemic challenges remain. Reports indicate that the state spends significantly less per capita on public health compared to many others, restricting rural health departments from adequately addressing community health needs. Richburg’s attempts to upgrade facilities and expand care capabilities reflect the urgent need for sustained investment in rural health infrastructure. “We were hoping those four specific beds would have been in place,” she lamented regarding the failed initiative for a bond to fund essential upgrades.

Conclusion

As the measles outbreak in Texas continues, rural communities are once again demonstrating resilience and adaptability. While improvisation serves as a temporary solution, it highlights the critical need for long-term investments in public health infrastructure and proactive healthcare strategies. Strengthening the healthcare system will not only prepare these regions for current health threats but will also safeguard against future public health emergencies.