How does one measure the health of a city?
And we’re not talking economic health. This is not an attempt to gauge the city’s public safety record or school district woes — though all of the above certainly factor into what we’re doing. No, we want to know the literal physical and mental well-being of those who call Fort Worth home.
While there is a lot that factors into answering such a query — some the responsibility of Fort Worth, others the responsibility of the Fort Worthian — we elected to narrow our focus to six aspects: life expectancy, obesity, cancer, mental health, and access.
As subject matter experts, we spoke to Dr. Brian Byrd, a family practice physician and former Fort Worth council member who currently serves as the Tarrant County Public Health Director. His incredible insights are at once academic and common-sense straight talk—a classic Fort Worthian.
Life Expectancy
Where We Stand
By our account, it first happened in 2019: a report that 76104, the Fort Worth ZIP code that encompasses a large swath of the city’s southside, including, ironically enough, the medical district, had the lowest life expectancy in the state of Texas. Five years later, a similar headline started making the rounds — “76104 Has Lowest Life Expectancy in State.”
According to a study by UT Southwestern Medical Center, the life expectancy of a person living in 76104 is 67 years, over 10 years less than the national average. However, Tarrant County’s overall life expectancy clocks in at 78.7, above both the national and Texas average. If one were to simply look at Tarrant County as a whole, he or she would presume it’s a reasonably healthy place to live with a good-to-average life expectancy — though falling significantly behind Austin’s Travis County at 82 years. Thus, the city contains pockets of lower life expectancy that bring the average down. While this points to large ZIP code discrepancies, this is nothing unique to Fort Worth.
Why?
There are many factors that contribute to low life expectancy, both cultural and economic. Affluent ZIP codes will typically have higher life expectancies, and, conversely, ZIP codes with high disadvantaged populations will have lower life expectancies.
According to Dr. Brian Byrd, 76104 is on the edge of being a food desert, meaning the area offers few grocers, which leads to “unhealthy food being bought at Dollar Stores.” Such unhealthy eating habits, which are simply the result of access and environment, can have a major effect on a community’s overall health.
With the medical district and, specifically, JPS and Mercy Clinic residing in 76104, access to medical care doesn’t appear to be a problem. And with government programs to assist in medical payments and Trinity Metro now offering On-Demand rideshares in the area, the obstacles to seek preventative care should be low. But, according to Byrd, there’s another issue at play.
“When I talk to leaders in the Black community, they’ll say, ‘Man, the distrust of the medical system is really high,’ which is understandable given what’s happened to African Americans in our country with the syphilis studies [the notorious 40-year CDC study on the effects of syphilis on Black men despite the disease being entirely treatable].”
And, according to Byrd, such distrust can get passed down from generation to generation.
“I don’t care where you live in Tarrant County,” Byrd says. “I don’t care what your ZIP code is. The formula for a healthy life is the same.”
By the Numbers
- 78.7 Average life expectancy in Tarrant County (6th among the 7 most populous counties in Texas)
- 77.4 Average life expectancy in U.S.
- 78.6 Average life expectancy in Texas
- 67 Average life expectancy in 76104
- 76002 (87.2 years) ZIP code with highest life expectancy in Fort Worth
How to Improve
- Improve economic circumstances — the upcoming Evans & Rosedale Redevelopment Project, an upcoming mixed-use urban village in the area, is a good start
- Increase healthy food access with grocers and community gardens
- Improve communication to earn medical trust
- The Roseto effect: Improve community togetherness, which leads to a healthier, longer life
Obesity
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Where We Stand
According to the Global Obesity Observatory (yes, that is a real thing), the United States has the highest obesity rate of all developed Western nations, which stands at 40.3%. While Tarrant County can celebrate being below this national average — we clock in at 37.7%, according to Data Commons — over two-thirds of county residents are either overweight or obese. And the county’s obesity rate remains over 3% higher than the Texas average.
So, how does Tarrant County stack up to other high-density population counties in Texas? Not great. According to Data Commons, Tarrant County has the highest percentage of people with obesity among the five most populous counties — Travis (Austin) 29.4%, Harris (Houston) 35.2%, Dallas 34.8%, and Bexar (San Antonio) 37.3%. We mistakenly thought everything was bigger in Texas, not just Fort Worth.
Of course, the reasons for a community to combat obesity go well beyond waistlines and aesthetics, as this complex disease can lead to a myriad of health issues, including diabetes and heart disease, which remains the No. 1 cause of death in the U.S.
Why?
Let’s face it, Fort Worth likes to eat. And, when Fort Worth eats, it likes to chow down on burgers, barbecue, and Tex-Mex — the holy trinity of high-calorie cuisine. So, yes, food and unhealthy eating habits are an obvious source for weight gain, especially when a city called Cowtown prides itself on its ability to smoke a mean brisket.
Of course, one can have the occasional burger outing, as long as it’s part of an overall balanced diet. But Fort Worth isn’t even doing that well. According to Tarrant County for Wellness, only one in six county residents eat fruits and vegetables five or more times a day, the recommended servings from the American Heart Association.
But the remedy for obesity is both diet and exercise.
According to U.S. News & World Report’s Healthiest Communities, 23.5% of Tarrant County residents have no leisure time or do physical activity. This is below both national and state averages. And the city doesn’t do much to curb this problem, as green spaces and recreational areas remain sparse.
Compared to Houston, Austin, Dallas, and San Antonio, all of which have over 2,900 square feet of green space per capita, Fort Worth sits at a mere 600 square feet of green space per capita. Add to this the city’s lack of walkable neighborhoods, and the couch-sitting epidemic becomes more understandable.
By the Numbers
- 37.7% Obesity prevalence in Tarrant County (highest among five most populous counties in Texas)
- 40.3% Obesity prevalence in the United States
- 34.7% Obesity prevalence in Texas
- 23.5% Tarrant County residents with no leisure time
- 1 in 6 Tarrant County residents that eat five servings of fruits and vegetables per day
- 600 Square feet of green space per capita in Fort Worth (lowest among five most populous cities in Texas)
How to Improve
- Increase healthy food options, including vegetarian and vegan options
- Placemaking for more walkable communities
- Preserve green spaces and create parks and recreational areas
- Healthy Dining Options: Righteous Foods, Boulevard of Greens, Local Foods Kitchen, Maiden, Vida Café, Flower Child, Magnolia Nutrition of Fort Worth
Cancer
Where We Stand
Becoming one of the most triggering words in the English language, cancer remains the leading cause of death worldwide and second — to heart disease — in the U.S. In Tarrant County, cancer prevalence, which measures the number of people 18 and older who have ever been diagnosed with cancer, sits at 5.8%. The U.S. average is 6.2%, while the Texas average is 5.7%. And, among similar Texas counties, Tarrant bests only Travis County, which sits at 5.9% cancer prevalence.
And when looking at cancer death rates (number of deaths per 100,000 people per year), Tarrant County doesn’t measure particularly well against others. According to the latest five-year average from statistics compiled by the National Cancer Institute, Tarrant County’s cancer death rate is 148.4 per 100,000. This number is higher than the national average (146), Texas average (143.5), and the other counties in Texas with comparable populations: Travis (123.1), Harris (135.6), Bexar (142), and Dallas (140). If you’re doing the math, this also means that Tarrant County’s overall cancer outcomes — deaths per diagnosis — are worse than the other counties. Travis County, despite having the higher cancer prevalence, is far and away leading the pack in cancer outcomes.
That said, the above statistic marks an improvement in cancer death rates within Tarrant County by 1.5 per 100,000. While this is in line with national and statewide trends, including our fellow densely populated Texas towns, the improvement is notable.
Why?
Healthy lifestyles usually lead to healthy outcomes. So, if Fort Worth is lagging behind other counties in obesity rates, which it is, then cancer outcomes are likely to follow this trend. This would explain why Travis County, which boasts the best obesity rate among large Texas cities, also boasts more positive cancer outcomes despite having a higher rate of cancer prevalence.
A lack of early detection thanks to prevailing medical mistrust is another factor that contributes to poor outcomes.
Additionally, while Fort Worth has an incredible network of hospitals and the Moncrief Cancer Institute, a nonprofit that will assist in early detection for those who are disadvantaged, Fort Worth isn’t a medical hub in the same vein as Houston, Dallas, or Austin, where cutting-edge treatments become more of an option for locals. While the vast majority of cancer medications and therapies are administered in Fort Worth medical centers, the city’s lack of a clinic affiliated with a prominent medical school (a la UT Southwestern) means Fort Worthians have to travel for such treatments.
By the Numbers
- 5.8% Cancer prevalence in Tarrant County (fourth among five most populous cities in Texas)
- 6.3% Cancer prevalence in the United States
- 5.7% Cancer prevalence in Texas
- 148.4 Cancer death rate in Tarrant County per 100,000 (highest among most populous counties in Texas)
How to Improve
- Promotion of a healthier lifestyle and cancer screenings, perhaps even expand the mission of Moncrief Cancer Institute
- Incentivize cancer research in the city
- Improve overall environment and lower pollutants that increase exposure to carcinogens
Mental Health
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Where We Stand
There’s little choice but to present this with bluntness: When it comes to addressing mental health, Fort Worth is failing. This is not a controversial statement; it’s one acknowledged and admitted by all. Granted, Fort Worth is not alone. Mental health services have long been a state-wide issue, with Texas continually ranking toward the bottom in mental health services.
And this at a time when mental health of Tarrant County is far from being in good shape.
According to Tarrant County Public Health, 21% of Tarrant County adults reported their mental health being not good for five or more days during the previous 30 days, and 10% report having frequent mental distress. And, in 2024, the county experienced 13.7 suicides per 100,000 residents. While this compares favorably to the national rate of 14.2 and the Texas rate of 14.4, Tarrant has the highest suicide rate among the five most populous counties in Texas. And, according to the same data, suicide remains the third leading cause of death for people between the ages of 15 and 24.
Mental health is also linked to alcohol and drug abuse. According to a 2022 Tarrant County Public Health brief, 5.6% of Tarrant County residents said they partake in heavy alcohol use (more than two drinks per day), with 17.1% saying they take part in binge drinking (consuming more than four drinks on one occasion in the past 30 days).
Why?
In 2024, the federal government designated 246 of the state’s 254 counties as “mental health professional shortage areas.” This, of course, includes Tarrant County. According to the 2025 Community Health Assessment, Tarrant County had a population of 560 per one mental health provider. While this is a major uptick from where Tarrant County was in 2016 (population of 1,090 per one mental health provider), it’s still well below the current national average of one mental health provider per 320 residents.
The area also doesn’t have an inpatient psychiatric hospital. “We’re the largest county that doesn’t have a dedicated inpatient psychiatric hospital,” Brian Byrd says. “And there’s a push for that in the state legislature, which I think will help.
“But they also don’t address some of the underlying problems,” Byrd continues. “I do think that we’ve seen mental health problems and psychiatric illnesses being traced back to smartphones and social media use.”
The National Institutes of Health performed a study in 2023 that showed a correlation between depression and smartphone use. According to the study, depression scores among participants increased with elevated smartphone use. In 2023, Gallup News reported a new high of 29% of adults had been diagnosed with depression in their lifetime. Meanwhile, eMarketer has annually reported a steady uptick in daily smartphone usage in the U.S. It’s doubtful this is a coincidence.
By the Numbers
- 21% Tarrant County adults who report mental health being not good for five or more days during the previous 30 days
- 10% Tarrant County adults who report having frequent mental distress
- 13.7 Suicide rate in Tarrant County per 100,000 (highest rate among the five most populous counties in Texas)
- 560 Population per one mental health provider in Tarrant County (U.S. average: 320)
How to Improve
- Incentivize mental health providers to come to Tarrant County
- Open dedicated inpatient psychiatric hospital
- “I recommended that parents not give their kids smartphones until they’re at least 14,” Byrd says. “And no social media until they’re 16.”
Vaccines
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Where We Stand
When Pfizer and Moderna unleashed their pair of COVID-19 vaccines in late 2020, with clinical trials showing they were safe and effective, most rushed to get a shot in their arms. Tarrant County, on the other hand, did not. When the vaccines became available, only 57% of Tarrant County residents elected to get vaccinated (and only 22% with a booster). This despite serious side effects being extremely rare (fewer than .01%) and the Commonwealth Fund estimating the vaccines likely saved 3.2 million lives. Tarrant County was the most populous county to achieve a less than 60% mark.
And this anti-vaccination trend has spread to most pediatric immunizations, including MMA, which largely irradicated measles, mumps, and rubella. Over the last five years, the rate of students who’ve received MMA in Fort Worth ISD fell from 95% in 2019 to 84% in 2024, the lowest among the five most populous cities. And, with a measles outbreak in nearby West Texas, this statistic has plenty of parents nervous.
Mercy Culture Preparatory Academy located on Oakhurst Scenic Drive, boasts that only 14.29% of their kindergartners were vaccinated for the 2023-24 school year — the most unvaccinated in Texas. And when we say they boast, we do mean they boast this statistic. On March 7, the Fort Worth Star-Telegram reported that Republican state Rep. Nate Schatzline of Fort Worth’s District 93 celebrated this distinction by suggesting the school receive a “medical freedom award.”
Why?
Medical mistrust plays a significant role in why Fort Worth remains one of the most populous unvaccinated cities. Despite a mountain of evidence proving the safety and efficacy of vaccines, many simply do not trust the very medications that have eradicated so many deadly and harmful diseases.
“I highly, highly recommend the set of childhood vaccines that we’ve all been getting” Brian Byrd says. “They’re unbelievably safe and unbelievably effective. In fact, they’re a lot more safe than a lot of the antibiotics we pass around like candy, like amoxicillin vaccines. They’re a lot safer than amoxicillin.”
All 50 states require vaccines for entry into kindergarten. However, many states also allow for medical and, in some cases, philosophical or religious exemptions that keep many children from being vaccinated. Texas is one such state that grants exemptions based on philosophical or religious reasons.
Concerning cost, CDC’s Vaccines for Children program provides vaccines at no cost, so one’s financial standing shouldn’t be an obstacle. Thus, to put it simply, the only thing keeping Fort Worthians or Fort Worth parents from getting themselves or their children vaccinated is purely a personal decision.
By the Numbers
- 84% MMA vaccine rate in Tarrant County
- 90.8% MMA vaccine rate in the United States
- 89.9% MMA vaccine rate in Texas
- 57% of Tarrant County residents elected to get COVID-19 vaccine
- 14.29% Percent of kindergartners at Mercy Culture Preparatory Academy vaccinated
How to Improve
- Combat misinformation concerning safety of efficacy of vaccines
- Increase community-led conversations around vaccines
- Partner with community organizations in areas of Fort Worth where vaccine rates are low to educate residents
Access
Where We Stand
The county hospital, which is JPS Health Network, has long remained one of the highest-rated hospitals in the country, even pulling in a first-place rating for teaching hospitals in a 2020 Washington Monthly article.
Hospital bed availability, which is a good measurement of whether a city has enough medical facilities, is higher in Tarrant County (3.6 hospital beds per 1,000 residents) than both the state (3.1) and national (2.7) averages. Among Texas’ five largest counties, this ranks third.
If one seeks medical care, there’s little doubt Fort Worth has it in spades. That said, there are barriers to access many Fort Worthians feel. According to U.S. News & World Report, 19.9% of Tarrant County residents do not have health insurance, which is 8.4% higher than the national average but does best the state average by a mere 0.4%. (Texas is the state with the highest uninsured rate in the nation.) This also ranks third among the five most populous cities in the state.
According to the Texas Medical Association, “those who are uninsured are up to four times less likely to have a regular source of health care and are more likely to die from health-related problems. They are much less likely to receive needed medical care, even for symptoms that can have serious health consequences.”
Why?
Many factors contribute to a resident being uninsured, including financial and political. When Texas chose not to expand Medicaid under the Affordable Care Act, which would have covered low-income adults deemed too poor for ACA subsidies but not eligible for Medicaid these people were caught in an in-between. According to Texas Impact, this lack of expansion is leaving 1.5 million Texans uninsured. Many of whom would undoubtedly be residing in Fort Worth.
Also, Fort Worth has a high percentage of small businesses, many of which are unlikely to provide health insurance due to cost. And, even when offered, the high premiums and deductibles can force employees to pass.
One must also remember that Fort Worth is, indeed, an urban area, where medical costs, and thus health insurance premiums, will be higher.
By the Numbers
- 3.6 Hospital beds in Tarrant County per 1,000 residents
- 19.9 Percent of uninsured in Tarrant County
- 11.5 Percent of uninsured in the United States
How to Improve
- If Texas really wants more residents insured, the expansion of Medicaid would be the ticket, but this is unlikely to happen
- Strengthen employer-based coverage with tax incentives
- Advocate for the state to set up a state-run marketplace instead of relying on the federal ACA marketplace
Conclusion
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At the end of my interview with Dr. Brian Byrd, I posed the very question this article is asking. “So, is Fort Worth healthy?” He paused, and I quickly reworded my query. “How would you grade Fort Worth? How are we doing in terms of health?”
“Yeah, the first question is the wrong question,” Byrd says. “I think we’re doing about average. We’re doing OK, but we can always do better. And, as you know, there’s a lot to this. You can’t just say barbecue’s bad for you. I mean, it’s not good for you physically, but it is good for you emotionally. And it brings people together. And anything that brings human beings together, that’s a big promoter of health.”
Now, how can you argue with that?
