Nacogdoches, Texas— Deep in the heart of East Texas, where the pine trees stretch high and communities thrive on resilience, a silent health crisis is mounting. At a recent Texas Forest Country Partnership Economic Development Forum, Dr. Andrea Cooley stood before a room of leaders and innovators with a sobering truth: East Texas ranks among the worst in the state—and nation—for health outcomes. Her message was clear: artificial intelligence (AI) might hold the key to turning the tide, but only if wielded with boldness, creativity, and a relentless focus on equity.
Dr. Cooley, a cardiothoracic surgeon with firsthand experience of the region’s health disparities, presented a compelling case. “If East Texas were its own state,” she began, “we’d rank 44th in overall mortality, 47th in cardiac deaths, and dead last in deaths from chronic lower respiratory disease. These numbers are not just statistics. They are lives—friends, neighbors, children.”
The most jarring statistic? Pediatric mortality in East Texas is 245% higher than the national average. That translates to 169 more children dying each year than would be expected if they lived elsewhere in the U.S.
A Region in Crisis
Spanning 25,000 square miles with a population of nearly two million, East Texas is a region of breathtaking beauty—and stark healthcare challenges. In 27 of its counties, there isn’t a single practicing pediatrician. For specialty care, most children and families must travel over 40 miles. Behavioral health access is even more dire, with only one child psychiatrist for every 45,000 children.
Dr. Cooley laid bare the structural inequities that drive these outcomes: limited healthcare infrastructure, chronic underfunding, and the digital divide. “It’s not just about whether you have broadband,” she explained. “It’s about whether you can afford it, whether you know how to use it, and whether you trust it.”
AI: Revolutionary, but Is It Disruptive?
Dr. Cooley argued that AI, often lauded as revolutionary, must also be disruptive to truly change the trajectory of healthcare in rural areas. She drew parallels to the disruptive innovation model pioneered by Harvard’s Clayton Christensen, explaining how targeting “nonconsumers”—those underserved by the current healthcare system—could drive systemic change.
“AI can process vast amounts of data, identify gaps, and predict needs in ways no human ever could,” she said. “But unless we design systems that serve those who currently fall through the cracks, we risk perpetuating the same inequities we’re trying to solve.”
One proposed solution is to leverage the vast amount of untapped data in rural communities. By collecting and monetizing data from underserved populations, the healthcare system could generate new revenue streams to reinvest in programs addressing social determinants of health.
The Digital Divide: A Super-Determinant of Health
Yet, the digital divide looms as a formidable barrier. In East Texas, 25% of households lack internet access, and nearly 27% rely solely on cellular data—a major hurdle for telemedicine and other digital health innovations.
“Access to healthcare is increasingly digital,” Dr. Cooley explained. “But without reliable internet and digital literacy, entire communities are being left further behind.”
She emphasized that bridging this divide is not just about infrastructure but also about adoption and trust. “We’ve been so focused on getting broadband into homes that we’ve ignored the need for digital education and culturally sensitive outreach,” she added.
A Call to Think Bigger
Dr. Cooley’s presentation was not merely a litany of grim statistics. It was a rallying cry. She proposed an audacious blueprint for health equity that marries AI with community-driven solutions. This includes establishing a regional data warehouse to fuel innovation, creating new business models to target underserved populations, and scaling digital infrastructure to enable access to care.
Her vision is bold: transform East Texas into a living laboratory for equitable, AI-driven healthcare. “We have an opportunity to lead—not just for Texas but for the nation,” she said. “If we can solve these problems here, we can solve them anywhere.”
A Shared Responsibility
The audience—composed of business leaders, healthcare professionals, and policymakers—responded with a palpable sense of urgency. Many expressed optimism about leveraging partnerships between the public and private sectors to address these challenges.
“We cannot wait years or decades for incremental progress,” Dr. Cooley urged. “Every year we lose over 3,000 lives to preventable causes. AI, big data, and innovative thinking can help us close the gap—but only if we work together.”
A Road Ahead
As the forum concluded, one thing was clear: the future of healthcare in East Texas demands bold ideas and transformative action. Dr. Cooley’s challenge resonated: think bigger, innovate smarter, and never lose sight of the communities most in need.
In the words of Dr. Cooley, “The story of East Texas is not one of despair but of potential. We have everything we need to build a better system. The question is, will we?”
Dr. Andrea Cooley, DO, FACOS
UT Tyler School of Medicine, Associate Professor of Medical Education
Dr. Andrea Cooley is a board-certified cardiothoracic surgeon and a passionate advocate for health equity. With years of experience treating some of the sickest patients in rural and underserved communities, Dr. Cooley has seen firsthand the profound disparities in healthcare access and outcomes. Her work focuses on leveraging innovative technologies like artificial intelligence (AI) and big data to transform healthcare delivery in regions facing significant challenges.
Dr. Cooley has been a vocal leader in addressing the unique needs of East Texas, a region grappling with some of the highest mortality rates in the country. Her efforts include advancing community-driven solutions, scaling healthcare infrastructure, and bridging the digital divide to ensure equitable access to care. Beyond her clinical expertise, Dr. Cooley is a sought-after speaker and thought leader, known for her ability to inspire actionable change in healthcare innovation and policy.
