Good thing Rick Perry has refused $30 million in federal funds for the Women’s Health Program! A new report by The Commonwealth Fund shows Texas ranks at the bottom in many areas of health care access, prevention and treatment, potentially avoidable hospital use and costs, and population health.

The survey compared 306 hospital regions nationally.

Dallas ranked No. 288 — tied with Houston, Corpus Christi and San Angelo — nationally in categories of adults insured, children insured, routine checkups in last two years, cost-related problems in seeing doctors, and dental visits in the last year. The lowest markets nationally were all in Texas — Amarillo, Beaumont, Victoria, Abilene, Odessa, El Paso, Waco, Harlingen and McAllen.

Texas has the highest rate of uninsured adults. In two areas of the state — McAllen and Harlingen — more than half the adults have no insurance. Three areas of Texas ranked highest in the country for uninsured children.

More than 20 percent of adults in Texas receive no healthcare because of cost, ranking the state with Florida, Georgia, Louisiana and Mississippi.

At 31 percent, Beaumont has the highest rate of smoking in the country. In only eight states more than 25 percent still smoke, with Texas among them.

Boulder, Colo. reported the lowest obesity rate in the country with 15 percent; Amarillo had the highest with 46 percent. The obesity rate statewide exceeds 35 percent, putting Texas with Alabama, Arkansas, Louisiana, Mississippi and Tennessee.

However, there were some bright spots.

McAllen has among the lowest mortality rates for breast cancer and colorectal cancer, although statewide, Texas has among the highest death rates for both cancers.

Only three communities in the U.S. had less than four infant deaths per 1,000 live births. Victoria was among them. The other two were San Francisco and Santa Rosa, Calif.

While Texas has some of the highest rates (15 percent) of tooth loss due to decay, infection or gum disease, Austin has the country’s lowest rate at less than 3 percent.

In the report, Dallas-Fort Worth is held up as a model for creating a database that combines billing data from many payers of health care services can help provide a more accurate understanding of the qual­ity and cost of care for a population. The DFW Hospital Council Education and Research Foundation developed a Regional Enterprise Master Patient Index, which is being used by hospitals and researchers to analyze trends in health care use across the region.