Pediatric surgical border health: Supply may not be meeting demand in South Texas communities

The Rio Grande Valley (RGV) has historically high incidence of congenital defects (CDs) necessitating intervention by pediatric surgical specialties. We examined mortality in this region and related workforce patterns. Mortality data related to CDs (2007–2021) and surgical workforce trends/projections (2024–2032) were collected using multiple databases: National Vital Statistics System, Texas Department of State Health Services, Texas Medical Board, Center for Disease Control. Nationally, RGV counties rank as high as 5th in CD mortality rates. Between 2020 and 2024, 3 of 4 studied pediatric surgical specialties experienced stagnant/decreasing workforces ranging from 0 to 66 ​%. Furthermore, the RGV is projected to have some of the most marked state-wide disparities in surgical providers over the next 8 years. High infant mortality rates along with ongoing and future shortages of surgical specialists is concerning. These results may inform allocation of public health resources and workforce distribution to improve outcomes. •The Rio Grande Valley (RGV) is home to a diverse rapidly growing population.•Ongoing RGV maternal-fetal crisis contributes to rates of congenital defects (CDs).•Mortality rates from CDs in the RGV are among some of the nation's highest.•There are current and future projected shortages of pediatric surgical specialists in the RGV.•These critical findings necessitate systemic reevaluation.