Innovative Houston program that combines engineering, medicine to graduate inaugural class

first in class

The EnMed program is housed out of the Texas A&M University System's new Discovery Tower in the Texas Medical Center. Image via Facebook/TAMU EnMEd

Priya Arunachalam knew that she had a calling to heal, but she also has a mind for solving problems. After earning a B.S. in biomedical engineering and an MBA in healthcare management and entrepreneurship from Johns Hopkins University, the Austin native applied to medical schools knowing that her trajectory would be working as “a doctor-plus,” as she puts it.

Fortunately, a new program that combined the powers of Houston Methodist and Texas A&M University was recruiting its first graduating class. The School of Engineering Medicine allows students to simultaneously earn both a medical doctorate and a master of engineering degree in four years. It was the perfect fit.

On May 19, she will be among the 22 first students to earn those degrees. Five of them are staying on at Houston Methodist and Arunachalam is one of them.

“I am doing a general surgery residency at Houston Methodist. I am leaning towards transplant,” Arunachalam tells InnovationMap.

It’s no easy task to become a member of the EnMed program, as it’s informally known. Classes are capped at just 50 students a year, says Dr. Timothy Boone, director of education at Houston Methodist Academic Institute. He says that in the four years since EnMed launched, the size and diversity of the applicant pool has continued to grow, but it’s a very specific type of student they’re looking for.

Students must have an undergraduate degree in engineering, for one. That, Boone says, attracts problem solvers who also want to practice medicine.

“If you just think of it as a job, you’re in it for the wrong reasons,” he says.

Throughout their four years of education, students put their problem solving to the test. As they learn about medicine, the students see issues at a patient level and come up with engineering solutions.

One of Arunachalam’s creations in her time in EnMed was a redesigned hospital gown that allows for exams despite being less exposed in the back. She’s currently trying to pilot them at Houston Methodist Hospital.

Boone also mentions an ophthalmology student who has gained a preliminary patent on a design for a chair that accommodates more body types than those currently being used by most doctors. Another group of students created Go Baby Go, a toy car specifically designed for children with significant mobility impairment.

EnMed isn’t Houston Methodist’s only innovative collaboration. The University of St. Thomas Cameron School of Business joins forces with Houston Methodist to offer a master in clinical translation management program to teach students how to turn their ideas into thriving companies.

With Arunachalam’s business background, one might have expected her to follow such a path. But she says she prefers to create solutions and “find the right teams to take those ideas forward.”

Instead, her future is in surgery, which she says, is its own kind of engineering.

“I think they’re very similar," she says. "In engineering, we take apart a problem and put it back together a little better. In surgery you have a system that is malfunctioning and we have to find novel ways to fix it.”

And her and her classmates’ novel discoveries will soon be helping countless patients.

The EnMed program is graduating its first class this week. Photo via HoustonMethodist.org

Houston Methodist's Roberta Schwartz and Texas A&M University's Dr. Roderic Pettigrew shared their thought leadership at a recent panel for Houston Tech Rodeo. Photos courtesy

2 Houston experts explain what's next in health care innovation — from tech to workforce development

Houston innovators podcast episode 124

The medical field is full of problems to solve — how to improve patient care, new diseases to treat, extending but also improving quality of life, and so much more. It's an industry that needs innovation — and in many cases, that means introducing new technologies and ideas.

At last week's Houston Tech Rodeo health tech saloon, two experts weighed in on the discussion. Roberta Schwartz, chief innovation officer of Houston Methodist, and Dr. Roderic Pettigrew, dean of the Intercollegiate School of Engineering Medicine at Texas A&M University, discussed how they view the health care industry's future — and what they are doing to make sure future health care providers and innovators are ready.

“You want the next generation to get equally as excited about what’s happening in that world (of health tech) and realize how much opportunity there is to disrupt the field of health care,” Schwartz says on the panel. “It’s so natural to us at Houston Methodist to say, ‘please come along and see the opportunities there are and seize them.’”

The panelists noted on where the conversation was taking place — TAMU's new EnMed building, which was constructed and dedicated to engineering medical students. Dr. Pettigrew says the new field is meant to train problem solvers.

“When you consider scientific progress throughout history and in the future, you realize that technological innovation is the engine of scientific progress,” he says. “When you think about what profession in our society solves problems for the benefit of society, it’s engineering."

The full panel recording is available on this week's Houston Innovators Podcast. Listen to it below — or wherever you stream your podcasts — and subscribe for weekly episodes.

Photo courtesy of Houston Methodist

Health care innovators joined Houston Methodist and Texas A&M University's ENMED program to discuss women in health care innovation and venture capital investment. Photo courtesy of Houston Methodist

Overheard: Houston experts discuss women in med tech, insight from investors, and more

Eavesdropping in Houston

Houston's health innovation community is making strides every day toward greater quality of care and technology adoption — but what challenges is the industry facing these days?

Through a partnership between Houston Methodist and Texas A&M University's ENMED program at Houston Tech Rodeo, health innovators weighed in on topics surrounding the industry, including biases and investment opportunities.

Missed the conversation? Here are seven key moments from the panels that took place at A&M's new ENMED building in the Texas Medical Center on Thursday, March 3.

“When I look at learning and understanding the priorities — how to take care of patients and also enable those who are doing that work, that’s part of understanding the culture and learning because in the 40 years that I’ve been in the industry, it’s never been the same. There are always things that continue to present challenges from unexpected places.”

— Ayse McCracken, founder of Ignite Healthcare Network, says on the "Four Fierce Females" panel, referencing the rate of tech disruption and how new technologies, medicine, etc. can change the health care industry and practitioners need to find ways to keep up and stay ahead of the curve.

“Whenever you experience biases, what can you do? You can lean into the fact that we are in a position to help educate and make a change. And that’s going to look different for every one of us, but lean into that instead of feeling down by it.”

— Samantha Lewis, principal at Mercury Fund, says on the "Four Fierce Females" panel, explaining that women across industries should lean into being a change agent when met with bias in the workplace.

“The reason I feel so passionate is (I’m always thinking,) ‘What more can we be doing for our community? What’s working well and what’s not working well,' so I can take that back and make positive changes in our organization.”

— Michelle Stansbury, vice president of innovation and IT applications at Houston Methodist, says on the "Four Fierce Females" panel, explaining that when she's on the other side of the equation as a patient, she really considers her experience and how it could be better.

“Every time you raise money you’re telling a story. You have to figure out what adds value to that story. … I think health care is tricky too because people getting into it aren’t necessarily aware of how complex it is.”

— Dan Watkins, venture partner and co-founder at Mercury Fund, says on the "Where’s My Money At?" investor panel, adding how important it is to investors that founders have specific information — market potential, road map, etc. — when pitching to VCs.

“As a health care startup founder and CEO, you have to wear so many different hats — especially if you’re talking about diagnostics and medical devices. It starts in the science, moves to engineering, and then winds up being commercial. To expect someone to be an expert at all those fields is very difficult.”

— Tim Marx, venture partner at Baird Capital, says on the "Where’s My Money At?" investor panel, adding that, “That’s why we look for the CEOs who really understand where they are, where they’re going, and what they need.”

“One of the things we really appreciate when we engage with founders, it’s not about ‘here’s why my company is great.’ It’s more about understanding the questions your business needs to answer. … If you think about that, that’s what we want to fund. We want to invest in the vision, opportunity, and the people, but we want to fund the — the roadmap — that usually comes with being thoughtful about the questions you’re trying to answer.”

— John Reale, venture lead at TMC Venture Fund, says on the "Where’s My Money At?" investor panel, adding "That's where we get energized."

“The idea to attract talent that’s already built great companies across the US and the world to come here, hire here, and grow here — that’s starting to actually pay off. One of the things that’s big about Houston is it’s really gritty — it’s very ‘show me the data and prove it to me first.’ … We’re having those proven points.”

— Emily Reiser, associate director of innovation at the Texas Medical Center , says on the "Where’s My Money At?" investor panel about the work TMC is doing with its accelerator program.

It's pay day for several Houston-area research teams thanks to two grant programs. Photo via Getty Images

Several Houston-area life science research teams receive thousands in grants

research roundup

Several health innovation research teams across Houston are celebrating fresh funds to go toward the development of breakthrough technologies and research projects.

In InnovationMap's latest roundup of research news, check out who received this crucial funding and how their research and work can change the standard of care across the life science industry.

Reliant doles out $100,000 to two Houston Methodist critical care physician-scientists

Reliant announced that the recipients of the Reliant Innovation Fund will be two individuals within Houston Methodist Center for Critical Care in collaboration with Texas A&M's Engineering Medicine (EnMed) program.

"Meaningful innovation is core to us at Reliant and the work these institutions, physicians and students are doing is truly amazing," says Elizabeth Killinger, president of Reliant, in a news release. "We appreciate how Houston Methodist is making a lasting difference in our community by continuing to revolutionize medicine and we are honored to support them through the EnMed program."

Dr. Hina Faisal and Dr. Asma Zainab — along with the EnMed students who will support their work — will use the funds to advance their work. An anesthesiologist and critical care physician, Faisal will lead a project on 3-D-simulated virtual reality technology to prevent delirium in critically ill patients. Zainab, who specializes in cardiovascular ICU and focuses on respiratory failure and ventilator use, will lead a project to help personalize care in lung failure, creating models specific to each patient to avoid unnecessary pressure and injury caused by ventilators, per the release.

"Innovation is at the heart of what we do," says Dr. Faisal Masud, director of the Center of Critical Care at Houston Methodist, in the release. "Thanks to Reliant's generous contribution and ongoing support, we are able to seek out new ways to provide the best quality care for our most vulnerable patients while supporting our physicians, our students and their research."

Researchers at Rice University and Texas Medical Center institutions snag grants

Six research teams have received funding from Rice University's Educational and Research Initiatives for Collaborative Health, known as ENRICH. Established in 2016, the program focuses on connecting Rice faculty with TMC institutions to encourage collaboration. Last year, more than a fifth of Rice faculty were engaged in active collaborations with TMC research partners, according to a news release.

"Partnerships with TMC are an institutional priority, and they enable our faculty to translate their research to clinical practice, directly benefiting the Houston community," says Marcia O'Malley, special advisor to the provost on ENRICH and the Thomas Michael Panos Family Professor in Mechanical Engineering, in the release. "ENRICH has been instrumental in facilitating faculty engagement with TMC partners, reducing barriers to collaboration and investing institutional resources in new partnerships."

The Provost's TMC Collaborator Fund awarded $60,000 in grants to:

Jason Hafner '98, professor of physics and astronomy at Rice, and Carly Filgueira '09, assistant professor of nanomedicine and cardiovascular surgery at Houston Methodist Research Institute, to explore the development of an optical sensor for clinical detection of cholesterol.
Lan Li, assistant professor of history at Rice; Ricardo Ernesto Nuila, associate professor of medicine, medical ethics and health policy at Baylor College of Medicine; and Fady Joudah, a poet, literary translator and physician at Baylor St. Luke's Medical Center, for a pilot study of community health care access that addresses larger questions about medical racism in Houston.
Oleg Igoshin, professor of bioengineering at Rice, and Anna Konovalova, assistant professor of microbiology and molecular genetics at the University of Texas Health Science Center at Houston's McGovern Medical School, to explore new targets for antibiotic treatment by probing the feedback loop between two important stress-response pathways in bacteria.

Additionally, Rice ENRICH and Baylor's Interdisciplinary Surgical Technology and Innovation Center (INSTINCT) awarded $60,000 in grants to:

Pulickel Ajayan, the Benjamin M. and Mary Greenwood Anderson Professor in Engineering and chair of Rice's Department of Materials Science and Nanoengineering, and Crystal Shin, assistant professor of surgery at Baylor, for development of a self-charging, wireless microsensor capable of detecting changes in flow in blood vessels that have been replaced in heart bypass surgery.
Meng Li, Noah Harding Assistant Professor in Statistics at Rice, and Gabriel Loor, associate professor of surgery at Baylor, to study inflammation following lung transplantation and search for the cause of inflammatory responses that differ between men and women.
Vaibhav Unhelkar, assistant professor of computer science at Rice, and James Suliburk, associate professor of surgery at Baylor, to explore how artificial intelligence can augment surgical training.

Reliant and Aramco Americas have provided Houston Methodist funds to move forward pertinent research and opportunities. Courtesy of Methodist Hospital/Facebook

2 corporations write checks to go toward Houston hospital's COVID-19 efforts

money moves

Two Houston companies have doled out cash to a Houston hospital's efforts in driving innovation during the pandemic as well as moving forward in a post-COVID-19 world.

Houston Methodist received $500,000 from Houston-based Aramco Americas and $130,000 from Houston-based Reliant. Aramco's gift will go toward funding ongoing research on convalescent plasma therapy as a treatment for COVID-19 and Reliant's donation will create the Reliant Innovation Fund.

"The challenges that we have and will continue to face with the COVID-19 pandemic amplifies the need for fresh ideas to combat this disease and treat those who have been affected," says Dr. Faisal Masud, medical director of the Center for Critical Care at Houston Methodist Hospital, in a news release from Reliant. "Innovating is at the core of what we do at Houston Methodist, and this generous gift from Reliant will make a difference for patients both now and for years to come."

According to the release, $100,000 will go toward supporting students in the Texas A&M University's Engineering Medicine program, which combines engineering and medical courses to allow for students to receive a master's in engineering and a medical degree in four years. Currently, A&M is renovating a building in the Texas Medical Center that will be the future home of the program.

"The EnMed program is educating a new type of physician — one with an engineering background and a forward-thinking, innovative medical mindset. Reliant's partnership and donation will allow our students to innovate for the dynamic needs on today's clinical front lines," says Dr. Timothy Boone, director of the Houston Methodist Education Institute and Associate Texas A&M Dean, in the release.

The other $30,000 of Reliant's gift will go towards expanding the hospital's patient-centric mobile app, CareSense, which Houston Methodist has used to connect with COVID-19 patients after they have left the hospital.

Aramco's donation will be used to support Houston Methodist's plasma research on COVID-19 treatment. The hospital was the first academic medical center in the United States to get FDA approval for this type of treatment on COVID-19 patients.

"Convalescent plasma therapy has been effective in other infectious diseases and our physician-scientists are working to develop it into a first-line treatment for COVID-19," says Dr. Dirk Sostman, president at the Houston Methodist Academic Institute, in a news release from Aramco.

The treatment collects blood from recovered COVID-19 patients and infuses the plasma into currently ill COVID-19 patients in hopes that the recovered patient's plasma can provide the antibodies for the ill patient to fight off the disease.

"Houston Methodist Hospital is a world-leader in healthcare as well as research and development," says Mohammad S. Alshammari, president and CEO of Aramco Americas in the release. "Our donation is an opportunity to support the innovative work occurring there in support of the Houston community and to contribute to long-term medical solutions for this global health crisis."

Texas A&M University is planning a three-building project to bring parking, housing, retail, and more to the Texas Medical Center. Photo courtesy of Texas A&M University System

Texas A&M University reveals plans for $546M medical complex in Houston

coming soon

Texas A&M University has announced a new three-building project in the Texas Medical Center that will bring a renovated space for its Engineering Medicine program, student housing, parking, retail, and more.

The $546 million complex will be funded in part by a public-private partnership, according to a news release from the university. The project includes one 18-story building to be purchased and renovated for $145 million, and an additional $401 million will go toward constructing two new buildings.

"The Board of Regents of the Texas A&M University System recognized an opportunity in Houston to help Texans and contribute more to the global medical community," says Elaine Mendoza, chairman of the Board of Regents of the Texas A&M University System, in the news release. "We are eager and fortunate to further enhance the world's greatest medical center through this endeavor."

The first of the three buildings to debut will be the EnMed renovation project at 1020 Holcombe Blvd. This project, which had previously been announced, is expected to deliver by this summer and should be monumental for the already successful program, says Bob Harvey, president and CEO of the Greater Houston Partnership, in a statement.

"Texas A&M's EnMed program fits right into what we are doing in Houston," Harvey says. "Our city has long been recognized as a destination for world-class health care and cutting-edge research, thanks to the incredible institutions in the Texas Medical Center. Houston is also becoming known as an attractive location for both mature and emerging life science and biotech companies. We are, indeed, becoming the 'third coast' for life sciences."

A&M TMC The first of the three buildings is expected to be complete this summer. Photo courtesy of Texas A&M University System

The two new construction buildings will be paid for through public-private partnerships. The student housing building, a 19-story building planned to have 572 units with 704 beds in a 365,000 square-foot space, will be completed by June 2022, according to the release. The building will also include a 3,444-spot parking garage. Students from A&M campuses will get priority housing, but students at other institutions will also be allowed spots if available.

"We saw a need for student housing and medical offices in Houston. Plus, our EnMed students needed the facilities to create the latest medical devices," says Greg Hartman, a vice chancellor at Texas A&M University System and interim senior vice president of the Texas A&M Health Science Center, in a news release. "So, we began the process of expanding the Texas A&M footprint in Houston and I believe the work done by Aggies in Houston will be life-changing for a lot of people."

The third component of the plans includes a 587,000-square-foot, 30-floor Integrated Medical Plaza — another public-private partnership — and it has a June 2023 expected completion. Thirteen of the stories will be parking, and 72,000 square feet of space will be for retail use, while 8,700 square feet will be green space.

According to the release, the developer for the two new construction projects is Houston-based Medistar Corp., which is run by CEO Monzer Hourani. New York-basedAmerican Triple I Partners is on the financing team and was founded by Henry Cisneros, a Texas A&M alumnus.

Representatives from both the school and the city see the potential impact of the complex for medical innovations.

"Last year, Houston had its best year ever in terms of attracting venture capital to the region," Harvey says in his statement on the news. "This program and this facility will provide one more reason for major VCs to give Houston's innovative companies a look – and for talented students, researchers, and entrepreneurs to make Houston their home."

Dr. M Katherine Banks, who serves the university of vice chancellor of engineering and national laboratories at the Texas A&M System, notes in the release how the EnMed program has set up its students for breakthrough medical device innovation.

"I expect to see transformative ideas generated by Texas A&M's broadened presence in Houston," says Dr. Banks in the release.

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Innovation Labs @ TMC set to launch for early-stage life science startups

moving in

The Texas Medical Center will launch its new Innovation Labs @ TMC in January 2026 to better support life science startups working within the innovation hub.

The new 34,000-square-foot space, located in the TMC Innovation Factory at 2450 Holcombe Blvd., will feature labs and life science offices and will be managed by TMC. The space was previously occupied by Johnson & Johnson's JLABS @TMC, a representative from TMC tells InnovationMap. JLABS will officially vacate the space in January.

TMC shares that the expansion will allow it to "open its doors to a wider range of life science visionaries," including those in the TMC BioBridge program and Innovation Factory residents. It will also allow TMC to better integrate with the Innovation Factory's offerings, such as the TMC Health Tech accelerator, TMC Center for Device Innovation and TMC Venture Fund.

“We have witnessed an incredible demand for life science space, not only at the TMC Innovation Factory, but also on the TMC Helix Park research campus,” William McKeon, president and CEO of the TMC, said in a news release. “Innovation Labs @ TMC enables us to meet this rising demand and continue reshaping how early-stage life science companies grow, connect, and thrive.”

“By bringing together top talent, cutting-edge research, and industry access in one central hub, we can continue to advance Houston’s life science ecosystem," he continued.

The TMC Innovation Factory has hosted 450 early-stage ventures since it launched in 2015. JLABS first opened in the space in 2016 with the goal of helping health care startups commercialize.

13 Houston businesses appear on Time's best midsize companies of 2025

new report

A Houston-based engineering firm KBR tops the list of Texas businesses that appear on Time magazine and Statista’s new ranking of the country’s best midsize companies.

KBR holds down the No. 30 spot, earning a score of 91.53 out of 100. Time and Statista ranked companies based on employee satisfaction, revenue growth, and transparency about sustainability. All 500 companies on the list have annual revenue from $100 million to $10 billion.

According to the Great Place to Work organization, 87 percent of KBR employees rate the company as a great employer.

“At KBR, we do work that matters,” the company says on the Great Place to Work website. “From climate change to space exploration, from energy transition to national security, we are helping solve the great challenges of our time through the high-end, differentiated solutions we provide. In doing so, we’re striving to create a better, safer, more sustainable world.”

KBR recorded revenue of $7.7 billion in 2024, up 11 percent from the previous year.

The other 12 Houston-based companies that landed on the Time/Statista list are:

No. 141 Houston-based MRC Global. Score: 85.84
No. 168 Houston-based Comfort Systems USA. Score: 84.72
No. 175 Houston-based Crown Castle. Score: 84.51
No. 176 Houston-based National Oilwell Varco. Score: 84.50
No. 234 Houston-based Kirby. Score: 82.48
No. 266 Houston-based Nabor Industries. Score: 81.59
No. 296 Houston-based Archrock. Score: 80.17
No. 327 Houston-based Superior Energy Services. Score: 79.38
No. 332 Kingwood-based Insperity. Score: 79.15
No. 359 Houston-based CenterPoint Energy. Score: 78.02
No. 461 Houston-based Oceaneering. Score: 73.87
No. 485 Houston-based Skyward Specialty Insurance. Score: 73.15

Additional Texas companies on the list include:

No. 95 Austin-based Natera. Score: 87.26
No. 199 Plano-based Tyler Technologies. Score: 86.49
No. 139 McKinney-based Globe Life. Score: 85.88
No. 140 Dallas-based Trinity Industries. Score: 85.87
No. 149 Southlake-based Sabre. Score: 85.58
No. 223 Dallas-based Brinker International. Score: 82.87
No. 226 Irving-based Darling Ingredients. Score: 82.86
No. 256 Dallas-based Copart. Score: 81.78
No. 276 Coppell-based Brink’s. Score: 80.90
No. 279 Dallas-based Topgolf. Score: 80.79
No. 294 Richardson-based Lennox. Score: 80.22
No. 308 Dallas-based Primoris Services. Score: 79.96
No. 322 Dallas-based Wingstop Restaurants. Score: 79.49
No. 335 Fort Worth-based Omnicell. Score: 78.95
No. 337 Plano-based Cinemark. Score: 78.91
No. 345 Dallas-based Dave & Buster’s. Score: 78.64
No. 349 Dallas-based ATI. Score: 78.44
No. 385 Frisco-based Addus HomeCare. Score: 76.86
No. 414 New Braunfels-based Rush Enterprises. Score: 75.75
No. 431 Dallas-based Comerica Bank. Score: 75.20
No. 439 Austin-based Q2 Software. Score: 74.85
No. 458 San Antonio-based Frost Bank. Score: 73.94
No. 475 Fort Worth-based FirstCash. Score: 73.39
No. 498 Irving-based Nexstar Broadcasting Group. Score: 72.71

Texas ranks as No. 1 most financially distressed state, says new report

Money Woes

Experiencing financial strife is a nightmare of many Americans, but it appears to be a looming reality for Texans, according to a just-released WalletHub study. It names Texas the No. 1 most "financially distressed" state in America.

To determine the states with the most financially distressed residents, WalletHub compared all 50 states across nine metrics in six major categories, such as average credit scores, the share of people with "accounts in distress" (meaning an account that's in forbearance or has deferred payments), the one-year change in bankruptcy filings from March 2024, and search interest indexes for "debt" and "loans."

Joining Texas among the top five most distressed states are Florida (No. 2), Louisiana (No. 3), Nevada (No. 4), and South Carolina (No. 5).

Texas' new ranking as the most financially distressed state in 2025 may be unexpected, WalletHub says, considering the state has a "bigger GDP than most countries" and still has one of the top 10 best economies in the nation (even though that ranking is also lower than it was in previous years).

Even so, Texas residents are stretching themselves very thin financially this year. Texans had the ninth lowest average credit scores nationwide during the first quarter of 2025, the study found, and Texans had the sixth-highest increase in non-business-related bankruptcy filings over the last year, toppling 22 percent.

"Texas also had the third-highest number of accounts in forbearance or with deferred payments per person, and the seventh-highest share of people with these distressed accounts, at 7.1 percent," the report said.

This is where Texas ranked across the study's six key dimensions, where No. 1 means "most distressed:"

No. 5 – "Loans" search interest index rank
No. 6 – Change in bankruptcy filings from March 2024 to March 2025 rank
No. 7 – Average number of accounts in distress rank
No. 8 – People with accounts in distress rank
No. 13 – Credit score rank and “debt” search interest index rank

Examining these financial factors on the state level is important for understanding how Americans are faring with economic issues like inflation, unemployment rates, or natural disasters, according to WalletHub analyst Chip Lupo.

"When you combine data about people delaying payments with other metrics like bankruptcy filings and credit score changes, it paints a good picture of the overall economic trends of a state," Lupo said.

On the other side of the spectrum, states like Hawaii (No. 50), Vermont (No. 49), and Alaska (No. 48) are the least financially distressed states in America.

The top 10 states with the most people in financial distress in 2025 are:

No. 1 – Texas
No. 2 – Florida
No. 3 – Louisiana
No. 4 – Nevada
No. 5 – South Carolina
No. 6 – Oklahoma
No. 7 – North Carolina
No. 8 – Mississippi
No. 9 – Kentucky
No. 10 – Alabama

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A version of this article originally appeared on CultureMap.com.

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