Mobile vet business, virtual reality for space, plant-based biotech, and more — all this innovation and more is coming out of Houston startups. Courtesy photos

Editor's note: As 2020 comes to a close, InnovationMap is looking back at the year's top stories in Houston innovation. This past year, InnovationMap featured profiles on dozens of these Houston startups — from blockchain and software companies to startups with solutions in health care and oil and gas. Here are excerpts of 10 that stood out throughout 2020 — be sure to click through to read the full story.

Houston health tech startup moves into new office amid major growth

BrainCheck has moved to a new office as it grows its team and expands its product. Natalie Harms/InnovationMap

Following a series A round of fundraising, a Houston digital health startup is on a bit of a hiring spree, leading to new office space the company has room to grow into.

BrainCheck, which was founded in 2015 by neuroscientist David Eagleman, is a cognitive assessment startup that has developed a software tool for primary care doctors to use to assess their patients' cognitive health so that they can more quickly diagnose and treat them for maladies like dementia.

The 19-person company headquartered in Houston — with a secondary office in Austin focused on product development — has relocated its operations from coworking space in the Texas Medical Center to an office in the Rice Village area. The move was made possible by an $8 million series A financing round that closed in October.

"It's pretty exciting to have reached this milestone where we need more space," Yael Katz, co-founder and CEO of BrainCheck, tells InnovationMap. "We were pretty much bursting at the seams in our old office." Click here to continue reading.

Houston startup raises $30M, plans to be 'next iconic chemical company' with plant-based alternatives

Solugen, which uses plant-centered biotechnology to produce environmentally friendly chemicals, has raised an additional $30 million and is speculated to soon reach unicorn status. Photo via solugentech.com

While Forbes recently anointed Houston-based Solugen Inc. as one of the next billion-dollar "unicorns" in the startup world, Dr. Gaurab Chakrabarti shrugs off the unicorn buzz.

Chakrabarti, a physician and scientist who's co-founder and CEO of the startup, concedes he doesn't know whether Solugen will be worth $1 billion or not. But he does know that the startup aspires to be a key competitor in the emerging "climate tech" sector, whose players strive to combat climate change. Chakrabarti estimates the climate-tech chemical space alone represents a global market opportunity valued at $1 trillion to $2 trillion per year.

Solugen's overarching goal in the climate-tech market: Replace petroleum-based chemicals with plant-based substitutes.

"I'd love it if we were the poster child that drives climate tech to be the next big, sexy trend," Chakrabarti says.

Chakrabarti acknowledges Solugen's investors, executives, and employees hope the startup succeeds financially. But success, he believes, goes beyond making money and plotting an exit strategy. Instead, Chakrabarti emphasizes "a shift in thinking" on climate tech that he says promises to transform the fledgling sector into a "true niche" that'll be "good for everyone." Click here to continue reading.

Houston mobile vet company plans to roll out services statewide

A Houston vet has seen growth in business for her mobile vet company due to the pandemic. Now, she's planning major growth. Photo courtesy of Rollin' Vets

It's safe to say that the real winners of work-from-home trends that sparked due to the pandemic are our pets. Dogs and cats that were used to not seeing their owners for eight hours every work day now have 24-hour access to attention, treats, and ear scratches.

This increased attention pets are getting from their owners has also meant an increased awareness of pet health, says Katie Eick, founder of Houston-based Rollin' Vets, a startup that has mobilized veterinary services.

"People are home and observing their animals more. They're seeing and recognizing things they might not have if they were at work all day," Eick says.

That's, of course, not the only way the pandemic has affected business for Eick. She founded her company in 2016 and was seeing steady growth as delivery and on-demand services like Uber, DoorDash, etc. increased in use and awareness. Click here to continue reading.

With fresh funds, this Houston entrepreneur plans to scale his industrial e-commerce startup

Tim Neal, CEO of Houston-based GoExpedi, shares how his company plans to scale following its recent series C closing. Photo by Colt Melrose for GoExpedi

Consumers are getting more and more used to picking up their laptops or phones and ordering everyday items in just a few clicks or taps — and seeing those items delivered in just a few days. To Tim Neal, CEO of Houston-based GoExpedi, ordering parts and tools for industrial businesses should be just as easy.

GoExpedi, which just closed a $25 million series C round, has seen rising demand for its e-commerce platform focused on industrial orders, and Neal credits this demand on a change in mindset within the industrial sector. Additionally, he says he's seen clients more and more focused on cutting costs.

Neal shared his company's plans for growth and scale, as well as how fundraising during a pandemic went, in an interview with InnovationMap. Click here to continue reading.

Family-owned composting startup redesigns how Houston disposes of waste

A Houston-area family has made it their business to help Houstonians reduce waste in a convenient, sustainable way. Photo courtesy of Happy Earth Compost

Jesse Stowers has always strived to do his part for the environment. From recycling and making eco-conscious choices, the Stowers were doing everything right, but was it enough?

The family of five was throwing away two trash bags of waste a day that would later end up in landfills until Stowers stumbled on composting as a solution. In May, he launched Happy Earth Compost, a company set on making Houston more sustainable.

If you're unfamiliar with composting, get ready for a crash course. Composting is a sustainable method of decomposing organic solid wastes and turning that waste into compost, a substance that helps plants grow. Food scraps and household items like rice, pasta, meat, poultry, fish, vegetables, fruits, coffee grounds, spoiled food, and tea bags are just a few of the many things that can be composted rather than thrown away.

"Your food waste and compostable waste is anywhere from 25 to 50 percent depending on the family," explains Stowers. According to Happy Earth Compost, one human creates an estimated 1,642 pounds of trash each year. Click here to continue reading.

Houston virtual reality company collaborates with space health organization

Houston-based Z3VR has been granted $500,000 to work or virtual reality applications in space. Photo courtesy of Z3VR

Houston-based startup Z3VR received a $500,000 grant from Baylor College of Medicine's Translational Research Institute for Space Health, or TRISH, last month to continue exploring how the wide world of virtual reality can boost mental and physical health for astronauts on a mission to Mars.

Founded in 2017 by a group of emerging tech enthusiasts, Z3VR discovered its niche in what CEO Josh Ruben calls the "intersection of biosensors and VR" and began consulting with TRISH in 2018. Last year, the company received its first funding from the institution to create virtual reality platforms that promote exercise and provide additional sensory experiences for isolated Mars-bound astronauts.

This new grant, however, takes Z3VR's mission one step farther. The year-long grant will allow Z3VR, in partnership with NASA labs in California and Houston, to further develop their VR platform to use eye movement tracking to identify cognitive, psychiatric, or ophthalmological issues before they arise.

Getting out ahead of issues is more important than ever on the Mission to Mars. Because of the duration and distance of the mission, these astronauts will be uniquely isolated and will face a communication lag of up to 45 minutes between space shuttle and command center.

"What that means from a health care perspective is that pretty much everything you need to treat and diagnose these astronauts needs to be self contained on the spacecraft itself," Ruben says. "The system that we are building is sensitive enough to pick up on these cognitive, ophthalmological, and psychiatric conditions well before they become clinically relevant. It'll be long before the astronaut knows there's a problem. That's the hope." Click here to continue reading.

Houston startup — buoyed by Halliburton — plans to scale

Houston-based Nanotech was the first company to be selected for Halliburton Labs, a recently announced startup incubator. Photo via halliburtonlabs.com

A Houston-based material science startup that uses nanotechnology for thermal insulation and fireproofing has been chosen as the first participant of Halliburton Labs, an innovation incubator, announced late last month by the oil and gas giant.

Halliburton Company chose Nanotech Inc., among a round of contenders to be the first participant of their 12-month program located at their Houston headquarters. Halliburton will provide Nanotech with its own office space, access to Halliburton facilities, technical expertise, and an extensive network to accelerate their product to market.

"With Nanotech's shield material we can have fireproofing infrastructure, saving lives and helping save the planet," says Mike Francis, CEO of Nanotech. "But it's tremendously difficult to scale our small lab to take our product globally, so when we heard about this opportunity with Halliburton Labs, we jumped immediately on it."

Nanotech Inc., started with a singular technology and a simple mission to fireproof the world and reduce energy consumption globally. The base nano shield, flex shield, and forged shield products contain nanoparticles ranging from 1 micrometer to 1 nanometer in a water-based solution with other inorganic compounds. The coating is heat resistant, non-flammable, and the nontoxic properties ensure it is sustainable for the environment. Click here to continue reading.Click here to continue reading.

This Houston tech startup is helping businesses find the funds during COVID-19 crisis and beyond

Houston startup Grant Source, which helps its clients find the right grants to apply for, has seen a surge in business amid the coronavirus shutdown. Getty Images

Since 2015, Grant Source has perfected the art of helping businesses, foundations, and organizations find and secure grant funding — and now their expertise has become vital to COVID-19 response initiatives.

With the devastation caused by the novel coronavirus, America's medical organizations have been scrambling to obtain the funds required to purchase the testing kits, masks, PPE, and other life-saving products needed to help curb the effects of the global pandemic and now, thanks to the mobile and web platform, they're getting the assistance they need to accomplish that goal.

"COVID-19 response is actually our claim to fame right now," says Allen Thornton, founder and CEO of Grant Source. "We have probably done more business in the last few months than we have since we started. Simply because we are helping people find grants with the CARES Act. There's over $500 billion out there, which has created overnight a $40 billion market opportunity for us."

Grant Source has worked extensively with city, county, state, and government agencies to secure grant funding, which is why they have become a game changer for those that need emergency capital to combat COVID-19's challenges. Click here to continue reading.

Houston energy tech startup raises $11M to grow its team locally

Houston-based Datagration Solutions Inc. has raised millions in its latest round — led partially by a local VC firm — to grow its local presence. Photo via Datagration Solutions/Facebook

An $11 million round of funding will fuel national and international growth at Houston-based Datagration Solutions Inc., whose cloud-based software aggregates data to improve workflows and analytics at upstream oil and gas operators.

Houston-based venture capital firm Quantum Energy Partners LLC and New York City-based venture capital firm Global Reserve Group LLC led the round. Datagration represents the sixth investment in energy tech involving the duo of Quantum Energy Partners and Global Reserve Group.

Braxton Huggins, chief marketing officer at Datagration, says the new capital will enable the company to build a technology team in Houston; add to its operations, sales, and marketing team in Houston; and supplement its development team in Austria. These new hires will help Datagration expand its national and international market presence, he says.

Huggins says Datagration aims to more than double in size by the end of 2021. The startup currently employs more than 30 people. Click here to continue reading.

Houston startup uses artificial intelligence to bring its clients better business forecasting calculations

Houston-based Complete Intelligence was just recognized by Capital Factory as the "Newcomer of the Year." Photo via completeintel.com

The business applications of artificial intelligence are boundless. Tony Nash realized AI's potential in an underserved niche.

His startup, Complete Intelligence, uses AI to focus on decision support, which looks at the data and behavior of costs and prices within a global ecosystem in a global environment to help top-tier companies make better business decisions.

"The problem that were solving is companies don't predict their costs and revenues very well," says Nash, the CEO and founder of Complete Intelligence. "There are really high error rates in company costs and revenue forecasts and so what we've done is built a globally integrated artificial intelligence platform that can help people predict their costs and their revenues with a very low error rate."

Founded in 2015, Complete Intelligence is an AI platform that forecasts assets and allows evaluation of currencies, commodities, equity indices and economics. The Woodlands-based company also does advanced procurement and revenue for corporate clients.

"We've spent a couple years building this," says Nash. "We have a platform that is helping clients with planning, finance, procurement and sales and a host of other things. We are forecasting equity markets; we are forecasting commodity prices, currencies, economics and trades. We built a model of the global economy and transactions across the global economy, so it's a very large, very detailed artificial intelligence platform."

That platform, CI Futures, has streamlined comprehensive price forecasting and data analysis, allowing for sound, data-based decisions.

"Our products are pretty simple," says Nash. "We have our basic off the shelf forecast which is called CI Futures, which is currencies, commodities, equities and economics and trade. Its basic raw data forecasts. We distribute that raw data on our website and other data distribution websites. We also have a product called Cost Flow, which is our procurement forecasting engine, where we build a material level forecasting for clients." Click here to continue reading.

This week's innovators to know in Houston includes Marcelo Cordini of December Labs, Courtney Sikes Longmore of Pure Palate, and Josh Ruben of Z3VR. Photos courtesy

3 Houston innovators to know this week

who's who

Editor's note: In today's Monday roundup of Houston innovators, I'm introducing you to three innovators representing a diverse set of industries — from virtual reality to software development — all making headlines in Houston this week.

Marcelo Cordini, co-founder of December Labs

Marcelo Cordini, co-founder of December Labs, joins the Houston Innovators Podcast to discuss the unique service his company provides an evolving tech workforce. Photo courtesy of December Labs

Marcelo Cordini realized that nowadays, software developers are like rockstars. They can make or break a startup or technology's success and finding the best development team can be hard to do. But hiring and cultivating software talent is a specialty most companies — big or small — has the time or expertise to handle. That's where December Labs comes in.

"We are always learning new technologies — that's our focus," Cordini says. "If you have a big company focused on real estate, your focus is on real estate — not technology. So, if you partner with a company like us, it will give you that value to have someone who knows how to hire developers and how to train them."

Cordini joined the Houston Innovators Podcast last week to discuss the unique service his company provides and the state of software employment is in these days. Read more and stream the episode.

Courtney Sikes Longmore, founder at Pure Palate

Women in the work place have been hit the hardest by the pandemic. Photo via Pexels

According to Labor Department statistics, 1.1 million people left the workforce in August and September, and of that 800,000 were women. This data wasn't surprising to Courtney Sikes Longmore, an entrepreneur and founder of Pure Palate — however it was a call to action. She teamed up with Sesh Coworking to host a panel (click here to stream) to discuss how COVID-19 has disproportionately affected women and co-wrote a guest article with Maggie Segrich on the subject too.

"A decline of women in the labor force, on teams, in leadership positions and in decision-making roles compromises not just our economy's recovery and productivity, but also the innovation and effectiveness in industry, competitiveness on a global scale, aspirations of future generations of women, and society as a whole," they write. Read more.

Josh Ruben, CEO of Z3VR

Houston-based Z3VR has been granted $500,000 to work or virtual reality applications in space. Photo courtesy of Z3VR

The Houston-based Translational Research Institute for Space Health is always trying to find and support innovations that will help current and future astronauts, and Josh Ruben's company, Z3VR, was a perfect fit to work on virtual reality applications in space. The company received a $500,000 grant from TRISH last month to continue exploring how the wide world of virtual reality can boost mental and physical health for astronauts on a mission to Mars.

"This TRISH funding means the world," he says. "Not only do we have these partnerships within NASA, which we expect will really help address these problems, but we are already taking the funds and putting them to work in the US health care system." Read more.

Houston-based Z3VR has been granted $500,000 to work or virtual reality applications in space. Photo courtesy of Z3VR

Houston virtual reality company collaborates with space health organization

money for the mission

Houston-based startup Z3VR received a $500,000 grant from Baylor College of Medicine's Translational Research Institute for Space Health, or TRISH, last month to continue exploring how the wide world of virtual reality can boost mental and physical health for astronauts on a mission to Mars.

Founded in 2017 by a group of emerging tech enthusiasts, Z3VR discovered its niche in what CEO Josh Ruben calls the "intersection of biosensors and VR" and began consulting with TRISH in 2018. Last year, the company received its first funding from the institution to create virtual reality platforms that promote exercise and provide additional sensory experiences for isolated Mars-bound astronauts.

This new grant, however, takes Z3VR's mission one step farther. The year-long grant will allow Z3VR, in partnership with NASA labs in California and Houston, to further develop their VR platform to use eye movement tracking to identify cognitive, psychiatric, or ophthalmological issues before they arise.

Getting out ahead of issues is more important than ever on the Mission to Mars. Because of the duration and distance of the mission, these astronauts will be uniquely isolated and will face a communication lag of up to 45 minutes between space shuttle and command center.

"What that means from a health care perspective is that pretty much everything you need to treat and diagnose these astronauts needs to be self contained on the spacecraft itself," Ruben says. "The system that we are building is sensitive enough to pick up on these cognitive, ophthalmological, and psychiatric conditions well before they become clinically relevant. It'll be long before the astronaut knows there's a problem. That's the hope."

Known as the Oculometric Cognition Testing and Analysis in Virtual Environments (OCTAVE) approach, Z3VR's program is modeled after a system at the Visuomotor Control Lab at NASA Ames in California. In the lab, scientists can use high-frequency eye trackers to monitor 21 physiological properties that can point to early signs of mental and physical conditions. The goal is to shrink down the same trackers to fit not just on the spacecraft, but inside a VR headset.

Other VR companies have been able to implement eye tracking into their platforms for some time now — but not at this level of preciseness. Partnering engineers on the project will have to increase the image quality four fold and capture about 10 times the number of images per second in order to detect the minute eye movements Ruben and team are searching for.

Still, Ruben thinks VR is the ideal fit for this process. "When you are in a VR application, the developers have what is effectively total control of your entire sensory experience," he says. "If I am monitoring various aspects of your physiology while you're in a VR experience, I know that the way your body is reacting is directly a result of our VR experience."

Too, the team and Z3VR envisions that through their platform this type of cognitive tracking can be a passive process. While astronauts are using the devices to exercise or learn how to fix a problem on board, their program will be tracking their eye movement in the background — much like how your smart watch would track your heart rate — alerting the command center only when a problem arises.

For Ruben, this is their giant leap for mankind moment and how they can use their tool to make an impact for earth-bound individuals.

"We imagine a world where just by interacting with a game through one of these devices we are able to flag these neurological issues well before they are issues," he says.

Though their technology likely won't be put to use in space until the 2030s, the group is already in talks with academic institutions about partnering on their program for new clinical uses and is working with the FDA to bring in regulatory oversight, Ruben says.

"This TRISH funding means the world," he says. "Not only do we have these partnerships within NASA, which we expect will really help address these problems, but we are already taking the funds and putting them to work in the US healthcare system."

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Texas Space Commission launches, Houston execs named to leadership

future of space

Governor Greg Abbott announced the Texas Space Commission, naming its inaugural board of directors and Texas Aerospace Research and Space Economy Consortium Executive Committee.

The announcement came at NASA's Johnson Space Center, and the governor was joined by Speaker Dade Phelan, Representative Greg Bonnen, Representative Dennis Paul, NASA's Johnson Space Center Director Vanessa Wyche, and various aerospace industry leaders.

According to a news release, the Texas Space Commission will aim to strengthen commercial, civil, and military aerospace activity by promoting innovation in space exploration and commercial aerospace opportunities, which will include the integration of space, aeronautics, and aviation industries as part of the Texas economy.

The Commission will be governed by a nine-member board of directors. The board will also administer the legislatively created Space Exploration and Aeronautics Research Fund to provide grants to eligible entities.

“Texas is home to trailblazers and innovators, and we have a rich history of traversing the final frontier: space,” Lieutenant Governor Dan Patrick says in a news release. “Texas is and will continue to be the epicenter for the space industry across the globe, and I have total confidence that my appointees to the Texas Space Commission Board of Directors and the Texas Aerospace Research and Space Economy Consortium Executive Committee will ensure the Texas space industry remains an international powerhouse for cutting-edge space innovation.”

TARSEC will independently identify research opportunities that will assist the state’s position in aeronautics research and development, astronautics, space commercialization, and space flight infrastructure. It also plans to fuel the integration of space, aeronautics, astronautics, and aviation industries into the Texas economy. TARSEC will be governed by an executive committee and will be composed of representatives of each higher education institution in the state.

“Since its very inception, NASA’s Johnson Space Center has been home to manned spaceflight, propelling Texas as the national leader in the U.S. space program,” Abbott says during the announcement. “It was at Rice University where President John F. Kennedy announced that the U.S. would put a man on the moon—not because it was easy, but because it was hard.

"Now, with the Texas Space Commission, our great state will have a group that is responsible for dreaming and achieving the next generation of human exploration in space," he continues. "Texas is the launchpad for Mars, innovating the technology that will colonize humanity’s first new planet. As we look into the future of space, one thing is clear: those who reach for the stars do so from the great state of Texas. I look forward to working with the Texas Space Commission, and I thank the Texas Legislature for partnering with industry and higher education institutions to secure the future of Texas' robust space industry."

The Houston-area board of directors appointees included:

  • Gwen Griffin, chief executive officer of the Griffin Communications Group
  • John Shannon, vice president of Exploration Systems at the Boeing Company
  • Sarah "Sassie" Duggleby, co-founder and CEO of Venus Aerospace
  • Kirk Shireman, vice president of Lunar Exploration Campaigns at Lockheed Martin
  • Dr. Nancy Currie-Gregg, director of the Texas A&M Space Institute

Additionally, a few Houstonians were named to the TARSEC committee, including:

  • Stephanie Murphy, CEO and executive chairman of Aegis Aerospace
  • Matt Ondler, president and former chief technology officer at Axiom Space
  • Jack “2fish” Fischer, vice president of production and operations at Intuitive Machines
  • Brian Freedman, president of the Bay Area Houston Economic Partnership and vice chairman of Wellby Financial
  • David Alexander, professor of physics and astronomy and director of the Rice Space Institute at Rice University

To see the full list of appointed board and committee members, along with their extended bios, click here.

City of Houston approves $13M for new security tech at renovated IAH​ terminal

hi, tech

A new terminal currently under construction at George Bush Intercontinental Airport just got the green light for new security technology.

This week, Houston City Council unanimously approved the funding for the new Mickey Leland International Terminal's security equipment. The Mickey Leland International Terminal Project is part of the $1.43 billion IAH Terminal Redevelopment Program, or ITRP, which is expected to be completed by early next year.

This new IAH International Terminal will feature an International Central Processor, or ICP, with state-of-the-art technology in a 17-lane security checkpoint — among the largest in the country — as well as ticket counters and baggage claim.

“Houston Airports strives to get passengers through TSA Security in 20 minutes or less. Today, we meet that goal at Bush Airport more than 90 percent of the time,” Jim Szczesniak, director of aviation for Houston Airports, says in a news release. “This investment in innovative technology will enhance our efficiency and ensure that our passengers have a world-class experience each time they visit our airports.”

Going through security at IAH is about to be smoother sailing. Rendering courtesy of Houston Airports

The funding approval came from two ordinances, and the first one appropriates $11.8 million from the Airports Improvement Fund to buy, service, install, and train staff on nine new automated screening lanes, called Scarabee Checkpoint Property Screening Systems, or CPSS.

Per the news release, each of these CCPS automated lanes "is capable of screening more than 100 additional people and bags/hour than existing equipment used today." Currently, Terminal D's TSA is using eight CPSS Lanes, so the additional nine lanes will bring the total to 17 lanes of security.

The other appropriates another $1.2 million from the Airports Improvement Fund to buy, install, maintain, and train staff on six new Advanced Imaging Technology Quick Personnel Security Scanners.

The new scanners, which don't require the traveler to raise their arms, "is capable of screening more than 100 additional people/hour than existing equipment used today," per the release.

“These new security screening machines are faster, have fewer false alarms and have improved detection rates, which creates a safer experience for our passengers and airlines,” Federal Security Director for TSA at IAH Juan Sanchez adds.

The Mickey Leland International Terminal originally opened in 1990 and is currently under renovation. Rendering courtesy of Houston Airports

Texas has the 5th highest health care costs in the nation, Forbes says

dollar signs

A new Forbes Advisor study shedding light on Americans' top financial worries has revealed Texas has the fifth highest health care costs in the nation.

Forbes Advisor's annual report compared all 50 states and Washington, D.C. across nine different metrics to determine which states have the most and least expensive health care costs in 2024.

Factors include the average annual deductibles and premiums for employees using single and family coverage through employer-provided health insurances and the percentage of adults who chose not to see a health care provider due to costs within the last year, among others. Each state was ranked based on its score out of a total 100 possible points.

Texas was No. 5 with a score of 91.38 points. North Carolina was No. 1, followed in order by South Dakota, Nebraska, and Florida.

According to Forbes, out-of-state families considering a move to the Lone Star State should be aware of the state's troubling statistics when it comes to family health care. More specifically, nearly 15 percent of Texas children had families who struggled to pay for their medical bills in the past 12 months, the highest percentage in the nation.

Furthermore, Texans have the highest likelihood in the U.S. to skip seeing a doctor because of cost. The report showed 16 percent of Texas adults chose not to see a doctor in the past 12 months due to the cost of health care.

"Unexpected medical bills and the cost of health care services are the top two financial worries for Americans this year, according to a recent KFF health tracking poll," the report said. "These financial fears have real-world consequences. The high cost of healthcare is leading some Americans to make tough choices—often at the expense of their health."

In the category for the percentage of adults who reported 14 or more "mentally unhealthy" days out of a month, who could not seek health care services due to cost, Texas ranked No. 3 in the U.S. with 31.5 percent of adults experiencing these issues.

The report also highlighted the crystal clear inequality in the distribution of health care costs across the U.S.

"In some states, residents face much steeper health care expenses, including higher premiums and deductibles, which make them more likely to delay medical care due to costs," the report said.

For example, Texas' average annual premiums for both plus-one health insurance coverage ($4,626, according to the study) and family coverage ($7,051.33) through employer-provided policies was the No. 4-highest in the nation.

Elsewhere in the U.S.

The state with the most expensive health care costs is North Carolina, with a score of 100 points. 27 percent of adults in North Carolina reported struggling with their mental health who could not seek a doctor due to cost, and 11.3 percent of all adults in the state chose not to see a doctor within the last 12 months because of costs.

Hawaii (No. 50) is the state with the least expensive health care costs, according to Forbes. Hawaii had the lowest percentages of adults struggling with mental health (11.6 percent) and adults who chose not to see a doctor within the last year (5.7 percent). The average annual premium for employees in Hawaii using a family coverage plan through employer-provided health insurance is $5,373.67, and the average annual deductible for the same family coverage plan is $3,115.

The top 10 states with the most expensive health care are:

  • No. 1 – North Carolina
  • No. 2 – South Dakota
  • No. 3 – Nebraska
  • No. 4 – Florida
  • No. 5 – Texas
  • No. 6 – South Carolina
  • No. 7 – Arizona
  • No. 8 – Georgia
  • No. 9 – New Hampshire
  • No. 10 – Louisiana

The full report and its methodology can be found on forbes.com.

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This article originally ran on CultureMap.