There are vital links among mental health conditions, chronic diseases, and substance use disorders. Simultaneous examination of the relationship among these three conditions is essential for providing well-integrated care to rural residents who have limited resources and for representing medically underserved areas. We aimed to assess the burden of behavioral health conditions and chronic diseases from a rural Texas community to garner context-specific insights and inform effective health

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... tion strategies in similar communities. We conducted a cross-sectional study among 181 residents from various zip codes in a rural Texas county. A self-administered, 18-item health-needs questionnaire was used to collect data from the participants. Of the total participants, 30.0% reported mental health conditions, 16.0% reported substance use disorders, and 44.2% reported having at least one type of chronic disease. Overall, mental health conditions were associated with substance use disorders [OR: 1.58 (95% CI: 0.73–2.42)] and chronic disease [OR: 1.07 (95% CI: 0.39–1.75)], but no associations were observed between substance use and chronic disease [OR: 0.62 (95% CI: -0.20–1.43)]. The economic and accessibility barriers that rural residents commonly face call attention to the need for integrated care that combines primary care and behavioral health services.