U.S. rural areas face wide-ranging health disparities. However, examining rural disparities is complicated by suboptimal measurement of rurality, including categorical/low spatial resolution measures and poor integration of the demographic, sociocultural, economic, and health-related aspects of rurality. The present research rectified these issues via computation of a 0-100 multidimensional high-resolution rural disadvantage index (RDI) for study of health disparities in Texas.The present work displayed the utility of multivariate index construction methods for building multidimensional rural indices to study health disparities at high resolution.