Which state association was established first among the mentioned states?

The state association established first among the mentioned states is Texas. Texas was a pioneer in the development of HOSA, with its state association being formed in the late 1970s. This early establishment played a significant role in shaping the national structure of HOSA, as Texas was integral in advocating for health science education and creating a platform for students interested in pursuing careers in the healthcare field.

Each of the other states mentioned followed at various later times when they recognized the value of having their own HOSA associations to support health science education. However, Texas's early involvement allowed it to influence the initial direction and growth of HOSA nationally, which is reflected in the timeline of state associations' establishment.