Medical deserts in the United States

The United States has many regions which have been described as medical deserts, with those locations featuring inadequate access to one or more kinds of medical services. ^[1] An estimated thirty million Americans, many in rural regions of the country, live at least a sixty-minute drive from a hospital with trauma care services.^[2] Regions with higher rates of Medicaid and Medicare patients, as well those who lack any health insurance coverage, are less likely to live within an hour of a hospital emergency room.^[2] Although concentrated in rural regions, health care deserts also exist in urban and suburban areas, particularly in predominantly Black communities in Chicago, Los Angeles and New York City.^[3] Racial demographic disparities in healthcare access are also present in rural areas, particularly in Native American communities which experience worse health outcomes and barriers to accessing quality medical care.^[4] Limited access to emergency room services, as well as medical specialists, leads to increases in mortality rates and long-term health problems, such as heart disease and diabetes.^[5]

Between 2010-2021, 136 hospitals in rural regions closed their doors, unable to bear worker shortages, low patient volume, and financial burdens of the COVID-19 pandemic.^[6] In addition to the immediate financial problems facing rural healthcare providers, inequities in rural healthcare are further aggravated by the disproportionately low amount of newly graduated doctors that are willing to work in rural areas.^[7] Addressing the doctor shortage in the U.S. remains a challenge in terms of improving healthcare in America. In the 2010s, a study released by the Association of American Medical Colleges (AAMC) projected a shortage of between 37,800 and 124,000 physicians, which impact rural and underserved communities the most directly^[8].

Proposed solutions to US health care deserts include the enactment of a national single payer health care system; adoption of a public option under the Affordable Care Act (ACA); the approval of higher Medicare reimbursements and tax credits for struggling hospitals; the establishment of strategically placed free-standing emergency centers; the expansion of telehealth and telemedicine to remote areas; and increased incentives to recruit doctors to practice in rural and underserved areas.