A new report from GoodRx finds that healthcare deserts––areas that lack adequate access to and infrastructure for healthcare services––exist in about 80 percent of counties in the United States. Nearly 60 percent of counties have more than one type of healthcare desert, and roughly one in three Americans are affected by healthcare deserts. Pharmacy deserts have expanded since 2021 while access to critical hospital services like trauma care and hospital beds has remained stagnant. The report pairs metrics with interactive maps and a video that follows Americans living in healthcare deserts as they try to access care.
AMANDA NGUYEN; [email protected]
Nguyen is a senior health economist at GoodRx.
Nguyen told the Institute for Public Accuracy: “We define a healthcare desert as any area that lacks adequate access to at least one essential health service––whether that’s a pharmacy, hospital, trauma center, hospital beds, primary care, or a low-cost community health center. Using geospatial modeling and infrastructure data, we identify areas where most residents live beyond reasonable travel times, like more than 15 minutes from the three nearest pharmacies or over 30 minutes from a hospital. We also consider federal shortage designations, including areas with fewer than two hospital beds per 1,000 residents. If a majority of a county’s population meets one or more of these criteria, we classify it as a healthcare desert. This approach helps reveal where access barriers overlap and where solutions are most urgently needed.
“In the last few years, pharmacy deserts have worsened considerably. Since 2021, more than 1,300 pharmacies have closed, pushing the number of people living in pharmacy deserts from 41 million to 48.4 million. That’s an increase of over 7 million people now facing longer travel times just to access a pharmacy.
“Hospital, trauma, and primary care deserts, meanwhile, have remained stagnant or worsened. Hospital bed availability has not improved, and about 20 percent of counties still qualify as hospital deserts. Some shortage designations have been reclassified, but in practice, access remains limited. We’re also seeing more overlap between access issues. Nearly 8 million people now live in counties with four or more types of healthcare deserts, making it even harder for people to receive consistent, comprehensive care.
“All healthcare deserts pose risks, but hospital and trauma center deserts are the most immediately life-threatening. Nearly 50 million people live more than an hour from a trauma center, and 28 million live over 30 minutes from the nearest hospital. In a critical emergency like a stroke or car accident, that distance can determine whether someone survives. Pharmacy deserts also carry serious long-term consequences, particularly for people managing chronic conditions. In rural areas, round-trip drives can exceed 85 minutes, making it harder to fill prescriptions, get vaccines, or consult with a pharmacist. Over time, these barriers contribute to missed medications, poor adherence, and worse health outcomes.
“Media coverage often misses how deeply systemic and interconnected healthcare access barriers really are. You can have insurance and still struggle to get care because your local pharmacy has closed, your medication is out of stock, or your insurance doesn’t cover the treatment you need. Access is often discussed in terms like ‘provider shortage area’ or ‘bed capacity,’ which are accurate and important but may not always connect to the everyday realities people face.”
Nguyen added that the healthcare-related provisions in the Trump administration’s HR 1 are likely to impact millions who rely on Medicaid for insurance as well as many other Americans. “When coverage disappears, so does funding for clinics, pharmacies, and hospitals, especially in rural or low-income areas. As patient volume and reimbursement decline, it creates a compounding problem, since financially strained providers may be forced to close––which in turn worsens the prevalence of healthcare deserts. These cuts could also lead to staffing shortages and higher out-of-pocket costs, adding strain to safety-net systems already operating at capacity. Even before this legislation passed, 27 percent of Americans reported leaving prescriptions unfilled due to cost. Without a strong safety net, that number will likely grow.”