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. 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. 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. 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's drive of a hospital emergency room.
Since 1975, over 1,000 hospitals, many in rural regions, have closed their doors, unable to bear the cost of care of uninsured patients, resulting in some patients in every state needing to drive at least an hour to a hospital emergency room, a problem that poses an even greater danger during the COVID-19 pandemic, when patients in respiratory distress urgently need oxygen and can ill afford an hour-long ambulance ride to reach a hospital. 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 apply for positions in rural areas.
Although concentrated in rural regions, health care deserts also exist in urban and suburban areas, particularly in Black majority census tracts in Chicago, Los Angeles and New York City. Medical literature addressing health disparities in urban centers has applied the term medical desert to areas that are more than a five-miles from the nearest acute care facility. Racial demographic disparities in healthcare access are also present in rural areas, with Native Americans living in rural areas in particular receiving inadequate medical care.
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.
In December 2021, an article from the financial publication Forbes argued that the "lack of funding for residency slots to expand the pool of physicians in the U.S. has been an issue for more than two decades." Other American news agencies such as The Nation and Newsweek have additionally addressed the topic. 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) titled The Complexities of Physician Supply and Demand: Projections From 2019 to 2034 specifically projected a shortage of between 37,800 and 124,000 individuals within the following two decades, approximately.
In rural areas
In 2019, the federal government identified nearly 80 percent of rural America as “medically underserved,” lacking in skilled nursing facilities, as well as rehabilitation, psychiatric and intensive care units. In rural areas, there are approximately 68 primary care doctors per 100,000 people, whereas there are 84 doctors per 100,000 in urban centers. According to the National Rural Health Association, 9% of rural counties had no doctors in 2017. Rural communities face lower life expectancy and increased rates of diabetes, chronic disease, and obesity. Fewer than half of rural women live within a thirty-minute drive of the nearest hospital able to provide obstetric services, and 12% do not live within a sixty-minute drive of the nearest such hospital, resulting in babies sometimes being born on the side of the road and increased maternal and infant mortality rates.