Research Alert: March 20, 2026

Examining Rural Population Characteristics and Access to Care in 2022: A Study of Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)

This chartbook describes Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs), comparing the population characteristics of designated and non-designated census tracts by rurality. The analysis focuses on geographic shortage designation report findings at the national level and by the U.S. Department of Health and Human Services (HHS) region for Primary Care HPSAs, Mental Health HPSAs, Dental Health HPSAs, and MUAs. Comparisons are made across small rural, large rural, and urban areas.

Key Findings:

• Primary Care HPSAs. Primary care shortages were more common in rural than urban areas across all regions. Small rural areas had higher shares of residents under 150 percent of the federal poverty level and lower levels of educational attainment than urban areas. These areas also revealed lower rates of college graduates and higher uninsured rates compared to designated urban tracts.
• Mental Health HPSAs. Mental health provider shortages were evident across rural and urban settings, including small rural census tracts. HHS regions with a high proportion of designated HPSAs had higher unemployment and lower educational attainment compared with regions with fewer designated HPSAs. The proportion of individuals with disabilities was consistently higher in mental health HPSA tracts.
• Dental Health HPSAs. The analysis of dental HPSAs showed that rural communities had higher poverty and more residents without health insurance. These areas also had larger shares of residents living in mobile homes and in overcrowded housing, which compounded access issues.
• Medically Underserved Areas. Census tracts designated as MUAs faced consistent socioeconomic challenges across small rural, large rural, and urban areas. Compared to non-designated tracts, MUAs had higher poverty, unemployment, and uninsurance rates, along with lower educational attainment. These tracts also reported more residents with disabilities, greater household crowding, and increased reliance on group quarters for housing. Differences were most pronounced in urban MUA tracts, with the largest gaps in educational attainment, internet access, and housing quality compared with non-MUA tracts.

Additional Resources of Interest:

• More FORHP-funded research on Rural statistics and demographics, Workforce
• More information about the ETSU/NORC Rural Health Research Center
• More information from the Rural Health Information Hub's topic guide: Healthcare Workforce