Research Alert: April 13, 2026

Identification and Characteristics of Under-Resourced and High-Need Rural Counties

This brief provides a metric describing how publicly available county-level data on health care workforce, chronic disease prevalence, and the socioeconomic environment of rural communities can assist policymakers in identifying the highest need counties for targeted policy initiatives and public health intervention.

Key Findings:

• A total of 270 out of 1,932 (14%) rural counties nationwide were identified as “high-need” – defined as having the top-tertile (i.e., top 33.33%) burdens across all three domains: high chronic disease prevalence, low socioeconomic status, and limited physician availability.
• Nearly two-thirds (64%; 1,237 out of 1,932) of rural counties nationwide were classified as high-need in at least one domain.
• High-need counties were predominantly (78%) located in the southern U.S. census region.
• Compared to low-need counties, high-need counties had significantly greater odds of not having access to a Federally Qualified Health Center, hospital, or pharmacy nationwide.
• There was no difference in odds of having access to Rural Health Clinics across county-need classifications.

Additional Resources of Interest:

• Examining the Burden of Chronic Disease and Low SES to Identify High-Need Rural Counties
• More FORHP-funded research on Poverty, Rural statistics and demographics
• More information about the University of South Carolina Rural Health Research Center
• More information from the Rural Health Information Hub's topic guide: Finding Statistics and Data