Rural-Urban Analysis of Persistent Health Professional Shortage Areas

Research center:
Lead researcher:
Project funded:
September 2020
Project completed:
May 2024

The purpose of the Health Professional Shortage Area (HPSA) designation is to identify areas of need and prioritization of healthcare resources to the people in those places. HPSA designations identify a shortage of either primary medical, dental, or mental health providers within an identified geographic area, population group, or healthcare facility.

Despite federal and state efforts to invest in the health workforce in underserved areas through loan repayment, technical assistance, and other funding, some communities continue to experience recruitment and retention challenges for many years. Previous studies completed by the University of North Carolina and WWAMI Rural Health Research Center identified persistent primary care HPSAs for whole or partial counties from 1996 to 2004. This study built upon this previous research, leveraging the existing definition of persistent HPSA to identify and explore the landscape of persistent HPSAs using the most recent data available.

In addition to assessing persistent primary care HPSAs, researchers included mental health and dental health HPSAs for both rural and urban counties for 2010 and 2015-2020 utilizing the Health Resources and Services Administration's 2019-2020 Area Health Resources File and shortage area data to classify persistent HPSA counties and partial counties by rural/urban status. Researchers defined rural/urban status using the U.S. Department of Agriculture Economic Research Service 2013 Urban Influence Codes (UIC), with rural defined as nonmetropolitan counties with UIC codes 3-12. The study focused on creating descriptive statistics to describe rural/urban differences in persistent HPSAs. Researchers also developed maps, with overlays for demographic characteristics and tribal reservations to explore the relationship of persistent HPSAs and majority minority counties.

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