The Supply and Distribution of the Primary Care Health Workforce in Rural America


Chronic and sometimes severe shortages of primary care providers in rural areas of the U.S. have challenged rural communities for decades. Primary care shortages especially threaten health and healthcare in rural communities in part because rural populations depend on primary care providers in ways that urban populations do not. Rural primary care providers deliver a wider range of medical services than their urban counterparts, coordinate care that must be obtained in other locations, and have an essential role in connecting patients to specialty services that are unavailable locally. The geographic maldistribution of primary care providers across rural areas creates particularly acute shortages in some regions and some types of rural areas, while other rural areas are relatively well supplied.

This study examines the 2019 supply and geographic distribution of primary care physicians, nurse practitioners, and physician assistants across rural areas of the U.S. We used 2019 primary care provider data from National Plan and Provider Enumeration System linked to county-level Urban Influence Codes and 2019 Claritas population data to calculate provider-to-population ratios for each provider type in all U.S. non-metropolitan counties. We compared supply between metropolitan, micropolitan, and non-core counties for each provider types. Findings are presented in a series of national maps, tables, and charts. (Individual state-level analyses are also available.) Nationally, the provider-to-population ratio of family physicians is slightly higher in rural than urban areas, but the overall per capita supply of primary care providers remains substantially lower in rural areas than urban areas. About 5% of rural counties, mostly non-core counties, have no family physicians. Maldistribution of primary care providers continues to exacerbate primary care provider shortages in some rural areas, especially in more remote non-core counties.

Lead Researcher: Eric H. Larson, PhD
Contact:  206-616-9601









Authors Title Type Date Documents/Media
Larson EH, Andrilla CHA, Garberson LA Supply and distribution of the primary care workforce in rural America: 2019 PUBLICATION 06-24-2020
Policy Brief
Larson EH, Andrilla CHA, Garberson LA Supply and distribution of the primary care workforce in rural America: a state-level analysis PUBLICATION 06-24-2020
Data Brief
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