Designated Primary Care Shortage Area

Why do we measure Designated Primary Care Shortage Area? 

Healthcare access is highlighted as a key social determinant of health by the U.S. Department of Health and Human Services’ Healthy People 2030 initiative.^1,2 However, over 100 million Americans do not have access to a regular source of primary care.³ This poses a fundamental challenge to sustaining a population’s health, as access to health care is a vital component of health and wellbeing.^4,5 One factor contributing to insufficient primary care access in the U.S. is a shortage of primary care providers nationwide.

Primary care is widely considered a cornerstone of a healthy population, delivering essential services like immunizations, screenings, health education, and chronic disease management.^2,4,6 A health system centered around primary care reduces unnecessary emergency room and hospital visits, improves population health outcomes, promotes health equity, and lowers health care expenditures.^2,4,6,7-11 Improving access to health requires a multi-faceted approach, encompassing strategic investments in primary care infrastructure as well as addressing barriers to access like affordability, availability, and accommodation. Approaches to these challenges can range from expanding insurance coverage to increasing the number of primary care providers, providing primary care services in multiple languages, and improving health literacy.^3-8,12

To draw attention and resources to health care infrastructure and provider shortages, the U.S. Health Resources and Services Administration established the Health Professional Shortage Area (HPSA) designation program. HPSAs are geographic areas, populations, or facilities that have a shortage of primary, dental or mental health care providers.^12,13 Populations living in these designated shortage areas often experience significant health disparities, as limited access to health care results in higher rates of preventable disease and poor health outcomes.^12,14-17 State primary care offices can apply for HPSA designation, opening an avenue for increased resource allocation from federal programs such as the National Health Service Corps, Nurse Corps, and Health Center Program, and increasing eligibility for state-specific funding opportunities and private grants.¹³

By strategically focusing on HPSA-designated primary care shortage areas, targeted efforts can improve primary care access, reduce disparities, and promote healthier communities for all. This approach to identifying and supporting underserved areas provides a framework for progress in addressing America's primary care crisis.^2-6,12

How do we measure Designated Primary Care Shortage Area?

This metric estimates the percentage of population living in a geographic primary care Health Professional Shortage Area (HPSA) as designated by Health Resources & Services Administration (HRSA).

Strengths and Limitations

Calculation

Designated Primary Care Shortage Area is calculated as the % of Total population living in a primary care geographic HPSA as defined by HRSA.

For more information on the calculation, please refer to the Congressional District Health Dashboard Technical Document.

Data Source

Estimates for this metric are from the Health Resources & Services Administration.

Years of Collection

Calculated by the Dashboard Team using data from 2025.

References

1. Center for Disease Control and Prevention. (2024, January 17). Social Determinants of Health (SDOH) https://doi.org/10.1016/j.amepre.2019.04.027

2. Office of Disease Prevention and Health Promotion. (n.d.).Health Care Access and Quality. Healthy People 2030. U.S. Department of Health and Human Services. https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality

3. National Association of Community Health Centers. (2023). Closing the Primary Care Gap. How Community Health Centers Can Address the Nation's Primary Care Crisis. https://www.nachc.org/resource/closing-the-primary-care-gap-how-community-health-centers-can-address-the-nations-primary-care-crisis/

4. Stange, K. C., Miller, W. L., & Etz, R. S. (2023). The Role of Primary Care in Improving Population Health. The Milbank quarterly, 101(S1), 795–840. https://doi.org/10.1111/1468-0009.12638

5. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on Implementing High-Quality Primary Care, Robinson, S. K., Meisnere, M., Phillips, R. L., Jr., & McCauley, L. (Eds.). (2021). Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. National Academies Press (US).

6. Office of Disease Prevention and Health Promotion. (n.d.).Access to Primary Care. Healthy People 2030. U.S. Department of Health and Human Services. https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/access-primary-care#cit23

7. Office of Disease Prevention and Health Promotion. (n.d.).Access to Primary Care. Healthy People 2030. U.S. Department of Health and Human Services. https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/access-primary-care#cit23

8. Office of Disease Prevention and Health Promotion. (n.d.).Increase the proportion of people with a usual primary care provider — AHS‑07. U.S. Department of Health and Human Services. https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality/increase-proportion-people-usual-primary-care-provider-ahs-07

9. Freeman, V. L., Naylor, K. B., Boylan, E. E., Booth, B. J., Pugach, O., Barrett, R. E., Campbell, R. T., & McLafferty, S. L. (2020). Spatial access to primary care providers and colorectal cancer-specific survival in Cook County, Illinois. Cancer medicine, 9(9), 3211–3223. https://doi.org/10.1002/cam4.2957

10. Smith-East, M., DNP, APRN-BC, EMT-B, & Neff, D. F. (2020). Mental Health Care Access Using Geographic Information Systems: An Integrative Review. Issues in mental health nursing, 41(2), 113–121. https://doi.org/10.1080/01612840.2019.1646363

11. Gaglioti, A. H., Petterson, S., Bazemore, A., & Phillips, R. (2016). Access to Primary Care in US Counties Is Associated with Lower Obesity Rates. Journal of the American Board of Family Medicine : JABFM, 29(2), 182–190. https://doi.org/10.3122/jabfm.2016.02.150356

12. Juarez P. D. (2023). Economic Determinants of Health Disparities and the Role of the Primary Care Provider. Primary care, 50(4), 561–577. https://doi.org/10.1016/j.pop.2023.05.002

13. U.S. Department of Health Resources & Services Administration. (2022) What Is Shortage Designation? Bureau of Health Workforce. https://bhw.hrsa.gov/workforce-shortage-areas/shortage-designation

14. McClellan C. B. (2024). Health care Utilization and Expenditures in Health Professional Shortage Areas. Medical care research and review : MCRR, 81(4), 335–345. https://doi.org/10.1177/10775587241235705

15. Basu S, Berkowitz SA, Phillips RL, Bitton A, Landon BE, Phillips RS. Association of Primary Care Physician Supply With Population Mortality in the United States, 2005-2015. JAMA Intern Med. 2019 Apr 1;179(4):506-514. doi: 10.1001/jamainternmed.2018.7624. PMID: 30776056; PMCID: PMC6450307.

16. Behr, C. L., Hull, P., Hsu, J., Newhouse, J. P., & Fung, V. (2022). Geographic access to federally qualified health centers before and after the affordable care act. BMC health services research, 22(1), 385. https://doi.org/10.1186/s12913-022-07685-0

17. Dassah, E., Aldersey, H., McColl, M. A., & Davison, C. (2018). Factors affecting access to primary health care services for persons with disabilities in rural areas: a "best-fit" framework synthesis. Global health research and policy, 3, 36. https://doi.org/10.1186/s41256-018-0091-x

Last updated: April 6, 2026