Medical desert is a term used to describe regions whose population has inadequate access to healthcare.[1] The term can be applied whether the lack of healthcare is general or in a specific field, such as dental or pharmaceutical.[2] It is primarily used to describe rural areas although it is sometimes applied to urban areas as well.[2] The term is inspired by the analogous concept of a food desert.[1]
An estimated 30 million Americans, many in rural regions of the country, live at least 60 minutes drive from a hospital with trauma care services.[3] Limited access to emergency room services, as well as medical specialists, leads to increases in mortality rates and long-term health problems, such as heart disease and diabetes.[4][5] Medicare, Medicaid, and uninsured patients are less likely than others to live within an hour's drive of a hospital emergency room.[3]
Since 1975, over 1,000 hospitals, many in rural regions, have closed their doors because they are unable to bear the cost of care of uninsured patients.[6] The risk of hospital closures has been increasing over the years as almost 700 rural hospitals are at risk of closing due to financial problems such as smaller patient populations and inadequate payment from insurance plans.[7] This has required some patients in every state to drive at least an hour to a hospital emergency room. The problem poses an even greater danger during the COVID-19 pandemic, when patients in respiratory distress urgently need oxygen[8] and can ill afford an hour-long ambulance ride to reach a hospital. In addition to the immediate financial problems facing rural healthcare providers, inequities in rural healthcare are further aggravated by the disproportionately low number of newly-graduated doctors applying for positions in rural areas. Many doctors decline to work in rural areas due to factors such as low pay and only around 11% of physicians practice in rural areas.[9] It is projected that there will be shortage of more than 20,000 primary care physicians living in rural areas by 2025.[10]
Although concentrated in rural regions, health care deserts also exist in urban and suburban areas, particularly in Black-majority census tracts in Chicago, Los Angeles, and New York City.[11] Medical literature addressing health disparities in urban centers has applied the term medical desert to areas that are more than five miles from the nearest acute care facility.[11] Racial demographic disparities in healthcare access are also present in rural areas, particularly with Native Americans living in rural areas receiving inadequate medical care.[12][13] Factors such physician shortages and transportational barriers exacerbate healthcare disparities for the native American population leading postponement of care.[14]
Pharmacy deserts have developed in some urban areas,[15][16] a situation that has increased the challenge of distributing and administering vaccines for the COVID-19 pandemic.[17][18][19] Pharmacy deserts have grown to become a major problem in the United States as around 15 million people live in Pharmacy deserts. Without pharmacies being close by it will be harder to obtain prescription and medicine for people and leading to people having to travel farther to get their prescription filled out.[20]
Dental deserts have also begun to grow; as of 2021 there are 60 million Americans who are experiencing a shortage of dentist where they live.[21] More than 6,000 areas in the United States are in a region where there is a shortage of dentists. It is projected that with this need there would need to be an increase of nearly 10,000 new hired dentist in order to help fill the demand.[22] Rural areas are the most negatively impacted by dental deserts and face negative health problems such as tooth loss and other dental complications that may arise from prolonged postponement of one's dental health.[23]
