More than 120M Americans lack adequate access to health care, study finds

More than 120M Americans lack adequate access to health care, study finds © amazing studio - stock.adobe.com

Over 120 million Americans live in counties lacking adequate health care access, according to new data from GoodRx Research. More than 80% of U.S. counties are affected, from pharmacy deserts to a lack of trauma care.

Health care infrastructure has remained stagnant or worsened in many regions over the last half decade.

The updated analysis builds on GoodRx’s 2021 whitepaper that mapped “health care deserts” — areas with limited or no access to pharmacies, primary care, hospitals, emergency services or low-cost community health centers. Their 2025 update is troublingly consistent. Nearly one in three Americans lives in a county with one or more of these access gaps.

Pharmacy closures widen the divide

Among the most dramatic changes since the 2021 report is the expansion of pharmacy deserts. Over 48 million people now reside in counties where the nearest pharmacy is more than a 15-minute drive away — up from 41 million in 2021.

That now accounts for 45% of all U.S. counties.

The farther patients live from pharmacies, the harder it is for them to access timely medications, especially in the midst of national drug shortages. A recent GoodRx survey found nearly one in five Americans had to visit multiple pharmacies to fill a single prescription.

Hospital and trauma access remains static

Access to hospital care has not improved in four years. Today, 28 million people live more than 30 minutes from a hospital, 79 million live in areas with fewer than two hospital beds per 1,000 residents and 50 million are over an hour from a trauma center.

Roughly 20% of counties remain hospital deserts. For trauma centers, that figure is 38%.

Extended travel times to receive emergency care can worsen outcomes. The concept of the “golden hour” — the critical first hour after a traumatic injury — underscores the risk of delayed treatment.

“When accessing a trauma center, every second counts,” the researchers wrote. “Appropriate hospital care may be too far away to survive a serious injury or illness.”

Primary care remains strained

While official shortage area designations have declined, the report attributes this drop to a federal reclassification, not actual gains in workforce.

In these shortage areas, a single full-time primary care physician may be responsible for more than 7,500 patients — well over twice the recommended caseload.

Community health centers have become slightly more accessible, with 71 million people now living in health center deserts, down from 78 million in 2021. But the gains may be short-lived, as federal funding faces threats in Washington.

Multiple deserts per county are common

Nearly 60% of U.S. counties are home to more than one kind of health care desert, and eight million Americans live in counties with at least four types of access gaps.

States with the highest percentage of residents in health care-desert counties include:

• Wyoming – 87%
• Vermont – 74%
• Montana – 70%
• New Mexico – 60%
• Alaska – 56%

In counties like Catron (New Mexico), Duval (Texas) and Hettinger (North Dakota), residents face barriers across every health care category, from prescriptions to trauma care.

Who is most affected?

The burden of health care deserts is not evenly shared. Counties with poor access tend to have higher uninsured rates, lower household incomes and poorer broadband access.

These social and economic factors compound physical access barriers, deepening health disparities. Even in areas with technically sufficient infrastructure, lack of insurance or transportation can still prevent people from receiving timely care.

The broader impact

“Lacking just one dimension of health care can be detrimental to individuals and communities at large,” the researchers concluded.

Although someone might live near a primary care physician, they may still need to drive hours to find a trauma center or struggle to find a pharmacy with their medication in stock.

The report concludes that addressing health care deserts requires sustained investment across the care continuum, from workforce development and infrastructure to policy protections for community health funding.