Critical Access Gaps Across America

132 counties across 23 states have no hospital, a primary care shortage, and high social vulnerability — the most acute healthcare access gaps in the country.

132

Critical Counties

States Affected

1,974,265

People Affected

Methodology: A “critical access gap” county meets three simultaneous criteria: (1) zero hospitals in the CMS Provider of Services file, (2) an active HRSA primary care HPSA designation, and (3) a CDC Social Vulnerability Index score above 0.75. See our data sources for full methodology.

Critical Access Gaps by State

States ranked by number of critical access gap counties. Click a state name to see individual county profiles.

State	Critical Counties	Population Affected	Avg SVI Score
Texas	26	453,878	0.86
Georgia	19	180,627	0.89
Kentucky	9	113,918	0.81
Virginia	9	153,697	0.84
Florida	8	173,781	0.85
North Carolina	8	174,027	0.91
Alaska	7	43,184	0.82
South Carolina	7	147,934	0.93
Arkansas	6	59,087	0.85
Mississippi	6	57,604	0.89
South Dakota	5	12,803	0.91
Missouri	4	85,169	0.91
New Mexico	3	95,428	0.86
Alabama	2	29,434	0.90
Colorado	2	9,421	0.87
Louisiana	2	13,053	0.85
Maryland	2	57,913	0.82
Oklahoma	2	25,909	0.83
Illinois	1	5,240	0.89
Kansas	1	31,486	0.82
Nevada	1	729	0.91
Tennessee	1	7,005	0.93
Washington	1	42,938	0.81

All Critical Access Gap Counties

Every county meeting all three criteria: hospital desert, primary care HPSA, and SVI above 0.75.

Texas26

County	Population	SVI	HPSA Types	Nearest Hospital
Zapata	13,889	1.00	Primary Care, Dental, Mental Health	40.7 mi
Hudspeth	3,202	0.99	Primary Care, Dental, Mental Health	50.9 mi
Presidio	6,131	0.99	Primary Care, Dental, Mental Health	43.8 mi
Willacy	20,164	0.98	Primary Care, Mental Health	16.3 mi
Duval	9,831	0.98	Primary Care	22.4 mi
Brooks	7,076	0.92	Primary Care, Dental, Mental Health	38.6 mi
La Salle	6,664	0.91	Primary Care, Dental, Mental Health	37.2 mi
Zavala	9,670	0.91	Primary Care, Dental, Mental Health	24.3 mi
Live Oak	11,335	0.90	Primary Care, Dental, Mental Health	24.3 mi
Harrison	68,839	0.90	Primary Care, Dental, Mental Health	19.6 mi
Shelby	24,022	0.88	Primary Care, Dental, Mental Health	18.0 mi
Hall	2,825	0.87	Primary Care, Dental, Mental Health	16.9 mi
Cass	28,454	0.86	Primary Care, Mental Health	29.9 mi
Menard	1,962	0.86	Primary Care, Dental, Mental Health	23.4 mi
Robertson	16,757	0.85	Primary Care, Dental, Mental Health	27.0 mi
Newton	12,217	0.85	Primary Care, Dental, Mental Health	17.2 mi
McMullen	600	0.81	Primary Care, Dental, Mental Health	37.0 mi
San Jacinto	27,402	0.81	Primary Care	22.8 mi
Milam	24,754	0.80	Primary Care	24.6 mi
Lee	17,478	0.79	Primary Care, Mental Health	20.8 mi
Real	2,758	0.78	Primary Care, Dental, Mental Health	41.4 mi
Morris	11,973	0.78	Primary Care, Mental Health	14.6 mi
Lipscomb	3,059	0.77	Primary Care, Dental, Mental Health	26.9 mi
Aransas	23,830	0.76	Primary Care, Mental Health	22.8 mi
Dickens	1,770	0.76	Primary Care, Dental, Mental Health	26.5 mi
Bastrop	97,216	0.76	Primary Care, Dental, Mental Health	23.0 mi

Georgia19

County	Population	SVI	HPSA Types	Nearest Hospital
Randolph	6,425	0.99	Primary Care, Mental Health	29.1 mi
Telfair	12,477	0.98	Primary Care, Dental	19.4 mi
Stewart	5,314	0.97	Primary Care, Dental, Mental Health	21.5 mi
Calhoun	5,573	0.97	Primary Care, Dental, Mental Health	21.4 mi
Turner	9,006	0.97	Primary Care, Mental Health	19.1 mi
Hancock	8,735	0.97	Primary Care	14.3 mi
Taylor	7,816	0.96	Primary Care, Dental	22.1 mi
Chattooga	24,965	0.95	Primary Care, Dental, Mental Health	16.1 mi
Johnson	9,189	0.93	Primary Care, Dental, Mental Health	19.6 mi
Dooly	11,208	0.93	Primary Care	12.2 mi
Marion	7,498	0.89	Primary Care	21.8 mi
Webster	2,348	0.84	Primary Care, Dental	16.7 mi
Atkinson	8,286	0.84	Primary Care, Dental	14.7 mi
Wilcox	8,766	0.82	Primary Care	20.2 mi
Quitman	2,235	0.82	Primary Care, Dental, Mental Health	33.9 mi
Wilkinson	8,877	0.78	Primary Care	20.0 mi
Wheeler	7,471	0.77	Primary Care, Dental	18.6 mi
Hart	25,828	0.77	Primary Care, Dental, Mental Health	9.5 mi
Montgomery	8,610	0.75	Primary Care, Dental	8.2 mi

Kentucky9

County	Population	SVI	HPSA Types	Nearest Hospital
Fulton	6,515	0.91	Primary Care, Dental, Mental Health	33.0 mi
Lee	7,395	0.85	Primary Care, Dental, Mental Health	15.7 mi
Whitley	36,712	0.84	Primary Care, Dental, Mental Health	11.5 mi
Powell	13,129	0.80	Primary Care, Dental, Mental Health	10.8 mi
Todd	12,243	0.80	Primary Care, Dental, Mental Health	14.8 mi
Wolfe	6,562	0.78	Primary Care, Dental, Mental Health	17.5 mi
Butler	12,371	0.76	Primary Care, Dental, Mental Health	20.1 mi
Elliott	7,354	0.76	Primary Care, Dental, Mental Health	16.4 mi
Magoffin	11,637	0.76	Primary Care, Dental, Mental Health	16.2 mi

Virginia9

County	Population	SVI	HPSA Types	Nearest Hospital
Martinsville	13,485	0.93	Primary Care, Dental, Mental Health	21.6 mi
Lunenburg	11,936	0.92	Primary Care, Dental, Mental Health	15.6 mi
Greensville	11,391	0.90	Primary Care, Dental, Mental Health	2.0 mi
Nottoway	15,642	0.84	Primary Care, Dental, Mental Health	23.7 mi
Brunswick	15,849	0.83	Primary Care, Dental, Mental Health	13.4 mi
Westmoreland	18,477	0.82	Primary Care, Dental, Mental Health	15.0 mi
Northampton	12,282	0.79	Primary Care, Dental, Mental Health	28.7 mi
Henry	50,948	0.78	Primary Care, Mental Health	26.3 mi
Norton	3,687	0.77	Primary Care, Dental, Mental Health	8.2 mi

Florida8

County	Population	SVI	HPSA Types	Nearest Hospital
Hamilton	14,004	0.98	Primary Care, Dental, Mental Health	26.9 mi
Glades	12,126	0.91	Primary Care, Dental, Mental Health	20.8 mi
Bradford	28,303	0.89	Primary Care, Dental, Mental Health	10.9 mi
Suwannee	43,474	0.85	Primary Care, Dental, Mental Health	18.4 mi
Lafayette	8,226	0.84	Primary Care, Dental, Mental Health	26.2 mi
Liberty	7,974	0.83	Primary Care, Dental, Mental Health	14.6 mi
Dixie	16,759	0.77	Primary Care, Dental, Mental Health	44.5 mi
Levy	42,915	0.76	Primary Care, Dental, Mental Health	24.4 mi

North Carolina8

County	Population	SVI	HPSA Types	Nearest Hospital
Warren	18,642	0.99	Primary Care, Dental, Mental Health	17.9 mi
Greene	20,451	0.99	Primary Care, Dental, Mental Health	14.4 mi
Richmond	42,946	0.99	Primary Care, Dental, Mental Health	20.2 mi
Martin	22,031	0.93	Primary Care, Dental, Mental Health	14.6 mi
Northampton	17,471	0.89	Primary Care, Dental, Mental Health	17.6 mi
Hyde	4,589	0.87	Primary Care, Dental, Mental Health	45.1 mi
Tyrrell	3,245	0.85	Primary Care, Dental, Mental Health	28.5 mi
Beaufort	44,652	0.81	Primary Care, Dental, Mental Health	27.1 mi

Alaska7

County	Population	SVI	HPSA Types	Nearest Hospital
Yukon-Koyukuk	5,343	0.88	Primary Care, Dental, Mental Health	117.7 mi
Northwest Arctic	7,793	0.87	Primary Care, Dental, Mental Health	36.8 mi
Kusilvak	8,368	0.86	Primary Care, Dental, Mental Health	110.7 mi
Prince of Wales-Hyder	5,753	0.82	Primary Care, Dental, Mental Health	62.1 mi
Lake and Peninsula	1,476	0.79	Primary Care, Dental, Mental Health	115.2 mi
Aleutians East	3,420	0.78	Primary Care, Dental, Mental Health	368.4 mi
North Slope	11,031	0.77	Primary Care, Dental, Mental Health	148.4 mi

South Carolina7

County	Population	SVI	HPSA Types	Nearest Hospital
Lee	16,531	0.97	Primary Care, Dental, Mental Health	15.5 mi
Williamsburg	31,026	0.96	Primary Care, Dental, Mental Health	28.8 mi
Barnwell	20,589	0.96	Primary Care, Dental, Mental Health	23.0 mi
Bamberg	13,311	0.96	Primary Care, Dental, Mental Health	19.9 mi
Marlboro	26,667	0.94	Primary Care, Dental, Mental Health	14.8 mi
Fairfield	20,948	0.89	Primary Care, Dental, Mental Health	21.0 mi
Saluda	18,862	0.82	Primary Care, Dental, Mental Health	19.5 mi

Arkansas6

County	Population	SVI	HPSA Types	Nearest Hospital
Lee	8,600	0.97	Primary Care, Dental, Mental Health	17.6 mi
Monroe	6,799	0.93	Primary Care, Dental, Mental Health	23.1 mi
Nevada	8,310	0.85	Primary Care, Dental, Mental Health	16.3 mi
Lafayette	6,308	0.81	Primary Care, Dental, Mental Health	28.3 mi
Woodruff	6,269	0.77	Primary Care, Dental, Mental Health	23.1 mi
Columbia	22,801	0.76	Primary Care, Mental Health	32.4 mi

Mississippi6

County	Population	SVI	HPSA Types	Nearest Hospital
Humphreys	7,785	0.98	Primary Care, Dental, Mental Health	20.1 mi
Tunica	9,782	0.96	Primary Care, Dental, Mental Health	23.8 mi
Issaquena	1,338	0.95	Primary Care, Dental, Mental Health	12.4 mi
Stone	18,333	0.86	Primary Care, Dental, Mental Health	23.8 mi
Amite	12,720	0.79	Primary Care, Dental, Mental Health	19.4 mi
Benton	7,646	0.77	Primary Care, Dental, Mental Health	12.3 mi

South Dakota5

County	Population	SVI	HPSA Types	Nearest Hospital
Buffalo	1,948	0.99	Primary Care, Dental, Mental Health	18.8 mi
Jackson	2,806	0.98	Primary Care, Dental, Mental Health	25.1 mi
Ziebach	2,413	0.88	Primary Care, Dental, Mental Health	31.1 mi
Lyman	3,718	0.87	Primary Care, Dental, Mental Health	26.9 mi
Mellette	1,918	0.86	Primary Care, Dental, Mental Health	26.9 mi

Missouri4

County	Population	SVI	HPSA Types	Nearest Hospital
Dunklin	28,283	0.97	Primary Care, Dental, Mental Health	18.8 mi
Mississippi	12,577	0.91	Primary Care, Dental, Mental Health	16.5 mi
McDonald	23,303	0.89	Primary Care, Dental, Mental Health	16.6 mi
Morgan	21,006	0.87	Primary Care, Dental, Mental Health	23.3 mi

New Mexico3

County	Population	SVI	HPSA Types	Nearest Hospital
Hidalgo	4,178	0.92	Primary Care, Dental, Mental Health	62.8 mi
Valencia	76,205	0.88	Primary Care	25.3 mi
Torrance	15,045	0.77	Primary Care, Dental, Mental Health	52.4 mi

Alabama2

County	Population	SVI	HPSA Types	Nearest Hospital
Lowndes	10,311	0.90	Primary Care, Dental	22.1 mi
Pickens	19,123	0.89	Primary Care, Dental, Mental Health	32.4 mi

Colorado2

County	Population	SVI	HPSA Types	Nearest Hospital
Costilla	3,499	0.87	Primary Care, Dental, Mental Health	28.4 mi
Crowley	5,922	0.86	Primary Care, Dental, Mental Health	25.7 mi

Louisiana2

County	Population	SVI	HPSA Types	Nearest Hospital
Catahoula	8,906	0.86	Primary Care, Dental, Mental Health	17.0 mi
Tensas	4,147	0.85	Primary Care, Dental, Mental Health	23.9 mi

Maryland2

County	Population	SVI	HPSA Types	Nearest Hospital
Somerset	24,620	0.88	Primary Care, Dental	24.2 mi
Caroline	33,293	0.76	Primary Care, Dental, Mental Health	14.9 mi

Oklahoma2

County	Population	SVI	HPSA Types	Nearest Hospital
Tillman	6,968	0.91	Primary Care, Dental	28.8 mi
McIntosh	18,941	0.75	Primary Care, Dental, Mental Health	15.8 mi

Illinois1

County	Population	SVI	HPSA Types	Nearest Hospital
Alexander	5,240	0.89	Primary Care, Mental Health	19.7 mi

Kansas1

County	Population	SVI	HPSA Types	Nearest Hospital
Montgomery	31,486	0.82	Primary Care, Dental, Mental Health	15.9 mi

Nevada1

County	Population	SVI	HPSA Types	Nearest Hospital
Esmeralda	729	0.91	Primary Care, Dental	73.0 mi

Tennessee1

County	Population	SVI	HPSA Types	Nearest Hospital
Lake	7,005	0.93	Primary Care, Dental, Mental Health	20.6 mi

Washington1

County	Population	SVI	HPSA Types	Nearest Hospital
Douglas	42,938	0.81	Primary Care, Dental, Mental Health	15.3 mi

Source: CMS Provider of Services (hospital presence), HRSA Health Professional Shortage Areas (HPSA designations), CDC/ATSDR Social Vulnerability Index 2022 (SVI scores), U.S. Census Bureau (population).

Related Analysis

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Rural Hospital Closures

Track every rural hospital closure since 2005 by state, year, and type.

Data Sources

CMS, CDC, HRSA, and more — the authoritative data behind every metric.

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Data from CMS Provider of Services (hospital presence), HRSA Health Professional Shortage Areas (HPSA designations), CDC/ATSDR Social Vulnerability Index 2022 (SVI scores), and U.S. Census Bureau (population).