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] That 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[7] 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.
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.[8] 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.[8] Racial demographic disparities in healthcare access are also present in rural areas, particularly with Native Americans living in rural areas receiving inadequate medical care.[9][10]
Pharmacy deserts have developed in some urban areas,[11][12] a situation that has increased the challenge of distributing and administering vaccines for the COVID-19 pandemic.[13][14][15]