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]
Primary care is a model of health care that supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care. It aims to optimise population health and reduce disparities across the population by ensuring that subgroups have equal access to services.
The Indian Health Service (IHS) is an operating division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing direct medical and public health services to members of federally recognized Native American Tribes and Alaska Native people. IHS is the principal federal health care provider and health advocate for American Indian people.
Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.
The University of North Texas Health Science Center at Fort Worth – HSC, Health Science Center, Health Science Center at Fort Worth – is an academic health science center in Fort Worth, Texas. It is part of the University of North Texas System and was founded in 1970 as the Texas College of Osteopathic Medicine, with its first cohort graduating in 1974. The Health Science Center consists of six schools with a total enrollment of 2,338 students (2022-23).
Mashhad University of Medical Sciences (MUMS) is a medical school in Iran. Located in Razavi Khorasan province in the city of Mashhad, it was established in 1949 with Ferdowsi University of Mashad and separated in 1986 from its parent institution by national legislation.
The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the health care of all its citizens. All healthcare in Cuba is free to Cuban residents, although challenges include low salaries for doctors, poor facilities, poor provision of equipment, and the frequent absence of essential drugs. There are no private hospitals or clinics as all health services are government-run. The current public health minister of Cuba is José Angel Portal Miranda.
NHS Scotland, sometimes styled NHSScotland, is the publicly–funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.
A health professional, healthcare professional, or healthcare worker is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician, physician assistant, registered dietitian, veterinarian, veterinary technician, optometrist, pharmacist, pharmacy technician, medical assistant, physical therapist, occupational therapist, dentist, midwife, psychologist, audiologist, or healthcare scientist, or who perform services in allied health professions. Experts in public health and community health are also health professionals.
In medicine, rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments. The concept of rural health incorporates many fields, including wilderness medicine, geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine.
The healthcare reform in China refers to the previous and ongoing healthcare system transition in modern China. China's government, specifically the National Health and Family Planning Commission, plays a leading role in these reforms. Reforms focus on establishing public medical insurance systems and enhancing public healthcare providers, the main component in China's healthcare system. In urban and rural areas, three government medical insurance systems—Urban Residents Basic Medical Insurance, Urban Employee Basic Medical Insurance, and the New Rural Co-operative Medical Scheme—cover almost everyone. Various public healthcare facilities, including county or city hospitals, community health centers, and township health centers, were founded to serve diverse needs. Current and future reforms are outlined in Healthy China 2030.
The Swedish health care system is mainly government-funded, universal for all citizens and decentralized, although private health care also exists. The health care system in Sweden is financed primarily through taxes levied by county councils and municipalities. A total of 21 councils are in charge with primary and hospital care within the country.
Healthcare in China is primarily provided by state-owned hospitals. Medical insurance is primarily administered by local governments. Over the twentieth century and twenty-first century, using both public and private medical institutions and insurance programs. As of 2020, about 95% of the population has at least basic health insurance coverage.
Healthcare in Senegal is a center topic of discourse in understanding the well-being and vitality of the Senegalese people. As of 2008, there was a need to improve Senegal's infrastructure to promote a healthy, decent living environment for the Senegalese.
Physician supply refers to the number of trained physicians working in a health care system or active in the labor market. The supply depends primarily on the number of graduates of medical schools in a country or jurisdiction but also on the number continuing to practice medicine as a career path and remaining in their country of origin. The number of physicians needed in a given context depends on several different factors, including the demographics and epidemiology of the local population, the numbers and types of other health care practitioners working in the system, and the policies and goals in place of the health care system. If more physicians are trained than needed, supply exceeds demand. If too few physicians are trained and retained, some people may have difficulty accessing health care services. A physician shortage is a situation in which there are not enough physicians to treat all patients in need of medical care. That can be observed at the level of a given health care facility, a province/state, a country, or worldwide.
A healthcare center, health center, or community health center is one of a network of clinics staffed by a group of general practitioners and nurses providing healthcare services to people in a certain area. Typical services covered are family practice and dental care, but some clinics have expanded greatly and can include internal medicine, pediatric, women's care, family planning, pharmacy, optometry, laboratory testing, and more. In countries with universal healthcare, most people use the healthcare centers. In countries without universal healthcare, the clients include the uninsured, underinsured, low-income or those living in areas where little access to primary health care is available. In Central and Eastern Europe, bigger health centers are commonly called policlinics.
Compared with other neighbouring countries, Guyana ranks poorly in regard to basic health indicators. Basic health services in the interior are primitive to non-existent, and some procedures are not available at all. Although Guyana's health profile falls short in comparison with many of its Caribbean neighbours, there has been remarkable progress since 1988, and the Ministry of Health is working to upgrade conditions, procedures, and facilities. Many Guyanese seek medical care in the United States, Trinidad and Tobago or Cuba.
Healthcare shortage areas are two types of designation within the United States determined by the Health Resources and Services Administration (HRSA). Health professional shortage areas (HPSAs) designate geographic areas or subgroups of the populations or specific facilities within them as lacking professionals in primary care, mental health, or dental care. Medically Underserved Areas and Populations only designate geographic areas or populations, and only for their lack of access to primary care services. Geographic areas can designate single or multiple counties, parts of cities, or other civil divisions depending on the state. Populations typically designate those subgroups which face barriers to healthcare access in an otherwise well-served population, such as homeless or low-income groups. Facilities designate specific healthcare locations such as clinics, mental hospitals, or prisons.
Healthcare in Angola consists of a network of hospitals, clinics, and dispensaries.
The United States has many regions which have been described as medical deserts, with those locations featuring inadequate access to one or more kinds of medical services. An estimated thirty million Americans, many in rural regions of the country, live at least a sixty-minute drive from a hospital with trauma care services. Regions with higher rates of Medicaid and Medicare patients, as well those who lack any health insurance coverage, are less likely to live within an hour of a hospital emergency room. Although concentrated in rural regions, health care deserts also exist in urban and suburban areas, particularly in predominantly Black communities in Chicago, Los Angeles and New York City. Racial demographic disparities in healthcare access are also present in rural areas, particularly in Native American communities which experience worse health outcomes and barriers to accessing quality medical care. 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.
Concerns of both a current and future shortage of medical doctors due to the supply and demand for physicians in the United States have come from multiple entities including professional bodies such as the American Medical Association (AMA). The subject has been analyzed as well by the American news media in publications such as Forbes, The Nation, and Newsweek. In the 2010s, a study released by the Association of American Medical Colleges (AAMC) titled The Complexities of Physician Supply and Demand: Projections From 2019 to 2034 specifically projected a shortage of between 37,800 and 124,000 individuals within the following two decades, approximately.
