Increased number of rural counties do not have any local primary care physicians
How did the number of pediatrician and family medicine physician (FMP) change between 2010 and 2020, particularly for rural areas? A paper by Ramesh and Yu (2023) use data from the Health Resources and Services Administration (HRSA) Area Health Resources Files and and county characteristics from the American Community Survey and find that:
From 2010 to 2020, the number of general pediatricians increased by 6.0% (53 600 vs 56 800 pediatricians), but fewer of them worked in rural counties (3000 vs 2900 pediatricians). Similarly, the number of FMPs increased by 14.1% (79 400 vs 90 600 FMPs) with fewer working in rural counties (13 000 vs 12 000 FMPs). Despite a small increase in general pediatrician density (6.44 vs 6.96 pediatricians per 10 000 children), the density decreased marginally in completely rural counties (0.92 vs 0.81 pediatricians per 10 000 children). There were 2.8% more rural counties without a general pediatrician in 2020 vs 2010 (1156 vs 1124 counties) and 8.4% more rural counties without both general pediatricians and FMP (284 vs 262 counties)
One additional consideration would be to examine would be whether the number of physician assistant and nurse practitioners has increased to offset the decline in pediatricians and family medicine physicians in rural areas.