Health Insurance

States with the Highest Healthcare Workforce Shortages

For 2018, a total of 16.8 million individuals worked within the health care industry. However, on average, 29% of counties within a state are experiencing a shortage of primary care professionals. This can lead to a lack of quality health care and decreased access to important health services for these states.

ValuePenguin used a combination of data from the Bureau of Labor Statistics (BLS) and Health Resources & Services Administration (HRSA) to provide a better understanding of the shortage areas within the United States.

Nevada has the highest acute shortage in health care practitioners per 1,000 population, at 20.7

This practitioner-to-population ratio is 22% less than the national average of 26.40. California and Washington also rank near the bottom for availability of health care practitioners, with an average of 21.20 professionals per 1,000 residents. According to the Bureau of Labor Statistics, a health care practitioner includes professions such as:

  • Primary care physicians
  • Dentists
  • Mental health practitioners
  • Pharmacists
  • Nurses
  • Surgeons
  • Psychiatrists
  • Gynecologists

Conversely, the District of Columbia, South Dakota and Massachusetts have the highest ratios with 46.57, 35.42 and 35.16 health care practitioners per 1,000 population, respectively.

To complement our state rankings by health care practitioners, ValuePenguin utilized the HRSA government database, which reports health care professional shortage areas (HPSA). The government database breaks down shortages into three separate disciplines: primary care, mental health and dental health.

Arizona, overall, has the most severe health care workforce shortages

Among the three core disciplines, Arizona actually faced the most shortages and ranked within the top three nationally. One hundred percent of counties within Arizona, according to the HRSA data, faced primary care and mental health practitioner shortages. This means that the counties in Arizona did not meet the minimum population-to-provider ratio. For primary care, this target ratio is 3,500 to 1.

Additionally, 67% of the counties in Arizona have dental health practitioner shortages.

Throughout the entire U.S., there was no other state that had similar shortages among the three disciplines. Nevada was the closest, ranking within the top 10 for both primary care as well as dental health shortages at 63% and 38%, respectively.

However, 95% of counties within Nevada have the optimal level of mental health professionals.


Along with Arizona, Hawaii and Alaska reported over 80% of their counties having primary care shortages

California, Maine and Utah rounded out the primary care shortage top 10 with 60%, 44% and 41% of the counties having an acute shortage, respectively. The average percentage of counties per state with primary care shortages is 29%.

On the other hand, Connecticut and New Jersey are the only states where 100% of the counties do not have any primary care professional shortages.


Maine, Texas, Washington, Alaska and Arizona ranked within the top five for mental health shortages

Fifty-eight percent of counties have a shortage in mental health professionals in Texas, which is the highest shortage percentage among the three disciplines for the state. Additionally, this was significantly higher than the average percentage of mental health shortages in a state, which is 16%.

Mental health professional shortages are the second worst of the three health disciplines analyzed. In fact, in Connecticut — which has zero underserved counties in primary and dental health — 25% of the counties are currently experiencing a mental health shortage.


Alaska and Arizona are the only states that have a dental health shortage in over 50% of the counties

Colorado reported having its highest shortage within the dental health discipline, showing a shortage in 31% of the state. On the same note, this is the only discipline in which Maryland appears to have a large shortage — 25% of counties reported lacking dental health practitioners.

On the other hand, California, a state that has large shortages in primary care and mental health, has an adequate number of dental health professionals in 97% of counties. Similarly, New Jersey was the only state in the nation that has zero counties with shortages in any of the three disciplines.

For 2019, over 53% of the total primary care practitioners deficit was in non-rural areas

Furthermore, non-rural practitioner needs were almost double the amount needed for counties in rural areas of the U.S.

Rural statusPractitioners needed to meet minimum requirement
Rural3,850
Non-rural7,679
Partially rural2,852
Unknown11

The rural status designation is based off the geographic area of the county and is determined by the HRSA. A status of non-rural indicates that the county has a significant percent of the total state population or a major city within that area.

Complete state rankings of health care practitioners

RankStateHealth care practitioners per 1K populationPrimary care shortageMental health shortageDental health shortage
1Nevada20.7063%0%38%
2California21.2060%19%3%
3Washington21.9341%64%33%
4Utah22.0941%21%3%
5Hawaii22.2980%40%20%
6New Mexico22.4027%9%6%
7Arizona22.52100%100%67%
8Idaho22.8530%14%11%
9Georgia23.569%4%4%
10Texas23.6634%58%20%
11Alaska24.0779%89%63%
12Oregon24.5325%3%0%
13Oklahoma24.618%0%0%
14South Carolina24.724%0%4%
15Virginia24.7725%5%7%
16Florida24.9919%16%3%
17Wyoming25.4378%0%4%
18Colorado25.6739%9%31%
19New Jersey26.530%0%0%
20Mississippi26.717%5%4%
21Alabama26.8018%3%0%
22Arkansas26.8411%3%8%
23North Carolina26.8613%15%2%
24Iowa27.7429%15%7%
25Illinois27.8031%26%4%
26Kentucky27.8117%7%1%
27New York27.9211%16%0%
28Kansas28.0617%18%23%
29Louisiana28.3036%38%8%
30Michigan28.3513%27%0%
31Montana28.5839%9%13%
32Maryland28.6621%21%25%
33Connecticut28.750%25%0%
34Tennessee28.868%5%1%
35New Hampshire29.0320%10%0%
36Indiana29.1633%11%0%
37Wisconsin29.4829%3%0%
38Vermont30.6214%0%14%
39Maine30.8444%56%19%
40Ohio31.0222%16%1%
41Missouri31.276%0%9%
42Rhode Island31.3220%0%0%
43Pennsylvania31.8815%0%0%
44Nebraska32.549%5%0%
45West Virginia32.679%7%4%
46Delaware32.7633%0%0%
47North Dakota33.9677%6%38%
48Minnesota33.9934%7%7%
49Massachusetts35.1629%0%0%
50South Dakota35.4239%11%8%

Methodology

In this health care workforce study, ValuePenguin compiled data from two databases: The U.S. Bureau of Labor Statistics (BLS) and the Health Resources & Services Administration (HRSA).

Using the BLS query system, health care practitioner data was pulled nationally and by state from the most recent year available, which in this case was for 2018. Then, using the HRSA database, year-end 2019 data was pulled regarding health care professional shortage areas (HPSAs) and aggregated by state.

Sterling Price

Sterling Price is a research analyst at ValuePenguin specializing in health and life insurance. He graduated from Syracuse University with a bachelors degree in Finance and Accounting and has previous experience as a licensed life insurance representative.

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