Hospital Deserts in America

Healthcare has become one of the biggest political points of contention in America with a constant battery of policy and cultural changes surrounding the issue being broadcasted across the national news every day. However, as much of a hot button topic it has become, it is a discussion which has real world consequences, and with an emphasis on affordable healthcare for all, the conversation seems to exclude a major facet of healthcare in America, the fact that there is a lack of healthcare coverage within rural America. These areas have become known as hospital desserts, where response times to emergencies find themselves at 2 hours in the upper limits, and travel times to health centers are within the same range. In this project, I aim to determine the correlation between healthcare spending and hospital desserts as well as characterize what these desserts look like geographically in order to better understand the factors that go into making healthcare inaccesible beyond sheer distance.

The map above illustrates all accreddited hospitals in the united states, and in term of density it is clear to see that the southwestern united states is statistically underserved when compared to the population statistics that are listed below.

This map illustrates the total population of the US using dot density symbology to represent the population of each county to scale. This map makes it apparent that the united states is most populated along it's cost and border, while middle america is more sparsely populated.

According to this map comparing the total population of the united states in 2010 and all accredited hospitals in the united states, there appears to be a direct coorelation between the amoint of hospitals in a given area and it's population, save for some areas in rural america. These areas, where the ratio of people to healthcare is off balance, are the most likely areas to be hospital desserts. These specific areas are the ones which I will be doing my analysis in Arc for, looking for the most isolated hospitals and then identifying the next closest one in order to identify that can be analyzed using the US topographic map which highlights both roadways and geographical features.

To provide greater context for hospital desserts, I identified a map which highlights US Health Insurance spending by county in order to then overlay the map containing all accredited hospitals within the US.

When overlaying these two maps, it becomes clear that there is little to no correlation between the amount of hospitals in a given area depending on the amount they spend on healthcare coverage. While the reason as to why this is the case lies outside the scope of the project, it is important to note that the funding disparities which cause hospital desserts are not visually represented in how much it costs to get coverage.

The first hospital dessert that I'm highlighting is in Montana, and is centered around Holy Rosary Healthcare. Located in Custer county, Holy Rosary Healtcare serves the population of Miles City which is 8,141, but custer county has a population of 11,696, meaning more than 3,000 people are living in rural areas and suburbs of Custer County. According to a Pew Research Study, rural people live on average, 10.5 miles out from their closest hospital. Therefore a buffer zone of 10.5 miles in radius has been extended from the location of the hospital ,highlighted in yellow, and one has been extended around the next closest hospital in blue.

The first hospital is accessible by only 3 main roads and does not have any identifiable geographical barriers to access, but in terms of distance it is clear that there is a large populated areas located more than 10.5 miles outside of both hospitals in the area, which are seperated by 100's of miles themselves.

Located in Elko, Nevada, Elko maintains a population of 18,297 according to the 2010 census, and 48,818 live in Elko county, the 4th largest county in the United States.

The entire region of Elko is serviced by one major highway, and supports a mostly rural population, the next hospital closest to it is serviced by the same road and is over 100 miles away. The Duck Valley Reservation is entirely serviced by this hospital.

Tuba city is a city of 8,611 people and is located on Navajo Land. In the entire Cococino county there are 134,421 people, all living in mostly rural areas.

The closest hospital near Tuba City is in Flagstaff, that is serviced by 5 main highways running through Arizona. What makes the Tuba City Regional Healthcare Association unique is that it services the entire Hopi reservation and is only connected by one highway.

Big Bend Regional Medical Center is located in Alpine, Texas, which has a population of 5,905, in Brewster County, which has a population of 9,232, it supports the border communities outside of Odessa.

Big Bend is the closest hospital to the US border that is not a military base, and is connected to one of the highways leading from Texas into Mexico. Being such a high traffic area, Big Bend Regional Medical Center supports the surrounding military bases and border towns. The next closest non-military hospital is located almost 100 miles in land.

Avera St. Mary Hospital is located in Pierre, South Dakota, with a population of 13,646, is located in Hughes County, which has a population of 17,022.

Avera St. Mary Hospital is located on the Missouri River and serves as the closest hospital to the Lower Brule and Crow Creek reservations. It serves an almost entirely rural population.

The method of creating a Buffer zone and overlaying it on the American topographic map was sufficient in illustrating the unserviced areas of each of these Hospital deserts. There is a clear issue with this lack of coverage, and graphic approaches such as this are effective in depicting the severity of the situation people living within these areas are experiencing. Through using the original map to identify the most remote hospitals in America, that the hospital dessert situation in America is far more severe than I imagined and is being criminally underrepresented. In order to further this analysis, I would seek access to higher resolution images of the rural settlements surrounding these hospitals and then routing them.

U.S 2010 Census

ArcGis Living Atlas

National Rural Health Association

 https://www.pewresearch.org/fact-tank/2018/12/12/how-far-americans-live-from-the-closest-hospital-differs-by-community-type/