Medical deserts are plaguing Ohio; urban areas also feeling the pain
Millions of people live in a medical desert, meaning they have inadequate access to healthcare, both in urban and rural settings. There are a variety of reasons why, including distance to a hospital, lack of broadband internet, lack of transportation and a shortage of healthcare workers. Despite these challenges, there are solutions. Brick by Brick examines workforce training and school health partnerships.
There are different kinds of medical deserts
HealthTech Magazine says, “Areas without access to hospitals, primary care physicians, pharmacies and other healthcare providers are called medical deserts.”
A 2025 study from GoodRx says Preble County has six medical deserts: lacking enough doctors, trauma centers, hospitals, hospital beds, health centers and pharmacies.
Other findings from GoodRx’s national study include:
- One in three Americans live in a medical desert and eighty percent of counties have them.
- Hospitals and federal funded health centers remain at risk of closure.
- People with lower incomes and those without health insurance are more likely to be affected.
Since GoodRx’s 2021 study, more than 1,300 pharmacies have closed and the supply of primary care professionals lags behind demand.
Medical care threats to Hamilton and Montgomery Counties
In 2018 Premier Health closed Good Samaritan Hospital in Dayton citing increased costs, an aging campus, not enough patients and the nearby Miami Valley Hospital.
Because of federal changes to Medicaid the Springfield and Hamilton Planned Parenthood clinics closed in August, 2025. The organization says it is still providing services at its other offices.
Threatened federal cuts may also put three Montgomery County nursing homes at elevated risk of closing as well as ten in Hamilton County according to a nationwide list generated by Brown University.
The Ohio Capital Journal says half of Ohio hospitals and 72-percent of rural hospitals have reported operating losses since 2022. Also concerning for The Ohio Hospital Association is pending federal cuts to Medicaid.
The Cincinnati Enquirer looked at 2024 financial disclosure statements to see “that all six Cincinnati-area hospitals received 10-percent or more of their revenue from the federal government through Medicaid.”
UC Health closed the Daniel Drake Center for Post-Acute Care in 2025 and eliminated the healthcare system’s mobile stroke unit. It has also started charging “hospital outpatient facility fees” for other services.
Lack of high-speed internet in rural Ohio and beyond limits telehealth
KFF Health News (formerly known as Kaiser Family Foundation) studied rural Ohio medical deserts finding not only are patients lagging when it comes to life expectancy, lack insurance but they also can’t get high-speed internet required for telehealth.
KFF found Adams and Brown Counties and a list of others lack adequate broadband. This is important because The National Institute of Healthcare Management Foundation estimates by 2036 the U.S. will be short more than 85,000 doctors.
In KFF’s report: Millions in US Live in Places Where Doctors Don’t Practice and Telehealth Doesn’t Reach Sarah Jane Tribble and her team report the problem is life threatening.
Tribble told Brick by Brick, “During COVID we heard a lot about telehealth. In fact, there was a lot of initiatives and funding put forth through Congress for telehealth and it was sort of referred to as a solution for people who couldn’t leave their homes and certainly a possible solution for people in rural America where there wasn’t enough providers. But what we found was in today’s world with telehealth, you often want to do video calls so the doctor can fully see the patient they’re dealing with. You need high-speed internet for that and many homes don’t have that.”
And it’s not just the presence of broadband but how fast it is. Tribble found numerous examples. Leroy Walker was hospitalized in Alabama. The hospital had high-speed internet but Tribble found it wasn’t fast enough for the hospital monitoring systems. Here’s an interactive link to the map below.
Healthcare worker shortage
Staffing shortages continue to complicate the issue of medical deserts. One assessment found, in some primary care health deserts, there is only one full-time primary care professional for every 8,000 people, more than double the ratio recommended, stretching health care access even thinner in those areas.
The American Hospital Association says “Structural changes within the healthcare workforce, combined with the profound toll of COVID have left hospitals and health systems facing a national staffing emergency.”
Heathcare as a career can be taxing. A Kaiser Family Foundation/Washington Post survey found nearly 60-percent of healthcare workers had experienced a decline in their mental health as a result of their work during the pandemic and nearly 30-percent had considered leaving their profession altogether.
Government data shows 623 hospitals (17-percent of reporting hospitals) anticipate a critical staffing shortage. Projections from the Bureau of Labor Statistics estimate US healthcare organizations will have to fill more than 203,000 open nursing positions every year until 2031.
The government’s plan to recruit more workers
There is some potentially promising news. The federal government is taking steps to shore up medical access in rural America. It has introduced a 50-billion-dollar Rural Healthcare Transformation (RHT) Program.
A news release says, RHT “Empowers states to strengthen rural communities across America by improving healthcare access, quality and outcomes by transforming the healthcare delivery ecosystem.”
It has these strategic goals:
- Make rural America healthy again-by supporting rural health innovations
- Sustainable Access-by helping rural providers become long-term access points for care by improving efficiency and sustainability.
- Workforce development-by attracting and retaining a high-skilled healthcare workforce by strengthening recruitment and retention.
- Innovative Care-spark the growth of innovative care models to improve health outcomes.
- Tech innovation-foster use of innovative technologies that promote efficient care delivery, data security and more.
KFF reports first-year awards range from $147 Million in New Jersey to $281 Million in Texas. Ohio received $202 Million or $69 per rural resident.
RHT Program funding will allocate $10 billion a year over five years beginning in 2026.
Ohio monitoring shortage areas, creating school-based health centers
The Ohio Department of Health operates 10 workforce programs, nearly all of which have a goal of increasing providers in the following regions. Here is a link to the types of shortages.
Spokesperson Ken Gordon says, “In recent years, under the leadership of Governor Mike DeWine, the state (including ODH) has pushed to establish school-based health centers, many of which are located in underserved communities in HPSA (health provider shortage areas).
School-based health centers, Children’s initiatives
Ohio supports 49 of them in 27 counties and recently provided money for a school-based health center in the Fayetteville Perry Local School District. Brick by Brick’s Hernz Laguerre Jr. reports on this and a more established one in Lower Price Hill at the Oyler School in this podcast.
Cincinnati Children’s Hospital Medical Center recognizes the need for school-based health centers. It operates three inside Cincinnati Public Schools and has recently opened one in the New Richmond School District. Design and construction were paid for with a grant New Richmond got from the state’s Appalachian Community Innovation Centers. It is within walking distance for about 1,000 students enrolled in either the middle school or the high school.
Spokesperson Barrett Brunsman says data indicates that families face a wide range of barriers to access care including transportation challenges, managing daily expenses and Medicaid restrictions. One solution to address such problems is expanding regional sites of care. Children’s has opened a $90 million medical building in Clermont County’s Eastgate area. There is also a new Children’s Wilmington Primary Care facility.
Ohio University’s workforce development
Ohio University has a good understanding of the lack of health care access because its main campus is in Appalachia, in Athens, Ohio. Ten years ago it applied for and received a grant from Medicaid to start a certified community healthcare worker training program, benefiting 20 counties in Southern Ohio.
Kerri Shaw directs it and explains what a community healthcare worker does. “I like to think of them as the connective tissue of our systems. So, they’re liaisons between the patients or clients that they’re working with and all the healthcare and social services systems that are out there and that they might need to connect to.
Monica Stobart had been an EMT for 14 years and decided to enroll in OU’s free program.
She says, “Working in the setting that I do, I had just run into a lot of the patients that we were seeing. They were losing their lives because they didn’t have access to healthcare or they didn’t have insurance, or they couldn’t afford their medications, or they just didn’t have transportation. So, it was something that weighed heavy on me for a very long time. And I was like, I’m just tired of being reactive to the problems. I want to find a solution.”
More than 500 community healthcare workers have graduated from this program, which has also been funded by the CDC, the Ohio Department of Health and others.
Hamilton County’s 513 Relief Bus
Even people in urban settings struggle with medical deserts. Without transportation, it’s difficult to get to a doctor. Prompted by COVID and a need to get vaccines to those who needed it, Hamilton County Commissioner Alicia Reece mimicked an idea from Hampton University to equip a bus with medical personnel. It drove around to dozens of Hamilton County neighborhoods and provided the shots residents needed. But she didn’t stop there. The 513 Relief Bus gradually added more services over the years. It now includes:
- Medical testing
- Cancer screening
- Rental assistance
- Help finding a job
- Birth Certificates
- Death Certificates
- Expungement assistance
- Unclaimed funds
Commissioner Reece calls it “Hamilton County on wheels.” There are more than 30 partners and after years of ARPA funding the county has put the bus in its budget.
A small-town model
Taking medical care on the road is also proving to be successful in a tiny town in the State of Washington. Belfair, across Puget Sound, is a medical desert. Residents used to just call 9-1-1 if they needed medical attention, even if it wasn’t an emergency and because of that there was a thirty percent increase in the number of calls to the fire department. Chief Beau Bakken had to do something.
He says, “The department was becoming the healthcare provider, not just the emergency healthcare provider, but the overall healthcare provider.”
That’s when the department, with funding from the local hospital, started a mobile integrated health program. It hired a physician assistant, a nurse and a psychiatric nurse practitioner. It now asks residents to call the fire department before individual medical cases get out of hand.
And for the first time, emergency calls have started to go down. What do residents think of the service that began in 2023?
Bakken says, “Where do I start? Tears, hugs, gift cards, notes of changing lives. It’s the best thing that we’ve done in the 30 years that I’ve been down here. I’d love to see this in every rural fire department in America.”
Limitations
This model and others are seeing success. There are limitations. Money. As hospitals face their own budgetary challenges, will their partnerships continue?
And Chief Bakken says even though this hasn’t been a problem in his community, “Dollars make the world go round, and if you all of a sudden start pulling patients from an ER or from a hospital or from a local provider and whatnot, now we’re starting to compete for dollars that are out there.
Other limitations for creating greater medical access include lack of Broadband Internet service. The State of Ohio has announced a 50-million-dollar investment in support of broadband expansion in Clermont, Brown and Adams Counties.
Looking ahead
State workforce training programs continue. Is it helping to ease the shortage? National government data shows 623 hospitals anticipate a critical staffing shortage and projections from the Bureau of Labor Statistics estimate US healthcare organizations will have to fill more than 203-thousand open nursing positions every year until 2031.
Many agree there is not a single solution for healthcare deserts in the U.S.
Some are hopeful the new government Rural Health Transformation Program, mentioned earlier, could make a difference, including Chief Rural Correspondent for KFF Health News Sarah Jane Tribble.
She says, “What’s sort of exciting about that when I talk to the experts who are watching it, is that it’s a transformation program and they expect it to go to innovative ideas. And when you read the law, it talks about using technology to improve the health outcomes of people in rural areas. So, the future could hold a lot of promise.”
How do we address the challenge of medical deserts? What kind of a difference can workforce training and school-based health centers make? Brick by Brick will also be digging into other possible solutions. We want to build community around context and solutions in our cities. Your feedback is very important to the effort, as we continue to dig deeper into the responses to some of our most pressing social issues, including the housing crisis. Click on the green button below to take a short survey to help reinforce and refine our work. Thank you.
Ann Thompson – Host, Producer
Over the last thirty years in Cincinnati, Ann Thompson has brought a wealth of knowledge and expertise to her reporting. She has reported and anchored for WVXU, WKRC, WCKY, WHIO-TV and Metro Networks and freelanced for NPR, CBS and ABC Radio. Her work has been recognized by the Associated Press and she has won awards from the Association of Women in Communications and the Alliance for Women in Media. She is a former News Director and Operations Manager. Ann has reported from India, Japan, South Korea, Germany and Belgium as part of fellowships. Ann thinks of the Brick by Brick project as “journalism for good.” She serves as host and producer. Ann lives in Anderson Township with her husband Scott. They have two boys. Jake graduated from the Air Force Academy in 2022 and Kurt attends West Point.
