published in 2022， and as of 2023， and since the femalepopulation of the U.S. is expected to increase by almost 10% by 2100，000 primary care clinicians， with consideration given to high-need indicators such as a high percentage of the population livingbelow 100% of the federal poverty level. See Scoring ShortageDesignations for information related to the criteria and calculations HRSA uses to determine HPSAs. Where are HPSAs located in rural areas? According to Stateof the Primary Care Workforce。
the NPworkforce grew by 9.4%。
see these RHIhub topic guides: Frequently Asked Questions Is there a healthcare workforce shortage in rural areas? Workforce shortages are very common in rural communities. It should be noted， such asadmitting more students from rural communities or who intend to practice in a rural community Offer rural-centric curricula and training tracks Develop distance education programs See the Education and Training of the Rural HealthcareWorkforce for more information. What strategies can rural healthcare facilities use to help meet their workforce needs? Rural healthcare facilities can employ various strategies to ease healthcare workforce shortages and improvecare. For instance， and opportunities forcareer advancement might also improve chances for success with recruitment and retention. For ideas on recruiting and retaining healthcare professionals， 117， or mentalhealth services. HPSAs are designated by the Health Resources and Services Administration (HRSA). Adetailed description of HPSAs can be found at the HRSA Bureau of Health Workforce's What is Shortage Designation? page.HPSAs may be: Geographic 。
2025， and issues related to the rural health workforce， Nonmetropolitan Psychiatrists (2019) 13.0 3.5 Psychologists (2021) 39.5 15.8 Social Workers (2021) 96.4 57.7 Psychiatric Nurse Practitioners (2021) 4.8 3.4 Counselors (2021) 131.2 87.7 Sources: Changesin the Supply and Rural-Urban Distribution of Psychiatrists in the U.S.， dental， per 100， 2025。
economic，。
including national percentages of HPSAs located in rural and urban areas， seethe U.S. Citizenship and Immigration pages on the H-1BProgram and H-1BSpecialty Occupations. Visa and visa waiver processes can be complex and expensive. Legal representation is typically needed.Applicants and facilities should be sure to understand the processes，000， and mental health， medical school enrollment， to practice in rural areas Expanding existing scopes of practice Expediting licensure of new healthcare professionals and reactivation of expired licenses What can schools do to meet rural healthcare workforce needs? Health professions schools can: Use admissions criteria that are likely to produce providers interested in rural practice， and graduatemedical educationthroughout the United States. The Kaiser Family Foundation's State HealthFacts: Providers Service Use Indicators provides data on physicians， MetropolitanProviders per 100K， and fees associatedwith the option they are pursuing. Where can I find statistics on healthcare workforce for my state， 2014-2021; Changesin the Supply and Rural-Urban Distribution of Social Workers in the U.S.， and exposure to infection. Whether shortages exist in rural communities and how severe they are can be difficult to determine sinceestimates of supply and demand for specific professions are not always available. The Health Resources andServices Administration's WorkforceProjections Dashboard shows projections of the supply of and demand for healthcare workers across theUnited States. This tool incorporates factors such as changing population size， who typically require more care. Rural populations tend to be poorer and may forego care due to cost. Rural Practice Characteristics When rural communities lack certain types of providers， more benefits，and federal or state correctional facilities In addition， for a subset of the population in a defined geographic area。
economics， and better workingconditions. Health professions that require longer and more expensive training can be less affordable forrural students. It may be difficult for providers to find adequate housing. What is a Health Professional Shortage Area (HPSA)? HPSA designations indicate shortages of healthcare professionals who provide primary care， 2033 (18% versus 4%)， as of 2019 there were 55.2NPs per 100， PAs， which can enable students to complete health professionstraining. Students must agree to complete a service commitment in a Health Professional Shortage Area. Accordingto the infographic BuildingHealthier Communities， 1995-2019; Changesin the Supply and Rural-Urban Distribution of Psychologists in the U.S.， particularlybeyond the community college level. Providers trained in urban areas may not be prepared for the challenges of working in ruralcommunities or the kinds of health concerns rural patients may present. Urban areas frequently draw potential healthcare professionals away from rural areas. Students inrural communities may have to travel or relocate to an urban area for health professions coursework， irrespective of rural or urban setting， and scope of practice issues Programs and policies that can be used to improve the rural healthcare workforce For additional information on rural healthcare workforce issues， State University of New York. It is funded by HRSA's Bureau of Health Workforce. ， demand， see HRSA's HPSA Find tool. Forstatisticson HPSAs，000 population in rural U.S. counties than in urban counties. The following chart shows rates of providers in rural areas as compared with urban areas for selected behavioralhealth professions: Per Capita Rates of Behavioral Health ProfessionalsOccupationProviders per 100K， asidentified by a state governor or designee. MUAs and MUPs are based on four factors: Ratio of population to primary care providers Infant mortality rate Percentage of population at or below the federal poverty level Percentage of population age 65 or older A list of MUAs and MUPs can be found at HRSA's Data Explorer.Tosearch for MUAs and MUPs by state and county， and as a result rural residents are more likely to rely on primary care providersfor their behavioral health needs. The WWAMI Rural Health Research Center's report Changesin the Supply and Rural-Urban Distribution of Counselors in the U.S.， as of July 2026. Higher scoresindicate greater need. To search for HPSAs by state and county， as of 2019 there were 24.1 PAs per 100， 2022 What state-level policies and programs can help address the shortages in the rural healthcare workforce? Funding options that states can use to address rural health workforce include: Policy options that states can use to address rural health workforce shortages include: Removing barriers to practice， advanced practiceregistered nurses。
from the WWAMI Rural Health Research Center， NPs。
and LoanRepayment for Rural Health Professions. Where can states get technical assistance for health workforce planning。
while others experience persistent shortages of healthprofessionals. The Council on Graduate Medical Education report Strengtheningthe Rural Health Workforce to Improve Health Outcomes in Rural Communities。
and 5.3% of women of childbearing age in the U.S. lived in counties with no OBGYNs. Maternal Health Physicians by Rurality， approximately 1 in 3 NHSC clinicians works in rural areas. This representsmore than 3。
15-49 Years Old Large metropolitan area 27.2% 38.5% 37.0% 40.9% 30.9% Medium metropolitan area 37.5% 42.1% 41.6% 45.4% 36.5% Small metropolitan area 24.4% 15.9% 17.3% 12.3% 22.4% Micropolitan area 9.6% 3.4% 4.0% 1.3% 9.2% Noncore area 1.2% 0.2% 0.1% 0.05% 1.0% Source: Stateof the U.S. Maternal Health Workforce， and key environmental factors? HRSA's National Center for HealthWorkforce Analysis provides in-depth data on supply，000 population in non-corecounties， 2023-2038， andhealthcare employment. The Robert Graham Center'sWorkforce Projections provides primary care physician workforce projection reports for all states. What are some federal policies and programs designed to improve the supply of rural health professionals? Area HealthEducation Centers (AHEC) Program AHECs promote interdisciplinary， see the HRSA Bureau of Health Workforce's ReviewingShortageDesignation Applications page. The primary factor used to determine whether a locationmay be designated as a HPSA is the number of full-time equivalent healthcare professionals relative to thepopulation， Stateof the Primary Care Workforce， nonmetro areas are expected to outpace metro areas in shortages of RNsin the next three interval years of 2028 (24% versus 5%)。
such as allowing telehealth services to be provided across state lines Allowing new or alternative provider types， 2014-2021 notes that there areonly about two-thirds as many counselors per 100，unless they can find degree programs offered online， and residentrecruitment. For more information see Scholarships， longer shifts， projectedgrowth。
administrators can take steps to recruit replacements in a timely manner， planning challenges。
based on the population of a defined geographic area Population-specific ， 2025 notes that rural counties have fewer behavioral healthproviders than urban areas， community-based training initiatives intended to improve the distribution， where appropriate. Changing policy to allow expansions to existing scopes of practice if evidence shows that the healthcareworkers can provide comparable or better care. Removing barriers to the use of telehealth to provide access to remote healthcare providers. As the United States struggles with shortages of healthcare providers。
Loans， notes that ruralareashave seen a decrease in access to maternal care in recent years， whichmay lead to healthcare provider burnout and be detrimental to the recruitment and retention ofclinicians. Economics Urban facilities and practices may offer higher salaries， however， due in large part to closure of obstetric unitsand a shortage of healthcare professionals who deliver babies. Significantly fewer obstetriciansserve nonmetro counties， National Center for Health Workforce Analysis Rural Physician Assistants (PAs) Stateof the Primary Care Workforce， whereas 12% in urbanareas are male. Rural Behavioral Health Professionals Stateof the Behavioral Health Workforce，Supplyand Distribution of the Primary Care Workforce in Rural America: 2019， such as public or nonprofit private clinics， there are safety net clinics that automatically receive shortage designation status. These include: Maternity Care Target Areas (MCTA) are geographic areas within existing HPSAs that have shortages of maternitycare professionals. Finalcriteria for MCTAs were published by HRSA in May 2022. How are HPSA designations determined? State Primary Care Offices are responsible for conducting needs assessments to determine which areas withintheir states should be considered shortage areas. They then submit applications to HRSA for review. For a fullerexplanation of the process， flexibility， demographics。
807) The same study found that the majority of nurses work in hospitals， to fill gaps in care causedby shortages. In addition， distribution， or for clinical training. Some do not return torural communities after completion of their studies. There are fewer clinician role models in rural communities. Rural secondary school students may have fewer opportunities to take advanced math andscience courses needed to pursue health careers. Rural Demographics and Health Status Rural populations usually have higher rates of chronic illness，800 additional physicians would be needed by 2036. The following factors were identified in an interview with WWAMIRural Health Research Center researchers and in various NRHA policydocuments: Education The current healthcare education system tends to be urban-centric. Access to healthcare training and education programs may be limited in rural areas， 2014-2021， and 2038 (11% versus 2%). Rural Licensed Practical Nurses (LPNs) According to an April 2024 articlefrom the Journal of Nursing Regulation，supply， Supplyand Distribution of the Primary Care Workforce in RuralAmerica:2019， it is important to plan for future workforce needs . By anticipatingretirements and departures of staff，the supply of every type of health professional is lower in nonmetro than metro areas: Health Professionals per 10K PopulationOccupationNonmetroMetro 2025 BLS Occupational Employment Statistics Registered Nurses (RNs) 67.1 101.0 Licensed Practical andLicensedVocational Nurses (LPNs/LVNs) 21.6 18.2 2024 Dentists 4.8 7.9 Physician Assistants(PAs) 3.7 6.0 Nurse Anesthetists 1.3 1.8 Nurse Practitioners(NPs) 10.0 12.9 Total Advanced PracticeRegistered Nurses 11.7 15.3 2023 Physicians (MDs) 11.2 33.1 Physicians (DOs) 2.1 3.2 Primary Care Physicians 5.1 7.9 Total Physicians 13.2 36.3 Rural Primary Care Physicians According to the HRSA research brief Stateof the Primary Care Workforce， facilities can use interprofessional care teams to provide moreefficient and high-quality care and can participate in educating rural healthcare professionals through offeringclinical training experiences. Redesigning practice and processes to allow professionals to work atthe top of their license and skill set can also lessen the effects of shortages. Facilities couldprovide opportunities for workers to learn new skills and encourage them to pursue career advancement throughapprenticeships and other educational opportunities. Rural areas often experience difficulties related to recruitment and retention of primary care and other healthprofessionals. Thus。
such as dental therapists， and urban LPNsis 48.0 years. Less likely to be male About 10% of rural LPNs are male。
and physicaltherapists. H-1B visas are issued for three years and can be extended to six years. For more information。
and geographicbarriers， leading to high levels ofstaff burnout， see the HRSA Data WarehouseDesignatedHealth Professional Shortage AreasStatistics. What are Medically Underserved Areas (MUAs)，000 women of childbearing age，000 population in non-corecounties，100 to 202， as well as K-12 students. National Health Service Corps (NHSC) NHSC offers scholarships and loan repayment programs， MUA Find. For further information on MUA/MUP designations，and avoid prolonged vacancies at their facilities. Increasing pay， as compared with 32.3 in micropolitan areas and 42.5 in metropolitan areas. The same report notes thatthe number of PAs being trained is increasing at a higher rate than that of primary care physicians， such asthose whose incomes are at or below 200% of the federal poverty level Facility-based ， including how to address rural needs? The Health Workforce Technical Assistance Center (HWTAC) offerstechnical assistance to states and organizations involved in health workforce planning. HWTAC activities caninclude: Direct technical assistance Educational webinars Facilitating access to health workforce data HWTAC is an academic research center based at the College of Integrated Health Sciences at the University atAlbany， state mental health hospitals， 2025， new entrants andexiting providers in various occupations。
and useof health personnel. The National Forum of State Nursing Workforce Centersprovides a list of state nursing workforce center initiatives throughout the nation. HRSA's Area Health Resources Files (AHRF)provides demographic and training information on more than 50 healthcare professions. The U.S. Department of Labor's Occupational EmploymentStatistics: May 2024 State Occupational Employment and Wage Estimates provides state-level informationon occupational employment within "Healthcare Practitioners and Technical Occupations" and "Healthcare SupportOccupations." The Association of American Medical Colleges (AAMC)'s U.S. PhysicianWorkforce Data Dashboard provides data on physician supply。
family physicians are more likely to deliver babies as the rurality of thecounty in which they practice increases. The HRSA report， thus increasing the number of NPs who might choose to work in rural areas. Rural Registered Nurses (RNs) The 2021 Journal of Professional Nursing article Rural-Urban Differences inEducational Attainment Among Registered Nurses: Implications for Achieving an 80% BSN Workforce notesthat urban nurses were more likely to have a Bachelor of Science in Nursing (BSN) degree than rural nurses(57.9% versus 46.1%). In a survey of34， particularly in primary care. The emphasis is ondelivery sites in rural and underserved areas. AHECs act as community liaisons with academic institutions andassist in arranging training opportunities for health professions students， see the Recruitment and Retention for Rural HealthFacilities guide. How do international medical graduates help fill rural healthcare workforce gaps? Many rural communities recruit international medical graduates with J-1 visawaivers to fill physician vacancies. The Conrad State 30 Program allows each state's health departmentto request J-1 Visa Waivers for up to 30 foreign physicians per year. The physicians must agree to work in afederally designated Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA). Interestedparties should contact the PrimaryCare Office in the state where they intend to work， nonimmigrant H-1B visas are sometimes used to fill employment gaps. Theseare employer-sponsored visas for "specialty occupations， 63.1% of primary care HPSAs are in ruralareas. The following mapsshow designated HPSAs for primary care， 2014-2021; Changesin the Supply and Rural-Urban Distribution of Psychiatric Nurse Practitioners in the U.S.， for more information and exact requirements. Seethe Rural J-1 Visa Waiver topic guide for details. In addition to the J-1 visa waiver。
TheSupply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S.，2025 notes that as of 2023 only 0.1% of OBGYN physicians practiced in areas with a population of lessthan 50， Medically Underserved Populations (MUPs)， Maintaining the healthcare workforce is fundamental to providing access to quality healthcare in rural areas.Rural healthcare facilities must employ enough healthcare professionals to meet the needs of the community. Theyshould have adequate education and training and hold appropriatelicensure or certification. When facilities promote coordination between health professionals and place them inroles where their skills can be used to best advantage，including: Supply and demand Distribution of the workforce Characteristics of the rural healthcare workforce Licensure， Compared to Female Population of Childbearing Age， compared tometropolitan counties. However， faculty development， and that workforceshortages are a problem even in areas that have retained their healthcare facilities. The report goes on to saythat the COVID-19 pandemic had the effect of exacerbating pre-pandemic shortages， notedthat rural hospital closures have reduced access to healthcare in some rural communities。
suggestingthat numbers of PAs providing primary care in rural areas will continue to grow. Rural Nurse Practitioners (NPs) According to the same June 2020 report， and differing levels of access to care. Maldistribution of healthcare professionals is also a problem affecting rural communities. The Association ofAmerican Medical Colleges document TheComplexities of Physician Supply and Demand: Projections From 2021 to 2036 notes that if populations whohave difficulty accessing care had healthcare use similar to populations with fewer sociodemographic， 7.2% of counties had no primary care physicians. The documentstates that in rural areas primary care physicians often provide women’s health services， there are lower ratios of primary carephysicians in ruralcommunities than in urban areas， visit HRSA's website， particularly specialists，and almost 700 dental clinicians. TeachingHealth Center Graduate Medical Education (THCGME)Program The THCGME program supports students in primary care and dental residency training programs in community-based ambulatorypatient care centers. There are two types of awards: Expansion awards for increasing the number of residentfull-time equivalent positions at existing HRSA THCGME programs and new awards to support new resident FTEpositions at new Teaching Health Centers. Rural ResidencyPlanning and Development (RRPD) Program The RRPD program provides funding to create new rural residency programs. Grants of up to $750，000 population in nonmetro areas as comparedwithmetro in areas for select professions. With the exception of Licensed Practical Nurses/Licensed VocationalNurses， an uneven distribution of workers meansthatshortages are often more profound in rural areas. This maldistribution is a persistent problem affecting thenation's healthcare system. This guide examines policy， certification， such as telehealth， and Governor-DesignatedSecretary-Certified Shortage Areas for Rural Health Clinics? Medically Underserved Areas (MUAs) and Medically Underserved Populations (MUPs) are federal shortagedesignations that indicate a lack of primary care services for an area or a population. Governor-DesignatedSecretary-Certified Shortage Areas for Rural Health Clinics are areas with provider shortages， 2025， they can use technology，000are provided to cover direct and indirect costs for accreditation，" including medical doctors， dental health， as compared with 64.6 in micropolitan areas and 69.5 in metropolitan areas. Between 2010-2016， that there is variationamong rural communities when it comes to the adequacy of their health workforce supply. Some communities rarelyexperience health workforce supply problems， benefits， education。
RNs。
anda higher percentage of rural nurses worked in skilled nursing facilities than urban nurses (12.7% versus 8.2%). According to the Bureau of Health Workforce's document NurseWorkforce Projections， eligibility rules，400 clinicians working in the areas of mental andbehavioral health，2014-2021; Changesin the Supply and Rural-Urban Distribution of Counselors in the U.S.， patients musttravel longer distances or forego care if telehealth services are not available or not an appropriateoption. Barriers such as reimbursement policies and lack of broadband availability have hinderedtelehealth adoption in some rural areas. Rural communities may offer fewer opportunities for career advancement. Understaffing causes increased workloads， WWAMI RuralHealth Research Center，104 nurses from all 50 states。
says that a significant and increasingamount of obstetric care inthe United States is being provided by primary care physicians. Stateof the U.S. Maternal Health Workforce， see What is a MedicallyUnderserved Area/Population (MUA/P)? on the HRSA website or contact your state PrimaryCare Office. How do the distribution and characteristics of the healthcare workforce compare across rural and urban areas? The following table shows ratios of health professionals per 10， which creates more demand. Rural areas tend to have higher proportions of older residents， patients will receive the best possible care. Strategies for optimizing the use of health professionals in rural areas include: Using interprofessional teams to provide coordinated and efficient care for patients and to extend the reachof each provider. Ensuring that all professionals are practicing to the full extent of their training and allowed scope ofpractice. Removing state and federal barriers to professional practice， more than 3， dentists， and less flexibility in scheduling， 2025 notes the importance of PAs and nursepractitioners (NPs) in ruralhealthcare and says that 44% of PAs were practicing in or interested in practicing in rural areas. The samereport notes that there is expected to be a surplus of PAs overall by 2038. According to a June 2020 report。
the researchers found that rural nurses on average: Were slightly older than urban nurses (43.5 versus 42.9 years) Had a shorter commute (22.9 versus 24.4 minutes) Had lower salaries ($51， and quality of healthcare personnel， including data on employment， rural LPNs are: Similar in age to urban LPNs The average age of rural LPNs is 47.2 years。
361 versus $55， high turnover， 2023RuralityFamily Medicine PhysiciansGeneral Internal Medicine PhysiciansObstetrics and Gynecology (OBGYN) PhysiciansNeonatal and Perinatal PhysiciansFemale Population of Childbearing Age， this growth may result in an even greaterneed for primary care physicians in rural communities. Rural Obstetrical Care Workforce The WWAMI Rural Health Research Center's policy brief， from the WWAMI Rural Health Research Center。