Understanding Medically Underserved Areas and Health Professional Shortages

What is a medically underserved area (MUA)? What about a medically underserved population? How do they differ from a health professional shortage area (HPSA)? To answer these questions, we turn to guidance from the United States Department of Health and Human Services Division of Health Resources and Services Administration (HRSA). HRSA is charged with collecting data about the availability of medical services and prevalence of medical professionals across the country. Using an Index of Medical Underservice, HRSA defines MUA’s and MUP’s on a quarterly basis each year. Presently, Community Commons has MUA and HPSA data as recent as April of 2016.

Index of Medically Underserved

Four variables are used for the Index:

  1. Ratio of primary care physicians per 1,000 population
  2. Infant mortality rate
  3. Percentage of the population with incomes below the poverty level
  4. Percentage of the population age 65 or over

These four variables are calculated and weighted to determine an index score of an area or a population.

Medically Underserved Areas

The key word here is “area.” Applying the Index score to an area is how medically underserved areas are defined. Areas can consist of:

  1. An entire county (non-metropolitan)
  2. Groups of contiguous counties (non-metropolitan)
  3. Groups of census tracts (metropolitan only)

Medically Underserved Popuations

Alternatively, MUP’s are determined by applying an index score to a population within a specific area. Population groups included in MUP calculations must have some sort of economic barriers, for example:

  1. Low-income populations
  2. Medicaid eligible populations
  3. Groups who have cultural or linguistic barriers – i.e. – English as a second language

MUAs and MUPs

Learn more about MUA and MUP indices and data at the Health Resource and Services Administration website.

Health Professional Shortage Areas

HPSA’s are broken down into three main categories:

  1. Primary care physicians
  2. Dental care providers
  3. Mental health providers

Instead of using multiple variables and an index to determine shortage areas, HPSA’s use a ratio – total health professionals : total population. The ratios for each category of health professional are:

  1. Primary care – 1 primary care physician per every 3,500 people
  2. Dental care – 1 dentist per every 5,000 people
  3. Mental health care – 1 psychiatrist per every 30,000 people


Check out the HRSA “Find Shortage Areas by Address” tool to explore shortage areas.


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