America’s Actual Healthcare Desert: An Infrastructure That Has Run Dry

You’ve heard of food deserts—areas where fresh, affordable food is hard to find. But what about healthcare deserts? This crisis leaves millions without timely, quality medical care, and many starving for access. Lack of access impacts 80% of U.S. counties, touching over 120 million people, meaning 1 in 3 Americans lack adequate healthcare. But this traditional definition of underserved America only scratches the surface. The reality is far more severe.

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A healthcare desert isn’t defined by geography alone. It reflects a complex web of barriers that keep people at a dangerous distance from the care they need. According to experts, a “medical desert” is an area where population healthcare needs are partially or entirely unmet due to inadequate access or poor-quality care. These gaps can stem from shortages of clinicians, limited facilities, long wait times, high costs, or sociocultural barriers. This is a man-made crisis—and it demands urgent attention.‍

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‍‍From agonizingly long wait times for a basic checkup to entire counties without a single hospital or pharmacy, the desert’s cactus pricks the population disproportionately, impacting our most vulnerable communities.

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‍A Problem That Spans Communities

‍In the 15 largest U.S. metro areas, the average wait to schedule an appointment is now a staggering 31 days, with specialist waits stretching as long as 67 days. This is more than an inconvenience—it’s a critical barrier to preventive care and early intervention, allowing treatable conditions to escalate into emergencies. The American Association of Medical Colleges (AAMC) projects a national physician shortage of 139,000 by 2033, further compounding these already dire delays.

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‍Structural Fallout‍

Beyond physician access, the healthcare infrastructure itself is eroding. Over 28 million Americans live more than 30 minutes from the nearest hospital. Nearly 44 million Americans live in a designated primary care shortage zone, and 78 million Americans reside in communities without access to a low-cost care center.

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‍An Uneven Burden‍

Healthcare deserts hit underserved populations hardest. Low income, lack of insurance, and limited internet access deepen existing disparities. These access gaps directly worsen chronic disease outcomes—with diabetes rates 30% higher among Native American and Latino populations compared to White Americans. Six conditions account for 86% of excess mortality among Black Americans, and nearly 45% of Black deaths before age 70 could be prevented with equitable access to quality care.

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Why It Persists: Systemic Barriers and Policy Concerns‍

The problem persists—but why? The causes are complex, require innovation, and cannot be solved with a single fix. Addressing healthcare deserts will require innovation, sustained investment, and new delivery models. Workforce shortages, infrastructure challenges, fragmented systems, policy constraints, and chronic underinvestment remain deeply embedded barriers to equitable healthcare access.

• Workforce Distribution: Healthcare providers remain heavily concentrated in urban centers, making recruitment and long-term retention in rural and underserved communities extremely challenging.

• Infrastructure Costs: Building, staffing, and maintaining healthcare facilities in underserved areas requires significant upfront capital and long-term financial commitment.

• Systemic Inefficiencies: Fragmented healthcare systems, administrative complexity, and rising demand contribute to persistent delays and strained resources.

• Sociocultural Obstacles: Language barriers, cultural differences, and systemic discrimination create additional hurdles, requiring tailored, community-centered approaches to care delivery.

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The Human Cost: Starving for Care‍

Behind every statistic is a human story—real lives shaped by the daily realities of living in a healthcare desert. These narratives reveal the profound personal toll of limited access to care, where routine medical needs become ongoing struggles with life-altering consequences.

Barbara Kingsolver—acclaimed author and longtime resident of rural Appalachia—is no stranger to the realities of healthcare deserts. In her novel Demon Copperfield, she illuminates the severe lack of meaningful healthcare access in economically distressed communities and the grave challenges that follow.

One character in Demon Copperfield, Dori, is forced to quit school to care for her ailing father because no local medical options exist. With her mother deceased, Dori must drive her father across state lines nearly every week to reach heart and lung specialists. As Kingsolver reflects, “That’s the case. Many times, I’ve driven to doctors who lived four or five hours away in the nearest city.”

Though Demon Copperfield portrays the devastating consequences of healthcare deserts through fiction, the crisis is painfully real—and millions of Americans face these barriers to care every single day.

Take Tchenavia Atkinson, for example. Hardee County, Florida—home to just 25,000 residents—has only one hospital, leaving basic healthcare access severely limited. Tchenavia shares that even routine care requires traveling to Lakeland, more than an hour away, turning everyday medical needs into time-consuming and burdensome journeys.

Barbara Kingsolver echoed this reality in a recent interview with Ezra Klein, highlighting how rural healthcare challenges are often invisible to those in urban areas. As she explains, “I think one of many things people in cities don’t understand is how hard it is for us to get to see doctors in the country. This is something that’s just—what we live with here. There are not enough physicians to meet our needs. And so you have to wait a long time to get into one. And that doctor doesn’t have the chance to follow you up. He’s got one chance to help.”

The lived reality of healthcare deserts is pervasive and deeply human—posing daily challenges that millions of Americans face quietly, and that many of us never have to consider.

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A Watering Hole Emerging

As traditional healthcare systems struggle to reach underserved communities, new solutions are stepping in to fill the gap. From mobile care models to evolving digital tools, innovation is reshaping how access can—and should—work.

Addressing healthcare deserts requires a multi-pronged approach that combines community-based care with the right technology:

• Mobile Clinics: Mobile care brings essential services directly into underserved areas, removing geographic barriers. While impactful, these programs can’t always provide the consistent, on-demand access patients need when care is urgent or ongoing.

• Telehealth: Telehealth expanded rapidly during the COVID-19 pandemic and showed real potential to connect patients and providers remotely. However, long-term adoption has been uneven. Many communities lack reliable broadband for a viable video appointment, and virtual visits often fall short when diagnostic tools or vitals are required. With nearly 70 million people without adequate internet access, digital access gaps remain a major challenge.

• Public-Private Partnerships: Models like the “hub-and-spoke” approach, highlighted by healthcare consultant Rita Numerof, offer a promising path forward, particularly in rural settings. By linking local care sites such as pharmacies or small clinics to larger specialty hubs through technology, these partnerships help create a more connected and resilient care ecosystem.

Quenching the Thirst

This is where OnMed's CareStation™ enters the picture. As an 8’ x 10’ Clinic-in-a-Box, it delivers everyday healthcare access almost anywhere there’s a power outlet. Designed to function as a first point of care, the OnMed CareStation is poised to become a foundational element of America’s public health infrastructure.  

By combining the comprehensive care, vitals monitoring, diagnostic tools, and human compassion of an in-person clinic with the speed, scalability, and reach of virtual care, OnMed amplifies the strengths of both models—while eliminating the limitations that have stalled each on their own. This is true hybrid care, delivered in ways traditional clinics and telehealth platforms simply can’t match.  

OnMed serves as a critical connective layer in America’s healthcare ecosystem, enabling meaningful cost savings while dramatically expanding access—and ensuring individuals receive timely, comprehensive, and consistent care where they live, work, and learn.  

Healthcare access shouldn’t require trekking miles through a healthcare desert. OnMed shows up where care is needed most—because everyone, everywhere, deserves to be cared for.

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