Why do medically underserved communities exist?

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Hzreio

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Is it because these areas are considered "less desirable" to practice in, resulting in physician shortage? Or are there other factors that play into it? I apologize if this post seems ignorant as I am trying to better educate myself.
 
why is there a poverty gap in America?

edit: There are underserved areas in part because many are rural (where physicians might be less inclined to practice) or in historically impoverished locations due to systemic racism in America.
 
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Is it because these areas are considered "less desirable" to practice in, resulting in physician shortage? Or are there other factors that play into it? I apologize if this post seems ignorant as I am trying to better educate myself.
Midwest some people just don’t have nearby hospitals or clinics and they have to drive like hours.
 
Is it because these areas are considered "less desirable" to practice in, resulting in physician shortage? Or are there other factors that play into it? I apologize if this post seems ignorant as I am trying to better educate myself.
Why do poor people exist?

Medicare/Medicaid also don't pay as well as patients with insurance.
 
Is it because these areas are considered "less desirable" to practice in, resulting in physician shortage? Or are there other factors that play into it? I apologize if this post seems ignorant as I am trying to better educate myself.
There's a lot of research out there, but if you want to see some reports from governmental agencies (they also explain what defines a medically underserved area), you can check out the Agency of Healthcare Research and Quality. Health People 2020 has a pretty good breakdown of what their goals are in reducing medical disparity and Health Resources and Service Administration has maps and explains how they designate an area as underserved. Here is also an article I like about how medical school curriculum and incorporation of free clinics can help reduced disparities.
 
I work in the ED of a rural critical care hospital, and almost all the physicians commute at least an hour from the nearest “big” city each day. We have very few PCPs in our area and the OB unit was shut down in recent years (meaning women have to travel ~45 min to properly deliver) for this same reason. I’m not sure what/how much other factors come into play, but desirability of living in the area definitely makes an impact.
 
I’m from a really small town (2,500 people) surrounded by thousands of acres of farming land and protected forest. We have a small hospital with family docs for the day to day stuff, but you’re going to drive 30-120 miles to deliver a baby, have surgery or see a specialist.

The area is poor, the public schools aren’t good and you have to drive anywhere from an hour to 2 hours to get to a major airport. There isn’t much in the way of entertainment or culture unless you count local sports (high school football, baseball & softball), local pageants and church.

We have a county fair every year where the local 4-H and FFA kids show livestock. We hunt, fish and get together with friends and grill for fun. To be a doctor here is to be beloved, if you commit to the community and they know you’re there to stay. It is a wholehearted commitment though, because you’re going to see your patients at the grocery store, the baseball field and at church every week. It’s not easy on the community to have fewer medical resources, and it’s not easy on the docs who have to make do with what they’ve got.
 
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