Data Source

All data comes directly from the HRSA Data Warehouse, maintained by the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS). This is the authoritative federal source for healthcare shortage area designations.

What We Map

• Health Professional Shortage Areas (HPSAs): Geographic, population-group, and facility-based designations identifying areas with insufficient healthcare providers. HPSAs are designated for three provider types: primary care (physicians), mental health (psychiatrists and other mental health professionals), and dental care (dentists). Each HPSA receives a severity score on a 0 to 25 scale (0 to 26 for dental), where higher scores indicate greater shortage severity and higher priority for federal resources. See the HRSA HPSA designation guide.
• Medically Underserved Areas (MUAs): Designations identifying areas with a shortage of personal health services, calculated using the Index of Medical Underservice (IMU). The IMU is a composite score based on four variables: the ratio of primary care providers to population, the infant mortality rate, the percentage of the population with incomes below the federal poverty level, and the percentage of the population aged 65 and older. An IMU score below 62.0 qualifies an area as medically underserved.

Coverage

PlainHealthAccess maps shortage area designations across 3,291 counties in all 50 states and US territories, covering all three HPSA designation types (primary care, mental health, dental) and MUA designations.

Processing Pipeline

1. Download raw HPSA and MUA designation files from the HRSA Data Warehouse
2. Parse designation type, HPSA score, designation status (active/withdrawn), and geographic identifiers (county FIPS codes)
3. Map designations to counties and states using FIPS codes
4. Compute county-level summaries: active HPSA count, population-under-shortage estimates, MUA designation status
5. Aggregate to state-level: total HPSAs, total population in shortage areas, count of counties with at least one designation
6. Load into our geographically indexed database

Corpus-relative placement

County profiles compare the number of current, active HPSA designation records assigned to that county with the same count for every real five-digit county FIPS in the database, including counties with zero active records. The displayed percentile is the share of counties with a strictly lower count, so tied counties share the same percentile. A second peer position ranks the same count against real counties in that county's state or territory; tied counts share a competition rank. A zero-active county is reported as tied in the lowest-volume tier rather than given a misleading percentage label.

State profiles first count distinct active HRSA designation IDs, then divide by the summed county resident population and report designations per 100,000 residents. That resident-population denominator excludes Connecticut's superseded legacy county FIPS (09001–09015): after CT replaced those counties with planning regions in 2022, HRSA records still reference both schemes, so summing every CT county row would double-count residents and understate density by about half. State shortage-share percentages in the database use the same exclusion. States and territories with usable population data are ranked from highest to lowest density; the page also reports the corpus median and the share with a lower density. The lead's highest, upper-middle, lower-middle, and lowest density tiers are equal rank quarters of that same usable-population corpus. A place without usable population data receives no placement rather than an estimate.

These are descriptive placements, not composite scores. Designations can overlap, and designation volume is not a count of people, providers, appointment availability, care quality, or outcomes. Per-capita state density also reflects rural geography because sparsely populated areas may require more separate designations. The comparisons use the same current HRSA records and source vintage shown on each profile.

HPSA Scores

HPSA scores express shortage severity within HRSA's designation process. Higher scores indicate greater need within the relevant federal criteria. For primary care, scores range from 0 to 25; for dental, 0 to 26; for mental health, 0 to 25. HRSA uses discipline-specific criteria that include provider-to-population ratios and other designation inputs; a score is not a measure of a person's appointment access or care quality.

Release comparisons

The release-change report compares two retained HRSA HPSA source snapshots by stable designation ID. Because one designation can repeat across several county relationship rows, each snapshot is first collapsed to one record per ID. An ID is excluded if its repeated rows disagree on a non-county field such as name, type, status, score, state, population served, or providers needed; the exclusion count is disclosed on the report.

“Added” and “absent” identify IDs found in only one export. An absent ID is not automatically classified as withdrawn. “Newly designated” and “no longer designated” are reserved for IDs present in both snapshots whose recorded status crossed the designated boundary. Score and provider-need directions likewise use only matched IDs with values in both snapshots.

The comparison is national and state-level. It does not publish county deltas because the earlier retained snapshot did not preserve every multi-county relationship, so a county comparison could invent change. These two snapshots describe changes in HRSA's published records; they do not establish cause or measure appointment availability, care quality, or patient outcomes.

Population denominators

County resident population used in ratios and per-capita placement comes from U.S. Census reference files shipped with the ETL, not from HRSA's HPSA "population served" fields (those are service-area figures that overlap across designation types and multi-county catchments). Most counties use 2020 Decennial Census county population. Connecticut's nine planning-region FIPS (09110–09190) use ACS 2018–2022 5-year total population because the 2020 Decennial county file does not carry those newer geographies. Those two vintages are never mixed inside a single CT state total: state and national resident-population sums keep only the planning-region rows for Connecticut and omit the eight legacy county FIPS that would otherwise double-count the same people.

National "share of residents in geographic shortage counties" divides the de-duplicated shortage-county resident population (from state aggregates) by that same CT-safe national resident total. Individual county pages may still show a legacy CT FIPS when HRSA still indexes designations to it; that page reports that geography's own Census population and is not used as the state denominator.

Data Vintage and Update Frequency

HRSA reviews and updates HPSA and MUA/P designations on a rolling basis. PlainHealthAccess records the source vintage used for each portal snapshot and does not claim that its pages are a real-time designation lookup. Use HRSA's official tools when a current designation status matters.

Accuracy Commitment

PlainHealthAccess reproduces HRSA designation data exactly as published. HPSA scores, designation types, population estimates, and geographic assignments are presented without modification. When a county has multiple overlapping HPSA designations (which is common, a county can have separate primary care, mental health, and dental HPSAs, each covering different geographic areas or populations), all active designations are reflected in the county profile. Withdrawn or expired designations are excluded.

Standards & References

HRSA's shortage-designation guidance defines the HPSA and MUA/P categories used here and explains which federal programs use them. Adjacent public-health sources answer different questions: the Centers for Disease Control and Prevention (CDC) publishes public-health information, and the Centers for Medicare & Medicaid Services (CMS) administers separate physician-payment programs, including HPSA bonuses. Neither is an input to this portal's HPSA/MUA figures or rankings. Program eligibility, provider availability, coverage, and clinical decisions require the current rules and records from the relevant agency, provider, insurer, or program administrator. PlainHealthAccess does not issue clinical, eligibility, or program-award guidance.

Limitations

• HRSA reviews designations on an ongoing basis; actual provider availability and healthcare access conditions in a community may differ from the most recently published designation data.
• Geographic HPSA designations represent entire service areas and may not capture shortage conditions within smaller sub-county areas or individual neighborhoods.
• Population-group HPSAs (designated for specific demographic groups such as migrant farmworkers or low-income populations) may not be fully reflected in county-level summaries that focus on geographic designations.
• The number of HPSA designations in a county does not directly measure healthcare access quality, designations reflect provider-to-population ratios and other factors, not patient outcomes or satisfaction.
• This data is for informational purposes and does not constitute medical advice. PlainHealthAccess is not affiliated with HRSA, HHS, or any government agency.

Contact

Questions about our methodology? Contact us.