Arizona Center for Rural Health brief highlights worsening workforce shortages in rural areas, citing growing and aging patient population


Soraya Marashi


The Arizona Center for Rural Health (AzCRH)’s recently released Physician Specialty Workforce Profile reveals the significant physician shortages in rural areas of the state. 


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Currently, Arizona meets only 37% of its primary care needs and needs 653 additional primary care providers to address this shortage. According to data from 2019 that AzCRH analyzed this brief, the ratio of physicians in the state was 243.6 per 100,000 people compared to the national median ratio of 272.0 physicians per 100,000 people. For rural areas of the state, the ratio of physicians per 100,000 people was 129.9 compared to 254.0 physicians per 100,000 people in urban areas of the state.

The brief also notes that while 10.2% of Arizonans live in rural areas, only 5.5% of physicians practice in rural areas in the state. 

The chart below lists the number of professionals with undergraduate medical education in each of the top 5 categories of providers.


Image: Arizona Center for Rural Health


Daniel Derksen, MD, the Walter H. Pearce Endowed Chair & Director at AzCRH, and Bryna Koch, Research Program Administrator at AzCRH, said this shortage is growing due to significant population growth occurring in the state, as well as an aging population. 

Derksen emphasized the challenges physician shortages brought upon health facilities during the pandemic. 

“When the pandemic hit [its] peak at various times, we saw in rural areas, sometimes when a single Intensive Care Unit nurse or a pulmonary lung specialist became ill or passed away from complications of COVID, that the ability of the rural infrastructure to meet the demand [of care] was severely strained and sometimes exceeded,” he said.

Koch highlighted the costs of these shortages on Arizona’s rural communities.

“The further away the care is, the less likely you are to receive care in a timely fashion. You’re talking about sparse populations and long travel times,” she said. “That distance disproportionately, even within rural [areas], affects people with lower incomes, lower literacy levels, those who have fewer resources to rely on, like access to a car … Having to travel for care really can increase some of the economic [and] social costs for an individual or families.”

Derksen said state efforts to encourage primary care providers to practice in federally designated Health Professional Shortage Areas (HPSAs) or Arizona Medically Underserved Areas (AzMUAs), such as the Arizona State Loan Repayment Program, are key strategies to addressing these shortages.

“The data shows that when you train health professionals, whether it’s a nurse practitioner, MD, or [doctor of osteopathic medicine] in a rural or underserved community, or if they grew up in a rural or underserved community, they’re much more likely to go into practice there,” he said.

“We’re one of the top states as far as the percentage of our population that’s American Indian. We have a very high percentage of our population that’s Hispanic Latino, and the evidence is quite clear that Hispanic Latino populations [and] American Indian populations tend to go into the specialties that are most needed, such as primary care, but also go into areas where they’re most needed and back into communities.”