Local Pharmacy Access in the United States Significantly Lower in Rural Areas


Researchers collected data to measure inequities in pharmacy access across the country.

In a study assessing drive time to local pharmacies across the United States, researchers found that urban and suburban locations provided significant access to at least 1 pharmacy within a 10- or 20-minute drive, while rural areas had the lowest share of at least 1 nearby pharmacy.1 Results of this study were published in the Journal of the American Pharmacists Association.1

“Community pharmacies play an important role in access to health services given that they dispense medication and offer immunization, medication consultations, patient education, and many other services,” wrote the authors of the study.1 “Patients also visit pharmacies 1.5 to 10 times more often than primary care physicians.”

Key Takeaways

  • Researchers collected data on the number of pharmacies within a 10- and 20-minute drive time in rural, suburban, and urban areas across the United States.
  • Suburban and urban areas had a significantly higher number of accessible pharmacies within 20 minutes, compared with a lower amount in rural areas.
  • Researchers highlighted the need for better health care services and resources in rural locales.

Authors also pointed out the continuously low use of mail-order pharmacies—more than 80% of people prefer going to their local pharmacy instead—as further solidifying pharmacies’ role in providing health care.

However, access to pharmacies in the United States remains staggered.

Because there is a lack of evidence around the ways that drive time affects nationwide pharmacy access, researchers sought to collect the most accurate pharmacy access data across rural, suburban, and urban areas, defined as census tracts, and determined inequity in pharmacy access by neighborhood type.

Pharmacy storefront | image credit: MP Studio - stock.adobe.com

Pharmacy storefront | image credit: MP Studio - stock.adobe.com

Community pharmacy data were obtained through the National Council for Prescription Drug Programs (NCPDP) 2015 dataset; investigators also gathered street-level data for geocoding and network analysis and used the 2020 Decennial Census to collect census block boundaries and population densities. Census tract data were categorized into urban, suburban, and rural.

READ MORE: Senate Introduces Bipartisan Bill to Ensure Continued Access to Pharmacist Care, Services for Seniors

Pharmacy Access in Rural, Suburban, and Urban Census Tracts

A total of 83,224 census tracks were included in the researchers’ analysis; 36.2% were rural, 21.5% were suburban, and 42.3% were urban.

In an analysis of pharmacy access, researchers found that 92.4% and 88.7% of urban and suburban census tracts, respectively, provided access to 1 or more pharmacies within a 10-minute drive, while just 60% of rural tracts had access to 1 or more pharmacy. And for pharmacies within a 20-minute drive, 96.6% and 94.5% of urban and suburban tracts, respectively, had access to 1 or more pharmacy while just 82.6% of rural tracts had access to at least 1 pharmacy per 10,000 people.1

Furthermore, when assessing the disparity between urban or suburban tracts and rural tracts, researchers found that 40% and 17.4% of rural tracts had access to less than 1 pharmacy within a 10- and 20-minute drive respectively. Only 7.6% and 11.3% of urban and suburban tracts had less than 1 pharmacy within 10 minutes respectively; 3.4% and 5.5% of urban and suburban tracts had less than 1 pharmacy within 20 minutes respectively.1

Finally, researchers identified the percentage of tracts that had access to 2 or more pharmacies within 10 and 20 minutes, what the authors defined as “convenient access.”Again, suburban and urban tracts were found to have the highest number of pharmacies with above 45% of both tracts having access within a 10- or 20-minute drive. Among rural tracts, 39% had convenient access to local pharmacies within a 10-minute drive.1

However, the researchers noted, convenient access remains low across all census tracts.1

“Pharmacy access is still limited when it comes to convenient access given that only approximately 45% of tracts have access to at least 2 pharmacies per 10,000 people within a reasonable drive time, limiting people’s choices,” continued the authors.1

The Need for Better Pharmacy Access in Rural Areas

With relatively easy access to local pharmacies in urban and suburban locales, researchers highlighted the growing need for health care access—aside from local pharmacies—in the United States.

“Treatment programs for opioid use disorders are geographically inaccessible. In fact, the average drive time to pharmacies is lower than opioid treatment programs,” wrote the authors, supporting the claim that better pharmacy access can lead to an increase in other health care services.

They also discussed opportunities for local pharmacies to increase food access and ameliorate diet-related health outcomes.

READ MORE: Food Is Medicine: Pharmacists Can Advance Policies for Healthier Communities

“Accurate measurement of pharmacy access is critical to appropriate resource distribution, pharmacy planning, and effective design of policy interventions to improve health care access,” the researchers concluded. By addressing the limitations of previous research on the accessibility of pharmacy and “highlight[ing] the magnitude of [the] pharmacy access problem in rural census tracts,” researchers highlighted the ways in which pharmacy access is still limited in the contiguous United States.

“Future efforts should improve pharmacy access in rural areas and consider expanding convenient access,” the authors concluded.1

1. Sharareh N, Zheutlin A, Qato D, Guadamuz J, Bress A, Vos R. Access to community pharmacies based on drive time and by rurality across the contiguous United States. J Am Pharm Assoc. 2024;64(2):476-482. doi.org/10.1016/j.japh.2024.01.004
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