Researchers analyzed data from every county in the US and aimed to address the association between high social vulnerability and pharmacy deserts.
In US counties where patients are experiencing high social vulnerability paired with a low primary care practitioner (PCP) density, pharmacy deserts were significantly more prominent. With an association between social vulnerability and chronic conditions as well, researchers’ findings highlighted the need for better access to both pharmacies and primary care in underserved communities.
“Nationally, 15.8 million (4.7%) of all people in the United States live in pharmacy deserts, spanning urban and rural settings in all 50 states. On average, communities that are pharmacy deserts have a higher proportion of people who have a high school education or less, have no health insurance, have low self-reported English ability, have an ambulatory disability, and identify as a racial or ethnic minority. While, on average, pharmacies are the most accessible health care setting in the United States, many people still do not have access to them,” wrote authors of a study published in Health Affairs Scholar.1
In the past 3 years alone, there have been major shake-ups on the corporate level for some of the largest pharmacy chains in the US. In 2021, CVS announced it would be closing about 900 stores, and in 2023, Rite Aid filed for bankruptcy, leading to 520 store closures within a 7-month span.2,3
“Retail pharmacy chains have been closing thousands of locations throughout the US, possibly playing a role in health care gaps. Similar to the concept of food deserts, areas in which medications are harder to obtain have been deemed pharmacy deserts,” wrote authors of a research letter published in JAMA Network Open.2
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In their research letter, the authors identified 3 main data points to address the association between social vulnerability and pharmacy access. First, they gathered data for pharmacy desert density, where a county was determined to have a high density if the number of pharmacy deserts per 1000 individuals was in the 80th percentile or higher.
Next, they used the social vulnerability index (SVI) to measure the extent of underserved communities across each county. And finally, they calculated the PCP (family medicine, general practice, general internal medicine, general pediatrics physicians) density by finding the number of PCPs per 10,000 individuals.
With 3143 counties included in the study, 46% had at least 1 pharmacy desert. Among the 1447 counties with at least 1 desert, 56.5% had low pharmacy desert density and 43.5% had high pharmacy desert density. Regarding PCP density in relation to pharmacy desert density, counties with higher pharmacy desert density were more likely to experience low PCP density, compared with areas of low pharmacy desert density.2
“Patients in higher SVI counties with a lower PCP density had a 30% to 40% higher likelihood to reside in regions with pharmacy deserts. These findings highlight how disparities compound to create barriers to access basic health care,” they wrote.
With more pharmacy deserts arising, stemming from the closure of hundreds of retail drug stores, compounded with a lack of PCP access in socially vulnerable areas, there is an unprecedented need for better health care in underserved communities. With the main focus of the study being on individuals’ PCP and pharmacy access, researchers were also sure to discuss how chronic conditions were associated with socially vulnerable individuals.
“There is an association between SVI and number of chronic conditions. For example, diabetes and hypertension tend to be more prevalent among Black patients living in rural areas,” they continued.2
Adding to the health care burdens of individuals in socially vulnerable locations, there are patients all across the US experiencing chronic diseases with limited access to both pharmacies and primary care facilities. While there is already extensive literature identifying the prominent association between health care access and socially vulnerable individuals, authors of this research letter suggested yet again the need for better health care services across the country.
“This finding suggests that people already at highest risk of being neglected by the health care system are most likely to be affected by pharmacy closures. More efforts are needed to maintain access to pharmacies in underserved communities,” concluded the authors.2
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