Why Pharmacy is a Cornerstone of Public Health in the US

Rural pharmacists have been filling gaps in health care infrastructure for decades without recognition or adequate reimbursement. Appalachian pharmacist Jennifer Hammons, PharmD, DrPH, director of rural health advancement at the Appalachian College of Pharmacy, says the system has to stop treating pharmacy like a product and start treating it like the public health service it has always been.

“Rural pharmacies aren't struggling because our pharmacies aren't innovative enough or because the communities no longer need it,” Hammons told Drug Topics®. “We're struggling because we've built a system that expects us to provide health care while compensating us like we're selling a product.”

In this week’s episode of the Over the Counter podcast, Hammons joins us to talk about the wonderful work being done in rural pharmacies and the high-level change needed to push the greater profession forward for the betterment of US health care. From her perspectives in one of the most rural locales in the US to her immense work in both the pharmacy and public health spaces, learn from Hammons about her approach to rural and public health care.

READ MORE: Student Pharmacists Can Actively Drive Community Health

Beyond Dispensing Medications to Community-Centered Care

Hammons emphasizes that medications serve as one of the most vital public health tools available, yet their efficacy hinges on whether patients can access, afford, and comprehend them. Pharmacists frequently identify critical everyday patient obstacles that remain invisible within the EHR, including prohibitive copays, inadequate transportation, or lack of reliable internet for digital health management.

This perspective aligns with broader public health principles that focus on protecting entire population groups by delivering health education, preventive services, and routine disease monitoring. Federal strategies from the CDC highlight how pharmacists leverage their unique accessibility to address social determinants of health, offering tailored interventions for chronic conditions such as cardiovascular disease and diabetes.^1,2

By recognizing challenges related to medication adherence and affordability early, pharmacy professionals are helping bridge the divide in real time between clinical treatment plans and actual patient behavior in local settings.²

Filling Critical Care Gaps in Underserved Regions

The vital necessity of this care model is most evident in rural areas across the US, where severe provider shortages leave only about 13 physicians for every 10,000 residents. In many remote towns, new patients face average wait times exceeding 30 days to schedule a primary care appointment.³

Because nearly 9 in 10 Americans live within 5 miles of a pharmacy, community pharmacists frequently serve as the initial or sole health care professional available to local residents. Innovative programs are transforming local drugstores into comprehensive care hubs where patients can receive point of care testing, conduct virtual physician visits, and obtain immediate treatments in a single trip.

Across rural communities, pharmacists can also leverage deep local trust by partnering with community groups and faith organizations to deliver vaccinations and health screenings directly to residents. Educational initiatives further strengthen this rural health workforce by embedding pharmacy students directly into interprofessional rural practice rotations alongside medical trainees.^2,4

Overcoming Policy Hurdles and Financial Strain

Despite providing indispensable community services, rural pharmacies face persistent economic threats that jeopardize their long-term viability.⁴

Hammons stresses that these facilities are not struggling due to a lack of innovation but because payment structures compensate them as product vendors rather than health care service providers. Over 2 decades of pressure from pharmacy benefit managers (PBMs) and reimbursement shifts led to a nearly 10% drop in rural pharmacies between 2003 and 2021.

When a rural pharmacy closes, residents are often left without medication access within a 45-mile radius. To preserve this essential infrastructure, health leaders advocate expanding collaborative practice agreements that allow pharmacists to manage chronic conditions and deliver formal clinical services. According to Hammons, treating pharmacy as a core public health infrastructure on par with roads, broadband, and emergency services is essential for building a resilient national health care system.²

READ MORE: Public Health Resource Center

REFERENCES

1. Public health. American Association of Colleges of Pharmacy. Accessed September 25, 2026. https://pharmacyforme.org/careers-in-pharmacy/public-health

2. Public health strategies for pharmacists to improve health for people with chronic disease. CDC. September 8, 2026. Accessed September 25, 2026. https://www.cdc.gov/cardiovascular-resources/php/public-health-strategy/index.html

3. How pharmacies support residents in rural communities. UnitedHealthCare. October 20, 2025. Accessed September 25, 2026. https://www.uhc.com/news-articles/community/pharmacies-rural-care

4. Zahnd W. Rural pharmacies provide multi-faceted value to rural communities. Rural Health Information Hub. July 12, 2023. Accessed September 25, 2026. https://www.ruralhealthinfo.org/rural-monitor/rural-pharmacies