Article

Insight into U.S. pharmacy deserts

A state-by-state look at the impact of pharmacy closures across the United States

Currently, there are growing concerns in the U.S. over the limited access to pharmacies in certain areas. In the United States there are 150 counties where there is no pharmacy, and nearly 4.8 million people who live in a county where there’s only one pharmacy for every 10,000 residents or more [1]. In recent years, several factors, including reimbursement challenges, rising costs, changing consumer behavior, and staff shortages, have forced many pharmacies to close, further worsening access to pharmacy services.

Pharmacy closures can lead to a rise of pharmacy deserts, meaning that there is no retail pharmacy within 1 mile (in urban areas), 2 miles (in suburban areas), or 10 miles (in rural areas) from an individual household [2]. Households located in pharmacy deserts must travel farther to get prescriptions, vaccines, screenings, and other necessary services inherent for healthy communities.

Cencora’s Enterprise Data & Analytics team built a dashboard with data and insight into pharmacy deserts and other socially vulnerable communities across the United States.

Based on our data methodology, an estimated 30 million [3] people live in U.S. pharmacy deserts. Once formed, such deserts are not just disruptive to care but also dangerous. Dima Qato, PharmD, MPH, PhD, a well-known pioneer in pharmacy desert research and now an associate professor of pharmacy at University of Southern California, has long warned about the dangers of pharmacy deserts, such as medication discontinuation and non-adherence (even for lifesaving drugs like statins) [4].

Pharmacy deserts disproportionately impact populations with lower socio-economic statuses and racial and ethnic minorities from the Hispanic/Latino and Black or African American communities [5]. However, other dimensions, like disability status and English-language proficiency, can also impact population social vulnerability and the amount of additional support they could need [6].

Community pharmacies can be an important part of the solution, not only to address medication non-adherence, but also by serving more broadly as sites of care in their communities.

Alabama

541,872

Number of households in pharmacy deserts [1]

24.08%

Portion of census tracts classified as pharmacy deserts [2]

512,561

Number of households considered most vulnerable [3]

Alaska

153,803

Number of households in pharmacy deserts [1]

51.41%

Portion of census tracts classified as pharmacy deserts [2]

91,794

Number of households considered most vulnerable [3]

Arizona

775,796

Number of households in pharmacy deserts [1]

26.46%

Portion of census tracts classified as pharmacy deserts [2]

888,525

Number of households considered most vulnerable [3]

Arkansas

541,872

Number of households in pharmacy deserts [1]

24.08%

Portion of census tracts classified as pharmacy deserts [2]

512,561

Number of households considered most vulnerable [3]

California

2,522,974

Number of households in pharmacy deserts [1]

17.63%

Portion of census tracts classified as pharmacy deserts [2]

4,852,617

Number of households considered most vulnerable [3]

Colorado

624,061

Number of households in pharmacy deserts [1]

24.74%

Portion of census tracts classified as pharmacy deserts [2]

371,689

Number of households considered most vulnerable [3]

Connecticut

407,954

Number of households in pharmacy deserts [1]

26.50%

Portion of census tracts classified as pharmacy deserts [2]

323,677

Number of households considered most vulnerable [3]

Delaware

112,523

Number of households in pharmacy deserts [1]

24.05%

Portion of census tracts classified as pharmacy deserts [2]

69,880

Number of households considered most vulnerable [3]

Florida

2,642,069

Number of households in pharmacy deserts [1]

24.36%

Portion of census tracts classified as pharmacy deserts [2]

2,691,591

Number of households considered most vulnerable [3]

Georgia

1,206,731

Number of households in pharmacy deserts [1]

26.75%

Portion of census tracts classified as pharmacy deserts [2]

1,199,998

Number of households considered most vulnerable [3]

Hawaii

166,566

Number of households in pharmacy deserts [1]

27.33%

Portion of census tracts classified as pharmacy deserts [2]

88,367

Number of households considered most vulnerable [3]

Idaho

188,728

Number of households in pharmacy deserts [1]

25.44%

Portion of census tracts classified as pharmacy deserts [2]

115,267

Number of households considered most vulnerable [3]

Illinois

953,948

Number of households in pharmacy deserts [1]

18.16%

Portion of census tracts classified as pharmacy deserts [2]

1,133,124

Number of households considered most vulnerable [3]

Indiana

696,625

Number of households in pharmacy deserts [1]

24.06%

Portion of census tracts classified as pharmacy deserts [2]

490,995

Number of households considered most vulnerable [3]

Iowa

301,124

Number of households in pharmacy deserts [1]

19.87%

Portion of census tracts classified as pharmacy deserts [2]

135,167

Number of households considered most vulnerable [3]

Kansas

281,047

Number of households in pharmacy deserts [1]

23.16%

Portion of census tracts classified as pharmacy deserts [2]

192,724

Number of households considered most vulnerable [3]

Kentucky

280,219

Number of households in pharmacy deserts [1]

13.09%

Portion of census tracts classified as pharmacy deserts [2]

336,630

Number of households considered most vulnerable [3]

Louisiana

468,880

Number of households in pharmacy deserts [1]

21.61%

Portion of census tracts classified as pharmacy deserts [2]

614,142

Number of households considered most vulnerable [3]

Maine

104,127

Number of households in pharmacy deserts [1]

13.51%

Portion of census tracts classified as pharmacy deserts [2]

41,542

Number of households considered most vulnerable [3]

Maryland

470,588

Number of households in pharmacy deserts [1]

17.63%

Portion of census tracts classified as pharmacy deserts [2]

432,671

Number of households considered most vulnerable [3]

Massachusetts

470,588

Number of households in pharmacy deserts [1]

17.63%

Portion of census tracts classified as pharmacy deserts [2]

432,671

Number of households considered most vulnerable [3]

Michigan

829,556

Number of households in pharmacy deserts [1]

17.60%

Portion of census tracts classified as pharmacy deserts [2]

743,487

Number of households considered most vulnerable [3]

Minnesota

670,170

Number of households in pharmacy deserts [1]

26.96%

Portion of census tracts classified as pharmacy deserts [2]

286,232

Number of households considered most vulnerable [3]

Mississippi

244,045

Number of households in pharmacy deserts [1]

18.56%

Portion of census tracts classified as pharmacy deserts [2]

438,111

Number of households considered most vulnerable [3]

Missouri

559,271

Number of households in pharmacy deserts [1]

20.86%

Portion of census tracts classified as pharmacy deserts [2]

451,760

Number of households considered most vulnerable [3]

Montana

144,428

Number of households in pharmacy deserts [1]

31.35%

Portion of census tracts classified as pharmacy deserts [2]

40,084

Number of households considered most vulnerable [3]

Nebraska

163,694

Number of households in pharmacy deserts [1]

22.06%

Portion of census tracts classified as pharmacy deserts [2]

122,472

Number of households considered most vulnerable [3]

Nevada

289,474

Number of households in pharmacy deserts [1]

22.34%

Portion of census tracts classified as pharmacy deserts [2]

409,816

Number of households considered most vulnerable [3]

New Hampshire

181,740

Number of households in pharmacy deserts [1]

26.29%

Portion of census tracts classified as pharmacy deserts [2]

35,327

Number of households considered most vulnerable [3]

New Jersey

600,349

Number of households in pharmacy deserts [1]

14.95%

Portion of census tracts classified as pharmacy deserts [2]

842,235

Number of households considered most vulnerable [3]

New Mexico

319,081

Number of households in pharmacy deserts [1]

35.13%

Portion of census tracts classified as pharmacy deserts [2]

367,933

Number of households considered most vulnerable [3]

New York

824,787

Number of households in pharmacy deserts [1]

9.35%

Portion of census tracts classified as pharmacy deserts [2]

2,335,453

Number of households considered most vulnerable [3]

North Carolina

1,231,931

Number of households in pharmacy deserts [1]

24.93%

Portion of census tracts classified as pharmacy deserts [2]

1,250,811

Number of households considered most vulnerable [3]

North Dakota

94,822

Number of households in pharmacy deserts [1]

28.95%

Portion of census tracts classified as pharmacy deserts [2]

33,342

Number of households considered most vulnerable [3]

Ohio

1,082,006

Number of households in pharmacy deserts [1]

20.36%

Portion of census tracts classified as pharmacy deserts [2]

784,898

Number of households considered most vulnerable [3]

Oklahoma

341,888

Number of households in pharmacy deserts [1]

21.49%

Portion of census tracts classified as pharmacy deserts [2]

545,664

Number of households considered most vulnerable [3]

Oregon

384,392

Number of households in pharmacy deserts [1]

21.08%

Portion of census tracts classified as pharmacy deserts [2]

414,257

Number of households considered most vulnerable [3]

Pennsylvania

880,071

Number of households in pharmacy deserts [1]

15.29%

Portion of census tracts classified as pharmacy deserts [2]

838,025

Number of households considered most vulnerable [3]

Rhode Island

100,284

Number of households in pharmacy deserts [1]

18.80%

Portion of census tracts classified as pharmacy deserts [2]

97,390

Number of households considered most vulnerable [3]

South Carolina

674,530

Number of households in pharmacy deserts [1]

25.32%

Portion of census tracts classified as pharmacy deserts [2]

570,646

Number of households considered most vulnerable [3]

South Dakota

120,072

Number of households in pharmacy deserts [1]

33.88%

Portion of census tracts classified as pharmacy deserts [2]

64,740

Number of households considered most vulnerable [3]

Tennessee

656,493

Number of households in pharmacy deserts [1]

21.99%

Portion of census tracts classified as pharmacy deserts [2]

646,579

Number of households considered most vulnerable [3]

Texas

2,831,223

Number of households in pharmacy deserts [1]

24.09%

Portion of census tracts classified as pharmacy deserts [2]

4,149,195

Number of households considered most vulnerable [3]

Utah

287,997

Number of households in pharmacy deserts [1]

25.42%

Portion of census tracts classified as pharmacy deserts [2]

141,962

Number of households considered most vulnerable [3]

Vermont

30,569

Number of households in pharmacy deserts [1]

9.33%

Portion of census tracts classified as pharmacy deserts [2]

15,444

Number of households considered most vulnerable [3]

Virginia

692,634

Number of households in pharmacy deserts [1]

19.11%

Portion of census tracts classified as pharmacy deserts [2]

523,626

Number of households considered most vulnerable [3]

Washington

812,942

Number of households in pharmacy deserts [1]

26.57%

Portion of census tracts classified as pharmacy deserts [2]

604,053

Number of households considered most vulnerable [3]

West Virginia

118,129

Number of households in pharmacy deserts [1]

13.4%

Portion of census tracts classified as pharmacy deserts [2]

77,126

Number of households considered most vulnerable [3]

Wisconsin

595,564

Number of households in pharmacy deserts [1]

20.36%

Portion of census tracts classified as pharmacy deserts [2]

271,185

Number of households considered most vulnerable [3]

Wyoming

86,937

Number of households in pharmacy deserts [1]

33.13%

Portion of census tracts classified as pharmacy deserts [2]

24,942

Number of households considered most vulnerable [3]

FAQs

What data sources and methodology were uses to identify U.S. pharmacy deserts?

The dashboard utilizes publicly available demographic data from the Centers for Disease Control and Prevention (CDC), the U.S. Census Bureau, and other statistical data available from the United States Department of Transportation and the NTIA (National Telecommunications and Information Administration). The data is extracted from these sources “as-is” and incorporated into geospatial analysis with only minimal transformation necessary for analysis. Gaps in the data sets are shown as NULL in the dashboard. The dashboard also utilizes NCPDP (National Council for Prescription Drug Programs) data for pharmacy location and pharmacy type attributes for every pharmacy in the United States. The NCPDP pharmacy directory is a commercially available data set described as the most timely, complete, and accurate pharmacy database available. For purposes of Pharmacy Desert analysis, only open/active pharmacy locations and provider/dispensary types of “Chain”, “Retail” and “Independent” were included in the analysis. Other pharmacy types (mail order, government, specialty, LTC, etc.) were excluded from scope as our focus was understanding pharmacy access through typical channels open to the public.

Is the data real-time?

As of August 7, 2024, this dashboard displays the most recent demographic estimates and statistical data available, sourced from government data sets below. Government data provided is from the year 2020 or 2021 (see “year in application” in table below). The NCPDP pharmacy data is as of the 5/2/23 snapshot date.

Note: The NCPDP source provides data updates on a weekly cadence, however for the purposes of formalizing and validating geospatial results, the data has not been updated since the original date of our analysis.

Parent site	Data source	Year in application
CDC	ATSDR SVI (Agency for Toxic Substances and Disease Registry Social Vulnerability Index) data	2020
CDC	CDC PLACES data	2020
Census	Census block data	2020
Census	ACS (American Community Survey) data; Published estimates based on 1-year or 5-year data collection. For more details on ACS data collection please visit: https://www.census.gov/content/dam/Census/programs-surveys/acs/about/ACS_Information_Guide.pdf	2020
Census	Disability data	2021
Census	Language data	2021
Census	Health Insurance data	2021
US Government	Bus stop data: United States Department of Transportation	2020
US Government	Broadband data: NTIA (National Telecommunications and Information Administration)	2021
NCPDP		02/05/2023

*Statistics calculated as of May 24, 2024*

References

[1] Kim, Soo Rin, et al. 'Pharmacy deserts' are new front in the race to vaccinate for COVID-19. ABC News. 6 March 2021. Accessed 8 Aug 2024. Available at: https://abcnews.go.com/Health/pharmacy-deserts-front-race-vaccinate-covid-19/story?id=76201564

[2] Anderson, Maia. How pharmacy deserts are formed. Healthcare Brew. 15 Mar 2023. Accessed 7 Aug 2024. Available at: https://www.healthcarebrew.com/stories/2023/03/15/how-pharmacy-deserts-are-formed .

[3] Cencora internal data analysis; Analytics are derived from available public and commercial third-party sources including the U.S. Census, American Community Survey, and NCPDP.

[4] Qato, Dima M, et al. Association Between Pharmacy Closures and Adherence to Cardiovascular Medications Among Older US Adults. JAMA Network Open. 19 Aug 2019.

[5] Accessed 7 Aug 2024. Available at: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2730785
Guadamuz, J, et al. Fewer Pharmacies In Black And Hispanic/Latino Neighborhoods Compared With White Or Diverse Neighborhoods, 2007–15. Health Affairs. 3 May 2021.

[6] Accessed 7 Aug 2024. Available at: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2020.01699
CDC/ATSDR Social Vulnerability Index (CDC/ATSDR SVI): Overview. Agency for Toxic Substances and Disease Registry. 14 June 2024. Accessed 7 Aug 2024. Available at: https://www.atsdr.cdc.gov/placeandhealth/svi/index.html

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