Special Report
Amid Pandemic, These Are the Counties With the Fewest Hospitals
Published:
The third wave of COVID-19 patients is worse than any before. The surge is already larger than what we saw in the spring and summer, and it’s not slowing down. Hospitals all over the country are overwhelmed and many are at a breaking point. On a daily basis doctors and nurses are working on the front lines of what is being described as a medical war zone. For people without health insurance, hospitals provide some sense of security as they are legally required to admit a patient in emergency situations.
24/7 Tempo reviewed data from the Centers for Medicare & Medicaid Services and population figures from the U.S. Census Bureau to find the number of hospitals per capita in U.S. counties. On average nationwide, there is one hospital for every 63,500 people.
There were more than 6,000 hospitals and 924,000 staffed beds registered in the United States as of 2018, the latest year for which data is available, according to the American Hospital Association. Of those hospitals, 5,339 are registered with Medicare. In normal circumstances, this is enough. But these are not normal times.
As of Dec. 12, 2020, there more than 13.8 million confirmed cases of COVID-19 in the United States — more than any other country in the world — and the numbers are rapidly rising. These are the states where the virus is spreading the fastest.
People who are sick are not spread evenly across the country. Most cases are found in more densely-populated urban areas — and these crowded places tend to also be the counties with fewest hospitals per capita.
Health experts are expecting COVID-19 cases to surge even more in the coming weeks, and with them there will be a surge in the more severe cases that require hospitalization. Already many hospitals are operating at capacity, and those that have not already reached their maximum capacity likely soon will.
Click here for the counties with fewest hospitals in the US.
Click here for our methodology.
50. Hampshire, Massachusetts
> Population : hospitals: 161,159 : 1
> Ambulatory surgery centers: 1
> Primary care physician to population ratio: 1 doctor per 719 people
> Pop. in 2017 reporting poor or fair health: 12.3%
> Pop. in 2018 without health insurance: 2.4%
> Most populous place in county: Northampton (population: 28,568)
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49. Chittenden, Vermont
> Population : hospitals: 162,052 : 1
> Ambulatory surgery centers: 1
> Primary care physician to population ratio: 1 doctor per 554 people
> Pop. in 2017 reporting poor or fair health: 9.9%
> Pop. in 2018 without health insurance: 3.3%
> Most populous place in county: Burlington (population: 42,513)
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48. Portage, Ohio
> Population : hospitals: 162,644 : 1
> Ambulatory surgery centers: 3
> Primary care physician to population ratio: 1 doctor per 2,459 people
> Pop. in 2017 reporting poor or fair health: 15.8%
> Pop. in 2018 without health insurance: 5.8%
> Most populous place in county: Kent (population: 29,824)
47. Kent, Rhode Island
> Population : hospitals: 163,861 : 1
> Ambulatory surgery centers: 4
> Primary care physician to population ratio: 1 doctor per 1,161 people
> Pop. in 2017 reporting poor or fair health: 14.3%
> Pop. in 2018 without health insurance: 3.7%
> Most populous place in county: Warwick (population: 81,079)
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46. Somerset, New Jersey
> Population : hospitals: 330,176 : 2
> Ambulatory surgery centers: 8
> Primary care physician to population ratio: 1 doctor per 862 people
> Pop. in 2017 reporting poor or fair health: 12.2%
> Pop. in 2018 without health insurance: 5.3%
> Most populous place in county: Somerset (population: 24,527)
45. Cumberland, North Carolina
> Population : hospitals: 332,106 : 2
> Ambulatory surgery centers: 4
> Primary care physician to population ratio: 1 doctor per 1,330 people
> Pop. in 2017 reporting poor or fair health: 19.5%
> Pop. in 2018 without health insurance: 10.2%
> Most populous place in county: Fayetteville (population: 209,867)
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44. Beaver, Pennsylvania
> Population : hospitals: 166,896 : 1
> Ambulatory surgery centers: 1
> Primary care physician to population ratio: 1 doctor per 2,340 people
> Pop. in 2017 reporting poor or fair health: 15.0%
> Pop. in 2018 without health insurance: 4.4%
> Most populous place in county: Aliquippa (population: 9,066)
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43. Aiken, South Carolina
> Population : hospitals: 166,926 : 1
> Ambulatory surgery centers: 3
> Primary care physician to population ratio: 1 doctor per 3,003 people
> Pop. in 2017 reporting poor or fair health: 17.7%
> Pop. in 2018 without health insurance: 11.3%
> Most populous place in county: Aiken (population: 30,464)
42. Chesterfield, Virginia
> Population : hospitals: 339,447 : 2
> Ambulatory surgery centers: 5
> Primary care physician to population ratio: 1 doctor per 1,142 people
> Pop. in 2017 reporting poor or fair health: 13.0%
> Pop. in 2018 without health insurance: 7.6%
> Most populous place in county: Richmond (population: 223,787)
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41. Licking, Ohio
> Population : hospitals: 172,293 : 1
> Ambulatory surgery centers: 1
> Primary care physician to population ratio: 1 doctor per 2,282 people
> Pop. in 2017 reporting poor or fair health: 16.1%
> Pop. in 2018 without health insurance: 6.4%
> Most populous place in county: Newark (population: 49,070)
40. Muskegon, Michigan
> Population : hospitals: 173,043 : 1
> Ambulatory surgery centers: 2
> Primary care physician to population ratio: 1 doctor per 1,639 people
> Pop. in 2017 reporting poor or fair health: 16.1%
> Pop. in 2018 without health insurance: 5.3%
> Most populous place in county: Muskegon (population: 37,969)
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39. Anoka, Minnesota
> Population : hospitals: 347,431 : 2
> Ambulatory surgery centers: 4
> Primary care physician to population ratio: 1 doctor per 1,952 people
> Pop. in 2017 reporting poor or fair health: 11.9%
> Pop. in 2018 without health insurance: 4.1%
> Most populous place in county: Minneapolis (population: 416,021)
38. Wake, North Carolina
> Population : hospitals: 1,046,558 : 6
> Ambulatory surgery centers: 13
> Primary care physician to population ratio: 1 doctor per 1,181 people
> Pop. in 2017 reporting poor or fair health: 13.4%
> Pop. in 2018 without health insurance: 8.9%
> Most populous place in county: Raleigh (population: 457,159)
37. Pitt, North Carolina
> Population : hospitals: 177,372 : 1
> Ambulatory surgery centers: 0
> Primary care physician to population ratio: 1 doctor per 942 people
> Pop. in 2017 reporting poor or fair health: 18.4%
> Pop. in 2018 without health insurance: 10.9%
> Most populous place in county: Greenville (population: 91,207)
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36. Butler, Pennsylvania
> Population : hospitals: 186,566 : 1
> Ambulatory surgery centers: 2
> Primary care physician to population ratio: 1 doctor per 1,509 people
> Pop. in 2017 reporting poor or fair health: 13.6%
> Pop. in 2018 without health insurance: 3.5%
> Most populous place in county: Butler (population: 13,182)
35. Orange, Florida
> Population : hospitals: 1,321,194 : 7
> Ambulatory surgery centers: 20
> Primary care physician to population ratio: 1 doctor per 1,144 people
> Pop. in 2017 reporting poor or fair health: 19.5%
> Pop. in 2018 without health insurance: 14.5%
> Most populous place in county: Orlando (population: 275,690)
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34. Johnston, North Carolina
> Population : hospitals: 191,172 : 1
> Ambulatory surgery centers: 0
> Primary care physician to population ratio: 1 doctor per 3,577 people
> Pop. in 2017 reporting poor or fair health: 16.7%
> Pop. in 2018 without health insurance: 12.2%
> Most populous place in county: Clayton (population: 20,324)
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33. Loudoun, Virginia
> Population : hospitals: 385,143 : 2
> Ambulatory surgery centers: 1
> Primary care physician to population ratio: 1 doctor per 1,292 people
> Pop. in 2017 reporting poor or fair health: 11.1%
> Pop. in 2018 without health insurance: 6.2%
> Most populous place in county: Leesburg (population: 52,125)
32. Hall, Georgia
> Population : hospitals: 195,961 : 1
> Ambulatory surgery centers: 15
> Primary care physician to population ratio: 1 doctor per 1,846 people
> Pop. in 2017 reporting poor or fair health: 18.3%
> Pop. in 2018 without health insurance: 17.4%
> Most populous place in county: Gainesville (population: 38,624)
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31. Delaware, Ohio
> Population : hospitals: 197,008 : 1
> Ambulatory surgery centers: 12
> Primary care physician to population ratio: 1 doctor per 701 people
> Pop. in 2017 reporting poor or fair health: 12.6%
> Pop. in 2018 without health insurance: 3.9%
> Most populous place in county: Columbus (population: 867, 628)
30. Kings, New York
> Population : hospitals: 2,600,747 : 13
> Ambulatory surgery centers: 14
> Primary care physician to population ratio: 1 doctor per 1,554 people
> Pop. in 2017 reporting poor or fair health: 18.1%
> Pop. in 2018 without health insurance: 8.2%
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29. Cabarrus, North Carolina
> Population : hospitals: 201,448 : 1
> Ambulatory surgery centers: 8
> Primary care physician to population ratio: 1 doctor per 1,149 people
> Pop. in 2017 reporting poor or fair health: 14.7%
> Pop. in 2018 without health insurance: 7.8%
> Most populous place in county: Concord (population: 89, 729)
28. Clermont, Ohio
> Population : hospitals: 203,216 : 1
> Ambulatory surgery centers: 2
> Primary care physician to population ratio: 1 doctor per 1,524 people
> Pop. in 2017 reporting poor or fair health: 15.1%
> Pop. in 2018 without health insurance: 5.7%
> Most populous place in county: Cincinnati (population: 300,357)
27. Bronx, New York
> Population : hospitals: 1,437,872 : 7
> Ambulatory surgery centers: 8
> Primary care physician to population ratio: 1 doctor per 1,768 people
> Pop. in 2017 reporting poor or fair health: 26.8%
> Pop. in 2018 without health insurance: 9.7%
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26. Yuma, Arizona
> Population : hospitals: 207,829 : 1
> Ambulatory surgery centers: 4
> Primary care physician to population ratio: 1 doctor per 2,118 people
> Pop. in 2017 reporting poor or fair health: 22.7%
> Pop. in 2018 without health insurance: 13.3%
> Most populous place in county: Yuma (population: 95,573)
25. Dakota, Minnesota
> Population : hospitals: 418,201 : 2
> Ambulatory surgery centers: 5
> Primary care physician to population ratio: 1 doctor per 1,512 people
> Pop. in 2017 reporting poor or fair health: 10.0%
> Pop. in 2018 without health insurance: 3.8%
> Most populous place in county: Lakeville (population: 62,489)
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24. Shelby, Alabama
> Population : hospitals: 211,261 : 1
> Ambulatory surgery centers: 1
> Primary care physician to population ratio: 1 doctor per 1,242 people
> Pop. in 2017 reporting poor or fair health: 16.5%
> Pop. in 2018 without health insurance: 6.8%
> Most populous place in county: Birmingham (population: 212,021)
23. Gaston, North Carolina
> Population : hospitals: 216,585 : 1
> Ambulatory surgery centers: 3
> Primary care physician to population ratio: 1 doctor per 1,643 people
> Pop. in 2017 reporting poor or fair health: 18.1%
> Pop. in 2018 without health insurance: 10.8%
> Most populous place in county: Gastonia (population: 75,138)
22. Whatcom, Washington
> Population : hospitals: 216,812 : 1
> Ambulatory surgery centers: 10
> Primary care physician to population ratio: 1 doctor per 1,096 people
> Pop. in 2017 reporting poor or fair health: 12.5%
> Pop. in 2018 without health insurance: 6.5%
> Most populous place in county: Bellingham (population: 87,071)
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21. Forsyth, Georgia
> Population : hospitals: 219,880 : 1
> Ambulatory surgery centers: 12
> Primary care physician to population ratio: 1 doctor per 2,561 people
> Pop. in 2017 reporting poor or fair health: 13.0%
> Pop. in 2018 without health insurance: 8.9%
> Most populous place in county: Cumming (population: 6,027)
20. Henry, Georgia
> Population : hospitals: 221,307 : 1
> Ambulatory surgery centers: 1
> Primary care physician to population ratio: 1 doctor per 2,110 people
> Pop. in 2017 reporting poor or fair health: 17.2%
> Pop. in 2018 without health insurance: 11.0%
> Most populous place in county: Stockbridge (population: 28,648)
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19. Gwinnett, Georgia
> Population : hospitals: 902,298 : 4
> Ambulatory surgery centers: 16
> Primary care physician to population ratio: 1 doctor per 1,584 people
> Pop. in 2017 reporting poor or fair health: 16.4%
> Pop. in 2018 without health insurance: 17.0%
> Most populous place in county: Lawrenceville (population: 29,401)
18. Union, North Carolina
> Population : hospitals: 226,694 : 1
> Ambulatory surgery centers: 2
> Primary care physician to population ratio: 1 doctor per 1,522 people
> Pop. in 2017 reporting poor or fair health: 13.9%
> Pop. in 2018 without health insurance: 9.4%
> Most populous place in county: Indian Trail (population: 37,983)
17. Seminole, Florida
> Population : hospitals: 455,086 : 2
> Ambulatory surgery centers: 7
> Primary care physician to population ratio: 1 doctor per 1,322 people
> Pop. in 2017 reporting poor or fair health: 16.1%
> Pop. in 2018 without health insurance: 10.4%
> Most populous place in county: Sanford (population: 58,862)
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16. Prince William, Virginia
> Population : hospitals: 456,749 : 2
> Ambulatory surgery centers: 3
> Primary care physician to population ratio: 1 doctor per 2,248 people
> Pop. in 2017 reporting poor or fair health: 15.3%
> Pop. in 2018 without health insurance: 11.4%
> Most populous place in county: Manassas (population: 41,457)
15. Will, Illinois
> Population : hospitals: 688,697 : 3
> Ambulatory surgery centers: 3
> Primary care physician to population ratio: 1 doctor per 1,828 people
> Pop. in 2017 reporting poor or fair health: 14.6%
> Pop. in 2018 without health insurance: 5.6%
> Most populous place in county: Aurora (population: 200,660)
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14. Clark, Washington
> Population : hospitals: 465,384 : 2
> Ambulatory surgery centers: 7
> Primary care physician to population ratio: 1 doctor per 1,417 people
> Pop. in 2017 reporting poor or fair health: 13.7%
> Pop. in 2018 without health insurance: 6.3%
> Most populous place in county: Vancouver (population: 178,413)
13. St. Johns, Florida
> Population : hospitals: 235,503 : 1
> Ambulatory surgery centers: 6
> Primary care physician to population ratio: 1 doctor per 1,046 people
> Pop. in 2017 reporting poor or fair health: 12.7%
> Pop. in 2018 without health insurance: 8.4%
> Most populous place in county: Jacksonville (population: 878,907)
12. Cherokee, Georgia
> Population : hospitals: 241,910 : 1
> Ambulatory surgery centers: 12
> Primary care physician to population ratio: 1 doctor per 2,579 people
> Pop. in 2017 reporting poor or fair health: 14.9%
> Pop. in 2018 without health insurance: 10.9%
> Most populous place in county: Woodstock (population: 30,362)
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11. Cobb, Georgia
> Population : hospitals: 745,057 : 3
> Ambulatory surgery centers: 20
> Primary care physician to population ratio: 1 doctor per 1,418 people
> Pop. in 2017 reporting poor or fair health: 13.7%
> Pop. in 2018 without health insurance: 13.0%
> Most populous place in county: Atlanta (population: 479,655)
10. Frederick, Maryland
> Population : hospitals: 248,472 : 1
> Ambulatory surgery centers: 15
> Primary care physician to population ratio: 1 doctor per 1,605 people
> Pop. in 2017 reporting poor or fair health: 11.5%
> Pop. in 2018 without health insurance: 4.8%
> Most populous place in county: Frederick (population: 70,166)
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9. Passaic, New Jersey
> Population : hospitals: 504,041 : 2
> Ambulatory surgery centers: 17
> Primary care physician to population ratio: 1 doctor per 1,762 people
> Pop. in 2017 reporting poor or fair health: 24.0%
> Pop. in 2018 without health insurance: 12.4%
> Most populous place in county: Paterson (population: 145,800)
8. York, South Carolina
> Population : hospitals: 258,641 : 1
> Ambulatory surgery centers: 3
> Primary care physician to population ratio: 1 doctor per 2,277 people
> Pop. in 2017 reporting poor or fair health: 14.2%
> Pop. in 2018 without health insurance: 8.7%
> Most populous place in county: Rock Hill (population: 71,903)
7. Guilford, North Carolina
> Population : hospitals: 523,582 : 2
> Ambulatory surgery centers: 14
> Primary care physician to population ratio: 1 doctor per 1,258 people
> Pop. in 2017 reporting poor or fair health: 16.3%
> Pop. in 2018 without health insurance: 10.1%
> Most populous place in county: Greensboro (population: 288,719)
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6. Anne Arundel, Maryland
> Population : hospitals: 567,696 : 2
> Ambulatory surgery centers: 28
> Primary care physician to population ratio: 1 doctor per 1,440 people
> Pop. in 2017 reporting poor or fair health: 12.2%
> Pop. in 2018 without health insurance: 4.7%
> Most populous place in county: Baltimore (population: 614,700)
5. Gloucester, New Jersey
> Population : hospitals: 290,852 : 1
> Ambulatory surgery centers: 11
> Primary care physician to population ratio: 1 doctor per 1,849 people
> Pop. in 2017 reporting poor or fair health: 16.1%
> Pop. in 2018 without health insurance: 4.6%
> Most populous place in county: Glassboro (population: 19,580)
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4. Spartanburg, South Carolina
> Population : hospitals: 302,195 : 1
> Ambulatory surgery centers: 2
> Primary care physician to population ratio: 1 doctor per 1,461 people
> Pop. in 2017 reporting poor or fair health: 17.1%
> Pop. in 2018 without health insurance: 10.9%
> Most populous place in county: Spartanburg (population: 37,370)
3. Howard, Maryland
> Population : hospitals: 315,327 : 1
> Ambulatory surgery centers: 14
> Primary care physician to population ratio: 1 doctor per 517 people
> Pop. in 2017 reporting poor or fair health: 9.7%
> Pop. in 2018 without health insurance: 4.0%
> Most populous place in county: Columbia (population: 103,663)
2. Henrico, Virginia
> Population : hospitals: 325,642 : 1
> Ambulatory surgery centers: 4
> Primary care physician to population ratio: 1 doctor per 950 people
> Pop. in 2017 reporting poor or fair health: 14.0%
> Pop. in 2018 without health insurance: 8.3%
> Most populous place in county: Richmond (population: 223,787)
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1. Queens, New York
> Population : hospitals: 2,278,906 : 7
> Ambulatory surgery centers: 12
> Primary care physician to population ratio: 1 doctor per 1,608 people
> Pop. in 2017 reporting poor or fair health: 18.5%
> Pop. in 2018 without health insurance: 10.5%
To identify the counties with the fewest hospitals per capita, 24/7 Tempo reviewed government data for all 5,339 hospitals and ambulatory surgery centers registered with Medicare, a federal health insurance program that serves the elderly and people with disabilities.
The number of ambulatory surgery centers, which provide surgical services to patients not requiring hospitalization, also came from Medicare.
Data on total county population, share of population without health insurance, and the number of primary care physicians came from the U.S. Census Bureau’s 2018 American Community Survey and are based on 5-year estimates.
The share of each county’s population in poor and fair health and living with diabetes came from the 2020 report by County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.
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