Positive Approaches Journal, Volume 13, Issue 4

Volume 13 ► Issue 4 ► March 2025

Data Discoveries

The goal of Data Discoveries is to present useful data using new methods and platforms that can be customized.

Health Professional Shortage Areas in Pennsylvania

The need for health care services in the United States has increased significantly in recent years as the population ages and grows, and there is some evidence suggesting that this need will soon outpace provider availability, exacerbating disparities in access to care. The National Center for Health Workforce Analysis projects that the United States will experience a total shortage of 187,130 full-time equivalent physicians in 2037, and 31 out of 35 specialties are expected to encounter shortages.1 Family Medicine is projected to experience a significant shortage, meeting only 73% of the projected need for services; similarly, General Internal Medicine is projected to meet 76% of that need. This could mean that about a quarter of those who need primary health care services will not be able to access them. 

The United States is also facing a mental health crisis with increasing unmet behavioral health needs across people of all ages. Behavioral health services can be difficult to access due to high costs, coverage gaps, and provider shortages.2 Currently, over one-third of the U.S. population lives in a Mental HealthCare Health Professional Shortage Area (HPSA), and substantial behavioral health worker shortages are projected in the future.2 Rural counties are often at greater risk for provider shortages compared to metro areas, further exacerbating unmet needs and access to services.1,2

People with intellectual and developmental disabilities (IDD), including those with autism and intellectual disabilities, often have multiple physical health and mental health needs,3 and experience higher rates of co-occurring mental health conditions compared to their peers without IDD.4  Autistic people are more likely to have unmet health care needs, experience challenges accessing treatment or counseling, and encounter higher health care costs compared to non-autistic people.3 Living in an HPSA may further increase risk for poor health and mental health outcomes among people with IDD, underscoring the importance of examining the percentage of this population who may be at risk for limitations in access to health care services due to a shortage of providers. Autistic Pennsylvanians of all ages and their families have reported difficulties finding needed services.5 Pennsylvania Autism Needs Assessment (PANA) data suggest that the most common barrier to accessing care is a lack of providers, and parents have reported no or few providers for specific needed services.5 This lack of provider access was reported to be worse in rural areas and for adult services.6 

The dashboard below displays the percentage of Pennsylvanians with and without IDD who live in Health Professional Shortage Areas. The Health Resources and Service Administration (HRSA) defines HPSAs as geographic areas, populations, and/or facilities that have a shortage of primary, dental, and/or mental health care providers. The dashboard focuses on geographic HPSAs, which are areas in which the entire population experiences the shortage and reflects the percentage of Pennsylvania Medicaid enrollees whose zip codes fall into geographic HRSA-defined HPSAs. The data can be filtered by important demographic characteristics, including age group, insurance, race/ethnicity, and gender. To provide national context and relevant comparison data for Pennsylvania, dashboard users may also view the percentage of those living in HPSA in New York, North Carolina, and Ohio. These states were selected as useful points of comparison due to their similarities in population, population density, median income, unemployment rates, and or geographic proximity. 

These data suggest that overall, a greater percentage of Medicaid enrollees in Pennsylvania live in a mental health professional shortage area compared to a primary care professional shortage area. This pattern is observed across most of the other states included in this dashboard. Across all age groups, a higher percentage of Pennsylvanians with IDD live in a mental health professional shortage area compared to people without IDD. Notably, however, we observe the greatest disparity between those with and without IDD in the 18–21-year-old age range, with 14% of those with IDD living in a mental health professional shortage area compared to 11% of those without IDD. 

The proportion of Medicaid enrollees with IDD who live in either a primary care or mental health professional shortage area also increases with age: 12% of Medicaid enrollees with IDD aged 1-17 live in HPSAs compared to 16% of those with IDD aged 40-64. Disparities are also observed across race/ethnicity and disability status: in Pennsylvania, 3.6% of Black people with IDD live in HPSAs compared to 3.1% of Black people without IDD. These differences are similar across the other states included in this dashboard.  

These findings highlight the importance of increasing access to primary care and mental health professionals for people with disabilities. This includes not only increasing the number of providers available in each area, but also improving knowledge and awareness of IDD among those providers to best support people in need of these services. Provider incentives, including those to encourage telehealth offerings, may support increased access, especially for people who live in rural areas. As the need for both physical health and mental health services persists, it is critical to continue monitoring how these shortages impact people with IDD in Pennsylvania.