Positive Approaches Journal, Volume 14, Issue 1

Volume 14 ► Issue 1 ► June 2025

June Resource Discoveries

Health Professional Shortage Area

Access to quality health care is a critical issue for people with Intellectual and Developmental Disabilities (IDD). Research finds that people with IDD often have complex mental and physical health care needs, and experience higher rates of comorbidities like obesity, diabetes, gastrointestinal issues, and sleep problems.1 People with IDD also have higher rates of co-occurring mental health conditions like anxiety, depression, and Post Traumatic Stress Disorder (PTSD) compared to people without IDD.2 Prior research estimates range from 37%-65% of people with IDD have a co-occurring mental health condition.2 People with IDD use preventative care less frequently and rely more on emergency departments (EDs) compared to those without IDD. Additionally, people with IDD have higher rates of emergency psychiatric service utilization.2 Adults with IDD also have higher annual health care costs than adults without IDD.1 Currently in the United States access to medical care is being limited by a shortage of health care providers for physical and mental health.3 The Health Resources and Services Administration (HRSA) designates geographic areas that lack access to health care due to shortages of care providers as Health Professional Shortage Areas (HPSAs).  People living in HPSAs generally have greater unmet health care needs, and are at increased risk of preventable hospitalizations, chronic disease, and death.3 The high rates of comorbidities combined with living in an HPSA can contribute to worse health outcomes for people with IDD compared to people without IDD.

Living in an HPSA may exacerbate the risks of poor mental and physical health outcomes among people with IDD. HPSAs tend to be in rural areas, have larger Black populations, lower employment levels, higher concentrations of lower-income individuals, individuals who are in worse physical and mental health, and more likely to be covered by public insurance.3 HPSAs reduce medical office visits for both White and Black people, however the effect is nearly twice as large for Black people.3  As stated in the previous Data Discoveries article, across all age groups, a higher percentage of Pennsylvanians with IDD live in a mental health professional shortage area compared to people without IDD. Additional disparities are found across race/ethnicity and disability status. For example, 3.6% of Black people with IDD live in HPSAs compared to 3.1% of Black people without IDD. The disparity is even greater for people with IDD who identify as more than one race, 11.5% live in an HPSA compared to less than 1% of people without IDD.

In Pennsylvania, investments are being made to strengthen the state’s rural health care workforce to improve access to care. Presently, rural communities are especially affected by the health professional shortages, where there is only one primary care doctor for every 522 residents.4 Rural Pennsylvanians have less access to health care and must travel further distances to see their doctors.4 Investments to support rural hospitals to prevent service cuts, and the expansion of the Primary Care Loan Repayment Program, which offers loan repayment for health care providers that serve rural communities, are included in the upcoming budget proposal.4 

Another potential solution to the shortage of primary care providers is to allow Physicians Assistants (PAs) and Nurse Practitioners (NPs) to provide more primary care services. The US is projected to have a surplus of NPs and PAs in 2037 which may alleviate the shortage of Primary Care Providers. 5 Investing in peer support programs can help alleviate the shortage of mental health providers. Growing availability of telehealth can address some of the geographic disparities in access for rural areas by allowing people to seek care across a larger area.

Given the complex medical needs of people with IDD, ensuring access to quality and continuous health care is crucial. The ASERT resource dashboard below provides key resources for finding and choosing health care providers to assist providers, individuals, families, and communities.