Ltrl Health Data
Where population growth has outrun primary care
Counties where the population grew quickly while primary care physicians per resident stayed low.
61,684,638 people live in counties with fewer than 71.8 primary care physicians per 100,000 residents, under 60% of the US rate of 119.6. 29,694,406 of them live in the 390 counties that also grew more than 5% since 2020.
Of the 224 growing counties of 25,000 or more listed below, 159 have no geographic primary care shortage designation from HRSA (as of October 21, 2026). Federal shortage programs and fast population growth are mostly found in different places.
Every county, by supply and population change
| Primary care supply | Population since 2020 | Counties | People | Median household income | In a metro area |
|---|---|---|---|---|---|
| Under 60% of US rate | Grew more than 5% | 390 | 29,694,406 | $71,373 | 57% |
| Under 60% of US rate | Grew 0–5% | 593 | 20,708,286 | $64,348 | 33% |
| Under 60% of US rate | Shrank | 629 | 11,281,946 | $59,286 | 18% |
| At or above | Grew more than 5% | 226 | 64,007,021 | $75,584 | 66% |
| At or above | Grew 0–5% | 674 | 132,074,451 | $70,343 | 50% |
| At or above | Shrank | 632 | 84,018,747 | $62,928 | 26% |
Growing counties with thin primary care (224)
| County | Population | Change since 2020 | Primary care physicians | Per 100,000 | Shortage area (primary care) |
|---|---|---|---|---|---|
| Kaufman County, TX | 209,235 | +42.2% | 54 | 25.8 | None |
| Jasper County, SC | 38,533 | +32.2% | 13 | 33.7 | Whole county |
| Liberty County, TX | 121,364 | +31.2% | 33 | 27.2 | Whole county |
| Jackson County, GA | 99,265 | +29.3% | 46 | 46.3 | None |
| Rockwall County, TX | 140,738 | +28.9% | 81 | 57.6 | None |
| Comal County, TX | 209,166 | +27.8% | 139 | 66.5 | None |
| Brunswick County, NC | 174,702 | +26.5% | 99 | 56.7 | None |
| Pinal County, AZ | 539,380 | +25.4% | 115 | 21.3 | Part of county |
| St. Johns County, FL | 346,328 | +25.0% | 226 | 65.3 | None |
| Montgomery County, TX | 781,194 | +24.9% | 473 | 60.5 | None |
| Hays County, TX | 304,390 | +24.8% | 166 | 54.5 | None |
| Ellis County, TX | 240,867 | +24.0% | 140 | 58.1 | None |
| Parker County, TX | 184,767 | +23.5% | 86 | 46.5 | Whole county |
| Hunt County, TX | 123,336 | +23.0% | 71 | 57.6 | None |
| Walton County, FL | 93,288 | +22.9% | 60 | 64.3 | None |
| Chambers County, TX | 57,594 | +22.6% | 17 | 29.5 | Whole county |
| Waller County, TX | 69,858 | +21.9% | 7 | 10.0 | None |
| Wise County, TX | 83,778 | +21.5% | 38 | 45.4 | None |
| Hendry County, FL | 48,276 | +21.5% | 27 | 55.9 | Whole county |
| St. Lucie County, FL | 402,449 | +21.4% | 256 | 63.6 | None |
| Bastrop County, TX | 118,908 | +21.3% | 38 | 32.0 | Whole county |
| New Kent County, VA | 28,022 | +21.2% | 9 | 32.1 | Whole county |
| Flagler County, FL | 140,360 | +21.0% | 82 | 58.4 | None |
| Johnson County, TX | 218,048 | +20.5% | 109 | 50.0 | None |
| Canadian County, OK | 187,189 | +20.4% | 86 | 45.9 | None |
| Caldwell County, TX | 55,150 | +20.0% | 14 | 25.4 | Whole county |
| Polk County, FL | 874,790 | +19.8% | 626 | 71.6 | None |
| Tooele County, UT | 87,461 | +19.2% | 31 | 35.4 | Whole county |
| Pender County, NC | 72,111 | +19.0% | 24 | 33.3 | None |
| Franklin County, NC | 82,037 | +18.8% | 9 | 11.0 | None |
| Barrow County, GA | 99,773 | +18.7% | 37 | 37.1 | None |
| Berkeley County, SC | 274,666 | +18.7% | 99 | 36.0 | Whole county |
| McClain County, OK | 49,647 | +18.4% | 26 | 52.4 | None |
| Lancaster County, SC | 114,296 | +18.3% | 66 | 57.7 | Part of county |
| Limestone County, AL | 122,928 | +18.0% | 43 | 35.0 | None |
| Johnston County, NC | 256,448 | +17.9% | 95 | 37.0 | None |
| Dallas County, IA | 118,457 | +17.8% | 48 | 40.5 | None |
| Wilson County, TN | 175,033 | +17.7% | 89 | 50.8 | None |
| Fort Bend County, TX | 975,191 | +17.4% | 659 | 67.6 | None |
| Washington County, UT | 213,670 | +17.4% | 142 | 66.5 | None |
| Nassau County, FL | 106,879 | +17.4% | 59 | 55.2 | Part of county |
| Goochland County, VA | 29,187 | +17.4% | 13 | 44.5 | None |
| Denton County, TX | 1,069,346 | +16.9% | 500 | 46.8 | None |
| Currituck County, NC | 33,158 | +16.7% | 13 | 39.2 | None |
| Elbert County, CO | 30,534 | +16.5% | 3 | 9.8 | Part of county |
| Union County, OH | 73,446 | +16.5% | 51 | 69.4 | None |
| Iron County, UT | 67,141 | +16.4% | 32 | 47.7 | None |
| Grimes County, TX | 34,252 | +16.3% | 14 | 40.9 | None |
| Edgefield County, SC | 29,808 | +16.1% | 18 | 60.4 | Whole county |
| Walton County, GA | 112,696 | +16.0% | 41 | 36.4 | None |
| Benton County, AR | 332,554 | +16.0% | 223 | 67.1 | None |
| Guadalupe County, TX | 201,111 | +15.8% | 74 | 36.8 | None |
| Bryan County, GA | 52,062 | +15.6% | 34 | 65.3 | None |
| Wagoner County, OK | 93,263 | +14.6% | 32 | 34.3 | None |
| Utah County, UT | 759,859 | +14.5% | 444 | 58.4 | None |
| Effingham County, GA | 74,397 | +14.1% | 26 | 34.9 | Part of county |
| Monroe County, GA | 32,023 | +14.1% | 11 | 34.4 | None |
| Hood County, TX | 70,501 | +13.6% | 35 | 49.6 | None |
| Louisa County, VA | 42,924 | +13.6% | 11 | 25.6 | Whole county |
| Jefferson County, ID | 35,297 | +13.6% | 6 | 17.0 | None |
| Hancock County, IN | 90,969 | +13.5% | 60 | 66.0 | None |
| Lincoln County, NC | 98,654 | +13.2% | 65 | 65.9 | None |
| Box Elder County, UT | 65,320 | +12.7% | 28 | 42.9 | Whole county |
| Paulding County, GA | 190,996 | +12.7% | 35 | 18.3 | None |
| Levy County, FL | 48,520 | +12.7% | 13 | 26.8 | None |
| Wakulla County, FL | 38,089 | +12.3% | 14 | 36.8 | Whole county |
| Harnett County, NC | 150,137 | +12.3% | 79 | 52.6 | None |
| Brazoria County, TX | 419,080 | +12.2% | 241 | 57.5 | Part of county |
| Wilson County, TX | 56,139 | +12.2% | 23 | 41.0 | Whole county |
| Forsyth County, GA | 282,805 | +11.8% | 159 | 56.2 | None |
| Union County, NC | 267,674 | +11.7% | 145 | 54.2 | None |
| Santa Rosa County, FL | 211,115 | +11.7% | 127 | 60.2 | None |
| Cherokee County, GA | 299,273 | +11.6% | 160 | 53.5 | None |
| Austin County, TX | 33,625 | +11.6% | 5 | 14.9 | Whole county |
| Kershaw County, SC | 73,166 | +11.6% | 33 | 45.1 | Whole county |
| Logan County, OK | 55,473 | +11.5% | 11 | 19.8 | None |
| Pickens County, GA | 37,167 | +11.4% | 24 | 64.6 | None |
| Lincoln County, MO | 66,676 | +11.4% | 18 | 27.0 | Whole county |
| Medina County, TX | 56,881 | +11.4% | 21 | 36.9 | Whole county |
| Caroline County, VA | 34,413 | +11.3% | 8 | 23.2 | Whole county |
| Newton County, GA | 125,583 | +11.2% | 43 | 34.2 | None |
| Wright County, MN | 157,559 | +11.1% | 80 | 50.8 | None |
| Chatham County, NC | 85,111 | +11.0% | 46 | 54.0 | None |
| Hart County, GA | 28,639 | +10.7% | 16 | 55.9 | None |
| Van Zandt County, TX | 66,130 | +10.7% | 16 | 24.2 | None |
| Suwannee County, FL | 48,149 | +10.6% | 15 | 31.2 | Whole county |
| Crook County, OR | 27,564 | +10.6% | 14 | 50.8 | Whole county |
| Franklin County, GA | 25,948 | +10.5% | 13 | 50.1 | None |
| King George County, VA | 29,646 | +10.5% | 8 | 27.0 | Whole county |
| Spotsylvania County, VA | 155,388 | +10.5% | 93 | 59.9 | None |
| Marshall County, TN | 38,071 | +10.5% | 11 | 28.9 | None |
| Matanuska-Susitna Borough, AK | 118,666 | +10.4% | 72 | 60.7 | Whole county |
| Webster County, MO | 43,054 | +10.4% | 22 | 51.1 | None |
| Wood County, TX | 49,688 | +10.3% | 23 | 46.3 | None |
| Nye County, NV | 57,336 | +10.3% | 28 | 48.8 | None |
| Sanpete County, UT | 31,453 | +10.3% | 21 | 66.8 | None |
| Dorchester County, SC | 178,397 | +10.1% | 80 | 44.8 | Whole county |
| Haralson County, GA | 33,066 | +10.0% | 19 | 57.5 | None |
| Midland County, TX | 187,855 | +10.0% | 111 | 59.1 | Whole county |
| Kendall County, IL | 145,470 | +9.9% | 50 | 34.4 | None |
| Robertson County, TN | 80,175 | +9.9% | 19 | 23.7 | Whole county |
| Hill County, TX | 39,503 | +9.8% | 10 | 25.3 | None |
| Carroll County, GA | 131,036 | +9.8% | 84 | 64.1 | None |
| Bedford County, TN | 55,273 | +9.7% | 19 | 34.4 | None |
| Henry County, GA | 264,922 | +9.5% | 169 | 63.8 | None |
| Macon County, TN | 27,663 | +9.5% | 7 | 25.3 | None |
| Walker County, TX | 83,842 | +9.5% | 45 | 53.7 | None |
| Camden County, GA | 60,143 | +9.5% | 32 | 53.2 | None |
| Lyon County, NV | 65,088 | +9.5% | 18 | 27.7 | Whole county |
| Jefferson County, TN | 60,024 | +9.3% | 36 | 60.0 | None |
| Habersham County, GA | 50,416 | +9.3% | 24 | 47.6 | None |
| Coweta County, GA | 160,240 | +9.2% | 103 | 64.3 | None |
| Grainger County, TN | 25,739 | +9.2% | 5 | 19.4 | None |
| Sumner County, TN | 215,538 | +9.2% | 127 | 58.9 | None |
| Warren County, MO | 39,016 | +9.2% | 11 | 28.2 | Whole county |
| Fannin County, TX | 39,265 | +9.1% | 16 | 40.7 | None |
| Hoke County, NC | 56,939 | +9.0% | 21 | 36.9 | None |
| Sarpy County, NE | 208,303 | +9.0% | 128 | 61.4 | None |
| Queen Anne's County, MD | 54,448 | +8.8% | 25 | 45.9 | None |
| Bulloch County, GA | 86,949 | +8.8% | 54 | 62.1 | None |
| Payette County, ID | 27,824 | +8.8% | 15 | 53.9 | None |
| Frederick County, VA | 99,955 | +8.8% | 19 | 19.0 | None |
| Madison County, GA | 32,919 | +8.8% | 11 | 33.4 | None |
| DeSoto County, FL | 37,078 | +8.8% | 18 | 48.5 | Whole county |
| Atascosa County, TX | 53,590 | +8.7% | 20 | 37.3 | Whole county |
| San Benito County, CA | 70,082 | +8.6% | 24 | 34.2 | Part of county |
| Lee County, AL | 189,881 | +8.6% | 110 | 57.9 | None |
| Livingston Parish, LA | 155,036 | +8.5% | 46 | 29.7 | Whole county |
| Cache County, UT | 145,000 | +8.5% | 89 | 61.4 | None |
| Houston County, GA | 178,214 | +8.5% | 127 | 71.3 | None |
| Christian County, MO | 96,725 | +8.3% | 49 | 50.7 | Whole county |
| Stafford County, VA | 170,803 | +8.3% | 42 | 24.6 | Whole county |
| Navarro County, TX | 57,181 | +8.2% | 23 | 40.2 | Whole county |
| Palo Pinto County, TX | 30,791 | +8.2% | 15 | 48.7 | None |
| Scott County, KY | 62,262 | +8.2% | 44 | 70.7 | None |
| Upshur County, TX | 44,410 | +8.2% | 8 | 18.0 | None |
| Yuba County, CA | 88,691 | +8.2% | 50 | 56.4 | None |
| York County, SC | 306,887 | +8.1% | 159 | 51.8 | Part of county |
| Douglas County, WA | 46,473 | +8.0% | 22 | 47.3 | Whole county |
| White County, TN | 29,612 | +7.9% | 13 | 43.9 | None |
| Gilmer County, GA | 33,894 | +7.9% | 18 | 53.1 | None |
| Columbia County, GA | 169,189 | +7.9% | 115 | 68.0 | None |
| Randall County, TX | 152,351 | +7.9% | 47 | 30.8 | Part of county |
| Mason County, WA | 71,165 | +7.8% | 38 | 53.4 | Whole county |
| Wayne County, GA | 32,481 | +7.7% | 18 | 55.4 | None |
| Dickson County, TN | 58,662 | +7.7% | 29 | 49.4 | None |
| Grady County, OK | 59,128 | +7.7% | 25 | 42.3 | None |
| Fayette County, TN | 45,071 | +7.7% | 11 | 24.4 | Whole county |
| Saline County, AR | 133,288 | +7.6% | 60 | 45.0 | None |
| McMinn County, TN | 57,404 | +7.6% | 33 | 57.5 | None |
| Lumpkin County, GA | 36,178 | +7.5% | 19 | 52.5 | None |
| Henderson County, TX | 88,595 | +7.5% | 57 | 64.3 | None |
| Clark County, IN | 130,451 | +7.5% | 77 | 59.0 | None |
| Okeechobee County, FL | 42,608 | +7.4% | 25 | 58.7 | None |
| Pickaway County, OH | 62,978 | +7.4% | 33 | 52.4 | Whole county |
| Aiken County, SC | 181,515 | +7.3% | 100 | 55.1 | None |
| Uintah County, UT | 38,278 | +7.3% | 23 | 60.1 | Part of county |
| Valencia County, NM | 82,013 | +7.2% | 27 | 32.9 | None |
| Pike County, PA | 62,808 | +7.2% | 22 | 35.0 | None |
| Monroe County, TN | 49,730 | +7.2% | 23 | 46.2 | None |
| Rogers County, OK | 102,197 | +7.1% | 47 | 46.0 | None |
| Cass County, MO | 115,859 | +7.1% | 35 | 30.2 | None |
| Madison County, OH | 46,985 | +7.1% | 24 | 51.1 | Whole county |
| St. Clair County, AL | 98,206 | +7.1% | 37 | 37.7 | None |
| San Jacinto County, TX | 29,488 | +7.1% | 4 | 13.6 | Whole county |
| Powhatan County, VA | 32,591 | +7.0% | 12 | 36.8 | None |
| Roane County, TN | 57,395 | +6.9% | 29 | 50.5 | None |
| Davie County, NC | 45,855 | +6.9% | 26 | 56.7 | None |
| Texas County, MO | 25,994 | +6.9% | 12 | 46.2 | None |
| Cherokee County, NC | 30,830 | +6.8% | 15 | 48.7 | None |
| Harris County, GA | 37,280 | +6.8% | 5 | 13.4 | Whole county |
| Sherburne County, MN | 104,194 | +6.8% | 36 | 34.6 | None |
| Isle of Wight County, VA | 41,321 | +6.7% | 22 | 53.2 | None |
| Platte County, MO | 114,400 | +6.7% | 72 | 62.9 | None |
| Douglas County, GA | 154,293 | +6.6% | 83 | 53.8 | None |
| Rockingham County, VA | 89,316 | +6.6% | 25 | 28.0 | None |
| Davidson County, NC | 180,182 | +6.6% | 75 | 41.6 | None |
| Shelby County, AL | 238,552 | +6.5% | 149 | 62.5 | None |
| Butts County, GA | 27,218 | +6.5% | 11 | 40.4 | None |
| Mohave County, AZ | 228,102 | +6.5% | 153 | 67.1 | Part of county |
| Cooke County, TX | 44,461 | +6.5% | 18 | 40.5 | None |
| Peach County, GA | 29,877 | +6.5% | 14 | 46.9 | Whole county |
| Ascension Parish, LA | 135,105 | +6.4% | 74 | 54.8 | Part of county |
| Franklin County, TN | 45,579 | +6.4% | 31 | 68.0 | None |
| Bingham County, ID | 51,153 | +6.4% | 20 | 39.1 | None |
| DeSoto County, MS | 197,918 | +6.3% | 101 | 51.0 | None |
| Coffee County, AL | 56,953 | +6.3% | 34 | 59.7 | None |
| Laurens County, SC | 71,848 | +6.2% | 31 | 43.1 | None |
| Shelby County, KY | 51,243 | +6.2% | 31 | 60.5 | None |
| Fluvanna County, VA | 28,975 | +6.2% | 13 | 44.9 | Part of county |
| Lawrence County, TN | 46,914 | +6.2% | 18 | 38.4 | None |
| Bradley County, TN | 115,465 | +6.1% | 68 | 58.9 | None |
| Newton County, MO | 62,263 | +6.1% | 25 | 40.2 | None |
| Hopkins County, TX | 39,063 | +6.1% | 18 | 46.1 | None |
| White County, GA | 29,802 | +6.0% | 12 | 40.3 | None |
| Polk County, GA | 45,514 | +6.0% | 26 | 57.1 | None |
| Duplin County, NC | 51,571 | +6.0% | 23 | 44.6 | None |
| Milam County, TX | 26,258 | +6.0% | 9 | 34.3 | Whole county |
| Putnam County, FL | 77,734 | +5.9% | 53 | 68.2 | None |
| Charles County, MD | 176,593 | +5.9% | 98 | 55.5 | None |
| Chilton County, AL | 47,708 | +5.9% | 27 | 56.6 | None |
| Miami County, KS | 36,240 | +5.9% | 14 | 38.6 | None |
| Polk County, TX | 53,434 | +5.9% | 28 | 52.4 | None |
| Weber County, UT | 278,174 | +5.8% | 199 | 71.5 | None |
| Baker County, FL | 29,737 | +5.8% | 20 | 67.3 | Whole county |
| Tangipahoa Parish, LA | 141,346 | +5.8% | 77 | 54.5 | None |
| Cherokee County, AL | 26,413 | +5.7% | 10 | 37.9 | Whole county |
| Franklin County, WA | 102,612 | +5.6% | 53 | 51.7 | Whole county |
| Pearl River County, MS | 59,363 | +5.6% | 26 | 43.8 | None |
| Hidalgo County, TX | 921,549 | +5.6% | 583 | 63.3 | None |
| Rowan County, NC | 155,096 | +5.6% | 100 | 64.5 | None |
| Anderson County, KY | 25,225 | +5.5% | 7 | 27.8 | None |
| Pine County, MN | 30,472 | +5.5% | 10 | 32.8 | Whole county |
| West Baton Rouge Parish, LA | 28,756 | +5.5% | 9 | 31.3 | None |
| Washington County, FL | 26,695 | +5.4% | 7 | 26.2 | Whole county |
| Cherokee County, TX | 53,337 | +5.4% | 34 | 63.7 | None |
| Jackson County, FL | 49,629 | +5.4% | 32 | 64.5 | None |
| Lincoln County, OK | 35,278 | +5.3% | 13 | 36.9 | None |
| Webb County, TX | 281,224 | +5.2% | 130 | 46.2 | Part of county |
| Cocke County, TN | 37,889 | +5.1% | 27 | 71.3 | None |
| Autauga County, AL | 61,920 | +5.1% | 31 | 50.1 | Whole county |
| Merced County, CA | 297,260 | +5.1% | 187 | 62.9 | Part of county |
| Scott County, MN | 159,017 | +5.1% | 88 | 55.3 | None |
| Hawkins County, TN | 59,559 | +5.0% | 24 | 40.3 | None |
Large counties with no listed specialist practice location
Counties of 50,000 or more people where NPPES lists no practice location in the specialty.
- Dermatology: 187 counties, 13,953,880 people. Largest: Kaufman County, TX; Guadalupe County, TX; Davidson County, NC; Wright County, MN; Cumberland County, NJ.
- Psychiatry: 61 counties, 4,160,256 people. Largest: Kendall County, IL; Newton County, GA; Limestone County, AL; Barrow County, GA; St. Clair County, AL.
- OB-GYN: 42 counties, 2,900,956 people. Largest: Livingston Parish, LA; Dallas County, IA; Cass County, MO; St. Clair County, AL; Polk County, OR.
- Rheumatology: 324 counties, 27,863,223 people. Largest: Pinal County, AZ; Clackamas County, OR; Union County, NC; St. Clair County, IL; Montgomery County, TN.
- Endocrinology: 286 counties, 23,843,549 people. Largest: Berkeley County, SC; Montgomery County, TN; Clay County, FL; Mohave County, AZ; Onslow County, NC.
- Gastroenterology: 182 counties, 13,642,229 people. Largest: Kaufman County, TX; Sarpy County, NE; Wilson County, TN; Stafford County, VA; Scott County, MN.
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Ltrl Health Data. Where population growth has outrun primary care. Data as of September 2026. https://ltrl.com/research/workforce/growth-gap-counties
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How this is counted
- Primary care physicians per 100,000: NPPES, September 2026, against Census population estimates (2025).
- Thin: under 60% of the US rate. Growing: population up more than 5% since 2020. Listed: 25,000 people or more. Method v1.
- County lines are not catchment areas. Residents of fast-growing counties near a city often see clinicians in the neighboring county.
- Shortage designations are HRSA's. Connecticut areas HRSA still lists under the pre-2022 counties are matched to the 2022 planning regions using Census crosswalks.
- These are facts, not a recommendation about where anyone should practice.
Registered, not necessarily practicing. Provider counts come from the national provider registry (NPPES): active individual clinicians, counted once under their primary specialty at their practice-location county. Some registered clinicians are retired or see few patients. Counts under 10, or places with fewer than 10,000 residents, are flagged and left out of rankings. Nothing is estimated or imputed. Methodology
Sources: NPPES (CMS); Census population estimates; Census ACS; Census SAHIE; HRSA shortage designations; USDA rural-urban codes. Methodology.