Special Report

7 Cities Losing Their Doctors

3. Midland, TX
> Pct. chg. primary care physicians 2010-2013: -14.2%
>Primary care physicians: 38.1 per 100,000
>Pct. population 65 and older: 9.7%
>Median household income: $66,689

More than one in five Midland residents do not have health insurance, one of the highest shares of any U.S. metro area. Those without insurance are far less likely to receive preventative care, and the high uninsured rate may lower demand in the West Texas city. There are only 38.1 primary care doctors for every 100,000 Midland residents, fewer than in all but seven other U.S. metro areas.

The share of doctors in Midland is also decreasing more rapidly than almost anywhere else in the country. Between 2010 and 2013, the number of primary care physicians per 100,000 area residents decreased by 14.2%. In contrast, the number of primary care doctors in the U.S. increased by 3.7% over the same time period.

2. Kingston, NY
> Pct. chg. primary care physicians 2010-2013: -14.7%
>Primary care physicians: 64.1 per 100,000
>Pct. population 65 and older: 17.6%
>Median household income: $58,592

The elderly often require frequent medical treatment, and as a result, older communities tend to have more physicians relative to the population. Kingston, New York, however, is an exception. Nearly 18% of Kingston’s 181,000 residents are 65 or older, a larger share than in the vast majority of U.S. metro areas. Yet, Kingston has fewer doctors per capita than the country as a whole.

Further, the number of primary care physicians per capita is declining in Kingston. Compared to 2010, when there were 75.1 primary care doctors for every 100,000 area residents — above average at that time — there are now 64.1 doctors per 100,000 area, a 14.7% drop.

1. Jacksonville, NC
> Pct. chg. primary care physicians 2010-2013: -17.9%
>Primary care physicians: 30.2 per 100,000
>Pct. population 65 and older: 8.5%
>Median household income: $46,141

Considering the economic and demographic characteristics of the city, it is not surprising that there are relatively few doctors practicing in Jacksonville. For example, the elderly typically require more frequent medical attention, and as a result, cities with older populations tend to have more doctors. Jacksonville, North Carolina, is one of the youngest cities in the country with only 8.5% of the population 65 or older. Doctors also have a financial incentive to practice in relatively affluent areas where people are more likely to spend more on health care. However, relatively few Jacksonville residents are high earners. Only 1.2% of households earn $200,000 or more a year, one of the smallest shares of any city in the country.

After a nation-leading 17.9% drop in primary care physicians per 100,000 people, Jacksonville is home to relatively few doctors. Only three U.S. metro areas have fewer primary care physicians per capita.

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