Special Report

Counties With the Fewest Hospitals

teemu08 / Flickr 22. Buncombe County, North Carolina > Hospitals: 1 (0.40 per 100,000 people) > Ambulatory surgical centers: 3 (1.19 per 100,000 people) > Population: 252,268 > Share of pop. without health insurance: 11.3% > Median household income: $48,464…

By Steven M. Peters

Published April 4, 2019, 9:58pm ET · 8 min read

Hospitals — a place no one ever wants to go, but most will, sooner or later. They are a necessity, providing emergency medical care and taking care of the sick (and these are states where people are too sick to work). For those without health insurance, they also provide a sense of security as hospitals are legally required to admit a patient in emergency situations — they cannot turn anyone away.

There were 6,210 hospitals and 931,203 staffed beds registered in the United States as of 2017, the latest year for which data is available, according to the American Hospital Association. That is about one bed per 351 American residents.

Most hospitals nationwide are community hospitals, defined as all nongovernment nonprofit hospitals, for-profit hospitals, and state and local government hospitals. These range from short-term general, gynecology, long-term acute-care, rehabilitation, and other specialty hospitals.

Hospital inpatient care accounts for a third of the total health care costs in the country — and this is what your state spends on your health care. Hospitalizations, which totaled more than 36.5 million across the country in 2017, are trending upwards. Not only is the population increasing, but it also aging, likely contributing to much of the increase in hospitalizations. Seasonal events, too, such a severe flu season, can increase hospitalizations.

24/7 Tempo reviewed Medicare data to find the number of hospitals per capita in a county area. Nationwide, there are 1.5 hospitals per 100,000 people.

The counties with the fewest hospitals per capita tend to be in areas that are more densely populated. This is why, for example, Kings County (Brooklyn) in New York ranks towards the bottom of the nearly 2,200 U.S. counties reviewed. It has the 27th largest number of hospitals in absolute terms in the United States, but it is also the nation’s eighth most populous county, which significantly lowers its per capita ranking.

The number of hospitals per person does not necessarily indicate a problem with access. Access to medical care can also be affected by income, as lower income Americans may be less likely to afford treatment. However, most of the counties on the list have a median annual household income much higher than the national median of $57,652.

Click here to see the U.S. counties with fewest hospitals.

To identify the counties with the fewest hospitals per capita, 24/7 Tempo reviewed government data for all 4,784 hospitals registered with Medicare, a federal health insurance program that serves the eldelry and people with disabilities. Population and income data came from the U.S. Census Bureau’s 2017 American Community Survey. The share of each county’s population without health insurance came from the 2019 report by County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.

52. Sangamon County, Illinois
> Hospitals: 1 (0.50 per 100,000 people)
> Ambulatory surgical centers: 2 (1.01 per 100,000 people)
> Population: 198,134
> Share of pop. without health insurance: 4.6%
> Median household income: $58,687

51. Richland County, South Carolina
> Hospitals: 2 (0.49 per 100,000 people)
> Ambulatory surgical centers: 9 (2.22 per 100,000 people)
> Population: 404,869
> Share of pop. without health insurance: 9.5%
> Median household income: $52,082

50. Yuma County, Arizona
> Hospitals: 1 (0.49 per 100,000 people)
> Ambulatory surgical centers: 5 (2.45 per 100,000 people)
> Population: 204,281
> Share of pop. without health insurance: 15.1%
> Median household income: $43,253

49. Tuscaloosa County, Alabama
> Hospitals: 1 (0.49 per 100,000 people)
> Ambulatory surgical centers: 4 (1.96 per 100,000 people)
> Population: 204,424
> Share of pop. without health insurance: 9.2%
> Median household income: $50,513

48. Berkeley County, South Carolina
> Hospitals: 1 (0.49 per 100,000 people)
> Ambulatory surgical centers: 3 (1.47 per 100,000 people)
> Population: 204,632
> Share of pop. without health insurance: 11.2%
> Median household income: $56,697

47. San Diego County, California
> Hospitals: 16 (0.49 per 100,000 people)
> Ambulatory surgical centers: 38 (1.16 per 100,000 people)
> Population: 3,283,665
> Share of pop. without health insurance: 8.1%
> Median household income: $70,588

46. Genesee County, Michigan
> Hospitals: 2 (0.49 per 100,000 people)
> Ambulatory surgical centers: 6 (1.46 per 100,000 people)
> Population: 410,881
> Share of pop. without health insurance: 6.4%
> Median household income: $45,231

45. Canyon County, Idaho
> Hospitals: 1 (0.48 per 100,000 people)
> Ambulatory surgical centers: 1 (0.48 per 100,000 people)
> Population: 207,027
> Share of pop. without health insurance: 15.3%
> Median household income: $46,426

44. Berks County, Pennsylvania
> Hospitals: 2 (0.48 per 100,000 people)
> Ambulatory surgical centers: 9 (2.17 per 100,000 people)
> Population: 415,500
> Share of pop. without health insurance: 7.5%
> Median household income: $59,580

43. Shelby County, Alabama
> Hospitals: 1 (0.48 per 100,000 people)
> Ambulatory surgical centers: 1 (0.48 per 100,000 people)
> Population: 208,721
> Share of pop. without health insurance: 7.4%
> Median household income: $74,063

42. Williamson County, Tennessee
> Hospitals: 1 (0.47 per 100,000 people)
> Ambulatory surgical centers: 3 (1.41 per 100,000 people)
> Population: 212,161
> Share of pop. without health insurance: 5.7%
> Median household income: $103,543

41. Whatcom County, Washington
> Hospitals: 1 (0.47 per 100,000 people)
> Ambulatory surgical centers: 10 (4.70 per 100,000 people)
> Population: 212,738
> Share of pop. without health insurance: 8.6%
> Median household income: $56,419

40. Solano County, California
> Hospitals: 2 (0.46 per 100,000 people)
> Ambulatory surgical centers: 3 (0.69 per 100,000 people)
> Population: 434,981
> Share of pop. without health insurance: 6.1%
> Median household income: $72,950

39. Kings County, New York
> Hospitals: 12 (0.46 per 100,000 people)
> Ambulatory surgical centers: 15 (0.57 per 100,000 people)
> Population: 2,635,121
> Share of pop. without health insurance: 8.8%
> Median household income: $52,782

38. New Hanover County, North Carolina
> Hospitals: 1 (0.45 per 100,000 people)
> Ambulatory surgical centers: 5 (2.27 per 100,000 people)
> Population: 219,866
> Share of pop. without health insurance: 10.9%
> Median household income: $51,457

37. Richmond County, Virginia
> Hospitals: 1 (0.45 per 100,000 people)
> Ambulatory surgical centers: 0 (0.00 per 100,000 people)
> Population: 220,892
> Share of pop. without health insurance: 12.0%
> Median household income: $42,356

36. Union County, North Carolina
> Hospitals: 1 (0.45 per 100,000 people)
> Ambulatory surgical centers: 2 (0.90 per 100,000 people)
> Population: 222,095
> Share of pop. without health insurance: 9.9%
> Median household income: $70,858

35. Seminole County, Florida
> Hospitals: 2 (0.45 per 100,000 people)
> Ambulatory surgical centers: 8 (1.78 per 100,000 people)
> Population: 449,260
> Share of pop. without health insurance: 12.1%
> Median household income: $60,739

34. El Paso County, Colorado
> Hospitals: 3 (0.44 per 100,000 people)
> Ambulatory surgical centers: 18 (2.67 per 100,000 people)
> Population: 674,826
> Share of pop. without health insurance: 7.1%
> Median household income: $62,535

33. Virginia Beach County, Virginia
> Hospitals: 2 (0.44 per 100,000 people)
> Ambulatory surgical centers: 5 (1.11 per 100,000 people)
> Population: 450,057
> Share of pop. without health insurance: 8.6%
> Median household income: $70,500

32. Prince George’s County, Maryland
> Hospitals: 4 (0.44 per 100,000 people)
> Ambulatory surgical centers: 19 (2.10 per 100,000 people)
> Population: 905,161
> Share of pop. without health insurance: 10.8%
> Median household income: $78,607

31. St. Johns County, Florida
> Hospitals: 1 (0.44 per 100,000 people)
> Ambulatory surgical centers: 6 (2.65 per 100,000 people)
> Population: 226,578
> Share of pop. without health insurance: 9.6%
> Median household income: $73,640

30. Fairfax County, Virginia
> Hospitals: 5 (0.44 per 100,000 people)
> Ambulatory surgical centers: 8 (0.70 per 100,000 people)
> Population: 1,142,004
> Share of pop. without health insurance: 9.3%
> Median household income: $117,515

29. Chesapeake County, Virginia
> Hospitals: 1 (0.42 per 100,000 people)
> Ambulatory surgical centers: 1 (0.42 per 100,000 people)
> Population: 235,410
> Share of pop. without health insurance: 8.8%
> Median household income: $72,214

28. Richmond County, New York
> Hospitals: 2 (0.42 per 100,000 people)
> Ambulatory surgical centers: 0 (0.00 per 100,000 people)
> Population: 475,948
> Share of pop. without health insurance: 5.4%
> Median household income: $76,244

27. Bronx County, New York
> Hospitals: 6 (0.41 per 100,000 people)
> Ambulatory surgical centers: 8 (0.55 per 100,000 people)
> Population: 1,455,846
> Share of pop. without health insurance: 9.4%
> Median household income: $36,593

26. Weber County, Utah
> Hospitals: 1 (0.41 per 100,000 people)
> Ambulatory surgical centers: 4 (1.64 per 100,000 people)
> Population: 244,101
> Share of pop. without health insurance: 9.6%
> Median household income: $62,036

25. Frederick County, Maryland
> Hospitals: 1 (0.41 per 100,000 people)
> Ambulatory surgical centers: 18 (7.31 per 100,000 people)
> Population: 246,105
> Share of pop. without health insurance: 5.5%
> Median household income: $88,502

24. Cobb County, Georgia
> Hospitals: 3 (0.41 per 100,000 people)
> Ambulatory surgical centers: 21 (2.84 per 100,000 people)
> Population: 739,072
> Share of pop. without health insurance: 13.5%
> Median household income: $72,004

23. Morris County, New Jersey
> Hospitals: 2 (0.40 per 100,000 people)
> Ambulatory surgical centers: 16 (3.21 per 100,000 people)
> Population: 498,847
> Share of pop. without health insurance: 5.6%
> Median household income: $107,034

22. Buncombe County, North Carolina
> Hospitals: 1 (0.40 per 100,000 people)
> Ambulatory surgical centers: 3 (1.19 per 100,000 people)
> Population: 252,268
> Share of pop. without health insurance: 11.3%
> Median household income: $48,464

21. Williamson County, Texas
> Hospitals: 2 (0.39 per 100,000 people)
> Ambulatory surgical centers: 2 (0.39 per 100,000 people)
> Population: 508,313
> Share of pop. without health insurance: 10.9%
> Median household income: $79,123

20. Passaic County, New Jersey
> Hospitals: 2 (0.39 per 100,000 people)
> Ambulatory surgical centers: 18 (3.53 per 100,000 people)
> Population: 510,563
> Share of pop. without health insurance: 13.5%
> Median household income: $63,339

19. Wake County, North Carolina
> Hospitals: 4 (0.39 per 100,000 people)
> Ambulatory surgical centers: 12 (1.17 per 100,000 people)
> Population: 1,023,811
> Share of pop. without health insurance: 9.2%
> Median household income: $73,577

18. Kitsap County, Washington
> Hospitals: 1 (0.39 per 100,000 people)
> Ambulatory surgical centers: 7 (2.70 per 100,000 people)
> Population: 258,903
> Share of pop. without health insurance: 6.3%
> Median household income: $68,336

17. Alachua County, Florida
> Hospitals: 1 (0.38 per 100,000 people)
> Ambulatory surgical centers: 7 (2.69 per 100,000 people)
> Population: 259,865
> Share of pop. without health insurance: 12.2%
> Median household income: $45,478

16. Lancaster County, Pennsylvania
> Hospitals: 2 (0.37 per 100,000 people)
> Ambulatory surgical centers: 9 (1.68 per 100,000 people)
> Population: 536,494
> Share of pop. without health insurance: 10.7%
> Median household income: $61,492

15. Dauphin County, Pennsylvania
> Hospitals: 1 (0.37 per 100,000 people)
> Ambulatory surgical centers: 9 (3.29 per 100,000 people)
> Population: 273,329
> Share of pop. without health insurance: 6.8%
> Median household income: $57,071

14. Weld County, Colorado
> Hospitals: 1 (0.35 per 100,000 people)
> Ambulatory surgical centers: 1 (0.35 per 100,000 people)
> Population: 285,729
> Share of pop. without health insurance: 8.7%
> Median household income: $66,489

13. Washington County, Oregon
> Hospitals: 2 (0.35 per 100,000 people)
> Ambulatory surgical centers: 7 (1.22 per 100,000 people)
> Population: 572,071
> Share of pop. without health insurance: 6.0%
> Median household income: $74,033

12. Howard County, Maryland
> Hospitals: 1 (0.32 per 100,000 people)
> Ambulatory surgical centers: 15 (4.80 per 100,000 people)
> Population: 312,495
> Share of pop. without health insurance: 4.4%
> Median household income: $115,576

11. Galveston County, Texas
> Hospitals: 1 (0.31 per 100,000 people)
> Ambulatory surgical centers: 1 (0.31 per 100,000 people)
> Population: 321,184
> Share of pop. without health insurance: 15.7%
> Median household income: $65,702

10. Orange County, Florida
> Hospitals: 4 (0.31 per 100,000 people)
> Ambulatory surgical centers: 21 (1.63 per 100,000 people)
> Population: 1,290,216
> Share of pop. without health insurance: 14.9%
> Median household income: $51,586

9. Will County, Illinois
> Hospitals: 2 (0.29 per 100,000 people)
> Ambulatory surgical centers: 2 (0.29 per 100,000 people)
> Population: 687,727
> Share of pop. without health insurance: 5.7%
> Median household income: $80,782

8. Collier County, Florida
> Hospitals: 1 (0.28 per 100,000 people)
> Ambulatory surgical centers: 10 (2.80 per 100,000 people)
> Population: 356,774
> Share of pop. without health insurance: 21.6%
> Median household income: $62,407

7. Queens County, New York
> Hospitals: 6 (0.26 per 100,000 people)
> Ambulatory surgical centers: 15 (0.64 per 100,000 people)
> Population: 2,339,280
> Share of pop. without health insurance: 11.3%
> Median household income: $62,008

6. Gwinnett County, Georgia
> Hospitals: 2 (0.22 per 100,000 people)
> Ambulatory surgical centers: 17 (1.91 per 100,000 people)
> Population: 889,954
> Share of pop. without health insurance: 16.7%
> Median household income: $64,496

5. Clark County, Washington
> Hospitals: 1 (0.22 per 100,000 people)
> Ambulatory surgical centers: 7 (1.53 per 100,000 people)
> Population: 457,474
> Share of pop. without health insurance: 6.5%
> Median household income: $67,832

4. Mecklenburg County, North Carolina
> Hospitals: 2 (0.19 per 100,000 people)
> Ambulatory surgical centers: 11 (1.06 per 100,000 people)
> Population: 1,034,290
> Share of pop. without health insurance: 12.1%
> Median household income: $61,695

3. Guilford County, North Carolina
> Hospitals: 1 (0.19 per 100,000 people)
> Ambulatory surgical centers: 12 (2.32 per 100,000 people)
> Population: 517,197
> Share of pop. without health insurance: 11.4%
> Median household income: $49,253

2. New Castle County, Delaware
> Hospitals: 1 (0.18 per 100,000 people)
> Ambulatory surgical centers: 14 (2.52 per 100,000 people)
> Population: 555,036
> Share of pop. without health insurance: 5.7%
> Median household income: $68,336

1. Union County, New Jersey
> Hospitals: 1 (0.18 per 100,000 people)
> Ambulatory surgical centers: 6 (1.08 per 100,000 people)
> Population: 557,320
> Share of pop. without health insurance: 12.1%
> Median household income: $73,376