Rural location and racial segregation drive gaps in primary care access in Virginia

Neighborhood determinants of primary care access in Virginia

2025-05-27

(Press-News.org) Background and Goal: This study aimed to identify geographic disparities of the primary care workforce in Virginia and factors associated with primary care physician (PCP) access.

Study Approach: Researchers used the 2019 Virginia All-Payers Claims Database to identify PCPs and the number of patients seen by each physician. They then measured how many PCPs each census tract could reach within a 30‑minute drive, flagging tracts with too few as having poor access. Researchers then assessed associations between PCP access and predisposing (age, race), enabling (income, insurance), need and structural (rurality, segregation) factors.

Main Results:

Nearly half (44%) of Virginia’s census tracts lacked adequate PCP access.

Racial segregation and rurality had the greatest associations with PCP access. Tracts with higher proportions of Black residents had significantly greater PCP access than those with higher proportions of white residents, while rural tracts had significantly less access.

Why It Matters: The findings of this study can guide policymakers in focusing incentive programs and clinic expansions on underserved areas to increase primary care physician access, which may in turn reduce preventable hospitalizations.

Neighborhood Determinants of Primary Care Access in Virginia

Hannah M. Shadowen, PhD, et al

Department of Health Policy, Virginia Commonwealth University, Richmond, Virginia

Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia

Medical Scientist Training Program, Virginia Commonwealth University, Richmond, Virginia

An accompanying episode of the Annals of Family Medicine Podcast, featuring study authors Hannah Shadowen, PhD, and Alexander Krist, MD, MPH, will be available here beginning 9am EDT May 28.

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