‘Pharmacy deserts’ are a threat to health in some areas, study warns

Researchers found that nearly 18% of Americans live in pharmacy deserts

By Mark Huffman of ConsumerAffairs

May 5, 2025

• Over 90% of U.S. prescriptions are filled by local pharmacies, which also serve as vital public health providers.

• Nearly 18% of Americans live in pharmacy deserts, with entire communities depending on a single keystone pharmacy.

• A new Yale study introduces a travel-time-based method to identify and prevent pharmacy deserts nationwide.

As pharmacies increasingly serve as more than just medication dispensariesproviding vaccines, health screenings, and medication managementnew research from Yale University is sounding the alarm on what experts are calling pharmacy deserts.

Drawing a parallel to food deserts, where communities face limited access to nutritious groceries, pharmacy deserts are regions with too few pharmacies to meet local needs. And for a significant slice of the U.S. population, that desert is already a harsh reality.

In a study published in JAMA Network Open, Yale researchers introduced a new approach to identifying pharmacy desertsnot by raw distance, but by actual travel time. This methodology accounts for regional differences, recognizing that rural residents might tolerate longer drives than their urban counterparts.

By mapping out every pharmacy across the country and calculating how long it would take 80% of people in each census tract to reach a supermarket (used as a common reference point), the researchers set a new standard: if no pharmacy exists within that threshold, the area qualifies as a pharmacy desert.

Pharmacies are frontline community health resources, Dr. Walter Mathis, assistant professor of psychiatry at Yale School of Medicine and the studys senior author, said in a statement. We wanted to develop a robust definition that was relevant on a national scale.

Millions at risk

The findings are sobering. Of the 323.5 million people living in the United States at the time of the study, 17.7%roughly 57 million peoplelived in a pharmacy desert. An additional 9% lived in areas served by just a single pharmacy, dubbed keystone pharmacies.

In 18 states, more than one in five residents live in pharmacy deserts. States like New Hampshire, South Dakota, West Virginia, Maine, and Vermont reported even higher rates, over 25%. And the burden is especially heavy in rural communities, which often rely on independently owned pharmacies rather than national chains.

The concept of keystone pharmaciesthose that serve as the only pharmaceutical provider for multiple neighborhoodsemerged as a critical discovery in the study. These pharmacies act as the glue holding entire communities together. The loss of just one keystone pharmacy could result in vast swathes of people losing access to vital medications and services.

If a pharmacy in Oxnard, California, which serves seven census tracts and potentially more than 34,000 residents, were to close, all those neighborhoods would fall into a pharmacy desert overnight.

These keystone pharmaciesalmost heroic in that if they were to go away, a neighborhood or neighborhoods would collapse into a dramatically underserved areaare really special cases, said Mathis.

Solutions

Rather than focusing solely on opening new pharmacieswhich requires considerable investmentthe Yale researchers suggest bolstering keystone pharmacies through financial support. Grants, subsidies, or revised insurance reimbursement policies could help keep these essential businesses viable.

The research team is already sharing its data with local organizations to stimulate community-level solutions and inform government policy at all levels.

The goal is to prevent pharmacy deserts before they form, said Mathis. By identifying at-risk communities early, we can ensure that pharmacy accessand by extension, basic health servicesremains within reach for all Americans.

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