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.
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