A new report from the State Comptroller’s Office lays out a stark warning: Many rural counties in New York are dangerously short on doctors, dentists, and mental health professionals — and the gap is growing.
The report, released in August, reviewed healthcare access across 16 rural counties and found that in some places, basic care simply isn’t available. Several counties have no pediatricians or OB/GYNs at all. Across the board, the number of providers falls well below state and national averages.
“Without access, rural New Yorkers may have worse health outcomes and have difficulty attracting people to live in these regions,” Comptroller Thomas DiNapoli said. He warned that as these areas age rapidly, the shortages could worsen unless action is taken.
Key findings show rural areas have just four primary care doctors per 10,000 people — less than half the state average. Pediatric care is even scarcer, with only 0.5 pediatricians per 10,000 residents. Three counties don’t have any.
For OB/GYNs, the report found a ratio of 0.4 per 10,000 — or one for every 23,000 people. Four counties have none at all, meaning women often travel long distances for maternal care. One hospital in Wyoming County even shut its maternity program altogether.
Dentist access is equally dire, with rural counties averaging 3.6 dentists per 10,000 people, compared to 8.3 statewide. Hamilton County has no dentists at all.
Mental health services may be in the worst shape. With only 6.9 practitioners per 10,000 residents, rural areas fall far short of the state average of 16.1. Every one of the 16 counties is designated a Mental Health Shortage Area. In Sullivan County, nearly 28,000 people are considered underserved.
Many of these regions rely heavily on nurse practitioners and physician assistants to fill gaps — but those numbers are low, too. Rural counties average 4.2 physician assistants and 10.5 nurse practitioners per 10,000 people, both below state levels.
The report also notes that federal policy changes could make things worse. Roughly 27% of residents in these counties are on Medicaid, and new federal limits could cut funding to rural hospitals already struggling with thin margins. Six rural hospitals in New York are among the top 10% nationally for Medicaid reliance, while five others have posted losses for three straight years.
To address the crisis, the Comptroller recommends expanding mobile clinics, school-based health centers, and telemedicine — especially in counties with poor transportation and limited broadband. Another fix could be offering more rural-specific training and loan forgiveness to attract and retain healthcare workers.
Despite New York producing more medical graduates than any other state, fewer than 5% plan to work in rural areas. Most loan forgiveness programs are geared toward nonprofit or public sector work, which overlaps with federal programs but doesn’t always reach rural clinics.
The report concludes that without urgent, coordinated action, rural health care shortages will continue to grow — putting residents at greater risk and making these communities harder to sustain.
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