Millions of Americans are receiving healthcare that rivals Third World standards. Vast regions of the country have seen medical services evaporate over the past decade. Hospitals have closed, doctors have left, and pharmacies have been forced into bankruptcy. In this series, Dried Up: America's Medical Deserts, the Washington Examiner will investigate what happened to these now barren terrains. Without adequate access to a hospital, primary care center, OBGYN, or other specialized medical services, the health of an estimated 30 million people is put in jeopardy.

When Michael Meit's wife went into labor 19 years ago in northwest Pennsylvania , the first-time father white-knuckled the five-minute drive to the closest hospital , Bradford Regional Medical Center, a busy 109-bed facility. The drive felt like it took forever, and he was a nervous wreck the entire time. Had his wife gone into labor in 2022, that ride would have been much longer. The Meits would have been forced to cross the county line and travel more than 20 miles in inclement weather to have their baby.

"It's absolutely terrifying," Meit , co-director of the Center for Rural Health Research at East Tennessee State University, told the Washington Examiner. "She could not be born there today."

Meit recently learned that the hospital now is just a shell of what it once was.

"I just found out that the hospital is currently a 10-bed hospital," he said. "They have gotten rid of all of their obstetric care. They have gotten rid of their surgical services. For any of their specialized service, you now have to go to the next county. And they are actually doing better than a lot of other communities because they still have those 10 beds. They still have an emergency room. In a lot of places, the whole hospital is closed."

BIDEN ADMINISTRATION MOVE COULD HURT RURAL HOSPITALS

That was the nightmare Nicholas Motley and his father Jim faced in rural West Virginia . Jim, an 87-year-old veteran, started experiencing signs of a stroke during dinner. He got worse and when his son saw his face start to sag, he knew it was serious. There wasn't enough time to call an ambulance, so Nicholas put his father in his pickup truck to get emergency medical help.

They drove for more than an hour, passing two shuttered hospitals along the way. By the time they got to a functioning facility, it was too late.

"I have always loved the country, living out here, but what happened to dad broke my heart," Nicholas told the Washington Examiner. "He suffered because there was no one around who could help him."

The Motleys' experience isn't a one-off.

Vast regions of the country, stretching from the Badlands of South Dakota to the Sonoran Desert in Arizona and beyond, have all seen medical services dry up over the past decade. Hospitals have closed, doctors have fled, and pharmacies have been forced into bankruptcy. What's left are barren terrains known as "medical deserts," a term coined for areas where residents have to travel more than an hour to get to a hospital, primary care center, OBGYN, or other specialized medical services.

For example, in Texas , 159 of the state's 254 counties have no general surgeons, 121 have no medical specialists, and 35 have no doctors at all.

Residents stuck in these medical wastelands have no option but to settle for subpar service that can put lives in jeopardy.

PANDEMIC PUSHED RURAL HOSPITAL CLOSURES TO RECORD NUMBER IN 2020

Despite its name, medical deserts are not confined to rural areas, though most are found there. The sober truth is that every state in the country has at least one desert county that fits the description, said Tori Marsh, director of GoodRx, a consumer-focused digital healthcare platform.

“Just because you live in a very populated city doesn’t necessarily mean you have the infrastructure needed,” she said. “It might mean that you have fewer hospital beds; it might mean that there are not enough providers for your community.”

Coast to coast, it is estimated that 30 million people currently live in medical deserts.

When it comes to rural communities, the federal government has designated nearly 80% of them as "medically under-served." Those areas are home to 20% of the U.S. population but house fewer than 10% of its doctors, a ratio that is growing more lopsided by the day.

Rural doctors are on average three years older than urban doctors, with half over 50, and more than a quarter beyond 60 and nearing retirement. For younger doctors who are either single or just starting families, there is little to no incentive to move to these areas. The infrastructure is poor, there are no real growth opportunities, and the pay is well below what they could make in bigger markets.

On average, healthcare provider deserts have one full-time primary care provider for every 10,449 people — a patient caseload that is more than three times the recommended level, according to a 2021 analysis from GoodRx Research .

When it comes to hospital deserts, the numbers are even more staggering.

There are approximately 29 million people who do not have adequate access to hospitals and must travel more than 30 minutes to the nearest facility. Vermont , Alaska , Arkansas , Alabama , and Maine have the largest share of people living in a hospital desert.

In 2020, the Pickens County Medical Center, located in west Alabama near the Mississippi border, shut its doors for good, citing the hospital's finances were no longer sustainable. It blamed too few patients, reduced federal funding, and large numbers of uninsured patients as catalysts. Closing the hospital, which had been operating since 1979, was a huge blow to the community. Residents lost their access to healthcare nearby, and the hospital, which had been the community's largest employer, laid off 150 workers. The 56-bed hospital was the only hospital in the county.

One resident didn't mince words about the effect of the closing.

"Leaving us to die on our way 2 Meridian, Ms," the person told AL . "Sad day for County - Sad day for Old Senior Citizen."

Rural hospitals across the country have been struggling financially for years, prompting the closure of 101 facilities from January 2013 through February 2020, according to a report from the U.S. Government Accountability Office . Another study from the Center for Healthcare Quality and Payment Reform found that 40% of all rural hospitals were at immediate risk of closing even before the coronavirus pandemic hit, crippling their practices even more.

RURAL HOSPITALS ARE ON THE BRINK OF COLLAPSE

Of the country's medical deserts, 47% are also hospital bed deserts, while more than 40% are trauma center deserts, where a patient has to travel more than an hour to reach a healthcare facility that is equipped to handle major traumatic injuries. For example, in Idaho, there are no Level 1 trauma centers, a designation for a place to treat patients with the most critical needs.

The uneven access to basic medical needs was most recently highlighted during the COVID-19 pandemic, when people in need of emergency respiratory care had to travel for hours for help. In some cases, people got much worse or even died along the way. Those lucky enough to make it were often left waiting for hours before they were treated.

Adding to the frustration are pharmacy deserts, classified as a neighborhood with an average distance to the nearest pharmacy being greater than a mile or the average distance to the nearest pharmacy being half a mile where at least 100 households had no vehicle or public transportation access. The GoodRx study found that more than 41 million people live in a pharmacy desert. South Dakota, Montana, and Nebraska were the top three states that had the largest number of counties that lacked access to pharmacies where residents had to drive more than 15 minutes to fill a prescription. That posed a concern because even if there was a healthcare provider available, finding a pharmacy to fill a prescription became problematic.

A deeper dive into pharmacy deserts revealed that the biggest disparities existed in large cities like Los Angeles and Chicago, where finding an open pharmacy often involved hopping on two trains and a bus followed by a several-block walk.

In Chicago, there are far fewer pharmacies operating on the city's South and West sides than in other parts, said Dima Qato, a professor at the University of Southern California.

"Chicago actually has the widest gaps between white and black neighborhoods in the country," she told the Chicago Sun-Times.

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A separate analysis by WBEZ showed access to the two largest pharmacy chains in the city, Walgreens and CVS, is much higher in Chicago's white communities than in its black or Latino ones. It also found that closures were exacerbated by the civil unrest of 2020, when 1 out of 5 pharmacies closed temporarily or permanently.

The numbers are rough in rural areas, too.

From 2003 to 2018, 1,231 of the nation's 7,624 independent rural pharmacies closed, according to the University of Iowa's Rural Policy Research Institute, leaving 630 communities with no independent or chain retail drugstore.