Nurse workforce change and metropolitan medically underserved areas in the United States

The continued healthcare crisis in the United States (US) is worrisome, especially as workforce shortages, particularly for nurses, are highlighted, often in some of the highest need areas. As the need for healthcare services grows, especially for services that nurses can deliver, the inability to meet those needs exacerbates existing disparities in access to care and can jeopardize the quality and timeliness of healthcare delivery in underserved communities. Prior investigations have used varying definitions to describe underserved, under-resourced, rural, or health professional shortage areas to examine the relationship between these areas and workforce shortages. Therefore, this study examines the relationship between changes in the nursing labor force changes and metropolitan medically underserved areas (MUA), defined by Health Resources and Services Administration (HRSA).

Secondary data were utilized to conduct descriptive and regression analyses of the nursing workforce population in metropolitan statistical areas from 2012 to 2022. The key outcome variable for the analyses was nurse workforce change per 10,000 population. Occupational Employment and Wage dataset from the Bureau of Labor Statistics was used to determine the number of nurses employed, at the level of the metropolitan statistical area from 2012 to 2022. The Index of Medical Underservice was extracted for each MUA from HRSA and geographically weighted to the metropolitan area.

The results of descriptive trends for nursing professions show that all nursing occupations reviewed have experienced positive change over both five- and ten-year periods. However, the results of nurse change models show that neither the change in Registered Nurses nor Nurse Practitioners is correlated with medically underserved areas.

These results emphasize the need for adaptive strategies in the nursing workforce to respond to the evolution of healthcare requirements over time. The findings from this study suggest the need for careful planning in workforce policy and education to grow the nurse workforce needs to meet evolving healthcare needs effectively.