{"main_topic":"health","sub_topic":"hrsa","topic":"mua_designations","key":"health/hrsa/mua_designations","version":"1.0.0","year_min":2000,"year_max":2026,"year_gaps":[],"update_frequency":"daily (re-pulled on demand)","detail_levels":["counties"],"default_detail":"counties","path_template":"health/mua_designations/year={year}/{detail}.parquet","grain":["year","county_fips","tract_geoid"],"title":"Medically Underserved Areas (HRSA)","summary":"Share of each county's residents living in a Medically Underserved Area, and how the county is designated, 2000 on.","description":"How much of each Georgia county is a Medically Underserved Area (MUA), each year from 2000, from HRSA's designation file: the share of the county's residents (2020 Census) living in a geographic MUA, our calculation, with the county's coverage status (whole county; whole county for a population group only, a Medically Underserved Population or MUP; part of the county; none), the number of area and population-group designations, and the lowest Index of Medical Underservice (IMU) score behind the status. HRSA uses MUA/P designations to decide where Health Center Program (community health center) grants can go. Past years are rebuilt from designation and withdrawal dates.","explorer":true,"search_aliases":{"en":["underserved communities","medical deserts","health care deserts","lack of doctors","no doctor nearby","MUA","MUP","IMU score","health center eligibility","underserved populations"],"es":["comunidades desatendidas","desiertos médicos","falta de médicos","sin médico cerca","poblaciones desatendidas","MUA","MUP","índice IMU","elegibilidad centros de salud","acceso a la salud"]},"source":"Health Resources and Services Administration (HRSA), Bureau of Health Workforce: Medically Underserved Areas/Populations detail file (data.hrsa.gov Data Downloads, built 2026-10-23, retrieved 2026-10-24); U.S. Census Bureau, 2020 Census P.L. 94-171 block and county subdivision populations, the 2010-to-2020 tract and block relationship files and the 2020 TIGER/Line block and county subdivision layers (our calculation of residents covered). Citation: Health Resources and Services Administration, data.hrsa.gov Data Downloads.","source_url":"https://data.hrsa.gov/data/download","endpoint":"/api/v1/health/mua_designations","columns":[{"name":"year","type":"integer","role":"year","nullable":false,"label":"Year","short_description":"","description":"The designations in effect on December 31 of the year (2026: on October 23, 2026, the date HRSA built its file), rebuilt from designation and withdrawal dates, 2000 on (see year_meaning).","valid_values":null,"example":2026,"unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"county_fips","type":"string","role":"fk_county","nullable":false,"label":"County FIPS","short_description":"","description":"5-digit county FIPS code (FK to the counties dimension). Every Georgia county has a row every year.","valid_values":null,"example":"13121","unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"tract_geoid","type":"string","role":"fk_tract","nullable":true,"label":"Tract GEOID","short_description":"","description":"Always NULL: this table has county rows only.","valid_values":null,"example":null,"unit":null,"value_min":null,"value_max":null,"null_meaning":"County row: the table has no tract rows.","key_metric_grain_contributor":false,"metric_component":null},{"name":"coverage_status","type":"string","role":"categorical","nullable":false,"label":"Coverage Status","short_description":"Whether the whole county, a population group across it, part of it, or none of it is designated.","description":"The widest kind of designation in effect in the county, first that applies: whole_county (a Medically Underserved Area, or a governor's exception area, covering the whole county); whole_county_population_group (a Medically Underserved Population covering a group of the whole county's residents: in Georgia always low-income residents); part_of_county (area or population designations of some census tracts or county subdivisions: the share is 0 where only population ones apply, as in Gwinnett, and Clayton's status from 2013 rests only on the airport tract, which has no residents); none. MUA/P has no facility designations. An attribute of the row, not part of its key. Population-group designations show here, not in the share.","valid_values":["whole_county","whole_county_population_group","part_of_county","none"],"example":"whole_county","unit":null,"value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"num_population_in_geographic_mua","type":"integer","role":"metric","nullable":true,"label":"Residents in a Geographic MUA","short_description":"","description":"Residents (2020 Census) living in a geographic Medically Underserved Area in effect in the county: the whole county population for a whole-county designation, otherwise the residents of the covered census tracts (2010 or 2020 tracts, through 2020 blocks) and county subdivisions (2020 census county divisions), each counted once and rounded to a whole person. Our calculation; the numerator of pct_population_in_geographic_mua. Never HRSA's designation population.","valid_values":null,"example":138390,"unit":"count","value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"num_population","type":"integer","role":"metric","nullable":true,"label":"County Population (2020 Census)","short_description":"","description":"The county's 2020 Census population (the sum of its 2020 blocks; equal to the tracts dimension's population_2020), the same in every year; Georgia 10,711,908. The denominator of pct_population_in_geographic_mua.","valid_values":null,"example":1066710,"unit":"count","value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"pct_population_in_geographic_mua","type":"number","role":"metric","nullable":true,"label":"Share of Residents in a Geographic MUA","short_description":"Share of the county's residents living in a geographic Medically Underserved Area.","description":"Share of the county's residents (2020 Census) living in a geographic Medically Underserved Area (including governor's exception areas) in effect at the year's as-of date: our calculation, num_population_in_geographic_mua / num_population, on the 0-1 scale (0.1297 = 12.97%). 1 for a county wholly designated; between 0 and 1 where some tracts or county subdivisions are; 0 where none is, including counties designated only for a population group (see coverage_status). 2026, Georgia pooled: 37.61%. For several counties, pool as SUM(num_population_in_geographic_mua) / SUM(num_population) within one year.","valid_values":null,"example":0.1297,"unit":"proportion","value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"num_geographic_designations","type":"integer","role":"metric","nullable":true,"label":"Area Designations","short_description":"","description":"Medically Underserved Areas (including governor's exception areas) in effect with any area in the county. Detail only: a designation spanning several counties counts in each.","valid_values":null,"example":1,"unit":"count","value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"num_population_designations","type":"integer","role":"metric","nullable":true,"label":"Population-Group Designations","short_description":"","description":"Medically Underserved Populations in effect with any area in the county: in Georgia, low-income residents, apart from Gwinnett's governor's exception for another group (and three withdrawn 2007 county MUPs HRSA types as areas). Detail only; a designation spanning several counties counts in each.","valid_values":null,"example":1,"unit":"count","value_min":null,"value_max":null,"null_meaning":null,"key_metric_grain_contributor":false,"metric_component":null},{"name":"min_imu_score","type":"number","role":"metric","nullable":true,"label":"Lowest IMU Score","short_description":"","description":"The lowest Index of Medical Underservice score (0-100; 62 or less qualifies; lower is more underserved) among the designations behind the coverage status: the whole-county area ones, the whole-county population ones, or the tract and subdivision ones. HRSA sets the score when it designates (or updates) an area from the poverty, age 65+, infant mortality and primary care provider data of that time, mostly 1978 or 1994 in Georgia, so it is not a current measure. Shown only for years on or after the last update of every designation behind the status.","valid_values":null,"example":56.7,"unit":"score","value_min":0,"value_max":100,"null_meaning":"coverage_status none; only governor's exceptions behind the status (they have no IMU score; HRSA shows 0); or a designation behind the status was last updated after the year's as-of date, so its score then is not in HRSA's file (always the case for a designation later withdrawn: the withdrawal is its last update).","key_metric_grain_contributor":false,"metric_component":null}],"key_metric":"pct_population_in_geographic_mua","numeric_filter_columns":["num_population_in_geographic_mua","num_population","pct_population_in_geographic_mua","num_geographic_designations","num_population_designations","min_imu_score"],"usage":"Star-schema fact table at county grain (tract_geoid always NULL), one row per county and year 2000-2026. Join the counties dimension on county_fips. pct_population_in_geographic_mua is the headline; coverage_status says whether the whole county, a population group across the whole county, part of it, or none of it is designated. For several counties, pool as SUM(num_population_in_geographic_mua) / SUM(num_population) within one year, never an average of shares; never sum the designation counts across counties (a multi-county designation counts in each). min_imu_score: lower is more underserved; NULL where the year's score is not in HRSA's file. Read directly with DuckDB over Parquet.","limitations":"Our calculation, not an HRSA figure: the share of a county's residents (2020 Census) in a geographic Medically Underserved Area (MUA), rebuilt yearly from HRSA's designation and withdrawal dates. It counts geographic designations only (population-group MUPs show in coverage_status) and is not a count of designations. MUAs are designated once on an Index of Medical Underservice (IMU) score of 62 or less and rarely re-scored: 130 of the 169 in effect in 2026 date from 1978 or 1994. A county wholly in a geographic MUA counts as 1. Tract and county-subdivision designations are weighted by 2020 Census population: each resident of a covered 2020 census block counts once, however many designations name the block, and a resident is placed in the county of the 2020 block. HRSA's own designation population is never used: it is not split by county (a multi-county designation repeats it on each county). Some designations still list 2010 census tracts. A designation with any tract code that is a 2010 tract and not a 2020 tract is read entirely as 2010 tracts, whose 2020 Census residents come from the Census Bureau's 2010-to-2020 block relationship file (a 2020 block split between 2010 tracts is split by land area). Seven 1994 designations list only codes valid in both 2010 and 2020; they are read as 2010 tracts too, like the other designations of their time (read as 2020 tracts, Muscogee would gain 27 residents). One designation, from 2026, uses 2020 tracts. Each year is rebuilt from HRSA's designation and withdrawal dates: the designations in effect on December 31 (the latest year: on October 23, 2026, the date HRSA built the file). A designation proposed for withdrawal is still designated. HRSA keeps withdrawn designations in its file but only each designation's current list of areas, so past years use today's lists; whether every old withdrawal is still in the file is not stated. County-subdivision designations are read as 2020 census county divisions (Georgia's division codes are the same in 2010 and 2020), each 2020 census block counted in the division that contains it. Five withdrawn designations have no withdrawal date; we date each withdrawal by HRSA's last update of the record (every dated withdrawal in the file was last updated on its withdrawal date), which keeps Early County wholly designated through 2006 and a Chatham tract through 2004. A Georgia designation's Alabama tract (South Columbus Service Area, Russell County) is left out. min_imu_score is the lowest IMU score (lower is more underserved) among the designations behind coverage_status, set when each was designated or last updated from the data of that time (most in 1978 or 1994), so it is not a current measure. It shows only in years on or after every one of those designations' last update (HRSA's file holds no earlier score), and governor's exceptions have no score. Clayton County's part_of_county status from 2013 rests only on the Hartsfield-Jackson airport tract, which has no residents, listed in a Fulton low-income designation. Georgia's pooled share stays between 37.16% and 37.74% in every year. A designation covering several counties counts in each county's designation counts: never add counts across counties.","null_semantics":{"suppressed_to_null":false,"zero_is_real":true},"available_years":[2000,2001,2002,2003,2004,2005,2006,2007,2008,2009,2010,2011,2012,2013,2014,2015,2016,2017,2018,2019,2020,2021,2022,2023,2024,2025,2026],"schema_hash":"4592c43a9dcc5a9a50fcabed368e33ff602a0e42d7f76b4bd28ab174c0130afe","tags":["health","health resources and services administration","mua_designations"],"granularity_description":"One row per year, county_fips, tract_geoid.","example_queries":[{"description":"Every county's coverage in the latest year, highest share first","query":"SELECT * FROM mua_designations WHERE year = 2026 ORDER BY pct_population_in_geographic_mua DESC"},{"description":"Georgia's share of residents in a geographic MUA by year (pooled over counties)","query":"SELECT year, SUM(num_population_in_geographic_mua)::DOUBLE / SUM(num_population) AS share FROM mua_designations GROUP BY year ORDER BY year"},{"description":"Fulton County's status over time","query":"SELECT year, coverage_status, pct_population_in_geographic_mua, min_imu_score FROM mua_designations WHERE county_fips = '13121' ORDER BY year"}],"foreign_keys":[{"column":"county_fips","target_object":"counties","target_columns":["county_fips"],"attribute_columns_added":["county_name"],"scope":"global"},{"column":"tract_geoid","target_object":"tracts","target_columns":["tract_geoid"],"attribute_columns_added":["tract_name"],"scope":"global"}],"filters":[{"param":"year","kind":"year_exact","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"year_min","kind":"year_range","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"year_max","kind":"year_range","type":"integer","multi_value":false,"enum_enforced":false,"values":null},{"param":"detail","kind":"detail","type":"string","multi_value":false,"enum_enforced":true,"values":["counties"],"default":"counties"},{"param":"county_fips","kind":"foreign_key","column":"county_fips","type":"string","multi_value":true,"enum_enforced":false,"values":null},{"param":"tract_geoid","kind":"foreign_key","column":"tract_geoid","type":"string","multi_value":true,"enum_enforced":false,"values":null},{"param":"coverage_status","kind":"categorical","column":"coverage_status","type":"string","multi_value":true,"enum_enforced":true,"values":["whole_county","whole_county_population_group","part_of_county","none"],"has_total":false,"total_value":null,"requires_single_value":false,"nullable":false,"null_filter_token":null}],"filter_hints":[],"non_additive":[{"column":"county_fips","reason":"A designation whose areas lie in several counties counts once in each county's designation counts, so a sum across counties counts it more than once and is not the number of designations.","metrics":["num_geographic_designations","num_population_designations"]}],"partitions":[],"value_implications":[],"year_meaning":"year Y (2000-2025) gives the Medically Underserved Area and Population designations in effect on December 31 of Y, rebuilt from HRSA's designation and withdrawal dates; 2026 gives those in effect on October 23, 2026, the date HRSA built the file (its current list), so 2026 is not a full year. Every year counts 2020 Census residents and each designation's current list of areas; an IMU score shows only from its designation's last update on.","pooled_rates":[{"column":"pct_population_in_geographic_mua","numerator":"num_population_in_geographic_mua","denominator":"num_population","scale":1}],"series_breaks":[],"year_window":null,"pooled_min_count":null,"values_endpoint":"/api/v1/health/mua_designations/values"}