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Underserved Populations in Kentucky

Delivering the right care, at the right time, in the right place is the ideal in healthcare, but, as every provider and patient knows, achieving this can be a challenge. In particular, a shortage of providers makes healthcare more difficult to access in many communities.

The U.S. Health Resources and Services Administration (HRSA) identifies geographic areas, population groups and facilities with a shortage of health providers or health services. This includes primary care.

In Kentucky, for example, 45 of the state’s 120 counties are designated as “Health Professional Shortage Areas” (HPSAs) for primary care, as of July 2021. The state also has 105 designated “Medically Underserved Areas/Populations” (MUA/Ps). When it comes to healthcare positions, Kentucky has large gaps to fill.

A Snapshot of Health Outcomes in Kentucky

County Health Rankings provides a county-by-county look at Kentucky’s health rankings. “Premature Death” is one of the measures. For Kentucky, that number is 9,500 per 100,000 population. By comparison, the U.S. figure for premature deaths is 6,900. Many of Kentucky’s lowest-ranked counties fall within the Appalachian Region.

Creating a Culture of Health in Appalachia: Disparities and Bright Spots is a research initiative administered by the Foundation for a Healthy Kentucky. Findings include a supply of primary care physicians (PCPs) that is 12% lower in the Appalachian Region than nationally.

How Can Nurse Practitioners Help?

Nurse practitioners (NPs) are helping to meet Kentucky’s urgent need in primary care. NPs are advanced practice registered nurses (APRNs) who have at least a Master of Science in Nursing (MSN). Some have a Doctor of Nursing Practice (DNP). NPs carry state APRN licensure and national certification in a “population focus,” such as:

  • Adult Gerontology Primary Care
  • Pediatric Primary Care

Laws governing NPs vary from state to state. According to the American Association of Nurse Practitioners (AANP), NPs in Kentucky can provide primary care under a reduced practice authority. This means NPs work under a collaborative agreement with another healthcare provider to offer primary care.

As primary care providers, NPs can help increase access to healthcare in Kentucky’s many underserved communities, reducing the delay patients might otherwise face if waiting for a physician.

Nurse practitioners can play an important role in diagnosing and treating substance abuse disorders. Substance abuse has become a national crisis. The National Institute on Drug Abuse reports that overdose death rates in Kentucky are in the second highest report level.

The Comprehensive Addiction and Recovery Act (CARA) expands access to substance use treatment services and overdose reversal medications. This includes extending prescribing privileges to qualifying NPs in accordance with state requirements.

RNs who want to advance their practice will find several options at Northern Kentucky University (NKU) at both the master’s and the doctoral level. NKU offers three master’s programs that prepare RNs for nurse practitioner certification, as well as a Post-Master’s Doctor of Nursing Practice (DNP), the highest level of education in the profession.

The Association of American Medical Colleges (AAMC) estimates a nationwide shortage of between 21,400 and 55,200 primary care physicians by 2033. NPs can help fill this primary care gap. For NPs working to make a difference in Kentucky’s underserved communities, added benefits may include scholarship and loan repayment programs.

Learn more about NKU’s online graduate-level nursing programs.


American Association of Nurse Practitioners: State Practice Environment

Creating a Culture of Health in Appalachia: Disparities and Bright Spots

County Health Rankings & Roadmaps:

Kentucky 2021

Kentucky State Level Data and Ranks

Community Anti-Drug Coalitions of America: Comprehensive Addiction and Recovery Act (CARA)

HRSA Data Warehouse: HPSA Find

HRSA Data Warehouse: MUA Find

HRSA Health Workforce: What Is Shortage Designation?

Kentucky Board of Nursing: APRN Practice

National Institute on Drug Abuse: Opioid Summaries by State

Association of American Medical Colleges: New AAMC Report Confirms Growing Physician Shortage

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