{
  "slug": "montana-county-primary-care-access-2026",
  "title": "Montana County Primary-Care Access & Health-Burden Scorecard",
  "summary": "A county-level targeting index for Montana, fusing adult chronic-disease and social-risk prevalence (CDC PLACES) with federally designated primary-care provider shortages (HRSA). Ranks all 56 counties by combined need so a health department or rural-health office can see where high burden and thin provider supply overlap.",
  "state": "Montana",
  "category": "Public Health & Risk",
  "tags": [
    "public-health",
    "health-access",
    "geospatial-risk",
    "government-data",
    "montana"
  ],
  "publishedDate": "2026-08-01",
  "accessAxisLabel": "Access & SDOH barriers",
  "generatedAt": "2026-08-01T06:58:56+00:00",
  "dataVintage": {
    "places": "PLACES: Local Data for Better Health, County Data, 2025 release (measure year 2023)",
    "hpsa": "HRSA Primary Care HPSA detail extract, accessed 2026-08-01",
    "acs": "ACS 2019-2023 5-year estimates"
  },
  "methodology": "A Health-Burden axis is built from CDC PLACES crude adult prevalence (diagnosed diabetes, obesity, high blood pressure, coronary heart disease, fair or poor self-rated health, frequent physical distress). An Access & SDOH barriers axis combines uninsured (adults 18-64), lack of reliable transportation, food insecurity, housing insecurity, below poverty (acs), households without a vehicle (acs) (Census ACS measures join CDC PLACES here). Each measure is min-max normalized across the state's counties to 0-100, then averaged within its axis. A Provider-Shortage axis scales each county's worst designated primary-care HPSA score against the HRSA 0-26 severity scale. The combined Targeting-Priority Index is the equal-weighted mean of the three axes. PLACES values are model-based estimates with confidence intervals (carried per county), not direct counts. Scores are relative WITHIN Montana: a 100 marks the worst county in the state on that axis, not a national benchmark.",
  "limitations": [
    "Scores are intra-state relative, not absolute or cross-state comparable.",
    "PLACES values are small-area model-based estimates with confidence intervals, not direct counts.",
    "HPSA aggregation takes the worst designated primary-care score per county; geographic, population-group, and facility designations are pooled.",
    "Equal axis weighting is a transparent default, not a calibrated policy model.",
    "Socioeconomic measures are ACS 2019-2023 5-year estimates; ACS estimates carry margins of error not reflected in the composite.",
    "This is informational analysis of public data, not clinical, individual, or actuarial advice."
  ],
  "sources": [
    {
      "name": "CDC PLACES — Local Data for Better Health (County Data)",
      "dataset": "PLACES: Local Data for Better Health, County Data, 2025 release (measure year 2023)",
      "url": "https://www.cdc.gov/places/",
      "apiUrl": "https://data.cdc.gov/resource/swc5-untb.json",
      "accessedDate": "2026-08-01"
    },
    {
      "name": "HRSA — Primary Care Health Professional Shortage Areas",
      "dataset": "Shortage Area HPSA detail (Primary Care discipline, designated)",
      "url": "https://data.hrsa.gov/data/download",
      "accessedDate": "2026-08-01"
    },
    {
      "name": "U.S. Census Bureau — American Community Survey (5-year)",
      "dataset": "ACS 2019-2023 5-year estimates",
      "url": "https://www.census.gov/programs-surveys/acs/",
      "apiUrl": "https://api.census.gov/data/2023/acs/acs5",
      "accessedDate": "2026-08-01"
    }
  ],
  "measures": {
    "burden": [
      {
        "id": "DIABETES",
        "label": "Diagnosed diabetes"
      },
      {
        "id": "OBESITY",
        "label": "Obesity"
      },
      {
        "id": "BPHIGH",
        "label": "High blood pressure"
      },
      {
        "id": "CHD",
        "label": "Coronary heart disease"
      },
      {
        "id": "GHLTH",
        "label": "Fair or poor self-rated health"
      },
      {
        "id": "PHLTH",
        "label": "Frequent physical distress"
      }
    ],
    "access": [
      {
        "id": "ACCESS2",
        "label": "Uninsured (adults 18-64)"
      },
      {
        "id": "LACKTRPT",
        "label": "Lack of reliable transportation"
      },
      {
        "id": "FOODINSECU",
        "label": "Food insecurity"
      },
      {
        "id": "HOUSINSECU",
        "label": "Housing insecurity"
      },
      {
        "id": "ACS_POVERTY",
        "label": "Below poverty (ACS)"
      },
      {
        "id": "ACS_NOVEHICLE",
        "label": "Households without a vehicle (ACS)"
      }
    ]
  },
  "stats": {
    "counties": 56,
    "countiesWithHpsa": 53,
    "countiesWithHpsaPct": 95,
    "medianDiabetes": 11.6,
    "diabetesMin": {
      "county": "Gallatin",
      "value": 6.7
    },
    "diabetesMax": {
      "county": "Prairie",
      "value": 16.2
    },
    "medianUninsured": 9.4
  },
  "keyFindings": [
    "53 of Montana's 56 counties (95%) fall within a federally designated primary-care Health Professional Shortage Area.",
    "Adult diagnosed-diabetes prevalence ranges from 6.7% in Gallatin County to 16.2% in Prairie County, a 9.5-point spread within a single state.",
    "Glacier County carries the highest combined targeting-priority index (84.4/100), led by its access & sdoh barriers score.",
    "The median county uninsured rate (adults 18-64) is 9.4%, and the median adult diabetes prevalence is 11.6%."
  ],
  "counties": [
    {
      "fips": "30035",
      "name": "Glacier",
      "population": 13609,
      "priorityIndex": 84.4,
      "burdenScore": 82.8,
      "accessScore": 89.5,
      "shortageScore": 80.8,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 6,
      "raw": {
        "DIABETES": 15.5,
        "OBESITY": 39.7,
        "BPHIGH": 36.2,
        "CHD": 8.5,
        "GHLTH": 31.3,
        "PHLTH": 20.7,
        "ACCESS2": 14.3,
        "LACKTRPT": 19.7,
        "FOODINSECU": 32.0,
        "HOUSINSECU": 21.8,
        "ACS_POVERTY": 30.3,
        "ACS_NOVEHICLE": 5.1
      },
      "ci": {
        "DIABETES": {
          "lo": 13.4,
          "hi": 17.6
        },
        "OBESITY": {
          "lo": 33.3,
          "hi": 45.9
        },
        "BPHIGH": {
          "lo": 32.2,
          "hi": 39.9
        },
        "CHD": {
          "lo": 7.5,
          "hi": 9.5
        },
        "GHLTH": {
          "lo": 27.1,
          "hi": 35.4
        },
        "PHLTH": {
          "lo": 18.0,
          "hi": 23.2
        },
        "ACCESS2": {
          "lo": 11.4,
          "hi": 17.5
        },
        "LACKTRPT": {
          "lo": 16.8,
          "hi": 22.6
        },
        "FOODINSECU": {
          "lo": 27.1,
          "hi": 37.0
        },
        "HOUSINSECU": {
          "lo": 18.3,
          "hi": 25.3
        }
      },
      "rank": 1
    },
    {
      "fips": "30085",
      "name": "Roosevelt",
      "population": 10319,
      "priorityIndex": 77.1,
      "burdenScore": 73.5,
      "accessScore": 84.6,
      "shortageScore": 73.1,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 19,
      "hpsaDesignations": 4,
      "raw": {
        "DIABETES": 14.1,
        "OBESITY": 41.0,
        "BPHIGH": 36.0,
        "CHD": 7.5,
        "GHLTH": 28.3,
        "PHLTH": 18.9,
        "ACCESS2": 12.9,
        "LACKTRPT": 17.3,
        "FOODINSECU": 27.9,
        "HOUSINSECU": 19.9,
        "ACS_POVERTY": 30.6,
        "ACS_NOVEHICLE": 10.4
      },
      "ci": {
        "DIABETES": {
          "lo": 12.3,
          "hi": 16.2
        },
        "OBESITY": {
          "lo": 33.9,
          "hi": 49.0
        },
        "BPHIGH": {
          "lo": 32.1,
          "hi": 40.3
        },
        "CHD": {
          "lo": 6.7,
          "hi": 8.5
        },
        "GHLTH": {
          "lo": 24.5,
          "hi": 32.5
        },
        "PHLTH": {
          "lo": 16.6,
          "hi": 21.6
        },
        "ACCESS2": {
          "lo": 10.2,
          "hi": 15.9
        },
        "LACKTRPT": {
          "lo": 14.7,
          "hi": 19.9
        },
        "FOODINSECU": {
          "lo": 23.2,
          "hi": 32.7
        },
        "HOUSINSECU": {
          "lo": 16.7,
          "hi": 23.2
        }
      },
      "rank": 2
    },
    {
      "fips": "30003",
      "name": "Big Horn",
      "population": 12751,
      "priorityIndex": 76.6,
      "burdenScore": 72.8,
      "accessScore": 80.0,
      "shortageScore": 76.9,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 20,
      "hpsaDesignations": 6,
      "raw": {
        "DIABETES": 15.1,
        "OBESITY": 35.5,
        "BPHIGH": 35.6,
        "CHD": 8.3,
        "GHLTH": 29.3,
        "PHLTH": 19.1,
        "ACCESS2": 14.1,
        "LACKTRPT": 18.1,
        "FOODINSECU": 29.2,
        "HOUSINSECU": 20.7,
        "ACS_POVERTY": 23.6,
        "ACS_NOVEHICLE": 5.4
      },
      "ci": {
        "DIABETES": {
          "lo": 13.2,
          "hi": 17.3
        },
        "OBESITY": {
          "lo": 29.6,
          "hi": 41.8
        },
        "BPHIGH": {
          "lo": 32.0,
          "hi": 39.3
        },
        "CHD": {
          "lo": 7.3,
          "hi": 9.4
        },
        "GHLTH": {
          "lo": 25.6,
          "hi": 33.5
        },
        "PHLTH": {
          "lo": 16.8,
          "hi": 21.8
        },
        "ACCESS2": {
          "lo": 11.2,
          "hi": 17.3
        },
        "LACKTRPT": {
          "lo": 15.5,
          "hi": 20.8
        },
        "FOODINSECU": {
          "lo": 24.6,
          "hi": 34.0
        },
        "HOUSINSECU": {
          "lo": 17.5,
          "hi": 24.2
        }
      },
      "rank": 3
    },
    {
      "fips": "30005",
      "name": "Blaine",
      "population": 6899,
      "priorityIndex": 71.1,
      "burdenScore": 73.0,
      "accessScore": 59.6,
      "shortageScore": 80.8,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 3,
      "raw": {
        "DIABETES": 14.3,
        "OBESITY": 41.1,
        "BPHIGH": 36.9,
        "CHD": 8.3,
        "GHLTH": 26.1,
        "PHLTH": 18.1,
        "ACCESS2": 11.9,
        "LACKTRPT": 13.7,
        "FOODINSECU": 22.6,
        "HOUSINSECU": 16.0,
        "ACS_POVERTY": 20.2,
        "ACS_NOVEHICLE": 7.8
      },
      "ci": {
        "DIABETES": {
          "lo": 12.4,
          "hi": 16.3
        },
        "OBESITY": {
          "lo": 34.4,
          "hi": 47.9
        },
        "BPHIGH": {
          "lo": 33.0,
          "hi": 40.8
        },
        "CHD": {
          "lo": 7.4,
          "hi": 9.2
        },
        "GHLTH": {
          "lo": 22.5,
          "hi": 29.6
        },
        "PHLTH": {
          "lo": 15.8,
          "hi": 20.4
        },
        "ACCESS2": {
          "lo": 9.4,
          "hi": 14.8
        },
        "LACKTRPT": {
          "lo": 11.6,
          "hi": 16.0
        },
        "FOODINSECU": {
          "lo": 18.6,
          "hi": 26.7
        },
        "HOUSINSECU": {
          "lo": 13.2,
          "hi": 18.8
        }
      },
      "rank": 4
    },
    {
      "fips": "30087",
      "name": "Rosebud",
      "population": 8160,
      "priorityIndex": 65.0,
      "burdenScore": 70.3,
      "accessScore": 55.4,
      "shortageScore": 69.2,
      "topDriver": "Health burden",
      "hpsaMaxScore": 18,
      "hpsaDesignations": 3,
      "raw": {
        "DIABETES": 13.6,
        "OBESITY": 39.5,
        "BPHIGH": 39.4,
        "CHD": 8.2,
        "GHLTH": 25.3,
        "PHLTH": 17.5,
        "ACCESS2": 12.2,
        "LACKTRPT": 12.9,
        "FOODINSECU": 21.9,
        "HOUSINSECU": 15.0,
        "ACS_POVERTY": 21.6,
        "ACS_NOVEHICLE": 5.2
      },
      "ci": {
        "DIABETES": {
          "lo": 11.8,
          "hi": 15.4
        },
        "OBESITY": {
          "lo": 33.4,
          "hi": 45.9
        },
        "BPHIGH": {
          "lo": 35.6,
          "hi": 43.1
        },
        "CHD": {
          "lo": 7.3,
          "hi": 9.2
        },
        "GHLTH": {
          "lo": 21.9,
          "hi": 28.6
        },
        "PHLTH": {
          "lo": 15.3,
          "hi": 19.5
        },
        "ACCESS2": {
          "lo": 9.8,
          "hi": 14.6
        },
        "LACKTRPT": {
          "lo": 11.1,
          "hi": 14.8
        },
        "FOODINSECU": {
          "lo": 18.4,
          "hi": 25.7
        },
        "HOUSINSECU": {
          "lo": 12.8,
          "hi": 17.6
        }
      },
      "rank": 5
    },
    {
      "fips": "30073",
      "name": "Pondera",
      "population": 6125,
      "priorityIndex": 64.6,
      "burdenScore": 68.3,
      "accessScore": 48.5,
      "shortageScore": 76.9,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 20,
      "hpsaDesignations": 3,
      "raw": {
        "DIABETES": 13.6,
        "OBESITY": 37.2,
        "BPHIGH": 37.6,
        "CHD": 8.9,
        "GHLTH": 25.0,
        "PHLTH": 17.7,
        "ACCESS2": 11.7,
        "LACKTRPT": 10.5,
        "FOODINSECU": 18.2,
        "HOUSINSECU": 12.7,
        "ACS_POVERTY": 22.9,
        "ACS_NOVEHICLE": 6.6
      },
      "ci": {
        "DIABETES": {
          "lo": 11.6,
          "hi": 15.7
        },
        "OBESITY": {
          "lo": 30.4,
          "hi": 44.7
        },
        "BPHIGH": {
          "lo": 33.5,
          "hi": 41.8
        },
        "CHD": {
          "lo": 7.7,
          "hi": 10.2
        },
        "GHLTH": {
          "lo": 21.4,
          "hi": 29.2
        },
        "PHLTH": {
          "lo": 15.5,
          "hi": 20.3
        },
        "ACCESS2": {
          "lo": 9.2,
          "hi": 14.5
        },
        "LACKTRPT": {
          "lo": 9.0,
          "hi": 12.2
        },
        "FOODINSECU": {
          "lo": 15.0,
          "hi": 22.0
        },
        "HOUSINSECU": {
          "lo": 10.5,
          "hi": 15.1
        }
      },
      "rank": 6
    },
    {
      "fips": "30079",
      "name": "Prairie",
      "population": 1112,
      "priorityIndex": 62.0,
      "burdenScore": 85.5,
      "accessScore": 42.8,
      "shortageScore": 57.7,
      "topDriver": "Health burden",
      "hpsaMaxScore": 15,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 16.2,
        "OBESITY": 33.5,
        "BPHIGH": 44.8,
        "CHD": 12.3,
        "GHLTH": 26.4,
        "PHLTH": 18.9,
        "ACCESS2": 12.2,
        "LACKTRPT": 8.6,
        "FOODINSECU": 15.2,
        "HOUSINSECU": 10.0,
        "ACS_POVERTY": 23.9,
        "ACS_NOVEHICLE": 6.5
      },
      "ci": {
        "DIABETES": {
          "lo": 13.9,
          "hi": 18.8
        },
        "OBESITY": {
          "lo": 25.8,
          "hi": 41.8
        },
        "BPHIGH": {
          "lo": 40.0,
          "hi": 49.6
        },
        "CHD": {
          "lo": 10.7,
          "hi": 14.1
        },
        "GHLTH": {
          "lo": 22.1,
          "hi": 31.1
        },
        "PHLTH": {
          "lo": 16.2,
          "hi": 21.9
        },
        "ACCESS2": {
          "lo": 9.5,
          "hi": 15.3
        },
        "LACKTRPT": {
          "lo": 7.3,
          "hi": 10.2
        },
        "FOODINSECU": {
          "lo": 12.2,
          "hi": 19.2
        },
        "HOUSINSECU": {
          "lo": 8.2,
          "hi": 12.1
        }
      },
      "rank": 7
    },
    {
      "fips": "30101",
      "name": "Toole",
      "population": 5133,
      "priorityIndex": 60.6,
      "burdenScore": 52.2,
      "accessScore": 44.9,
      "shortageScore": 84.6,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 22,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 11.5,
        "OBESITY": 35.6,
        "BPHIGH": 34.1,
        "CHD": 7.5,
        "GHLTH": 23.0,
        "PHLTH": 15.7,
        "ACCESS2": 13.2,
        "LACKTRPT": 10.0,
        "FOODINSECU": 16.9,
        "HOUSINSECU": 12.4,
        "ACS_POVERTY": 12.3,
        "ACS_NOVEHICLE": 7.4
      },
      "ci": {
        "DIABETES": {
          "lo": 9.8,
          "hi": 13.5
        },
        "OBESITY": {
          "lo": 28.5,
          "hi": 43.2
        },
        "BPHIGH": {
          "lo": 30.2,
          "hi": 38.3
        },
        "CHD": {
          "lo": 6.5,
          "hi": 8.6
        },
        "GHLTH": {
          "lo": 19.4,
          "hi": 27.2
        },
        "PHLTH": {
          "lo": 13.5,
          "hi": 18.2
        },
        "ACCESS2": {
          "lo": 10.1,
          "hi": 17.0
        },
        "LACKTRPT": {
          "lo": 8.5,
          "hi": 11.9
        },
        "FOODINSECU": {
          "lo": 13.7,
          "hi": 20.6
        },
        "HOUSINSECU": {
          "lo": 10.2,
          "hi": 15.0
        }
      },
      "rank": 8
    },
    {
      "fips": "30051",
      "name": "Liberty",
      "population": 1974,
      "priorityIndex": 60.0,
      "burdenScore": 67.4,
      "accessScore": 55.0,
      "shortageScore": 57.7,
      "topDriver": "Health burden",
      "hpsaMaxScore": 15,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 13.1,
        "OBESITY": 34.0,
        "BPHIGH": 39.4,
        "CHD": 9.6,
        "GHLTH": 25.0,
        "PHLTH": 17.7,
        "ACCESS2": 11.8,
        "LACKTRPT": 9.6,
        "FOODINSECU": 16.6,
        "HOUSINSECU": 11.3,
        "ACS_POVERTY": 25.5,
        "ACS_NOVEHICLE": 13.3
      },
      "ci": {
        "DIABETES": {
          "lo": 11.0,
          "hi": 15.4
        },
        "OBESITY": {
          "lo": 26.0,
          "hi": 43.1
        },
        "BPHIGH": {
          "lo": 35.0,
          "hi": 44.2
        },
        "CHD": {
          "lo": 8.2,
          "hi": 11.1
        },
        "GHLTH": {
          "lo": 20.3,
          "hi": 30.2
        },
        "PHLTH": {
          "lo": 14.8,
          "hi": 20.8
        },
        "ACCESS2": {
          "lo": 8.5,
          "hi": 15.4
        },
        "LACKTRPT": {
          "lo": 7.8,
          "hi": 11.6
        },
        "FOODINSECU": {
          "lo": 12.6,
          "hi": 21.0
        },
        "HOUSINSECU": {
          "lo": 8.9,
          "hi": 14.0
        }
      },
      "rank": 9
    },
    {
      "fips": "30041",
      "name": "Hill",
      "population": 16276,
      "priorityIndex": 59.8,
      "burdenScore": 59.4,
      "accessScore": 46.8,
      "shortageScore": 73.1,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 19,
      "hpsaDesignations": 4,
      "raw": {
        "DIABETES": 12.1,
        "OBESITY": 38.5,
        "BPHIGH": 36.3,
        "CHD": 7.5,
        "GHLTH": 23.2,
        "PHLTH": 16.6,
        "ACCESS2": 11.5,
        "LACKTRPT": 11.3,
        "FOODINSECU": 18.2,
        "HOUSINSECU": 13.3,
        "ACS_POVERTY": 19.7,
        "ACS_NOVEHICLE": 6.0
      },
      "ci": {
        "DIABETES": {
          "lo": 10.5,
          "hi": 13.9
        },
        "OBESITY": {
          "lo": 32.5,
          "hi": 44.9
        },
        "BPHIGH": {
          "lo": 32.7,
          "hi": 40.1
        },
        "CHD": {
          "lo": 6.5,
          "hi": 8.5
        },
        "GHLTH": {
          "lo": 20.0,
          "hi": 27.1
        },
        "PHLTH": {
          "lo": 14.5,
          "hi": 19.0
        },
        "ACCESS2": {
          "lo": 9.0,
          "hi": 14.0
        },
        "LACKTRPT": {
          "lo": 9.6,
          "hi": 13.1
        },
        "FOODINSECU": {
          "lo": 14.9,
          "hi": 21.7
        },
        "HOUSINSECU": {
          "lo": 11.0,
          "hi": 15.7
        }
      },
      "rank": 10
    },
    {
      "fips": "30053",
      "name": "Lincoln",
      "population": 21895,
      "priorityIndex": 57.3,
      "burdenScore": 73.8,
      "accessScore": 29.0,
      "shortageScore": 69.2,
      "topDriver": "Health burden",
      "hpsaMaxScore": 18,
      "hpsaDesignations": 5,
      "raw": {
        "DIABETES": 14.0,
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        "ACS_POVERTY": 4.2,
        "ACS_NOVEHICLE": 0.2
      },
      "ci": {
        "DIABETES": {
          "lo": 9.3,
          "hi": 13.0
        },
        "OBESITY": {
          "lo": 25.1,
          "hi": 40.3
        },
        "BPHIGH": {
          "lo": 33.7,
          "hi": 42.5
        },
        "CHD": {
          "lo": 7.0,
          "hi": 9.3
        },
        "GHLTH": {
          "lo": 15.3,
          "hi": 21.9
        },
        "PHLTH": {
          "lo": 12.5,
          "hi": 16.8
        },
        "ACCESS2": {
          "lo": 6.4,
          "hi": 10.7
        },
        "LACKTRPT": {
          "lo": 5.1,
          "hi": 7.1
        },
        "FOODINSECU": {
          "lo": 7.2,
          "hi": 11.7
        },
        "HOUSINSECU": {
          "lo": 5.9,
          "hi": 9.0
        }
      },
      "rank": 50
    },
    {
      "fips": "30025",
      "name": "Fallon",
      "population": 2994,
      "priorityIndex": 28.2,
      "burdenScore": 36.9,
      "accessScore": 20.8,
      "shortageScore": 26.9,
      "topDriver": "Health burden",
      "hpsaMaxScore": 7,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 10.2,
        "OBESITY": 31.4,
        "BPHIGH": 32.7,
        "CHD": 6.8,
        "GHLTH": 18.5,
        "PHLTH": 14.2,
        "ACCESS2": 9.1,
        "LACKTRPT": 7.0,
        "FOODINSECU": 11.1,
        "HOUSINSECU": 8.8,
        "ACS_POVERTY": 12.1,
        "ACS_NOVEHICLE": 6.5
      },
      "ci": {
        "DIABETES": {
          "lo": 8.6,
          "hi": 12.1
        },
        "OBESITY": {
          "lo": 24.0,
          "hi": 40.2
        },
        "BPHIGH": {
          "lo": 28.4,
          "hi": 37.6
        },
        "CHD": {
          "lo": 5.9,
          "hi": 7.9
        },
        "GHLTH": {
          "lo": 15.5,
          "hi": 22.0
        },
        "PHLTH": {
          "lo": 12.2,
          "hi": 16.5
        },
        "ACCESS2": {
          "lo": 7.1,
          "hi": 11.6
        },
        "LACKTRPT": {
          "lo": 5.9,
          "hi": 8.2
        },
        "FOODINSECU": {
          "lo": 8.8,
          "hi": 13.7
        },
        "HOUSINSECU": {
          "lo": 7.2,
          "hi": 10.6
        }
      },
      "rank": 51
    },
    {
      "fips": "30083",
      "name": "Richland",
      "population": 11173,
      "priorityIndex": 26.2,
      "burdenScore": 36.2,
      "accessScore": 15.5,
      "shortageScore": 26.9,
      "topDriver": "Health burden",
      "hpsaMaxScore": 7,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 9.2,
        "OBESITY": 37.9,
        "BPHIGH": 31.3,
        "CHD": 6.2,
        "GHLTH": 17.1,
        "PHLTH": 13.4,
        "ACCESS2": 9.3,
        "LACKTRPT": 6.7,
        "FOODINSECU": 10.1,
        "HOUSINSECU": 8.6,
        "ACS_POVERTY": 7.1,
        "ACS_NOVEHICLE": 5.4
      },
      "ci": {
        "DIABETES": {
          "lo": 7.8,
          "hi": 10.7
        },
        "OBESITY": {
          "lo": 31.5,
          "hi": 44.5
        },
        "BPHIGH": {
          "lo": 27.7,
          "hi": 35.2
        },
        "CHD": {
          "lo": 5.3,
          "hi": 7.0
        },
        "GHLTH": {
          "lo": 14.3,
          "hi": 20.2
        },
        "PHLTH": {
          "lo": 11.6,
          "hi": 15.4
        },
        "ACCESS2": {
          "lo": 7.6,
          "hi": 11.6
        },
        "LACKTRPT": {
          "lo": 5.6,
          "hi": 7.8
        },
        "FOODINSECU": {
          "lo": 8.0,
          "hi": 12.3
        },
        "HOUSINSECU": {
          "lo": 6.9,
          "hi": 10.3
        }
      },
      "rank": 52
    },
    {
      "fips": "30069",
      "name": "Petroleum",
      "population": 554,
      "priorityIndex": 26.2,
      "burdenScore": 54.8,
      "accessScore": 4.6,
      "shortageScore": 19.2,
      "topDriver": "Health burden",
      "hpsaMaxScore": 5,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 12.4,
        "OBESITY": 32.9,
        "BPHIGH": 39.6,
        "CHD": 9.0,
        "GHLTH": 19.5,
        "PHLTH": 15.2,
        "ACCESS2": 8.5,
        "LACKTRPT": 6.3,
        "FOODINSECU": 10.1,
        "HOUSINSECU": 7.6,
        "ACS_POVERTY": 6.5,
        "ACS_NOVEHICLE": 0.0
      },
      "ci": {
        "DIABETES": {
          "lo": 10.4,
          "hi": 14.6
        },
        "OBESITY": {
          "lo": 24.9,
          "hi": 42.0
        },
        "BPHIGH": {
          "lo": 34.8,
          "hi": 44.6
        },
        "CHD": {
          "lo": 7.7,
          "hi": 10.5
        },
        "GHLTH": {
          "lo": 16.3,
          "hi": 23.4
        },
        "PHLTH": {
          "lo": 13.0,
          "hi": 17.7
        },
        "ACCESS2": {
          "lo": 6.6,
          "hi": 10.6
        },
        "LACKTRPT": {
          "lo": 5.2,
          "hi": 7.4
        },
        "FOODINSECU": {
          "lo": 7.8,
          "hi": 12.8
        },
        "HOUSINSECU": {
          "lo": 6.1,
          "hi": 9.2
        }
      },
      "rank": 53
    },
    {
      "fips": "30009",
      "name": "Carbon",
      "population": 11419,
      "priorityIndex": 20.3,
      "burdenScore": 50.6,
      "accessScore": 10.4,
      "shortageScore": 0.0,
      "topDriver": "Health burden",
      "hpsaMaxScore": 0,
      "hpsaDesignations": 0,
      "raw": {
        "DIABETES": 11.8,
        "OBESITY": 33.0,
        "BPHIGH": 40.1,
        "CHD": 8.0,
        "GHLTH": 18.9,
        "PHLTH": 14.6,
        "ACCESS2": 8.5,
        "LACKTRPT": 6.3,
        "FOODINSECU": 9.9,
        "HOUSINSECU": 7.7,
        "ACS_POVERTY": 8.5,
        "ACS_NOVEHICLE": 3.6
      },
      "ci": {
        "DIABETES": {
          "lo": 9.8,
          "hi": 13.7
        },
        "OBESITY": {
          "lo": 26.3,
          "hi": 40.3
        },
        "BPHIGH": {
          "lo": 35.7,
          "hi": 44.6
        },
        "CHD": {
          "lo": 6.9,
          "hi": 9.2
        },
        "GHLTH": {
          "lo": 15.7,
          "hi": 22.5
        },
        "PHLTH": {
          "lo": 12.5,
          "hi": 16.9
        },
        "ACCESS2": {
          "lo": 6.4,
          "hi": 10.7
        },
        "LACKTRPT": {
          "lo": 5.2,
          "hi": 7.4
        },
        "FOODINSECU": {
          "lo": 7.6,
          "hi": 12.5
        },
        "HOUSINSECU": {
          "lo": 6.1,
          "hi": 9.4
        }
      },
      "rank": 54
    },
    {
      "fips": "30021",
      "name": "Dawson",
      "population": 8810,
      "priorityIndex": 17.4,
      "burdenScore": 37.1,
      "accessScore": 15.0,
      "shortageScore": 0.0,
      "topDriver": "Health burden",
      "hpsaMaxScore": 0,
      "hpsaDesignations": 0,
      "raw": {
        "DIABETES": 10.1,
        "OBESITY": 32.8,
        "BPHIGH": 33.2,
        "CHD": 6.8,
        "GHLTH": 17.6,
        "PHLTH": 13.9,
        "ACCESS2": 9.0,
        "LACKTRPT": 6.7,
        "FOODINSECU": 10.2,
        "HOUSINSECU": 8.3,
        "ACS_POVERTY": 8.8,
        "ACS_NOVEHICLE": 5.0
      },
      "ci": {
        "DIABETES": {
          "lo": 8.6,
          "hi": 11.8
        },
        "OBESITY": {
          "lo": 26.2,
          "hi": 39.9
        },
        "BPHIGH": {
          "lo": 29.4,
          "hi": 37.3
        },
        "CHD": {
          "lo": 5.8,
          "hi": 7.7
        },
        "GHLTH": {
          "lo": 14.6,
          "hi": 20.9
        },
        "PHLTH": {
          "lo": 11.9,
          "hi": 16.1
        },
        "ACCESS2": {
          "lo": 7.0,
          "hi": 11.5
        },
        "LACKTRPT": {
          "lo": 5.6,
          "hi": 8.0
        },
        "FOODINSECU": {
          "lo": 7.9,
          "hi": 12.8
        },
        "HOUSINSECU": {
          "lo": 6.7,
          "hi": 10.1
        }
      },
      "rank": 55
    },
    {
      "fips": "30031",
      "name": "Gallatin",
      "population": 126409,
      "priorityIndex": 2.6,
      "burdenScore": 0.0,
      "accessScore": 7.9,
      "shortageScore": 0.0,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 0,
      "hpsaDesignations": 0,
      "raw": {
        "DIABETES": 6.7,
        "OBESITY": 23.0,
        "BPHIGH": 23.7,
        "CHD": 4.3,
        "GHLTH": 13.0,
        "PHLTH": 10.8,
        "ACCESS2": 8.3,
        "LACKTRPT": 6.4,
        "FOODINSECU": 8.5,
        "HOUSINSECU": 7.3,
        "ACS_POVERTY": 10.2,
        "ACS_NOVEHICLE": 2.3
      },
      "ci": {
        "DIABETES": {
          "lo": 5.6,
          "hi": 7.9
        },
        "OBESITY": {
          "lo": 19.2,
          "hi": 26.8
        },
        "BPHIGH": {
          "lo": 21.1,
          "hi": 26.4
        },
        "CHD": {
          "lo": 3.7,
          "hi": 5.0
        },
        "GHLTH": {
          "lo": 10.7,
          "hi": 15.4
        },
        "PHLTH": {
          "lo": 9.2,
          "hi": 12.5
        },
        "ACCESS2": {
          "lo": 6.2,
          "hi": 10.7
        },
        "LACKTRPT": {
          "lo": 5.1,
          "hi": 7.8
        },
        "FOODINSECU": {
          "lo": 6.3,
          "hi": 11.0
        },
        "HOUSINSECU": {
          "lo": 5.6,
          "hi": 9.0
        }
      },
      "rank": 56
    }
  ],
  "faq": [
    {
      "question": "What does the Montana county health-access scorecard measure?",
      "answer": "It ranks all 56 Montana counties by a combined Targeting-Priority Index that fuses adult chronic-disease and social-risk prevalence from CDC PLACES with federally designated primary-care provider shortages from HRSA, highlighting where health need and thin provider supply overlap."
    },
    {
      "question": "Which public datasets is it built from?",
      "answer": "CDC PLACES county estimates (PLACES: Local Data for Better Health, County Data, 2025 release, measure year 2023) and the HRSA Primary Care Health Professional Shortage Area detail file, both fully open federal sources accessed 2026-08-01."
    },
    {
      "question": "How should the Targeting-Priority Index be used?",
      "answer": "As a transparent first-pass screen for where to focus outreach, workforce, or program resources. Scores are relative within the state and equal-weighted by default; a real engagement would calibrate weights to a program's goals and add socioeconomic and utilization layers."
    }
  ],
  "contentHash": "7b1b70c79c2d15a5"
}