{
  "slug": "south-carolina-county-primary-care-access-2026",
  "title": "South Carolina County Primary-Care Access & Health-Burden Scorecard",
  "summary": "A county-level targeting index for South Carolina, fusing adult chronic-disease and social-risk prevalence (CDC PLACES) with federally designated primary-care provider shortages (HRSA). Ranks all 46 counties by combined need so a health department or rural-health office can see where high burden and thin provider supply overlap.",
  "state": "South Carolina",
  "category": "Public Health & Risk",
  "tags": [
    "public-health",
    "health-access",
    "geospatial-risk",
    "government-data",
    "south carolina"
  ],
  "publishedDate": "2026-08-01",
  "accessAxisLabel": "Access & SDOH barriers",
  "generatedAt": "2026-08-01T06:59:08+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 South Carolina: 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": 46,
    "countiesWithHpsa": 46,
    "countiesWithHpsaPct": 100,
    "medianDiabetes": 16.5,
    "diabetesMin": {
      "county": "Charleston",
      "value": 11.4
    },
    "diabetesMax": {
      "county": "Marion",
      "value": 22.0
    },
    "medianUninsured": 13.1
  },
  "keyFindings": [
    "46 of South Carolina's 46 counties (100%) fall within a federally designated primary-care Health Professional Shortage Area.",
    "Adult diagnosed-diabetes prevalence ranges from 11.4% in Charleston County to 22.0% in Marion County, a 10.6-point spread within a single state.",
    "Allendale County carries the highest combined targeting-priority index (90.7/100), led by its access & sdoh barriers score.",
    "The median county uninsured rate (adults 18-64) is 13.1%, and the median adult diabetes prevalence is 16.5%."
  ],
  "counties": [
    {
      "fips": "45005",
      "name": "Allendale",
      "population": 7369,
      "priorityIndex": 90.7,
      "burdenScore": 89.8,
      "accessScore": 97.6,
      "shortageScore": 84.6,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 22,
      "hpsaDesignations": 3,
      "raw": {
        "DIABETES": 21.6,
        "OBESITY": 46.7,
        "BPHIGH": 50.1,
        "CHD": 9.1,
        "GHLTH": 31.4,
        "PHLTH": 17.8,
        "ACCESS2": 17.6,
        "LACKTRPT": 15.7,
        "FOODINSECU": 34.6,
        "HOUSINSECU": 24.5,
        "ACS_POVERTY": 26.5,
        "ACS_NOVEHICLE": 16.5
      },
      "ci": {
        "DIABETES": {
          "lo": 19.0,
          "hi": 24.3
        },
        "OBESITY": {
          "lo": 38.2,
          "hi": 55.5
        },
        "BPHIGH": {
          "lo": 45.6,
          "hi": 54.6
        },
        "CHD": {
          "lo": 8.1,
          "hi": 10.2
        },
        "GHLTH": {
          "lo": 27.3,
          "hi": 35.7
        },
        "PHLTH": {
          "lo": 15.4,
          "hi": 20.1
        },
        "ACCESS2": {
          "lo": 14.2,
          "hi": 21.7
        },
        "LACKTRPT": {
          "lo": 13.5,
          "hi": 18.3
        },
        "FOODINSECU": {
          "lo": 29.6,
          "hi": 40.0
        },
        "HOUSINSECU": {
          "lo": 21.0,
          "hi": 28.4
        }
      },
      "rank": 1
    },
    {
      "fips": "45067",
      "name": "Marion",
      "population": 28508,
      "priorityIndex": 87.1,
      "burdenScore": 92.1,
      "accessScore": 84.6,
      "shortageScore": 84.6,
      "topDriver": "Health burden",
      "hpsaMaxScore": 22,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 22.0,
        "OBESITY": 45.3,
        "BPHIGH": 49.6,
        "CHD": 9.5,
        "GHLTH": 31.7,
        "PHLTH": 18.7,
        "ACCESS2": 16.1,
        "LACKTRPT": 15.0,
        "FOODINSECU": 33.4,
        "HOUSINSECU": 23.2,
        "ACS_POVERTY": 27.3,
        "ACS_NOVEHICLE": 10.7
      },
      "ci": {
        "DIABETES": {
          "lo": 19.5,
          "hi": 24.7
        },
        "OBESITY": {
          "lo": 37.7,
          "hi": 53.3
        },
        "BPHIGH": {
          "lo": 45.4,
          "hi": 53.9
        },
        "CHD": {
          "lo": 8.4,
          "hi": 10.6
        },
        "GHLTH": {
          "lo": 27.8,
          "hi": 35.8
        },
        "PHLTH": {
          "lo": 16.4,
          "hi": 21.1
        },
        "ACCESS2": {
          "lo": 13.2,
          "hi": 19.4
        },
        "LACKTRPT": {
          "lo": 13.0,
          "hi": 17.3
        },
        "FOODINSECU": {
          "lo": 28.8,
          "hi": 38.2
        },
        "HOUSINSECU": {
          "lo": 20.0,
          "hi": 26.6
        }
      },
      "rank": 2
    },
    {
      "fips": "45069",
      "name": "Marlboro",
      "population": 25704,
      "priorityIndex": 85.4,
      "burdenScore": 83.7,
      "accessScore": 91.7,
      "shortageScore": 80.8,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 4,
      "raw": {
        "DIABETES": 20.5,
        "OBESITY": 41.0,
        "BPHIGH": 49.1,
        "CHD": 9.0,
        "GHLTH": 32.0,
        "PHLTH": 18.6,
        "ACCESS2": 17.6,
        "LACKTRPT": 15.5,
        "FOODINSECU": 33.5,
        "HOUSINSECU": 23.4,
        "ACS_POVERTY": 26.2,
        "ACS_NOVEHICLE": 13.8
      },
      "ci": {
        "DIABETES": {
          "lo": 18.2,
          "hi": 22.8
        },
        "OBESITY": {
          "lo": 33.9,
          "hi": 48.9
        },
        "BPHIGH": {
          "lo": 45.1,
          "hi": 53.4
        },
        "CHD": {
          "lo": 8.0,
          "hi": 10.0
        },
        "GHLTH": {
          "lo": 28.3,
          "hi": 35.7
        },
        "PHLTH": {
          "lo": 16.4,
          "hi": 20.8
        },
        "ACCESS2": {
          "lo": 14.5,
          "hi": 21.0
        },
        "LACKTRPT": {
          "lo": 13.5,
          "hi": 17.5
        },
        "FOODINSECU": {
          "lo": 29.1,
          "hi": 37.9
        },
        "HOUSINSECU": {
          "lo": 20.3,
          "hi": 26.5
        }
      },
      "rank": 3
    },
    {
      "fips": "45061",
      "name": "Lee",
      "population": 15967,
      "priorityIndex": 83.2,
      "burdenScore": 78.3,
      "accessScore": 79.1,
      "shortageScore": 92.3,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 24,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 20.1,
        "OBESITY": 43.7,
        "BPHIGH": 48.3,
        "CHD": 8.6,
        "GHLTH": 29.6,
        "PHLTH": 17.2,
        "ACCESS2": 15.9,
        "LACKTRPT": 14.6,
        "FOODINSECU": 31.6,
        "HOUSINSECU": 22.7,
        "ACS_POVERTY": 23.3,
        "ACS_NOVEHICLE": 11.4
      },
      "ci": {
        "DIABETES": {
          "lo": 17.7,
          "hi": 22.6
        },
        "OBESITY": {
          "lo": 35.8,
          "hi": 51.5
        },
        "BPHIGH": {
          "lo": 43.9,
          "hi": 52.4
        },
        "CHD": {
          "lo": 7.6,
          "hi": 9.6
        },
        "GHLTH": {
          "lo": 25.5,
          "hi": 33.6
        },
        "PHLTH": {
          "lo": 15.0,
          "hi": 19.3
        },
        "ACCESS2": {
          "lo": 12.7,
          "hi": 19.5
        },
        "LACKTRPT": {
          "lo": 12.5,
          "hi": 16.8
        },
        "FOODINSECU": {
          "lo": 26.8,
          "hi": 36.6
        },
        "HOUSINSECU": {
          "lo": 19.3,
          "hi": 26.0
        }
      },
      "rank": 4
    },
    {
      "fips": "45033",
      "name": "Dillon",
      "population": 27698,
      "priorityIndex": 82.4,
      "burdenScore": 85.8,
      "accessScore": 88.3,
      "shortageScore": 73.1,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 19,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 20.3,
        "OBESITY": 45.3,
        "BPHIGH": 47.4,
        "CHD": 9.1,
        "GHLTH": 31.6,
        "PHLTH": 18.5,
        "ACCESS2": 16.6,
        "LACKTRPT": 15.8,
        "FOODINSECU": 33.8,
        "HOUSINSECU": 23.3,
        "ACS_POVERTY": 29.2,
        "ACS_NOVEHICLE": 10.2
      },
      "ci": {
        "DIABETES": {
          "lo": 17.9,
          "hi": 22.9
        },
        "OBESITY": {
          "lo": 37.2,
          "hi": 53.8
        },
        "BPHIGH": {
          "lo": 43.0,
          "hi": 52.1
        },
        "CHD": {
          "lo": 8.1,
          "hi": 10.2
        },
        "GHLTH": {
          "lo": 27.7,
          "hi": 35.8
        },
        "PHLTH": {
          "lo": 16.3,
          "hi": 21.0
        },
        "ACCESS2": {
          "lo": 13.6,
          "hi": 19.9
        },
        "LACKTRPT": {
          "lo": 13.9,
          "hi": 18.2
        },
        "FOODINSECU": {
          "lo": 29.3,
          "hi": 38.7
        },
        "HOUSINSECU": {
          "lo": 20.1,
          "hi": 26.7
        }
      },
      "rank": 5
    },
    {
      "fips": "45089",
      "name": "Williamsburg",
      "population": 29891,
      "priorityIndex": 79.2,
      "burdenScore": 80.2,
      "accessScore": 76.6,
      "shortageScore": 80.8,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 3,
      "raw": {
        "DIABETES": 20.4,
        "OBESITY": 45.0,
        "BPHIGH": 49.9,
        "CHD": 8.6,
        "GHLTH": 29.3,
        "PHLTH": 16.8,
        "ACCESS2": 15.5,
        "LACKTRPT": 13.3,
        "FOODINSECU": 30.1,
        "HOUSINSECU": 21.7,
        "ACS_POVERTY": 23.6,
        "ACS_NOVEHICLE": 13.4
      },
      "ci": {
        "DIABETES": {
          "lo": 17.9,
          "hi": 22.9
        },
        "OBESITY": {
          "lo": 38.3,
          "hi": 52.2
        },
        "BPHIGH": {
          "lo": 45.9,
          "hi": 54.0
        },
        "CHD": {
          "lo": 7.7,
          "hi": 9.8
        },
        "GHLTH": {
          "lo": 25.6,
          "hi": 33.3
        },
        "PHLTH": {
          "lo": 14.7,
          "hi": 19.0
        },
        "ACCESS2": {
          "lo": 12.6,
          "hi": 18.8
        },
        "LACKTRPT": {
          "lo": 11.5,
          "hi": 15.4
        },
        "FOODINSECU": {
          "lo": 25.9,
          "hi": 34.8
        },
        "HOUSINSECU": {
          "lo": 18.8,
          "hi": 24.9
        }
      },
      "rank": 6
    },
    {
      "fips": "45049",
      "name": "Hampton",
      "population": 18122,
      "priorityIndex": 76.2,
      "burdenScore": 73.9,
      "accessScore": 73.9,
      "shortageScore": 80.8,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 21,
      "hpsaDesignations": 4,
      "raw": {
        "DIABETES": 20.2,
        "OBESITY": 41.6,
        "BPHIGH": 46.7,
        "CHD": 8.6,
        "GHLTH": 29.1,
        "PHLTH": 16.9,
        "ACCESS2": 16.6,
        "LACKTRPT": 13.7,
        "FOODINSECU": 30.2,
        "HOUSINSECU": 21.6,
        "ACS_POVERTY": 20.0,
        "ACS_NOVEHICLE": 11.2
      },
      "ci": {
        "DIABETES": {
          "lo": 17.7,
          "hi": 22.7
        },
        "OBESITY": {
          "lo": 33.5,
          "hi": 49.6
        },
        "BPHIGH": {
          "lo": 42.3,
          "hi": 51.0
        },
        "CHD": {
          "lo": 7.6,
          "hi": 9.7
        },
        "GHLTH": {
          "lo": 25.2,
          "hi": 32.9
        },
        "PHLTH": {
          "lo": 14.7,
          "hi": 19.1
        },
        "ACCESS2": {
          "lo": 13.7,
          "hi": 19.7
        },
        "LACKTRPT": {
          "lo": 11.8,
          "hi": 15.6
        },
        "FOODINSECU": {
          "lo": 25.6,
          "hi": 34.6
        },
        "HOUSINSECU": {
          "lo": 18.4,
          "hi": 24.7
        }
      },
      "rank": 7
    },
    {
      "fips": "45075",
      "name": "Orangeburg",
      "population": 82820,
      "priorityIndex": 74.0,
      "burdenScore": 69.5,
      "accessScore": 67.8,
      "shortageScore": 84.6,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 22,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 19.0,
        "OBESITY": 42.2,
        "BPHIGH": 47.3,
        "CHD": 8.4,
        "GHLTH": 27.5,
        "PHLTH": 16.3,
        "ACCESS2": 14.5,
        "LACKTRPT": 13.5,
        "FOODINSECU": 29.4,
        "HOUSINSECU": 20.5,
        "ACS_POVERTY": 23.9,
        "ACS_NOVEHICLE": 8.9
      },
      "ci": {
        "DIABETES": {
          "lo": 16.8,
          "hi": 21.4
        },
        "OBESITY": {
          "lo": 36.8,
          "hi": 48.1
        },
        "BPHIGH": {
          "lo": 43.8,
          "hi": 51.1
        },
        "CHD": {
          "lo": 7.4,
          "hi": 9.4
        },
        "GHLTH": {
          "lo": 23.7,
          "hi": 31.6
        },
        "PHLTH": {
          "lo": 14.3,
          "hi": 18.6
        },
        "ACCESS2": {
          "lo": 11.5,
          "hi": 17.9
        },
        "LACKTRPT": {
          "lo": 11.5,
          "hi": 15.6
        },
        "FOODINSECU": {
          "lo": 24.9,
          "hi": 33.9
        },
        "HOUSINSECU": {
          "lo": 17.4,
          "hi": 23.6
        }
      },
      "rank": 8
    },
    {
      "fips": "45011",
      "name": "Barnwell",
      "population": 20447,
      "priorityIndex": 73.3,
      "burdenScore": 78.6,
      "accessScore": 79.7,
      "shortageScore": 61.5,
      "topDriver": "Access & SDOH barriers",
      "hpsaMaxScore": 16,
      "hpsaDesignations": 1,
      "raw": {
        "DIABETES": 19.4,
        "OBESITY": 44.2,
        "BPHIGH": 45.7,
        "CHD": 9.2,
        "GHLTH": 29.4,
        "PHLTH": 17.9,
        "ACCESS2": 15.9,
        "LACKTRPT": 14.0,
        "FOODINSECU": 30.5,
        "HOUSINSECU": 21.0,
        "ACS_POVERTY": 28.5,
        "ACS_NOVEHICLE": 11.4
      },
      "ci": {
        "DIABETES": {
          "lo": 17.2,
          "hi": 21.9
        },
        "OBESITY": {
          "lo": 36.6,
          "hi": 51.9
        },
        "BPHIGH": {
          "lo": 41.6,
          "hi": 50.0
        },
        "CHD": {
          "lo": 8.2,
          "hi": 10.3
        },
        "GHLTH": {
          "lo": 25.6,
          "hi": 33.6
        },
        "PHLTH": {
          "lo": 15.8,
          "hi": 20.3
        },
        "ACCESS2": {
          "lo": 12.9,
          "hi": 19.2
        },
        "LACKTRPT": {
          "lo": 12.0,
          "hi": 15.9
        },
        "FOODINSECU": {
          "lo": 25.9,
          "hi": 34.8
        },
        "HOUSINSECU": {
          "lo": 17.9,
          "hi": 24.1
        }
      },
      "rank": 9
    },
    {
      "fips": "45009",
      "name": "Bamberg",
      "population": 12974,
      "priorityIndex": 71.6,
      "burdenScore": 71.5,
      "accessScore": 70.1,
      "shortageScore": 73.1,
      "topDriver": "Provider shortage",
      "hpsaMaxScore": 19,
      "hpsaDesignations": 2,
      "raw": {
        "DIABETES": 19.5,
        "OBESITY": 42.0,
        "BPHIGH": 47.1,
        "CHD": 8.7,
        "GHLTH": 27.3,
        "PHLTH": 16.7,
        "ACCESS2": 14.1,
        "LACKTRPT": 12.9,
        "FOODINSECU": 27.6,
        "HOUSINSECU": 19.4,
        "ACS_POVERTY": 21.6,
        "ACS_NOVEHICLE": 15.9
      },
      "ci": {
        "DIABETES": {
          "lo": 17.1,
          "hi": 22.0
        },
        "OBESITY": {
          "lo": 34.1,
          "hi": 50.5
        },
        "BPHIGH": {
          "lo": 42.8,
          "hi": 51.4
        },
        "CHD": {
          "lo": 7.7,
          "hi": 9.8
        },
        "GHLTH": {
          "lo": 23.4,
          "hi": 31.4
        },
        "PHLTH": {
          "lo": 14.5,
          "hi": 18.9
        },
        "ACCESS2": {
          "lo": 11.0,
          "hi": 17.6
        },
        "LACKTRPT": {
          "lo": 10.9,
          "hi": 15.2
        },
        "FOODINSECU": {
          "lo": 23.1,
          "hi": 32.7
        },
        "HOUSINSECU": {
          "lo": 16.5,
          "hi": 22.9
        }
      },
      "rank": 10
    },
    {
      "fips": "45087",
      "name": "Union",
      "population": 26629,
      "priorityIndex": 67.1,
      "burdenScore": 80.5,
      "accessScore": 63.2,
      "shortageScore": 57.7,
      "topDriver": "Health burden",
      "hpsaMaxScore": 15,
      "hpsaDesignations": 1,
      "raw": {
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      "topDriver": "Provider shortage",
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      "rank": 43
    },
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      "topDriver": "Provider shortage",
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    },
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      "topDriver": "Provider shortage",
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      "rank": 45
    },
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      "name": "Greenville",
      "population": 558036,
      "priorityIndex": 25.2,
      "burdenScore": 14.7,
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      "shortageScore": 46.2,
      "topDriver": "Provider shortage",
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      "ci": {
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        "ACCESS2": {
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        "LACKTRPT": {
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        "FOODINSECU": {
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      "rank": 46
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  ],
  "faq": [
    {
      "question": "What does the South Carolina county health-access scorecard measure?",
      "answer": "It ranks all 46 South Carolina 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": "39515ef6f45e11f6"
}