Health professional shortages have been and continue to be a concern throughout the United States, but the rural communities are faring worse than others. Health professionals include primary care practitioners, dental and mental health providers. As noted in the map below, for some states, the shortages are noted throughout the state to include urban and rural areas, but for the majority of the states the greatest shortages are in rural areas.

The primary care provider shortage is more dramatic (6,799), compared to dental (5,592) and mental health (4,724). According to the Rural Health Information Hub, health professional shortage areas may be designated according to geographic region, population-specific or facility-based. The geographic designation as implied is based on a demarcated geographic area. Some designations, occasionally in urban areas, and shortage areas are selected based on a subset of the population, usually with incomes 200 percent below federal poverty level.

Health Professional Shortage Areas (HRSA Data Warehouse)

Some health care facilities considered safety net such as Federally Qualified Health Centers and Federally Qualified Center Look-Alikes, Indian Health Services and some Rural Health Clinics automatically receive the shortage designation.

So what is being done about this health professional shortage crisis? Area Health Education Centers Program supports community-based interprofessional clinical training, continuing education, and outreach activities in order to improve the distribution, diversity, quality, and supply of the primary care health professions workforce serving in rural and underserved health care delivery sites. Area Health Education Centers (AHEC) are located throughout the United States, and AHECs have been around for over fifty years. In 2016, there were 52 centers throughout the United States, with at least one in each state.
Introduction to health careers for AHEC programs typically begins at the high school level for students. The goal is to matriculate students interested in health careers into a career pipeline. Activities facilitated by different AHECs include introducing students to the different health related career opportunities through education/presentations and participation in youth health service corps. Additionally, high school students are introduced to different health careers through field trips that include tours of medical facilities, simulation centers and summer camp. Students are kept engaged at the undergraduate level by providing internships and memberships in collegiate service corps. Exposure to the different career opportunities through mentorships and volunteerism are integral in the process of remaining in the pipeline because these activities are used to strengthen medical applications.

AHECs are required to maintain a database that includes the number of students reached each year by the services provided and although these numbers are impactful, the difference is evident in the individual student stories. One such story, shared below, is written by Christian Castro:

As I prepare to begin the next chapter in my life I can’t help but think back on how I got to this point. Walking onto the Texas Tech campus my freshman year I felt just like every other student in their 1st year: anxious, nervous, excited and even a little proud.

Christian Castro

You see I come from a traditional Hispanic family whose seeds come from individuals who immigrated to the United States at an early age with little education in order work and support people other than themselves. My grandparents were not fortunate enough to have completed their education, apart from one grandfather who completed his high school education. Instead my grandparents left their homes in Mexico to come to the United States to work, and at as early as 14 years old some of them were even the primary source of income for their families back in Mexico.

Education was a luxury that they could not afford, but working at multiple jobs they were able to make a better life for themselves and their children. Because of their sacrifices they could provide the opportunities that were never offered to them through proper education for their children and so forth. So, to have even been standing on a campus of a university as prestigious as Texas Tech University was a testament to not only my determination and will to succeed, but the support and hard work of my entire family.

Despite being proud of this milestone in my life, I would be lying if I said I wasn’t also terrified as an incoming freshman. Sure, I had the support of a wonderful family, but I was 300 plus miles away from home. I was on my own, and whatever was going to happen from here on in was going to be solely my responsibility.

I knew I wanted to be a doctor, but no one in my family or group of friends had ever done this, so I had no one to guide me. Probably the scariest thing I remember feeling was starting my freshman year not knowing anything about how to go about becoming a doctor. However, I was not going to let this stop me, so I began searching for organizations and opportunities that would help guide me along my path, and luckily for me I came across the Double T Health Service Corps.

The DTHSC (Double T Health Service Corp) was one of my guiding lights in pursuit of getting into medical school. I was introduced to students interested in the same field as me, partnerships with entities such as West Texas AHEC research opportunities, volunteer opportunities, and leadership opportunities. I would go on to climb the ranks of the organization until I reached the highest position of President in my last year, and along the way I was able to found many high school outreach programs and mentoring programs for students that were interested in pursuing careers in health professions. In a way I founded these programs with the idea that I could be a guiding light for students coming from similar backgrounds as myself and providing at least some guidelines for how to go about completing and continuing your education into a health profession.

My journey was not without hardships and failures, it was not without times when I felt like giving up, but I never did. Four long, hard years of biology, chemistry, organic chemistry, virology, immunology, etc., but I never quit. I never gave up. I like to think that I never gave up because I learned from my parents and from my grandparents that no matter how tough something is or how hard a class may be, if you set your mind to it nothing is impossible.

The countless sleepless nights, the long hours of studying before tests, and the many microwavable noodles over four years culminated into one of the greatest achievements in my life, acquisition of my Bachelors of Science in Biology from Texas Tech University.
As proud as this accomplishment makes me, it was a phone call I made in December that I will remember most about my last year at Texas Tech. The phone call was to my father and mother, and I told them for the first time that I would be attending Paul L. Foster School of Medicine in 2017. This moment of joy and tears after all the sacrifices made by my family, the hard work of my parents, and the support of organizations such as the DTHSC and West Texas AHEC was by far the most proud and accomplished I had ever felt in my life.
Now, as I prepare to continue my education as a medical student I will always remember the people that helped me get where I am today because without them I would not be here. I know the road ahead will be difficult, but with the support of those around me and the ideals I was raised with I know I can accomplish anything.

My name is Christian Michael Castro, and I am proud to say that I am a part of the Paul L. Foster School of Medicine Class of 2021.

This is but one among hundreds of success stories shared among AHECs nationally.
Stories like Christian Castro’s are the reason AHEC programs and youth health service corps such as the Double T Health Service Corp are instrumental in the recruitment of physicians and other health care professionals into the career pipeline.

These personal stories are the ones that speak to the effectiveness of the program provided through AHECs throughout the country.

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Debra Flores
Dr. Debra Flores is Managing Director for T-CORE and West Texas AHEC at the F. Marie Hall Institute for Rural and Community Health in Lubbock, TX.

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