What are pharmacy deserts and why do they matter?
Recently, I was on Chicago Public Radio to explain.
What is a Pharmacy Desert?
The term “pharmacy desert” is borrowed from our original food desert report which raised national awareness and encouraged Congress to act. Today, the desert metaphor is increasingly being adapted to other conditions of scarcity or absence. We now regularly hear about bank deserts, public transit deserts, and, lately, pharmacy deserts.
Pharmacy deserts are large areas with few, if any, physical pharmacy locations. There is not yet a perfect distance threshold that defines one. We have not completed the statistical analysis needed to determine whether the recent closures are creating full-fledged pharmacy deserts in these South Side communities. What we can say, however, is that these closures could negatively impact public health and broader retail conditions.
Pharmacies are community stores where families pick up prescriptions, receive vaccinations, purchase over-the-counter medications, and ask clarifying questions of pharmacists and trained staff. They also sell convenience goods and some food items that support everyday needs. And most are SNAP-authorized retailers.
Some of the Walgreens closures are in areas we previously identified as food deserts. Years ago, we calculated the negative health impacts associated with those conditions and found that residents experienced higher rates of diet-related disease and premature death because quality grocers were absent, even after controlling for other factors. These communities are already vulnerable.
See our website for the full report and other background: marigallagher.com
Because these communities still lack larger grocery stores that typically include in-store pharmacies, the additional loss of smaller freestanding pharmacies has an even greater impact than it would in other neighborhoods.
Some of these Chicago communities also experience high crime rates that make both retail operations and residential life more difficult. I know these areas personally and professionally through years of research, on-the-ground projects, and community collaboration. The vast majority of residents are law-abiding people who simply want what we all do: safe, attractive, affordable communities with decent schools and nearby retail.
The National Picture Behind Pharmacy Closures
It is unfair to paint Walgreens, or other pharmacies, as the obvious villain in this story without understanding the full complexity behind each closure.
There is significant disruption happening across the pharmacy industry, and stores are closing nationwide, including in rural communities, not just disinvested urban areas. In many ways, these communities share common challenges: aging populations needing in-person assistance, higher rates of disease, mobility limitations, poverty, lower employment levels, and other structural barriers.
And the reality is this: pharmacy closures will likely expand into more advantaged communities as well. More change is on the horizon.
The reasons for these closures are numerous and complex: reduced reimbursement rates for prescription drugs, pressure to cut costs, extensive paperwork requirements, the liability of managing sensitive patient information, staffing shortages, and the reality that mail-order prescriptions are cheaper to provide than maintaining physical storefronts.
The disappearance of pharmacies is also troubling because of the important role pharmacies play as employers.
Economist Joseph Ferrie recently pointed out in a comment to one of my LinkedIn posts that Nobel Prize-winning economist Claudia Goldin and Larry Katz described pharmacists as among the most egalitarian of the professional occupations (Journal of Labor Economics, 2016). Over the last 25 years, the growth of national pharmacy chains expanded employment opportunities overall, but especially for women, who benefited disproportionately from flexible scheduling and stronger wage equity compared to many other professions.
Employment within large pharmacy chains helped increase female labor force participation and narrow wage gaps between men and women. The potential loss of these opportunities deserves far more attention as stores continue closing nationwide.
At the same time, enrollment in pharmacy schools has reportedly declined due to workplace burnout, student debt, and diminishing wage returns relative to the cost of the degree. Rising costs of groceries, housing, transportation, and other essentials may further discourage students, particularly women and disadvantaged populations, from pursuing pharmacy careers in the future.
These workforce pressures are occurring while pharmacies themselves are under increasing strain. Staff are often overloaded with expanding responsibilities, insurance complications, staffing shortages, and growing pressure to reduce costs. Pharmacists and technicians spend more time navigating insurance approvals and frustrated customer interactions while having less time available for in-person guidance and care.
Residents in more advantaged communities may have other ways to access trusted health guidance and support. Residents in troubled markets often do not.
As previously mentioned, communities at risk of becoming pharmacy deserts should explore creative alternatives, including smaller pharmacy-only counters located inside existing stores or community facilities. This could preserve access to pharmaceuticals, vaccinations, and professional guidance without the overhead costs and operational burdens tied to larger standalone stores.
Retailers absolutely have responsibilities related to safety and operations, but only to a point. Long-term neighborhood quality of life and public safety must also involve local officials, community leaders, and broader public-private collaboration committed to equitable access across communities.
What Communities Can do
Communities should inventory their assets and work proactively to retain, grow, and strengthen them.
This is especially important for vulnerable neighborhoods, but it applies more broadly as well. Over the next decade, we will likely see a thinning of pharmacies across many types of communities.
In our work, we can predict, for example, where pharmacies and other retailers are likely to close. This helps elected officials, economic development professionals, community leaders, and others understand and prioritize strategic action. We need to reach out to these businesses before closures happen to better understand challenges and identify ways to support them. Some pharmacy stores can be retained, and if they need to close, explore offering locations to nest them for pharmacy-only counters within other retail locations.
Be proactive. Look for ways to help stabilize important community assets before they disappear.
For more advice on what to do in your community, you can reach us at: Mari@marigallagher.com or submit a request through our website contact form.
Chicago Public Radio Clip
For those interested in the recent Chicago pharmacy closures, here is the radio segment:
Kudos to host Sasha-Ann Simons and producer Cianna Greves for their excellent reporting!
Who is Mari Gallagher?
Mari Gallagher, founder and principal of Mari Gallagher Research & Consulting Group, is a nationally recognized expert in food access, grocery market analysis, hyperlocal data modeling, and community health impacts. Her original food desert research raised national awareness about inequitable food access and its impacts on public health and market conditions. Her seminal Chicago food desert report encouraged Congressional action and investment into underserved communities.
Today, the “desert” metaphor from that work continues to shape public dialogue around other forms of scarcity and disinvestment, including pharmacy deserts, bank deserts, and public transit deserts.
Her firm also created a unique hyperlocal “missing meals” model, the Meal Deficit Metric (MDM), which quantifies unmet food need after accounting for all ways households receive groceries or meals, including government programs and charitable food sources. The model is designed to support both market and community-based solutions.
Mari continues to influence public policy, community development, and market initiatives nationwide through research and strategy grounded in both rigorous analysis and real-world implementation.
