Primary Care Access Across Michigan Counties: Where the Shortage Is Real

Primary care access is a foundational driver of population health. Counties with more primary care providers per resident tend to have better preventive care uptake, earlier disease detection, and lower rates of preventable emergency department use. Michigan Signals uses Census County Business Patterns data (2022, NAICS 6211 — Offices of Physicians) to calculate primary care practices per 100,000 residents across all ten dashboard counties.

Primary Care Practices Per 100,000 Residents

• Oakland County: 125.5 per 100k
• Genesee County: 102.6 per 100k
• Macomb County: 91.4 per 100k
• Kalamazoo County: 51.5 per 100k
• Kent County: 57.0 per 100k
• Ingham County: 56.9 per 100k
• Wayne County: 56.4 per 100k
• Washtenaw County: 45.7 per 100k
• Livingston County: 43.7 per 100k
• Ottawa County: 30.7 per 100k

Surprises in the Data

Genesee County at 102.6 is the second-highest in the dataset. This may seem counterintuitive given the county's economic challenges. It likely reflects Flint's concentration of federally qualified health centers (FQHCs) and community health clinics that serve low-income populations. The water crisis also brought substantial healthcare investment into Flint, some of which persists in provider infrastructure. The count of physician office establishments may include FQHC satellite sites that serve similar functions to primary care offices. Explore Genesee County data

Ottawa County at 30.7 is the lowest in the dataset — despite being one of the stronger economic performers in Michigan Signals. Ottawa's geographic structure (large suburban and rural areas, relatively dispersed population) and the concentration of healthcare resources in Spectrum Health (based in Kent County) rather than local Ottawa County facilities may explain this. Residents may access primary care in Grand Rapids or Kalamazoo rather than within Ottawa County itself.

Washtenaw County at 45.7 is mid-range despite hosting U-M Health, one of the largest academic medical systems in the country. This reflects that the CBP metric counts establishments, not beds or providers — and U-M Health's massive outpatient infrastructure may count as a small number of large entities rather than many small physician offices.

Important Caveats

This metric counts physician office establishments, not individual physicians or patients served. A county with one large multi-physician group practice and a county with fifteen solo practitioner offices would count very differently, even if patient capacity is similar. The Michigan Signals health page notes this clearly: this is a proxy for access, not a definitive measure of physician supply. The HRSA Area Health Resources Files (AHRF) provide individual physician counts and are a more precise access measure.

Data Sources

• Census Bureau County Business Patterns (2022): NAICS 6211 — Offices of Physicians (except mental health). Establishment counts by county. Census CBP
• Census PEP (2023): Population for per-100k calculation. Census PEP