A federal label could bring more health care to the South Side, but the neighborhoods that need it most don’t have it

Latika Scott has to take two buses or walk more than 20 minutes to get to the Metra train to get to and from her prenatal appointments. Those are the best options in her neighborhood in Burnside on Chicago’s Far South Side. 

“Sometimes I just don’t even go to my appointment because it’s just too much,” Scott said. “I’m pregnant and tired. My feet already hurt. It shouldn’t be this hard just to get a checkup.”

Scott has decided to give birth at the closest hospital to her with a maternity ward. It’s in Hyde Park. It’s important to her to know the doctor delivering her baby, she said, so she gets her prenatal care there too. Her neighborhood hospital, Jackson Park Hospital, closed its maternity ward in 2019.

Scott’s trip is a familiar one on the Far South Side. Since 2018, three obstetric facilities that served South and West Side residents have closed, according to a 2024 report from the American Medical Association and Sinai Urban Health Institute. Many South Side ZIP codes have no OB-GYNs at all.

“You probably have to take several buses,” said Melissa Gutierrez Kapheim, director of health equity research at Sinai Urban Health Institute, describing what a pregnant patient on the South Side faces. “So what is the likelihood that you are going to get to your appointment, get to your appointment on time?”

The federal government has a label meant to send help to neighborhoods like Scott’s. It’s called a Medically Underserved Area, or MUA. It decides where new community health centers can open and get federal funding, and as of this year, which Chicago pharmacies can get state money to stay open.

Dozens of South Side neighborhoods qualify for that label but don’t have it. The reason isn’t that they aren’t poor enough or sick enough. The state only checks whether a neighborhood qualifies when someone asks, and in these neighborhoods, no one has.

How a neighborhood gets the label

The federal Health Resources and Services Administration (HRSA) scores regions on a scale from 0 to 100 based on four criteria: the number of primary care providers per 1,000 individuals, the percentage of people living in poverty, the percentage of residents aged 65 and older, and the infant mortality rate. Areas that receive a score of 62 or below qualify for assistance.

But qualifying doesn’t mean getting the label. MUA designations “are generally evaluated or updated by the PCO upon stakeholder request,” an Illinois Department of Public Health spokesperson said, referring to the department’s State Primary Care Office. Unlike other federal health labels, HRSA doesn’t regularly rescore them.

That means a clinic, community group, or other organization has to know the label exists and ask the state to look. Many people who work in these neighborhoods don’t know. 

University of Illinois Chicago researchers led by Sage J. Kim sorted every Chicago census tract by whether it qualified and whether it was designated. They found 87 tracts that qualified but were never designated, most of them on the South Side.

Those tracts are home to about 260,000 people. More than 92% of residents there are Black, compared with about 40% in the tracts that got the label. Poverty was higher in the tracts left out, too.

The gap shows up in where clinics are. Designated tracts had about 41 federally funded health centers for every 100,000 low-income residents. The tracts left out had 15.5.

The poorest neighborhoods were the least likely to be designated. As poverty rose, a tract’s chances of getting the label went up until about 69% of residents lived in poverty. After that, the odds dropped. Those tracts were also overwhelmingly Black.

The researchers found that neighborhoods with more nonprofits and community groups were more likely to get the label. They wrote that the status should be granted to qualifying areas whether or not anyone applies.

“If it doesn’t count, it’s not counted”

Part of the problem is how health data gets measured. Much of it is reported for the whole city or county, which can hide what’s happening block by block.

Look up Cook County on the March of Dimes maternity care map and it shows full access to maternity care. “But we know that’s not true,” Gutierrez Kapheim said.

“Chicago’s not medically underserved,” she said. “But the South Side and the West Side are medically underserved, and all of our data masks that.”

To map where OB-GYNs actually practice, her team needed data from the American Medical Association that isn’t public. “This data isn’t even available to the average person,” she said.

When the numbers hide the problem, she said, it’s easier to blame patients. “If we mask what happens, there’s not a problem,” she said. “It’s so easy to say, well, you didn’t go to the doctor.”

Layer the maps on top of each other, she said, and the same neighborhoods show up again and again. “That, in my mind, points to systemic issues,” she said, “not a person not seeking medical care.”

The state checks one label but not the other

A second federal label works very differently. A Health Professional Shortage Area, or HPSA, flags places with too few primary care providers, dentists, or mental health providers. Clinicians who work in these areas can qualify for federal student loan repayment and Medicare bonus payments.

For this label, the state does the checking itself. IDPH staff evaluate every Chicago community area “at least every 3 years from the date they were designated or updated, or upon stakeholder request,” the spokesperson said. HRSA also reruns the numbers every year. Every organization inside a designated area is covered, and “individual organizations do not have to apply separately,” the spokesperson said.

The state’s office has been busy with this work. It submitted 203 shortage-area applications to HRSA in 2025 and 2026, according to IDPH.

Much of the Far South Side has this label. Parts of West Pullman, Roseland, Pullman, and Riverdale sit inside shortage areas for primary care, dental care, and mental health care, according to HRSA’s lookup tool. Some of those same addresses are not in a Medically Underserved Area.

Those South Side shortage areas are now at risk. They failed a nationwide federal data review in September 2025 and are listed as “proposed for withdrawal.” They stay designated until HRSA’s next annual federal notice, and HRSA has given states until July 2027 to submit changes.

IDPH said many Chicago community areas had boundary changes. The department said it will prioritize areas in “proposed for withdrawal” status, areas with no shortage designation, and areas whose scores dropped.

Both the HPSA and MUA labels run through the same state office. They rely on many of the same measures, including provider counts and poverty. Only one of them, however, gets checked on a schedule. For the other, South Side neighborhoods that qualify on paper keep waiting for someone to ask.

Who feels the impacts the most

Access to maternity care is likely the most pronounced example of how this disparity shows up. A report by the AMA and Sinai evaluated the accessibility of maternal care in different ZIP codes. Many low-access areas were located on the South and West sides of the city and predominantly served Black communities. These neighborhoods, where it was difficult to access OB-GYN services, also experienced higher rates of infant mortality, preterm births, and low birth weight. 

Holy Cross Hospital’s 2025 community health needs assessment, produced in collaboration with the Sinai Urban Health Institute, identifies the South Side as a maternity care desert. In Englewood, the infant mortality rate is 2.5 times the citywide rate. Infant mortality is one of the four measures that decide whether a neighborhood qualifies as medically underserved.

Gutierrez Kapheim said safety net hospitals like Sinai carry much of the load, often with less money than wealthier systems. “If you put one thing in your article, it’s safety net hospitals are doing the brunt of this work in the city,” she said.

She worries the next round of cuts will land in the same places. Medicaid cuts, she said, are “just more evidence that the places that are going to get cut are the places that need this care the most.”

In June, Illinois sent $24.7 million to 434 pharmacies through a new grant program funded by fees on pharmacy benefit managers. Each pharmacy got $56,892. In large counties like Cook, a pharmacy qualified under the medically underserved category only if it sat in a federally designated underserved area or population. A pharmacy in a South Side tract that qualifies but was never designated could miss out.

Gutierrez Kapheim said closing these gaps takes policy change and steering resources to the hospitals and clinics already serving these neighborhoods. Taxpayers pay for the gaps either way, she said.

“You’re spending it either way,” she said. “It’s just more expensive at the back end.”

Any clinic, community group, or health organization can ask IDPH’s State Primary Care Office to review an area for designation. To check whether your block is designated, search your address in HRSA’s shortage area lookup tool at data.hrsa.gov.

This reporting was made possible through the ARCC/Public Narrative Health Science Reporting Fellowship and the Chicago Community, Media & Research Partnership