Millions of companion animals in the U.S. aren’t getting the veterinary care they need. Whether it’s a regular check-up, vaccines, or emergency treatment, a growing number of guardians struggle to access veterinary services. This issue isn’t just about money — it also involves location, transportation, and even how many veterinarians are available in an area. These challenges have led to what some experts are calling “veterinary care deserts.”

This scoping review describes the first working definition of veterinary care desert in order to help organizations, governments, and veterinarians identify and address areas where companion animals and their guardians are being left behind.

To develop their definition, the authors conducted a broad analysis of existing literature on both human and veterinary care deserts published between January 2000 and December 2022. They were able to identify three main issues that contribute to the formation of veterinary care deserts.

1. Accessibility: Can people physically get to a clinic? Do they have reliable transportation?
2. Affordability: Can people afford care? Are they living in poverty or on a limited income?
3. Availability: Are there enough veterinarians or clinics in the area?

Accessibility

Accessibility refers to how easily companion animal guardians can physically reach a veterinary clinic. Distance is the simplest way to measure this, but it’s not the only factor. Even if a clinic is nearby, people may still struggle if they don’t have a car, if public transport doesn’t allow animals, if schedules are limited, or if the area lacks safe walking routes or parking.

Research in both human and veterinary fields consistently shows that transportation is one of the biggest barriers to accessing care. In fact, after cost, lack of transportation is one of the top reasons guardians can’t get their companion animals seen by a veterinarian. As most public transport systems don’t allow companion animals and many guardians lack access to a private vehicle, this highlights that improving accessibility requires more than simply increasing the number of veterinary clinics.

Affordability

Affordability has two sides: the guardian’s income and the cost of veterinary services. The authors emphasize income because reliable data are available from census information, allowing targeted identification of communities most likely to struggle.

Low-income households are more likely to have difficulty paying for care, but affordability issues affect companion animal guardians across income levels. Many guardians view their companion animals as family members, yet still can’t pursue preventative or urgent care because of cost. Some companion animal guardians don’t seek care even when they could afford it — often because they don’t fully understand the importance of early or preventative treatment.

When financial barriers or structural problems (such as lack of local services) are removed, more guardians make use of care. Improving education around preventative care and creating more flexible care options can help increase timely veterinary visits.

Veterinary care is also expensive to provide. Many veterinarians and support staff carry high educational debt and face comparatively low wages, leading to financial strain within the profession. Cost pressures affect both clients and providers, making “affordable care” challenging to define.

Availability

Availability focuses on whether there are enough veterinary professionals in an area to meet demand. The Veterinary Care Accessibility Project reports large variation across the U.S., with many counties having far fewer veterinary employees per household than needed.

When there are too few veterinarians, technicians, and support staff, companion animals may wait longer for appointments — or miss out on care entirely. Determining what counts as “enough” veterinary professionals is difficult because published data are limited, and workforce needs vary by community.

Low availability of veterinary care is driven by several interconnected workforce pressures. Many regions simply don’t have enough veterinarians, technicians, or support staff to meet local demand, with particularly severe shortages in fields such as farmed animal practice, public health, and shelter medicine.

High turnover — about 26% among veterinarians, roughly twice that of human physicians — combined with burnout and compassion fatigue further reduces the stable workforce, as professionals leave positions or cut back their hours. Clinics are also seeing fewer patients per hour than in previous years, lowering overall productivity even when staffing levels appear adequate.

At the same time, the high cost and student debt burden of veterinary education can deter new graduates from entering the profession or push them toward higher-paying urban roles, contributing to the uneven geographical distribution of veterinarians. Together, these factors limit the capacity of clinics and leave many communities without adequate veterinary support.

A Working Definition Of Veterinary Care Desert

Drawing on these three main issues, the authors arrive at a working definition along with its parameters:

A veterinary care desert is a geographic area where accessible, affordable, and available veterinary care is limited.

• Low accessibility: A veterinary care facility is located > 2 miles and > 10 miles from the census tract’s center for urban and rural areas, respectively.
• Low affordability: The census tract’s poverty rate is ≥ 20% or the median family income ≤ 80% of the metropolitan’s or statewide median family income for urban and rural areas, respectively.
• Low availability: The census tract is located in a county with 0 to 0.8 veterinary employees per 1,000 households.

Multiple Barriers, Multifaceted Solutions

Compounding these challenges, education was also identified as a contributing factor, and because education and income are often closely intertwined as socioeconomic variables, differences in guardian education can influence whether people recognize illness in their companion animals and seek timely care.

As such, because veterinary care deserts arise from more than just a shortage of clinics, effective solutions must address multiple barriers at once:

• Flexible pricing and payment plans
• “Spectrum of care” or incremental care approaches that align treatment options with a guardian’s financial capacity while safeguarding animal welfare
• Improved public education about the value of preventative care
• Lean inventory systems to reduce clinic costs and minimize waste
• Efficient division of labor between clinic staff, including full utilization of technicians and support personnel
• Telemedicine and mobile clinics to bring care directly to underserved communities

Finally, it’s important to recognize the limits of this definition. It describes potential access (where care could be obtained), not necessarily realized access (where guardians actually go). It also reflects the needs of dog and cat guardians since most research focuses on these species. Other animals — such as farmed animals — may experience different shortages requiring additional species- or specialty-specific definitions.

Defining veterinary care deserts is an initial step. Improving access requires engaging with communities directly, understanding their needs, and building trust. Applying this definition across urban and rural census tracts will help identify areas most affected, guide resource allocation, and support efforts to close the veterinary care gap.