NHSC clinician-to-population ratio was computed as total number of NHSC clinicians in a given year divided by total population of designated HPSAs in that year, stratified by HRSA rural-urban status. We did not include 2014 and 2015 because the HRSA’s HPSA Quarterly Summary was unavailable for these 2 years, leading to missing information about HPSA populations. The Quarterly Summaries categorized rural vs urban areas as metropolitan and nonmetropolitan before 2014, and as rural, partially rural, and nonrural after 2016. We standardized the rurality definition across years by classifying an HPSA as rural if it was listed as nonmetropolitan, partially rural, or rural and as urban if metropolitan or nonrural.