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Healthcare in South Dakota

South Dakota's healthcare system serves a sparse population across the Great Plains, with approximately 2,400 active physicians and a per capita rate of 269 per 100,000. Sioux Falls is the state's healthcare hub, home to Sanford Health and Avera Health, two large regional healthcare systems that extend services across the Dakotas and beyond. The University of South Dakota Sanford School of Medicine is the state's only medical school, with a distributed campus model designed to train physicians in rural settings. Rapid City serves as the healthcare center for western South Dakota, with Monument Health providing regional services. The state's Native American population, including the Oglala Lakota on the Pine Ridge Reservation and the Rosebud Sioux, faces severe healthcare disparities and some of the lowest life expectancies in the nation. Indian Health Service facilities on reservations are chronically underfunded and understaffed. South Dakota has not expanded Medicaid, though the state approved expansion by ballot measure in 2022. Critical access hospitals serve as essential healthcare infrastructure in rural communities spread across vast distances. Telehealth has been transformative for connecting rural South Dakotans with specialists in Sioux Falls and Rapid City. The state's agricultural economy creates demand for occupational health services related to farming and ranching.