This Primary Care Needs Assessment identifies communities in Nevada with the greatest unmet health needs as well as health disparities through comparisons across communities and populations. There are many lenses through which health needs can be viewed, and the Primary Care Office (PCO) has a very distinct lens with the health professional shortage area (HPSA) designation process. Incorporating population-to-provider ratios with data for population health, demographics and geographic features within a rational service area, the designation process is a reasonable foundation for directing resources toward the greatest unmet health needs.