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Population-based geographic access to endocrinologists in the United States, 2012

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Lu, Hua, Holt, James B., Cheng, Yiling J., Zhang, Xingyou, Onufrak, Stephen, Croft, Janet B.·2015·BMC Health Services Research
DOI 10.1186/s12913-015-1185-5PMC PMC4672571
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Abstract

BACKGROUND: Increases in population and life expectancy of Americans may result in shortages of endocrinologists by 2020. This study aims to assess variations in geographic accessibility to endocrinologists in the US, by age group at state and county levels, and by urban/rural status, and distance. METHODS: We used the 2012 National Provider Identifier Registry to obtain office locations of all adult and pediatric endocrinologists in the US. The population with geographic access to an endocrinologist within a series of 6 distance radii, centered on endocrinologist practice locations, was estimated using the US Census 2010 block-level population. We assumed that persons living within the same circular buffer zone of an endocrinologist location have the same geographic accessibility to that endocrinologist. The geographic accessibility (the percentage of the population with geographic access to at least one endocrinologist) and the population-to-endocrinologist ratio for each geographic area were estimated. RESULTS: By using 20 miles as the distance radius, geographic accessibility to at least one pediatric/adult endocrinologist for age groups 0-17, 18-64, and ≥ 65 years was 64.1%, 85.4%, and 82.1%. The overall population-to-endocrinologist ratio within 20 miles was 39,492:1 for children, 29,887:1 for adults aged 18-64 years, and 6,194:1 for adults aged ≥ 65 years. These ratios varied considerably by state, county, urban/rural status, and distance. CONCLUSIONS: This study demonstrates that there are geographic variations of accessibility to endocrinologists in the US. The areas with poorer geographic accessibility warrant further study of the effect of these variations on disease prevention, detection, and management of endocrine diseases in the US population. Our findings of geographic access to endocrinologists also may provide valuable information for medical education and health resources allocation.

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Fig. 1 Illustration of calculation for each endocrinologist covered population and census block points covered by endocrinologists
Fig. 1 Illustration of calculation for each endocrinologist covered population and census block points covered by endocrinologistsCC BY · PubMed Central
Fig. 2 Endocrinologist locations overlaid with 2010 census population count by US counties. (a) Endocrinologists overlaid with adults aged ≥18 years and (b) Pediatric endocrinologists overlaid with children aged 0–17 years
Fig. 2 Endocrinologist locations overlaid with 2010 census population count by US counties. (a) Endocrinologists overlaid with adults aged ≥18 years and (b) Pediatric endocrinologists overlaid with children aged 0–17 yearsCC BY · PubMed Central
Fig. 3 Percentage of US population with access to at least one endocrinologist. (a) Percentage of adults aged ≥18 years with access to at least one endocrinologist, by age group, urban/rural characteristics, and distance to endocrinologist locations. Age groups include 18–64 years (solid line) and ≥65 years (dashed line). (b) Percentage of children aged 0–17 years with access to at least one pediatric endocrinologist by urban/rural characteristics and distance to endocrinologist locations
Fig. 3 Percentage of US population with access to at least one endocrinologist. (a) Percentage of adults aged ≥18 years with access to at least one endocrinologist, by age group, urban/rural characteristics, and distance to endocrinologist locations. Age groups include 18–64 years (solid line) and ≥65 years (dashed line). (b) Percentage of children aged 0–17 years with access to at least one pediatric endocrinologist by urban/rural characteristics and distance to endocrinologist locationsCC BY · PubMed Central
Fig. 4 State-specific percentage of population with access to at least one endocrinologist by distance. (a) State-specific percentage of adults aged 18–64 years with access to at least one endocrinologist within 20 miles. (b) State-specific percentage of adults aged 18–64 years with access to at least one endocrinologist within 50 miles. (c) State-specific percentage of children aged 0–17 years with access to at least one pediatric endocrinologist with 20 miles. (d) State-specific percentage of children aged 0–17 years with access to at least one pediatric endocrinologist with 50 miles
Fig. 4 State-specific percentage of population with access to at least one endocrinologist by distance. (a) State-specific percentage of adults aged 18–64 years with access to at least one endocrinologist within 20 miles. (b) State-specific percentage of adults aged 18–64 years with access to at least one endocrinologist within 50 miles. (c) State-specific percentage of children aged 0–17 years with access to at least one pediatric endocrinologist with 20 miles. (d) State-specific percentage of children aged 0–17 years with access to at least one pediatric endocrinologist with 50 milesCC BY · PubMed Central
Fig. 5 Endocrinologist accessibility for adults aged 18–64 years by US county, 2012. (a) Percentage of adults aged 18–64 years who had access to at least one endocrinologist with 20 miles. (b) Ratio of adults aged 18–64 years to endocrinologist for covered population within 20 miles
Fig. 5 Endocrinologist accessibility for adults aged 18–64 years by US county, 2012. (a) Percentage of adults aged 18–64 years who had access to at least one endocrinologist with 20 miles. (b) Ratio of adults aged 18–64 years to endocrinologist for covered population within 20 milesCC BY · PubMed Central
Fig. 6 Pediatric endocrinologist accessibility for children aged 0–17 years by US county, 2012. (a) Percentage of children aged 0–17 years who had access to at least one pediatric endocrinologist within 20 miles (b) Ratio of children aged 0–17 years to pediatric endocrinologist for covered population within 20 miles
Fig. 6 Pediatric endocrinologist accessibility for children aged 0–17 years by US county, 2012. (a) Percentage of children aged 0–17 years who had access to at least one pediatric endocrinologist within 20 miles (b) Ratio of children aged 0–17 years to pediatric endocrinologist for covered population within 20 milesCC BY · PubMed Central

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Research works printed but not linked: 2

  1. Health, United States, 2012: With Special Feature on Emergency Care. [ http://www.ncbi.nlm.nih.gov/books/NBK148940/toc/ ].
  2. Cromley EK, McLafferty SL. Analyzing access to health services. In: GIS and Public Health. 2nd ed. New York: The Guilford Press; 2012. p. 303–37.

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Metadata

Authors
Lu, H., Holt, J. B., Cheng, Y. J., Zhang, X., Onufrak, S., & Croft, J. B.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Lu, Hua
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2015-06
Volume
15
Issue
1
Pages
541-541
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-015-1185-5
PMC
PMC4672571
OpenAlex
W2191992790
Cited by
121
References
22
Citations by year
2026: 11 · 2025: 19 · 2024: 13 · 2023: 18 · 2022: 16 · 2021: 9 · 2020: 16 · 2019: 9 · 2018: 3 · 2017: 4 · 2016: 3
FWCI
5.75
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health Workforce Issues
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
Keywords
pediatric endocrinology, urban-rural disparities, health workforce distribution, healthcare resource allocation, endocrine disorders
MeSH terms
Adolescent, Adult, Aged, Child, Child, Preschool, Endocrinology, Female, Health Services Accessibility, Humans, Infant, Infant, Newborn, Male, Middle Aged, Residence Characteristics, United States, Rural Health Services, Urban Health Services, Censuses, Young Adult

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