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Growth and Distribution of Child Psychiatrists in the United States: 2007–2016

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McBain, Ryan K., Kofner, Aaron, Stein, Bradley D., Cantor, Jonathan H., Vogt, William B., Yu, Hao·2019·Pediatrics

DOI 10.1542/peds.2019-1576PMC PMC6889947

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Abstract

BACKGROUND: Historically, there has been a shortage of child psychiatrists in the United States, undermining access to care. This study updated trends in the growth and distribution of child psychiatrists over the past decade. METHODS: Data from the Area Health Resource Files were used to compare the number of child psychiatrists per 100 000 children ages 0 to 19 between 2007 and 2016 by state and county. We also examined sociodemographic characteristics associated with the density of child psychiatrists at the county level over this period using negative binomial multivariable models. RESULTS: From 2007 to 2016, the number of child psychiatrists in the United States increased from 6590 to 7991, a 21.3% gain. The number of child psychiatrists per 100 000 children also grew from 8.01 to 9.75, connoting a 21.7% increase. County- and state-level growth varied widely, with 6 states observing a decline in the ratio of child psychiatrists (ID, IN, KS, ND, SC, and SD) and 6 states increasing by >50% (AK, AR, NH, NV, OK, and RI). Seventy percent of counties had no child psychiatrists in both 2007 and 2016. Child psychiatrists were significantly more likely to practice in high-income counties (P < .001), counties with higher levels of postsecondary education (P < .001), and metropolitan counties compared with those adjacent to metropolitan regions (P < .05). CONCLUSIONS: Despite the increased ratio of child psychiatrists per 100 000 children in the United States over the past decade, there remains a dearth of child psychiatrists, particularly in parts of the United States with lower levels of income and education.

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Authors: McBain, R. K., Kofner, A., Stein, B. D., Cantor, J. H., Vogt, W. B., & Yu, H.
Affiliations: RAND Corporation (US)
University of Georgia (US)
Harvard University (US)
Corresponding author: McBain, Ryan K.
ORCID: McBain, Ryan K.
Kofner, Aaron
Stein, Bradley D.
Cantor, Jonathan H.
Yu, Hao
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2019-12-01
Volume: 144
Issue: 6
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2019-1576
PMC: PMC6889947
OpenAlex: W2986510570
Cited by: 162
References: 36
Citations by year: 2026: 15 · 2025: 20 · 2024: 32 · 2023: 20 · 2022: 34 · 2021: 27 · 2020: 13 · 2019: 1
FWCI: 27.51
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: PEDIATRICS (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (R01MH112760)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health Workforce Issues
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Gender Studies › Diversity and Career in Medicine
Keywords: child psychiatrists, workforce shortage, access to mental health care, physician density, county-level distribution, sociodemographic factors, income inequality, educational attainment, metropolitan areas
MeSH terms: Adolescent, Career Choice, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Psychiatry, Retrospective Studies, United States, Neurodevelopmental Disorders

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