• Sarah Rahman, Justin C McCarty, Shekhar Gadkaree, Robert S Semco, Wenya Linda Bi, Amar Dhand, Molly P Jarman, Gezzer Ortega, Tarsicio Uribe-Leitz, and Regan W Bergmark.
• Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
• World Neurosurg. 2021 Jul 1; 151: e146-e155.

ObjectiveLarge disparities in access to neurosurgical care are known, but there are limited data on whether geographic distribution of the neurosurgery workforce potentially plays a role in these disparities. The goal of this study was to identify the geographic distribution of neurosurgeons in the United States and to study the association of the per capita workforce distribution with socioeconomic characteristics of the population.MethodsThe number of practicing neurosurgeons in the United States in 2016 was obtained from the 2017-2018 American Medical Association Masterfile contained within the Area Health Resource File. The association of the number of neurosurgeons per 100,000 population with socioeconomic characteristics was assessed through linear regression analysis at Hospital Referral Region (HRR) level.ResultsThe median number of neurosurgeons per capita across all HRRs was 1.47 neurosurgeons per 100,000 population (interquartile range, 1.02-2.27). Bivariable analysis showed that greater supply of neurosurgeons was positively associated with regional levels of college education, median income, and median age. The number of neurosurgeons per capita at the HRR level was negatively associated with unemployment, poverty, and percent uninsured.ConclusionsRegions characterized by low socioeconomic status have fewer neurosurgeons per capita in the United States. Low income, low number of college graduates, and high unemployment rate are associated with fewer numbers of neurosurgeons per capita. Further research is needed to determine if these geographic workforce disparities contribute to poor access to quality neurosurgical care.Copyright © 2021 Elsevier Inc. All rights reserved.

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