• J Am Board Fam Med · Jan 2022

    Local Economic Inequality and the Primary Care Physician Workforce in North Carolina.

    • Joseph Nenow, Andrew Nenow, Allison Priest, Kendall M Campbell, and Dmitry Tumin.
    • From Brody School of Medicine, East Carolina University, Greenville NC (JN); University of North Carolina-Chapel Hill, Chapel Hill NC (AN); Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville NC (AP, DT); Research Group for Underrepresented Minorities in Academic Medicine, Division of Academic Affairs, Brody School of Medicine, East Carolina University (KMC). josephnenow@gmail.com.
    • J Am Board Fam Med. 2022 Jan 1; 35 (1): 354335-43.

    BackgroundIncome inequality has been associated with multiple adverse health outcomes including diabetes and obesity, with this relationship potentially mediated by limited access to primary care. We explore the association between county-level economic inequality and the primary care physician (PCP) workforce in North Carolina.MethodsCounty-level economic and demographic data were obtained for 2013 to 2018. Economic inequality was quantified using the Gini coefficient of household income. PCP workforce data were obtained from a statewide database and correlated with county characteristics using fixed-effects linear regression.ResultsThe analysis included 600 county-years. An increase of 0.1 in the Gini coefficient was correlated with a decrease in PCP workforce by 0.58 physicians/1000 residents in a given county. Within family medicine, a 0.1 increase in the Gini coefficient was associated with a decrease of 0.53 family medicine physicians per 1000 residents.ConclusionsLocal increases in economic inequality are associated with local decreases in PCP workforce (per capita), particularly in family medicine. Although further research is needed to identify specific reasons for the decrease, medical schools in areas with high economic inequality should consider prioritizing training of physicians in family medicine and other primary care specialties to better serve community health care needs.© Copyright 2022 by the American Board of Family Medicine.

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