Geographic Maldistribution of Primary Care for Children

Despite increases in the overall number of physicians and general pediatricians, the current distribution of the workforce may leave some regions of the country still in great need of physicians and in particular, physicians serving children.

This study examined the demographic characteristics of general pediatricians and family physicians serving children (child physicians) over the 10 years from 1996 to 2006. During that time the child population increased by 9 percent; the number of children living in rural areas decreased in real numbers.

Taking into account the proportion of time family physicians spend caring for adults, overall there were 1,420 children per practicing child physician in the United States in 2006. The areas with the highest supplies of physicians had 661 children per child physician; those with the lowest supplies had 4,400 children per child physician. Some 950,000 children in 47 states live where there are no primary care physicians to treat them. High-supply regions had greater median household incomes. Low-supply areas were predominately rural.

Even states with abundant per capita supplies of child physicians exhibited pronounced internal maldistribution.

Policy changes to correct disparities in geographic access to care could be driven by accountability requirements for the use of federal funds to finance medical education.