A national evaluation of geographic accessibility and provider availability of obesity medicine diplomates in the United States between 2011 and 2019

Background/Objectives Obesity is a pressing health concern within the United States (US). Obesity medicine “diplomates” receive specialized training, yet it is unclear if their accessibility and availability adequately serves the need. The purpose of this research was to understand how accessibility...

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Bibliographic Details
Published in:International Journal of Obesity 2022-03, Vol.46 (3), p.669-675
Main Authors: Pollack, Catherine C., Onega, Tracy, Emond, Jennifer A., Vosoughi, Soroush, O’Malley, A. James, McClure, Auden C., Rothstein, Richard I., Gilbert-Diamond, Diane
Format: Article
Language:English
Subjects:
692/699/2743/393
692/700/1538
692/700/2817
692/700/478/174
Accessibility
Adult
Aged
Availability
Census
Censuses
Current distribution
Educational Status
Epidemiology
Ethnicity
Health Promotion and Disease Prevention
Humans
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Obesity
Obesity - epidemiology
Patients
Public Health
Roads
Rural Population
Transportation networks
Travel
Travel time
United States - epidemiology
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Summary:Background/Objectives Obesity is a pressing health concern within the United States (US). Obesity medicine “diplomates” receive specialized training, yet it is unclear if their accessibility and availability adequately serves the need. The purpose of this research was to understand how accessibility has evolved over time and assess the practicality of serving an estimated patient population with the current distribution and quantity of diplomates. Methods Population-weighted Census tracts in US counties were mapped to the nearest facility on a road network with at least one diplomate who specialized in adult (including geriatric) care between 2011 and 2019. The median travel time for all Census tracts within a county represented the primary geographic access measure. Availability was assessed by estimating the number of diplomates per 100 000 patients with obesity and the number of facilities able to serve assigned patients under three clinical guidelines. Results Of the 3371 diplomates certified since 2019, 3036 were included. The median travel time (weighted for county population) fell from 28.5 min [IQR: 13.7, 68.1] in 2011 to 9.95 min [IQR: 7.49, 18.1] in 2019. There were distinct intra- and inter-year travel time variations by race, ethnicity, education, median household income, rurality, and Census region (all P  
ISSN:0307-0565
1476-5497
1476-5497
DOI:10.1038/s41366-021-01024-9