Rural communities had about one-fourth the psychologist workforce rate of urban areas, making psychologists the most underrepresented healthcare profession examined in a new study published June 9 in Annals of Internal Medicine.
Researchers from University of Kentucky in Lexington and Des Moines University in Iowa conducted a cross-sectional analysis using 2019 to 2023 American Community Survey data to estimate healthcare workforce rates across 23 occupation groups. Workforce rates were compared between metropolitan and nonmetropolitan areas based on workers’ reported place of employment, with disparities measured using rate ratios.
The analysis included physicians, psychologists, counselors, social workers, nurses, therapists and other clinical occupations. Researchers also performed two sensitivity analyses to assess the robustness of the findings.
Here are five findings to know:
- Psychologists had the lowest workforce rate ratio among all occupations studied. Nonmetropolitan areas had a rate ratio of 0.26 compared with metropolitan areas, and were nearly 74% less represented, according to the study.
- Counselors and social workers also showed significant disparities. Nonmetropolitan areas had about half the per-capita rate of counselors and social workers compared with metropolitan areas, with a rate ratio of 0.51.
- Behavioral health shortages coincide with widening mortality disparities. The rural-urban mortality gap grew from roughly 6% in 1999 to 18% by 2016, according to the study. Researchers said shortages of psychologists, counselors and social workers may compound those challenges.
- Previous research has documented similar workforce gaps. Data from 2022 showed psychologist rates of 15.8 per 100,000 population in rural areas compared with 39.5 per 100,000 in urban areas, according to a June news release from the American Journal of Managed Care.
- Rural workforce shortages extend beyond behavioral health. Although psychologists had the largest disparity, nonmetropolitan areas accounted for 13.8% of the U.S. population but only 8.4% of the actively employed healthcare workforce.
Additional research is needed to determine the causes of the disparities and their effects on access, quality and patient outcomes, according to the researchers.
At the Becker's Fall Behavioral Health Summit, taking place November 4–5 in Chicago, behavioral health leaders and executives will explore strategies for expanding access to care, integrating services, addressing workforce challenges and leveraging innovation to improve outcomes across the behavioral health continuum. Apply for complimentary registration now.
