North Carolina Providers: Supply and Distribution by Race July 27, 2006 Jennifer King.

North Carolina Providers:North Carolina Providers:Supply and Distribution by RaceSupply and Distribution by Race

North Carolina Providers:North Carolina Providers:Supply and Distribution by RaceSupply and Distribution by Race

July 27, 2006

Jennifer King

Overview

• Race of NC providers compared to NC population

• Rates of practicing in rural and underserved areas by race

• Geographic distribution of underrepresented NC physicians compared to population

Race of Population and Providers, North Carolina 2004

Source: North Carolina Health Professions Data System and US Census. Note: Counts include active, in-state, non-federal physicians, PAs, and NPs. Race data were missing for 604 physicians, 212 NPs, and 215 PAs; percentages are based on the providers for whom race information was available. AI/AN is American Indian/Alaskan Native. PI is Pacific Islander. NH is Non-Hispanic.

69%

82% 88% 90%

21%6%

5% 5%1%

6%2% 2%

2% 7% 1% 1%1%1%<1%1%

2% 3% 4% 3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Population Physicians PAs NPs

Other

AI/AN

Asian/PI

Hispanic

Black/NH

White/NH

N = 17,349*N = 8,541,221 N = 2,498*N = 2,256*

Race of Physicians by Medical School Location, North Carolina 2003

Source: North Carolina Health Professions Data System. Note: Counts include active, in-state, non-federal physicians. Medical school location data were missing for 101 physicians and race data were missing for 529 physicians; percentages are based on the physicians for whom both race and medical school information were available. AI/AN is American Indian/Alaskan Native. PI is Pacific Islander. NH is non-Hispanic.

89% 87%

36%

6% 6%

6%

1% 1%

7%

2% 3%

36%

1%

<1%

<1%2% 3%

15%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

NC Other US & Canada International

Other

AI/AN

Asian/PI

Hispanic

Black/NH

White/NH

N = 4,565* N = 1,815*N = 10,609*

Share of Physicians Practicing in Rural and Persistent Shortage Areas, North Carolina 2004

Source: North Carolina Health Professions Data System and US Census. Note: Counts include active, in-state, non-federal physicians. Race data was missing for 604 physicians. PI is Pacific Islander. AI/AN is American Indian/Alaskan Native. NH is non-Hispanic. PHPSA is Persistent Health Professional Shortage Area, a county that has been designated a shortage area by the federal government in 6 of the last 7 years.

21% 22% 22% 22%

56%

25%

79% 78% 78% 78%

44%

75%

6%

35%33%

43%

30%36%

25%

39%

64%

50%

65%58%

40%

56%

5%7%3% 5%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Rural Urban Whole County PHPSA Part County PHPSA Non-PHPSA

N=75N=279N=13,658

White/NH Hispanic Other

Race

Per

cen

t P

ract

icin

g i

n C

ou

nty

Ty

pe

Black/NH Asian/PI AI/AN

N=936 N=1,102 N=695

Share of Primary Care Physicians, PAs, and NPs Practicing in Rural and Persistent Shortage Areas,

North Carolina 2004

Source: North Carolina Health Professions Data System and US Census. Note: Counts include active, in-state, non-federal providers who indicate a primary care specialty. PI is Pacific Islander. AI/AN is American Indian/Alaskan Native. NH is non-Hispanic. PHPSA is Persistent Health Professional Shortage Area, a county that has been designated a shortage area by the federal government in 6 of the last 7 years.

27% 24% 26% 26%

60%

25%

73% 76% 74% 74%

40%

75%

8%

41%35%

42%

37% 37%

36%

39%

61%

48%56% 54%

22%

56%

7%10%4% 5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


N=85N=164N=7,494


Race

Per

cen

t P

ract

icin

g i

n C

ou

nty

Ty

pe


N=711 N=577 N=352

Black Non-Hispanic Population as a Share of Total Population,North Carolina 2004

Produced by: North Carolina Health Professions Data System, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill. Data Source: U.S. Census Population Estimates Program, 2004.

Black Non-Hispanic Population as a Share of Total Population(# of counties)

34.9% to 62.7% (25)19.2% to 34.8% (25)

5.6% to 19.1% (25)0.3% to 5.5% (25)

Black Non-Hispanic Physicians as a Share of Total Physicians,North Carolina 2004

Produced by: North Carolina Health Professions Data System, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill with data derived from the NC Medical Board, 2004.

*Counts include active, in-state, non-federal physicians who reported their race as "Black, non-Hispanic" on their licensure form.

Black Non-Hispanic Physicians as a Share of Total Physicians(# of counties)

13.6% to 55.6% (17)7.7% to 13.5% (18)5.2% to 7.6% (16)0.6% to 5.1% (17)

No Black Physicians (32)

Do Black Non-Hispanic physicians practice in counties where Black Non-Hispanics live?

Source: North Carolina Health Professions Data System and US Census. Note: Counts include active, in-state, non-federal physicians.

Black Non-Hispanic Population and Physicians,North Carolina 2004

-10%

0%

10%

20%

30%

40%

50%

60%

70%

0% 10% 20% 30% 40% 50% 60% 70%

Share of County Population that Is Black Non-Hispanic

Sh

are

of

Co

un

ty P

hy

sic

ian

s t

ha

t Is

Bla

ck

N

on

-His

pa

nic

Bertie

Warren

Hispanic Population as a Share of Total Population,North Carolina 2004


Hispanic Population as a Share of Total Population(# of counties)

6.5% to 17.8% (25)3.6% to 6.4% (25)2.0% to 3.5% (25)0.6% to 1.9% (25)

Hispanic Physicians as a Share of Total Physicians,North Carolina 2004


*Counts include active, in-state, non-federal physicians who reported their race as "Hispanic" on their licensure form.

Hispanic Physicians as a Share of Total Physicians(# of counties)

3.8% to 20.0% (15)2.3% to 3.7% (15)1.4% to 2.2% (15)0.3% to 1.3% (15)No Hispanic Physicians (40)

Do Hispanic physicians practice in counties where Hispanics live?

Source: North Carolina Health Professions Data System and US Census. Note: Counts include active, in-state, non-federal physicians.

Hispanic Population and Physicians,North Carolina 2004

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%

Share of County Population that Is Hispanic

Sh

are

of

Co

un

ty P

hy

sic

ian

s t

ha

t Is

H

isp

an

ic

Greene

Hoke

Distribution of AI/AN Population and Physicians

• Robeson County is home to

– 47% of NC’s AI/AN population

– 31% of NC’s AI/AN physicians

• 12 counties are home to

– 31% of NC’s AI/AN population (1%-5% each)

– 28% of NC’s AI/AN physicians (0%-1% each)

• 87 counties are home to

– 22% of NC’s AI/AN population (<1% each)

– 41% of NC’s AI/AN physicians (<1% each)

American Indian/Alaskan Native Physicians as a Share of Total Physicians,North Carolina 2004


*Counts include active, in-state, non-federal physicians who reported their race as "American Indian/Alaskan Native" on their licensure form.

American Indian/Alaskan Native (AI/AN) Physicians as a Share of Total Physicians(# of counties)

2.0% to 18.3% (7)1.1% to 2.0% (7)0.4% to 1.0% (6)0.6% to 0.3% (7)No AI/AN Physicians (73)

Many nonwhites live in NC counties with no physician of the same race

• 78,013 Black/NHs in 32 counties

• 48,217 Hispanics in 40 counties

• 22,727 AI/ANs in 73 counties

• 1,108 Asian/PIs in 14 counties

Additional Data Slides

Share of Physician Assistants Practicing in Rural and Persistent Shortage Areas, North Carolina 2004

Source: North Carolina Health Professions Data System and US Census. Note: Counts include active, in-state physician assistants. Race data was missing for 215 physician assistants. PI is Pacific Islander. AI/AN is American Indian/Alaskan Native. NH is non-Hispanic. PHPSA is Persistent Health Professional Shortage Area, a county that has been designated a shortage area by the federal government in 6 of the last 7 years.

24% 27%

14% 18%

35%

20%

76% 73%

86% 82%

65%

80%

3%

23%

37%

43%41%

50%

39%

40%

58%49%

54%47%

38%

50%

10%5% 8% 5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


N=31N=44N=2,020


Race

Per

cen

t P

ract

icin

g i

n C

ou

nty

Ty

pe


N=114 N=34 N=40

Share of Nurse Practitioners Practicing in Rural and Persistent Shortage Areas, North Carolina 2004

Source: North Carolina Health Professions Data System and US Census. Note: Counts include active, in-state nurse practitioners. Race data was missing for 212 nurse practitioners. PI is Pacific Islander. AI/AN is American Indian/Alaskan Native. NH is non-Hispanic. PHPSA is Persistent Health Professional Shortage Area, a county that has been designated a shortage area by the federal government in 6 of the last 7 years.

25%16%

26%

13%

46%

16%

75%84%

74%

87%

54%

84%

29%

36%41%

23% 25%

46%

37%

59%54%

77% 75%

25%

63%

5% 5%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


N=28N=31N=1,845


Race

Per

cen

t P

ract

icin

g i

n C

ou

nty

Ty

pe


N=105 N=16 N=19

Share of Primary Care Physicians Practicing in Rural and Persistent Shortage Areas, North Carolina 2004

Source: North Carolina Health Professions Data System. Note: Counts include active, in-state, non-federal physicians who designated a primary care specialty. Medical school location data was missing for 43 primary care physicians. PHPSA is Persistent Health Professional Shortage Area, a county that has been designated a shortage area by the federal government in 6 of the last 7 years.

24% 24%33%

76% 76%67%

35% 34%

38%

61% 61%52%

4% 5% 10%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


N=871N=4,185N=2,166

North Carolina Other U.S. & Canada International

Medical School Location

Per

cen

t P

ract

icin

g i

n C

ou

nty

Ty

pe

Share of Primary Care Physicians Practicing in Rural and Persistent Shortage Areas, North Carolina 2004

Source: North Carolina Health Professions Data System and US Census. Note: Counts include active, in-state, non-federal physicians who indicated a primary care specialty. Race data was missing for 43 primary care physicians. PI is Pacific Islander. AI/AN is American Indian/Alaskan Native. NH is non-Hispanic. PHPSA is Persistent Health Professional Shortage Area, a county that has been designated a shortage area by the federal government in 6 of the last 7 years.

25% 23% 26% 27%

67%

28%

75% 77% 74% 73%

33%

72%

8%

48%34%

43%

35%37%

29%

41%

62%

48%

59% 55%

23%

51%

7%3%

9% 6%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


N=48N=133N=5,489

White/NH Hispanic OtherRace

Per

cen

t P

ract

icin

g i

n C

ou

nty

Ty

pe


N=580 N=549 N=321

Share of Physicians Practicing in Rural and Persistent Shortage Areas, North Carolina 2004

Source: North Carolina Health Professions Data System. Note: Counts include active, in-state, non-federal physicians. Medical school location data was missing for 101 physicians. PHPSA is Persistent Health Professional Shortage Area, a county that has been designated a shortage area by the federal government in 6 of the last 7 years.

20% 21%27%

80% 79%73%

33% 34%36%

64% 63%57%

7%3%3%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


N=1,815N=10,609N=4,565

North Carolina Other U.S. & Canada International

Medical School Location

Per

cen

t P

ract

icin

g i

n C

ou

nty

Ty

pe

American Indian/Alaskan Native Population as a Share of Total Population,North Carolina 2004


American Indian/Alaskan Native Population as a Share of Total Population(# of counties)

0.46% to 37.81% (25)0.34% to 0.45% (25)0.26% to 0.33% (25)0.01% to 0.25% (25)

Asian/Pacific Islander Population as a Share of Total Population,North Carolina 2004


Asian/Pacific Islander Population as a Share of Total Population(# of counties)

0.96% to 5.25% (25)0.51% to 0.95% (25)0.29% to 0.50% (25)0.04% to 0.28% (25)

Asian/Pacific Islander Physicians as a Share of Total Physicians,North Carolina 2004


*Counts include active, in-state, non-federal physicians who reported their race as "Asian/Pacific Islander" on their licensure form.

Asian/Pacific Islander (PI) Physicians as a Share of Total Physicians(# of counties)

12.3% to 41.7% (22)7.9% to 12.2% (21)5.0% to 7.8% (21)1.1% to 4.9% (22)

No Asian/PI Physicians (14)

Black Non-Hispanic Population, North Carolina 2004


Black Non-Hispanic Population(# of counties)

18,508 to 216,318 (25)10,829 to 18,507 (25)

2,379 to 10,828 (25)41 to 2,378 (25)

Black Non-Hispanic Physicians, North Carolina 2004


*Counts include active, in-state, non-federal physicians who reported their race as "Black, non-Hispanic" on their licensure form.

Black Non-Hispanic Physicians(# of counties)

15 to 136 (13)8 to 14 (12)6 to 7 (12)1 to 5 (31)

No Black Physicians (32)

Black Non-Hispanic Physicians per 10,000 Black Non-Hispanic Population,North Carolina 2004

Produced by: North Carolina Health Professions Data System, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill with data derived from the NC Medical Board and the U.S. Census Populuation Estimates Program.

*Counts of physicians include active, in-state, non-federal physicians who reported their race as "Black, non-Hispanic" on their licensure form.

Black Non-Hispanic Physicians per 10,000 Black Non-Hispanic Population(# of counties)

6.9 to 24.8 (17)4.3 to 6.8 (17)2.9 to 4.2 (17)Less than 0.1 to 2.8 (17)No Black Physicians (32)

Hispanic Population, North Carolina 2004


Hispanic Population(# of counties)

5,944 to 60,700 (25)1,831 to 5,944 (25)

515 to 1,831 (25)64 to 515 (25)

Hispanic Physicians, North Carolina 2004

Hispanic Physicians(# of counties)

13 to 36 (5)6 to 12 (7)1 to 5 (48)

No Hispanic Physicians (40)


*Counts include active, in-state, non-federal physicians who reported their race as "Hispanic" on their licensure form.

Hispanic Physicians per 10,000 Hispanic Population,North Carolina 2004


*Counts of physicians include active, in-state, non-federal physicians who reported their race as "Hispanic" on their licensure form.

Hispanic Physicians per 10,000 Hispanic Population(# of counties)

16.7 to 69.6 (15)6.1 to 16.6 (15)3.7 to 6.0 (15)0.7 to 3.6 (15)

No Hispanic Physicians (40)

American Indian/Alaskan Native Population, North Carolina 2004


American Indian/Alaskan Native Population(# of counties)

571 to 47,111 (25)205 to 570 (25)

76 to 204 (25)2 to 75 (25)

American Indian/Alaskan Native Physicians, North Carolina 2004

American Indian/Alaskan Native (AI/AN) Physicians(# of counties)

24 (1)6 (1)1 to 5 (25)

No AI/AN Physicians (73)


*Counts include active, in-state, non-federal physicians who reported their race as "American Indian/Alaskan Native" on their licensure form.

American Indian/Alaskan Native (AI/AN) Physicians per 10,000 AI/AN Population,North Carolina 2004


*Counts of physicians include active, in-state, non-federal physicians who reported their race as "American Indian/Alaskan Native" on their licensure form.

AI/AN Physicians per 10,000 AI/AN Population(# of counties)

49.4 to 236.3 (7)24.2 to 49.3 (7)

9.6 to 24.1 (7)2.6 to 9.5 (6)

No AI/AN Physicians (73)

Asian/Pacific Islander Population, North Carolina 2004


Asian/Pacific Islander Population(# of counties)

830 to 28,038 (25)259 to 829 (25)

68 to 258 (25)4 to 67 (25)

Asian/Pacific Islander Physicians, North Carolina 2004

Asian/Pacific Islander (PI) Physicians(# of counties)

20 to 124 (13)11 to 19 (12)6 to 10 (12)1 to 5 (49)



*Counts include active, in-state, non-federal physicians who reported their race as "Asian/Pacific Islander" on their licensure form.

Asian/Pacific Islander (PI) Physicians per 10,000 Asian/PI Population,North Carolina 2004


*Counts of physicians include active, in-state, non-federal physicians who reported their race as "Asian/Pacific Islander" on their licensure form.

Asian/PI Physicians per 10,000 Asian/PI Population(# of counties)

268.6 to 769.3 (22)151.9 to 268.5 (21)

94.1 to 151.8 (21)21.0 to 94.0 (22)


White Non-Hispanic Population as a Share of Total Population,North Carolina 2004


White Non-Hispanic Population as a Share of Total Population(# of counties)

87.8% to 97.7% (25)72.6% to 87.7% (25)59.6% to 72.5% (25)30.3% to 59.5% (25)

White Non-Hispanic Physicians as a Share of Total Physicians,North Carolina 2004


*Counts include active, in-state, non-federal physicians who reported their race as "White, non-Hispanic" on their licensure form.

White Non-Hispanic Physicians as a Share of Total Physicians(# of counties)

93.0% to 100.0% (26)86.4% to 92.9% (24)76.0% to 86.3% (25)25.0% to 75.9% (25)

White Non-Hispanic Population, North Carolina 2004


White Non-Hispanic Population(# of counties)

70,248 to 474,010 (25)32,401 to 70,247 (25)17,093 to 32,400 (25)

2,229 to 17,092 (25)

White Non-Hispanic Physicians, North Carolina 2004

White Non-Hispanic Physicians(# of counties)

121 to 1,544 (23)56 to 120 (22)21 to 55 (22)

6 to 20 (20)1 to 5 (13)


*Counts include active, in-state, non-federal physicians who reported their race as "White, non-Hispanic" on their licensure form.

White Non-Hispanic Physicians per 10,000 Black Non-Hispanic Population,North Carolina 2004


*Counts of physicians include active, in-state, non-federal physicians who reported their race as "White, non-Hispanic" on their licensure form.

White Non-Hispanic Physicians per 10,000 White Non-Hispanic Population(# of counties)

21.4 to 115.3 (25)11.7 to 21.3 (25)

7.2 to 11.6 (25)1.9 to 7.1 (25)

North Carolina Providers: Supply and Distribution by Race July 27, 2006 Jennifer King.

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