Poster #78 - Partisan and Spatial Dynamics of the U.S. Physician Shortage: A County-Level Analysis

• In Event: Friday Poster Reception

Abstract

The persistent shortage of doctors in the United States poses a significant public health challenge, with far-reaching implications for healthcare access—particularly in medically underserved and rural areas. These regions, often characterized by low population density, are disproportionately concentrated in Republican-leaning jurisdictions. This paper examines the intersection of political geography and healthcare access by analyzing how physician shortages correlate with partisan voting patterns and demographic distributions.

Focusing on the “polity” behind the “policy,” I investigate historical and contemporary legislative responses at both national and state levels, including increased funding for graduate medical education (GME), cross-state licensure initiatives, and discourse regarding immigrant medical professionals. Employing a multi-method quantitative approach, I combine spatial autocorrelation techniques with aspatial statistical analyses to generate spatial visualizations and examine relationships among key indicators such as county-level physician supply from the Health Resources and Services Administration (HRSA), population density, racial and ethnic demographics from the U.S. Census, and presidential election results from 1920 to 2024. Additionally, I consider state-level races and campaign platforms in which the doctor shortage has emerged as a key issue.

Preliminary findings reveal significant clustering of physician shortages in rural, Republican-leaning counties, suggesting a geographically and politically patterned healthcare access crisis that has persisted over time. I analyze policy tools aimed at mitigating these disparities, such as the Resident Physician Shortage Reduction Act (H.R.2389/S.1302) and the Interstate Medical Licensure Compact, both of which aim to increase physician mobility and expand the healthcare workforce, particularly in states with limited capacity to train or retain healthcare workers.

Finally, I propose future research on community attitudes toward immigration in counties with varying dependence on internationally trained physicians—an increasingly critical component of the medical workforce. By integrating geospatial and political analysis, this study advances understanding of how spatial inequality, public policy, and partisanship converge to shape the medical workforce crisis. The findings underscore the urgency of solutions that are both geographically informed and politically responsive as the provider-to-patient ratio continues to decline nationwide.

Author

• Elora Choudhury, University of Michigan Ann Arbor
  Presenting Author