Disparities in access to dermatological care in Texas counties and their implications on public health

德克萨斯州各县皮肤科医疗服务获取方面的差异及其对公共卫生的影响

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Abstract

BACKGROUND: Rural communities face challenges of insufficient healthcare professionals. Studies show that rural populations experience disparities in skin cancer care and delayed diagnoses. METHODS: Data describing Texas dermatologist locations from 2015 to 2022 were obtained from the Texas Department of Health Services. County-level data, including estimated population, rural-urban continuum codes, public health regions, and poverty percent, were collected from the Texas Department of Health Services, the Economic Research Service at the US Department of Agriculture, and the US Census Bureau. RESULTS: Only 2 public health regions met the recommended ratio of 4 dermatologists per 100,000 people in 2022. While dermatologist density has increased with a compound annual growth rate of 2.47%, rural areas with <5000 people showed a negative compound annual growth rate of -9.12%. Dermatologist density in public health regions surrounding the largest cities in Texas-San Antonio, Houston, Austin, and Dallas-was 4.01 per 100,000 dermatologists in 2022, which was significantly higher than the rest of Texas at 1.86 (P < 0.05). CONCLUSIONS: These findings highlight insufficient access to Texas dermatologists and describe disparities linked to population, poverty, and urban proximity. Efforts are needed to address these inequalities and their consequences on dermatologic outcomes in rural communities.

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