Geospatial and Socioeconomic Disparities in Access to Interventional Radiology Care in the United States

To determine and analyze the geographic distribution of interventional radiologists in the United States to identify populations that have decreased accessibility to IR care.

The Society of Interventional Radiology public database was reviewed for board-certified interventional radiologists in all cities within the United States. US Census data was used to acquire county-level data sets on poverty, population, unemployment, median household income, education, and racial diversity. Odds ratios were calculated for access to IR care between the 75th and 25th percentile for each population variable. Counties with IRs were compared to counties without for each variable via t-Tests. QGIS was used to map the distribution of IRs.

2989 board-certified US interventional radiologists were found to be operating in 15.5% (n=487) of all counties. Almost a third of the country's population (31.2%) did not have access to an interventional radiologist within their county. The mean interventional radiologist:population ratio was 0.305 per 100,000 people. The average median income among counties with IRs was greater at $67,649 compared to $53,528 among counties without (P<0.05). In addition, an average of 31.3% of the population had a college degree in counties with IRs versus 20.3% in other counties (P<0.001). Higher average percentages of African Americans, Pacific Islanders, and Hispanics were observed in counties with IRs at 13.1%, 0.232%, and 13.7%, respectively (P<0.05).

Interventional radiologists are disproportionately distributed, with higher densities practicing near urban areas. Access is also limited to counties with higher incomes and a greater percentage of citizens with college education.