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Physician Workload Attenuates the Impact of Mental Health Care Workload on Community Health Outcomes: Implications
Gregory J Privitera1, James J Gillespie2, Arpitha Pamula3
1Department of Psychology, St. Bonaventure University, St. Bonaventure, New York, USA.
Abstract:
Physician workload is known to impact provider well-being and individual patient encounters, but less is understood about how provider availability affects broader community health outcomes. Primary care physicians (PCPs) often serve as de facto mental health providers, particularly in underserved communities. This study evaluated whether PCP and mental health provider workload, measured by provider-to-resident ratios, predict population-level physical and mental health outcomes. County-level data from the 2024 Robert Wood Johnson Foundation County Health Rankings dataset (N = 3142 counties) were analyzed using two path analysis models; such models are used to estimate both direct and indirect relationships among multiple predictors and outcomes simultaneously. Predictor variables included provider ratios, percent uninsured (mediator), and self-reported physically and mentally unhealthy days (outcomes). Higher PCP workload was significantly associated with greater numbers of poor physical and mental health days. Mental health provider ratios were not directly associated with either outcome. Indirect effects through the percent uninsured were also significant, particularly for physical health outcomes. These findings suggest that PCPs play a disproportionate role in shaping both mental and physical health at the community level. The analysis supports the conclusion that addressing provider shortages and improving insurance coverage can enhance health outcomes, particularly when efforts are integrated into collaborative care models that distribute workload across providers and align treatment approaches with the diverse psychosocial and medical needs of the populations they serve.
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