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Geographic Disparities in the Oral and Maxillofacial Surgery Workforce: A Statewide Analysis of Georgia
Shervin Eskandari1, Kaamya Mehra1, Marshall F Newman2
1Medical Student, Medical College of Georgia.
Background:
Workforce planning is an urgent need for oral and maxillofacial surgery (OMS). Access to OMS is essential for managing a wide range of conditions, yet disparities in specialist distribution may limit access in rural regions.
Purpose:
This study aims to evaluate the geographic distribution of the OMS workforce in Georgia and identify disparities in access between metropolitan and nonmetropolitan regions.
Study Design:
A cross-sectional study was conducted using the 2024 Georgia Board of Dentistry database to identify licensed OMS in Georgia. County-level demographic and socioeconomic data were obtained from the U.S. Census.
Predictor Variable:
The primary predictor variable was county-level geographic classification, defined using 2023 Rural-Urban Continuum Codes (RUCC), which categorize counties as metropolitan (codes 1 to 3) or nonmetropolitan (codes 4 to 9). Additional variables included county-level socioeconomic indicators (median household income and percent rural population) and OMS demographics (sex and age).
Outcome Variable:
The primary outcome variable was OMS density by county, defined as the number of surgeons per 100,000 residents and per 100 square miles.
Covariates:
None.
Analyses:
The Kruskal-Wallis test was used to compare the data between the 9 RUCCs, and the Mann-Whitney U test was used to compare data between metropolitan and nonmetropolitan counties. Statistical significance was defined as P < .05.
Results:
A total of 205 OMS were identified, of whom 182 (88.8%) were male. Of these, 193 (94.1%) practiced in metropolitan counties. Surgeon density was statistically significantly higher in metropolitan versus nonmetropolitan counties (1.12 ± 0.95 vs 0.34 ± 0.88 per 100,000, P < .001), and 89.4% of nonmetropolitan counties had no surgeon present. Surgeon density differed statistically significantly across RUCC categories (P < .001), with RUCC 1 counties having the highest density (1.33 ± 1.81 per 100,000) and RUCC 9 counties having none. Median household income was statistically significantly higher in metropolitan counties ($70,153.81 ± $18,908.06 vs $52,072.22 ± $10,011.87, P < .001).
Conclusion And Relevance:
The OMS workforce in Georgia is highly concentrated in metropolitan areas, leaving most rural counties with limited access to specialty care. These findings highlight statistically significant geographic disparities and the need for targeted workforce strategies to improve access in underserved regions.
