Clinical Report: Disparities in Access to Neurosurgical Services Across the United States

Overview

This report highlights significant disparities in access to neurosurgical services in the United States, with 9.8% of the population lacking adequate access. Rural and socioeconomically disadvantaged communities are particularly affected, necessitating systemic changes to improve access and workforce diversity.

Background

Access to neurosurgical care is critical for timely treatment of conditions like traumatic brain injury and spinal cord compression. Despite a sufficient national neurosurgeon density, geographic maldistribution leaves many areas underserved, particularly rural regions. Addressing these disparities is essential for improving patient outcomes and reducing healthcare inequities.

Data Highlights

Approximately 9.8% of the US population lacks adequate access to neurosurgical services, translating to over 32 million Americans. Only 2.3% of neurosurgeons practice in nonmetropolitan areas, highlighting significant geographic maldistribution.

Key Findings

• 80% of US counties lack neurosurgeons.
• Unemployment, low educational attainment, and poverty predict reduced neurosurgeon availability.
• States with fewer training programs have lower representation of women in neurosurgery.
• Graduating medical students from underrepresented groups are more likely to intend to practice in underserved areas.
• Women represented only 9.6% of board-certified neurosurgeons in 2020.

Clinical Implications

Healthcare systems must implement targeted strategies to enhance neurosurgical access, particularly in rural and underserved areas. Initiatives such as telemedicine and rural training programs can help bridge the gap in care availability and workforce diversity.

Conclusion

Addressing the disparities in neurosurgical access is crucial for ensuring equitable healthcare delivery. A multifaceted approach is required to improve workforce distribution and representation in the field.

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3. Congenital Malformations in Low- and Middle-Income Nations: The Overlooked Aspect of Global Surgical Care, 2014
4. The ASCO Post, 2023 -- Rural Patients With Cancer: Receipt of Surgical Care at High- vs Low-Volume Hospitals
5. Frontiers, 2026 -- Inequitable Access to Neurosurgical Care in the United States
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