Growth and Distribution of Child Psychiatrists in the United States

2007–2016

Published in: Pediatrics: Official Journal of the American Academy of Pediatrics, Volume 144, Number 6 (December 2019). doi: 10.1542/peds.2019-1576

Posted on RAND.org on November 06, 2019

by Ryan K. McBain, Aaron Kofner, Bradley D. Stein, Jonathan Cantor, William B. Vogt, Hao Yu

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Background

Historically, there has been a shortage of child psychiatrists in the United States, undermining access to care. This study updated trends in the growth and distribution of child psychiatrists over the past decade.

Methods

Data from the Area Health Resource Files were used to compare the number of child psychiatrists per 100,000 children ages 0 to 19 between 2007 and 2016 by state and county. We also examined sociodemographic characteristics associated with the density of child psychiatrists at the county level over this period using negative binomial multivariable models.

Results

From 2007 to 2016, the number of child psychiatrists in the United States increased from 6,590 to 7,991, a 21.3% gain. The number of child psychiatrists per 100,000 children also grew from 8.01 to 9.75, connoting a 21.7% increase. County- and state-level growth varied widely, with 6 states observing a decline in the ratio of child psychiatrists (ID, IN, KS, ND, SC, and SD) and 6 states increasing by >50% (AK, AR, NH, NV, OK, and RI). Seventy percent of counties had no child psychiatrists in both 2007 and 2016. Child psychiatrists were significantly more likely to practice in high-income counties (P < .001), counties with higher levels of postsecondary education (P < .001), and metropolitan counties compared with those adjacent to metropolitan regions (P < .05).

Conclusions

Despite the increased ratio of child psychiatrists per 100,000 children in the United States over the past decade, there remains a dearth of child psychiatrists, particularly in parts of the United States with lower levels of income and education.

Research conducted by

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