The Racial and Ethnic Diversity of the Family Physician Workforce in Non-Metropolitan and Metropolitan Counties


On average, rural populations have a greater proportion of White people than urban populations, but variation exists with rural minorities often concentrated in counties with higher social deprivation. In general, physicians are disproportionately White and male compared to the U.S. workforce and population, but little is known about racial and ethnic distribution of family physicians (FPs) according to rurality and how this compares to urban FPs. Thus, it is likely that minority rural FPs may not be distributed evenly across rural areas. Our objective was to determine the distribution of FPs in rural areas by race/ethnicity and also whether rural minority physicians were more likely to be in underserved rural areas.

Our sample included 5,063 early career FPs from the American Board of Family Medicine's (ABFM) National Graduate Survey and 19,234 FPs who sought to continue their ABFM certification. FPs in micropolitan and non-core/non-metro areas were generally White, non-Hispanic, and U.S. medical graduates. Early career FPs were more racially/ethnically diverse, and majority female, compared to the continuing certification cohort and more females were in non-core/non-metro counties in this cohort. We found that younger FPs are more racially diverse and more likely to be female than older FPs. However, these gains in racial diversity overall have not reached the non-metropolitan FP workforce. In non-metropolitan America, Black FPs are more likely to practice in persistent poverty counties.

Rural and Underserved Health Research Center
Lars Peterson, Zachary Morgan