(A147) Sociodemographic Factors Associated With Access to Otolaryngology Care

Introduction: This study examined county-level social and demographic characteristics with respect to access to otolaryngology care among 3,143 counties in the United States.

Methods: This observational, cross-sectional study utilized sociodemographic data collected from the 2023 Small Area Income and Poverty Estimates and the 2023 American Community Survey. Additionally, data on otolaryngologists and their respective distribution was obtained from the American Academy of Otolaryngology-Head and Neck Surgery (ENTnet.org) as of December 2024. Counties were classified as rural or urban based on the 2023 Rural-Urban Continuum Codes as defined by the United States Department of Agriculture. The study’s primary outcome was access, defined as having at least one otolaryngologist per county. Multivariate and univariate logistic regression analyses were performed in R.

Results: Significant disparities in otolaryngologist access were identified between rural and urban counties across all regions (p < .001). Rural counties were 86% less likely to have at least one otolaryngologist per county. After adjusting for other variables, counties in the Midwest were 68% less likely to have access to an otolaryngologist, 59% less likely in the West, and 64% less likely in the South in comparison to their Northeastern counterparts (P < .001). Controlling for poverty status and urban and region status, race was not found to be a significant predictor of otolaryngology access (0.43-0.98, p > 0.9). Furthermore, counties with less than 20% poverty rates had ~3 (2.35, 3.84, p < 0.001) times greater odds of access than counties with higher poverty rates.

Conclusions: This study not only highlights the regional and urban-rural disparities in otolaryngologist availability but also the sociodemographic factors that contribute to the disproportionate burden of these disparities. These findings support health policies and incentive structures that aim to ameliorate the disparities found in high poverty and rural communities in the US.