The Relationship between Healthcare Provider Density and Diabetes Prevalence in the United States

Abstract

The prevalence of diabetes varies geographically in the United States, yet little is known whether healthcare providers are located in areas most in need of diabetes care. This study examined the relationship between healthcare provider density and diabetes prevalence in the United States at the county level. We used data from the Centers for Disease Control and Prevention’s Interactive Diabetes Atlas, the Area Health Resources Files, and the American Community Survey. We used the Getis-Ord Gi* statistic to detect hot spots and cold spots of diabetes prevalence and multinomial logistic regression to examine the relationship between healthcare provider density and a county’s location in a hot spot or cold spot. Nurse practitioner density was positively associated with location in a hot spot of diabetes prevalence. Policy makers should consider using incentives to encourage providers to locate to areas with a high prevalence of diabetes.