Evaluating the Distribution of Otological and Neurotological Surgeons in the United States With the Social Vulnerability Index

Objective Assess the relationship between neighborhood-level social determinants of health (SDoH) and the distribution of otology and neurotology surgeons (ONSs) with the Social Vulnerability Index (SVI). Study Design Cross-sectional study. Setting United States. Methods A dataset of US-based ONS and their practice addresses were obtained from the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) and American Neurotology Society (ANS) directories. The overall SVI and its four subthemes, socioeconomic status (SES), household composition and disability status (HH), racial-ethnic minority status (RE), and housing and transportation status (HT), were used to quantify neighborhood-level disadvantage at the census-tract level. The distance from each census-tract to the nearest ONS was calculated. Subsequently, multivariable and univariable linear regression analyses were performed to assess associations between SVI quartiles and distance to the closest ONS. Results This study included 415 otology and neurotology surgeons. The most vulnerable quartile of overall SVI, SES, and HH was associated with greater distances to the nearest otologist ( p < 0.001). Conversely, the most vulnerable quartile of RE and HT were associated with decreased distance to the nearest ONS ( p < 0.001). Conclusion Regions experiencing greater social vulnerability across specific SDoH are further from ONS. SVI may be useful in identifying regions deficient in ONSs while characterizing the factors that contribute to this disparity. The projected workforce deficit highlights the need for proactive measures to ensure equitable access to ONS care, guiding future research and policy efforts aimed to improve healthcare equity and access.