Geospatial analysis of accessibility to oculofacial plastic surgery in the United States: Driving distance and sociodemographic disparities

To identify disparities in access to complex oculofacial plastic care by mapping American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) members’ service coverage areas (SCAs) in the United States (US). Cross-sectional analysis We analyzed US-based ASOPRS members’ practice locations in ArcGIS Pro (Esri) to define SCAs as regions within a 60-minute drive. With American Community Survey data and chi-square tests, we compared social determinants of health within and outside SCAs. Of the 322,561,852 Americans, 260,154,031 (80.7%) lived within a 60-minute driving time from one of the 635 ASOPRS members. The population outside 60-minute SCAs was significantly more likely to be White, Non-Hispanic, without university education, receiving social security income, residing in a household below federal poverty level, and lacking health insurance, compared to the population inside SCAs (each P<0.001). States with the most ASOPRS members were California (n=95, 2.4 per million residents), Texas (n=47, 1.5/million) and Florida (n=45, 2.0/million), while none practiced in Montana, North Dakota, South Dakota, New Mexico and Wyoming. Inequitable geographic distribution of ASOPRS members disproportionately affects patients in rural areas and those with lower socio-economic status. Recognizing these geographic-social obstacles can inform policies to reduce barriers to complex oculofacial plastic care access.