The current landscape of Ohio otolaryngologists and associated conditions: a state-level analysis

As demographics continue to shift in the United States, the access gap to physicians in specialized fields remains of utmost importance. This study examined the prevalence of otolaryngologists and otolaryngology subspecialists in Ohio, emphasizing related head and neck conditions and associations with social determinants of health. This cross-sectional study utilized data from the Centers for Medicare & Medicaid Services (CMS) and the CDC’s Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) mortality file. Health outcomes for all 88 counties in Ohio, Appalachian versus non-Appalachian county status, and otolaryngologist distribution were examined using t-tests and proportion tests. T-tests also assessed disparities in the prevalence of hearing impairment and oral malignancies, Pearson correlation tests evaluated associations between otolaryngologists and various social determinants of health. A total of 361 otolaryngologists practiced in Ohio. The mean number of otolaryngologists per county differed across Appalachian and non-Appalachian regions (1.3 ± 1.7 vs. 5.7 ± 14.0; P = 0.02) and southeastern regions (1.2 ± 1.4 vs. 4.6 ± 12.3; P = 0.03). However, the population-adjusted mean did not differ between Appalachian and non-Appalachian counties (P = 0.4) or southeastern and non-southeastern counties (P = 0.8). The prevalence of hearing impairment was higher in non-Appalachian counties (6.1 ± 1.2% vs. 5.6 ± 1.1%; P = 0.03); no difference was observed in southeastern and non-southeastern counties. In counties reporting at least one case of oral cancer, Appalachian counties had a higher prevalence of oral cancers compared to non-Appalachian counties (5.6 ± 2.3 vs. 4.4 ± 1.3, P = 0.04). In relation to social determinants of health, a significant negative relationship was observed between otolaryngologists and rurality (R=-0.2, P = 0.02) and long commutes (R=-0.2, P = 0.01). We observed lower otolaryngologist density and greater access challenges in Appalachian and southeastern counties, which may require patients to travel longer distances to receive specialty care or rely on less specialized providers. Targeted outreach initiatives and regional clinics are needed to address these disparities.