Variable Representation of Ethnic and Minority Academic Neurosurgeons Stratified by Hospital Catchment Area

Introduction: Geographic disparities in access to neurosurgical care are prevalent within the United States (US) healthcare system. However, the relationship between these disparities and diversity within the academic neurosurgical workforce has not been well characterized. Here, the authors quantify the representation of ethnic and minority academic neurosurgeons and assess changes and variability in representation by hospital zip code.

Methods: Lists of all academic neurosurgeons practicing in the US in 2019 and demographic details of the US population in 2020 were obtained from the American Association of Neurological Surgeons and US Census Bureau, respectively. A representation ratio, defined as the ratio of the proportion of academic neurosurgeons of a specific race/ethnicity divided by the proportion of the population of the same race/ethnicity, was calculated for each hospital’s zip code.

Results: The study cohort included data from 115 unique institutions. There were a total of 1197 neurosurgeons, 72.7% of whom were White, 19.6% were Asian, 3.1% were Black, 2.8% were Hispanic/Latino, and 1.8% belonged to other racial denominations; no academic neurosurgeons were of Native American/Alaska Natives or Native Hawaiians/Other Pacific Islanders denominations. A total of 279 unique zip codes were used to calculate representation ratios. Representation ratios varied significantly between race/ethnicities: White (range: 0.46-44.01; mean: 1.96), Black (range: 0-10.59; mean: 0.52), and Asian (range: 0-545.31; mean: 9.23). Representation ratios could not be calculated for the Native American/Alaska Natives or Native Hawaiians/Other Pacific Islanders cohorts.

Conclusion : There is significant geographic variability in the representation of ethnic and minority academic neurosurgeons when compared to their hospitals’ surrounding areas. Further studies are warranted to establish the impact of this variability on patient care.