Nurse Practitioners Increase Low-Income Access to Care

Study finds physicians tend to practice in more affluent communities while NPs practice in areas of higher socioeconomic need. 

In healthcare there’s a long-standing assumption that physicians go where the money is—affluent communities with already healthy populations.

Researchers at the University of Michigan wondered if this was, in fact, true, and sought to find out via the study, Supply of Healthcare Providers in Relation to County Socioeconomic and Health Status, published in the Journal of General Internal Medicine.  

"The U.S. health workforce is now an eclectic mix of different providers. We thought it'd be interesting to see if other providers such as nurse practitioners and physician assistants established their practices in more affluent communities such as medical physicians," says Matthew Davis, PhD, assistant professor at the U-M School of Nursing, in a news release.

The researchers compared the number of physicians, physician assistants, NPs, and chiropractors available in counties at different levels of income and health status using life expectancy as an indicator of the need for healthcare.

They found that more physicians, PAs, and chiropractors are available in the most affluent areas with people who have a high life expectancy.

NPs, however, are different.

When the researchers examined where NPs work, they found the availability of NPs was about 50% higher in the least-healthy counties compared to the healthiest.

Additionally, more NPs practiced in lower-income areas with low life expectancy.

"That was nice to see," Davis says. "The nurse practitioner workforce appears to be having some positive effects. Our work shows that nurse practitioners are more likely to set up shop in areas of higher need and other studies have shown that they provide a substantial amount of care for individuals with chronic illness."

This, paired with the fact that in many states NPs can practice independently, is something that should be considered when setting policies aimed at improving access to care, the researchers write.