Access to healthcare services is a top priority for policy makers at federal, state, and local levels. How the healthcare workforce is distributed impacts access to care, particularly in rural and remote areas of the State of Arizona. This report provides rural and urban healthcare workforce comparisons and multi-year trends that can be used to examine changes in access to care that can be used to develop new or revise existing workforce related policies and programs.
The health professions examined in this report include physicians (primary care, specialist, obstetrics-gynecologist, and psychiatrist), physician assistants, nurses (registered nurses, nurse practitioners, certified nurse midwives, nurse anesthetists, licensed practical nurses, and certified nurse assistants), dentists (general and specialist), pharmacists, pharmacy technicians, and emergency medical technicians. In the report, workforce data is presented from 2002 to 2006 for each health profession and for some professions 2007 data is also included in the report. The results from other health care workforce studies are presented to add context to the data and information presented.
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Trends in the number of licensed healthcare professionals relative to the population in Arizona from 2002 to 2006 have generally been stable or have increased. The rural areas have fewer licensed professionals relative to the population than the urban areas. The workforce trends for many professions show the inequalities between urban and rural areas are increasing, especially for the more rural areas of Arizona. There were statewide and urban increases in the number of healthcare professionals studied.
The growth trends for number of licensed healthcare professionals relative to the population were greater for pharmacy technicians (68%), certified registered nurse anesthetists (50%), physician assistants (29%), specialist dentists (25%), pharmacists (23%), and nurse practitioners (21%) from 2002 to 2006. During the same period, the number of obstetrics-gynecologists relative to the population they serve decreased 3 percent.
The number of primary care professionals (primary care physicians, physician assistants, and nurse practitioners) has increased in the state, but there are still primary care physicians and nurse practitioners distribution inequalities between urban and rural areas.
Five rural-rural classified counties were ranked lowest in number of health professional per 100,000 population for the state in 2006. Apache and La Paz counties were ranked in the bottom for 15 out of 17 health professionals examined. Santa Cruz County was ranked in the bottom for 11 out of 17, Pinal County was ranked in the bottom for 10 out of 17, and Greenlee County was ranked in the bottom for 9 out of 17.
How to Use the Report
The report is divided into seven major sections:
- Arizona Characteristics
- Physician Assistants
- Pharmacists and Pharmacy Technicians
- Emergency Medical Technicians.
There is also a Data Source and Methods section. For the rural and urban health workforce distribution and trend comparisons, two geographic classifications are used to measure rurality. One method aggregated data for each county into three state wide categories: urban counties, rural-urban counties, and rural-rural counties. The other method, rural urban commuting areas (RUCAs) classification, aggregated data for each postal zip code into four state wide categories: urban areas, large rural town areas, small town areas, and isolated small town areas. If available, national health professional ranking and state health professional practice profiles are reported.
There are 90 figures (graphs), 95 tables, and 30 maps in the report. For each health professional section, there are comparison graphs that show multi-year healthcare professional number and health professional-population ratio trends for the state, and urban and rural areas. There are four sets of tables in each health professional section:
- Net numeric changes over time for the state, urban and rural areas, and for each of the 15 counties
- The annual health professional-population ratios for the state, urban and rural areas, and for each of the 15 counties
- The RUCA net numerical changes over time for the state, urban areas, large rural town areas, small rural town areas, and isolated small rural towns
- The annual health professional-population ratios for the four RUCA geographical classifications.
Health professional-population ratio ranking maps are presented in each health professional section. Appendix E provides tables for both the Arizona, counties, and RUCAs health professional percentage changes for 2002 to 2006 and the Arizona, counties, and RUCAs health professional/population ratios for 2006. From the information presented in the report, one can assess the changes in Arizona, urban and rural, and county workforce over time.