O1002: Disparities in Pediatric Cardiology Access: An Area Deprivation Index Analysis Across Major U.S. States

Background: Disparities in pediatric cardiology care across different communities can be influenced by socioeconomic factors. The Area Deprivation Index (ADI) is a measure of the socioeconomic status of a neighborhood, incorporating factors such as income, education, employment, and housing quality, ranked from least to most deprived. This study investigates the distribution of pediatric cardiology providers in relation to their ADIs across FL, CA, and TX, which encompass the largest pediatric populations in the United States.

Methods: We identified pediatric cardiology providers using the National Provider Identifier taxonomy code 2080P0202X and cross-referenced their practice locations (by zip code) with the ADI. The ADI was categorized into national quartiles (1 = 0-25, 2 = 26-50, 3 = 51-75, 4 = 76-100) and state deciles (1-10). The dataset included 341 providers for TX, 419 for CA, and 383 for FL.

Results: Texas displayed a mean ADI category of 1.96 with a median of 2.00, standard deviation of 1.05, and variance of 1.10, indicating a modest spread around less deprived areas. The skewness of 0.625 suggests a slight concentration in the lower ADI categories. California showed a lower mean ADI category of 1.17, median of 1.00, standard deviation of 0.49, variance of 0.24, and high skewness of 3.28, pointing towards a significant clustering in the least deprived quartile. Florida's data revealed a mean ADI category of 1.59, median of 1.00, standard deviation of 0.85, and variance of 0.73, with a skewness of 1.10, again indicating a concentration in areas with lower deprivation. Across all states, the distribution of state ADI deciles showed an unequal concentration of providers, with a skewness for less socioeconomically deprived areas.

Conclusion: There is an evident discrepancy in the availability of pediatric cardiology providers in relation to area deprivation, with a higher concentration of providers in less deprived areas. This distribution suggests a potential accessibility and resource allocation gap for pediatric patients from more deprived neighborhoods. Efforts to address these disparities are crucial in improving health equity and access to specialized pediatric care.