Birth Origins and Distribution Tables

Robert C. Bowman, M.D.

About the Birth Origins Database

 

Birth origins are available in the American Medical Association Masterfile for 97% of the allopathic graduates of medical schools in the United States (US MD Grads). Birth city, state, and nation categories were cleaned and linked to county of birth. Birth state can be compared to medical school to determine students most likely to have instate birth. Data can be compiled by medical school, by state, by medical school types or rankings, by county, or by demographic variables linked to counties. Data can also be compared year to year or over longer time periods.

 

The distributional careers and locations include all physicians in rural zip codes, (Hart RUCA 1.1) office-based primary care physicians, office-based primary care in underserved locations, and office based family physicians. Underserved locations were defined as zip codes associated with a whole county primary care shortage area, a Community Health Center site, a National Health Service Corps site, or a population with over 20% in poverty. Military zip codes and Major Medical Center zip codes were not considered underserved.  Zip codes outside MMC locations were more closely associated with underservice.  MMC zip codes had over 75 physicians or were associated with medical schools. The cross section involves physicians as of 2005 locations using Office Max software to select the most likely practice zip code. The methods used are not easily transferred to subsets at the state or regional level due to variation in distributions of population, income, or poverty.

 

Studies that involve multiple years beyond the most recent graduates reflect equilibrium conditions, not just obligations or first practice locations. The use of office based designations prioritizes the primary care delivery component and minimizes resident, teaching, research, administration, inactive, or hospital based practice activities. Over time those who specialize, return to major medical centers, and transition away from office based care are the ones who leave the primary care workforce.  

 

Birth Origins n=203,600 for MD Grads of 1987 1999

% of Medical Student Totals

% of  1970Popu-lation Totals

Office Family Practice

All Rural Careers

Office Primary Care

Under-served Office Primary Care

Major Medical Center

Totals

100%

100%

11.7%

11.0%

30.0%

9.4%

70.9%

Core Metro Over 1 Million Birth

49.1%

48%

10.2%

8.8%

28.6%

7.8%

73.2%

Metro Less Than 1 Million Birth

23.2%

29%

14.0%

13.6%

31.9%

10.3%

68.4%

NonMetro Organized (larger)

6.2%

12%

17.7%

23.0%

35.1%

13.4%

62.9%

NonMetro Less Organized

3.6%

10%

22.3%

26.4%

38.9%

15.2%

58.3%

Foreign Born*

14.2%

9.4%

8.3%

6.1%

28.5%

8.8%

74.2%

Whole County Shortage Area

1.3%

4.6%

19.3%

23.9%

37.0%

22.4%

60.2%

Not Born Instate

59.6%

 

10.4%

9.9%

28.9%

9.2%

72.1%

Born Instate

40.4%

 

13.4%

12.6%

31.7%

9.7%

69.2%

Up to 25 yrs at Graduation

7.3%

 

7.0%

6.8%

25.6%

7.4%

75.3%

Age 26 to 29 at Graduation

70.3%

 

11.1%

10.5%

29.6%

8.7%

71.8%

Age 30 and Up at Graduation

22.4%

 

14.9%

14.0%

32.8%

11.9%

66.9%

Birth County Factors

 

 

 

 

 

 

 

1969 Income in 1989 dollars

 

 

 

 

 

 

 

$3000 6,999 per capita

1.5%

9.8%

19.7%

24.5%

37.1%

26.8%

59.2%

$8,000 8,999 per capita

6.0%

15%

15.0%

16.5%

32.7%

13.2%

64.5%

$10,000 10,999 per capita

15.7%

20%

12.2%

10.8%

30.1%

7.8%

70.1%

$12,000 12,999 per capita

10.8%

8.7%

11.9%

8.4%

30.8%

7.4%

73.5%

$14,000 and above per capita

10.7%

4.5%

6.7%

7.0%

25.1%

6.9%

76.3%

Pop Per Square Mile 1970

 

 

 

 

 

 

 

Population Density 32 64

4.6%

18%

19.9%

22.8%

37.2%

13.3%

62.0%

Population Density 125 250

6.4%

10%

15.6%

17.0%

32.9%

10.3%

67.6%

Population Density 500 1000

8.9%

11%

12.9%

11.9%

31.3%

10.7%

70.3%

Population Density 2500 5000

6.8%

7%

10.5%

9.6%

27.9%

7.5%

73.5%

Population Density 10000 up

12.3%

11%

6.1%

5.8%

24.8%

6.4%

77.2%

*Reference population is current 19 million who are foreign born

 

When comparing admissions percentages to population percentages those least likely to be admitted are the most likely to distribute to careers and locations in most need. Older students, instate born students, and students born in counties with medium and low densities of population or income or college graduates are the most likely to distribute. This presents a dilemma for admissions committees, states, public schools, and education systems.

 

Those most likely to distribute also have middle and lower Medical College Admission Test scores. Their middle and older age is a reflection of the barriers of income and education that they have had to overcome. In states with greater high school graduation rates and broader distribution of education and health resources to middle and lower income areas, physicians are more likely to choose family medicine and to distribute to middle and lower income areas. With increasing concentrations of income, population, and college graduates at a state or county level; the choices of distributional careers by those born in the state or born in the county decline.

 

The intersection of high school graduation rate increase with college graduation rate decrease as indicated in choice of family medicine is first generation to college. Mexican American, Vietnamese, and rural populations all had over 19% choice of family medicine. (Ethnicity and Gender) Without improving early education and first generation college access, the nation will not be graduating sufficient service oriented professionals such as teachers, nurses, public servants, and family physicians. The needs of the fastest growing populations will not be met. The states that fail to invest will continue to take health and education resources from other states and other nations. They will also continue to have the highest costs of education, prisons, health care, unemployment, and insurance which are also strongly related to poor high school graduation rates and concentrations of income. (Bright Future)

 

Admissions Characteristics

Divisions by Medical School by Level of  FP Choice 1987-2000 FP/GP FP Match 2004 % Born in County >  1 million Metro < 1 million Foreign Born Rural Born Older than 29 Years MCAT Average NIH Grant Funds
All Allopathic Private   7.1% 57.7% 17.2% 17.3% 5.5% 18.7%   93520600
Least FP 3.6% 1.9% 62.5% 15.0% 18.1% 4.1% 14.8% 10.9 162318284
Next Least FP 7.4% 5.6% 60.3% 17.2% 17.7% 4.7% 17.2% 10.5 121606535
Next Most FP 12.5% 8.0% 54.3% 15.1% 16.2% 4.8% 21.4% 9.6 58427197
Most FP 19.0% 12.9% 52.4% 21.7% 16.9% 8.6% 22.4% 9.4 31730383
All Allopathic Public   12.1% 46.1% 26.8% 12.8% 12.5% 22.8%   56215553
Least FP 12.0% 7.7% 55.1% 19.0% 15.8% 5.6% 18.1% 9.8 84583798
Next Least FP 17.5% 11.0% 46.8% 28.8% 13.5% 10.4% 21.3% 9.5 56878605
Next Most FP 21.2% 13.2% 42.0% 30.0% 11.3% 15.8% 24.9% 9.6 48617780
Most FP 28.0% 18.9% 37.0% 31.5% 8.9% 21.8% 29.3% 9.3 34748877
All Osteopathic     47.4% 22.8% 12.6% 12.2% 38.5%   10626974
Least FP 27.4% 13.0%* 56.0% 18.5% 13.7% 6.0% 31.0% 8.4 5324347
Most FP 36.2% 18.2%* 40.3% 26.4% 11.8% 17.3% 44.7% 8.2 15340421
Average Totals US 15.2% 11.1% 51.0% 20.3% 14.0% 10.2% 23.1%   62317076
All 1987 2000 Grads 312217       30.5%   20.4%    

Does not include osteopathic FP physicians choosing osteopathic residency programs.

 

Outcomes

Divisions by Level of  FP Choice

1987-2000 FP/GP

FP Match 2004

Research Grads 87-94

MS to State Retain (Not FP)

MS to State Retain (FP/GP)

Rural FP/GP

All Rural Docs

All Primary Care

Office-Based Primary Care

Office PC in Poverty

All Allopathic Private

 

7.1%

1.4%

 

 

1.5%

6.7%

37.2%

27.1%

3.3%

Least FP

3.6%

1.9%

2.8%

30.8%

18.3%

0.4%

4.0%

33.5%

22.4%

3.2%

Next Least FP

7.4%

5.6%

1.4%

25.8%

21.2%

0.9%

5.8%

35.0%

25.2%

3.0%

Next Most FP

12.5%

8.0%

0.9%

31.3%

33.9%

1.6%

7.0%

39.5%

29.5%

3.9%

Most FP

19.0%

12.9%

0.5%

31.4%

34.8%

3.2%

10.4%

41.7%

32.0%

3.3%

All Allopathic Public

 

12.1%

0.6%

 

 

4.5%

12.3%

42.9%

33.4%

4.0%

Least FP

12.0%

7.7%

0.9%

44.2%

49.3%

1.8%

7.5%

38.1%

28.8%

3.9%

Next Least FP

17.5%

11.0%

0.7%

47.2%

56.5%

3.6%

12.2%

42.8%

33.3%

4.0%

Next Most FP

21.2%

13.2%

0.5%

47.6%

60.3%

5.1%

14.0%

44.2%

35.2%

4.0%

Most FP

28.0%

18.9%

0.5%

41.1%

53.5%

7.9%

17.5%

48.6%

38.3%

4.0%

All Osteopathic

 

 

0.1%

 

 

8.3%

17.7%

53.5%

40.8%

3.2%

Least FP

27.4%

13.0%*

0.1%

48.9%

52.4%

5.1%

12.2%

50.2%

37.4%

2.5%

Most FP

36.2%

18.2%*

0.1%

26.7%

36.7%

11.1%

22.2%

56.2%

43.6%

3.7%

Average Totals US

15.2%

11.1%

0.7%

39.3%

48.3%

3.8%

11.1%

42.2%

32.0%

3.7%

All 1987 2000 Grads

312217

 

0.7%

 

 

3.3%

10.5%

45.1%

31.4%

3.7%

 

Birth Origins Articles

 

Physician Workforce Studies

 

www.ruralmedicaleducation.org

 

sport blue 3s louis vuitton outlet retro jordans for sale retro jordans for sale louis vuitton outlet louis vuitton outlet sport blue 6s Sport blue 14s lululemon yoga pants coach outlet sport blue 3s sport blue 3s louis vuitton outlet jordan 3 sport blue nike kd vii coach factory outlet retro jordans Michael Kors Outlet louis vuitton outlet kate spade outlet