Geographic Variation in Gender Disparities in the US Radiologist Workforce

Purpose: To assess geographic variation in gender disparities in the US radiologist workforce. Methods: Gender, location, and practice affiliation of all radiologists and gender of all nonradiologists were identified for all providers listed in the Medicare Physician Compare database. Variation in female representation among radiologists was summarized at state, county, and individual practice levels, and associations with a variety of county-level population characteristics were explored. Results: Nationally, 23.1% (7,501 of 32,429) of all radiologists were women versus 46.6% (481,831 of 1,034,909) of Medicare-participating nonradiologists. At the state level, female representation among radiologists was overall highest in the Northeast and Mid-Atlantic regions (Washington DC, 39.3%; Massachusetts, 34.3%; Maryland, 31.5%) and lowest in the West and Midwest (Wyoming, 9.0%; Montana, 10.7%; Idaho, 11.7%). At the county level, female representation varied from 0.0% to 100.0%, with weak positive correlations with county-level population (r = +0.39), median household income (r = +0.25), college education (r = +0.23), English nonproficiency (r = +0.21), mammography screening rates (r = +0.12), Democratic voting in the 2016 presidential election (r = +0.28), and weak negative correlation with county-level rural population percentage (r = −0.32). Among practices with ≥10 members, female representation varied greatly (0.0% to 100.0%). Female representation was higher among academic (32.3%) than nonacademic (20.6%) radiologists, and in states with higher female-to-male relative earnings (r = +0.556). Conclusion: Compared with nonradiologists, women are underrepresented in the national radiologist workforce. This underrepresentation is highly variable at state, county, and practice levels and is partially explained by a variety of demographic, socioeconomic, and political factors. These insights could help inform and drive initiatives to reduce gender disparities and more actively engage women in the specialty.