Black patients live longer where they have Black primary care physicians

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Black patients are healthier and live longer where they have access to Black primary care physicians (PCPs).

That may be good news, along with recent growth in the number of Black PCPs. But Black physicians continue to be under-represented in the nation’s pool of doctors, and fewer than half the counties in the United States had them.

The findings were part of a new study, “Black Representation in the Primary Care Physician Workforce and Its Association With Population Life Expectancy and Mortality Rates in the US,” published in JAMA Network Open.

“Taken together, these findings suggest that Black PCP workforce representation levels are relevant to and potentially affect Black population health,” the study said. Researchers found each 10% increase in Black PCP representation was associated with a higher life expectancy of 30.61 days.

The researchers noted the importance of primary care physicians to patient health, and the importance of diversity, inclusion, and equity in the workforce.

“Primary care physicians are a source of continuous, comprehensive care for their patients, serving to prevent and manage disease across the lifespan and coordinating the care provided to their patients elsewhere in the health care system,” the study said. “In addition, PCPs promote patient physical, mental, and general health and well-being; engage patients in actively participating in the management of their own health; often address the broader determinants of health within patients’ environment; and work to ensure equitable patient access to necessary health resources.”

The numbers of Black physicians increased in the study period. Black PCPs operated in 1,198 counties in 2009, 1,260 counties in 2014, and 1,308 counties in 2019, a 9.8% increase.

But at most, that was less than half the 3,142 counties defined by the U.S. Census as of 2014, according to the study. Proportionally, the percentage of Black PCPs was 5.7%, 6.3%, and 6.7%, respectively for each year, whereas Black individuals comprised 13% to 13.4% of the population from 2009 to 2019. Overall, Black individuals remain underrepresented in most health care professions with multiple years of advanced training.

Among counties with Black PCPs, 55.8% were urban, the study said. The researchers noted people do not necessarily seek primary care only in the county where they live, and living close to PCPs does not guarantee access to care.

There are programs that could help. For example, the U.S. Health Resources and Services Administration supports a diverse PCP workforce, and the American Medical Association and Association of American Medical Colleges have initiatives to expand student interaction with peers from different racial and ethnic backgrounds.