ArticleJournal of the American Academy of Orthopaedic Surgeons. Global research & reviews2026
Socioeconomic Disparities in Geographic Access to Physical and Occupational Therapy Services in the United States: A Correlation With Area Deprivation and Social Vulnerability Indices.
Article in Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPhysical and occupational therapy (PT/OT) services are critical for optimizing outcomes and reducing complications after orthopaedic surgery. Lower socioeconomic status (SES) is associated with reduced access to health care and increased rates of surgical complications. The purpose of our study was to establish the relationship between SES and access to PT/OT.
methodsWe compiled county-level population, land area, and business data from 2020 US Census Bureau Reports. SES data were collected from the 2020 Centers for Disease Control Social Vulnerability Index (SVI) and Area Deprivation Index (ADI). PT/OT businesses were identified using the North American Industry Classification System code 621340. Density of business by county population and land area were calculated, and regression analyses were conducted to determine a correlation between SES and these measures.
resultsCounties with greater density of PT/OT tended to be on the East Coast, whereas those with lower density were located in the Western US. A strong inverse relationship was observed between county-level ADI and PT/OT density (R2 = 0.97 and 0.94). Overall SVI displayed a variable relationship with PT/OT density. The household characteristics and SES domains of the SVI demonstrated an inverse relationship with PT/OT density (R2 = 0.68, 0.49 and R2 = 0.59, 0.28, respectively). Race and ethnicity displayed an inverse parabolic relationship with PT/OT density based on population alone (R2 = 0.83 and 0.57). However, there was a mild positive correlation between race and ethnicity when considering population and land area (R2 = 0.39 and 0.22).
conclusionPT/OT services are important for postoperative care; however, notable barriers to access exist. There exists an inverse correlation between the density of PT/OT services and SES measures, particularly ADI. This may affect postoperative recovery and complication rates in orthopaedic patients.
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