December 04, 2006
Taking your child to a pediatric subspecialist may mean a big-time travel commitment, researchers at the University of North Carolina at Chapel Hill’s School of Public Health have found.

Although about half the children in the United States live within 10 miles of most pediatric specialists, almost one in three must travel 40 miles or more to receive subspecialty care from certain physicians. The lack of available subspecialists, who are trained to treat specific ailments in children, could mean some patients are not getting sufficient care, the researchers said.

Photograph of Dr. Michelle Mayer

Photograph of Dr. Michelle Mayer

“The results suggest that the supply of pediatric subspecialists is inadequate in some locales, and the number of subspecialists is not distributed equitably,” said Dr. Michelle Mayer, research assistant professor in the school’s department of health policy and administration. “While we don’t know to what extent these distances are barriers to subspecialty care, we think they may be problematic for low-income families with limited access to transportation or work-leave benefits.”

Mayer found that the distances parents must travel to receive pediatric subspecialty care for their children range from 15 miles for neonatology (infant care) to 78 miles for pediatric sports medicine.

The results of the study, which was funded by the Agency for Healthcare Research and Quality, appear in the December 2006 issue of Pediatrics.

Mayer cited the low number of pediatric endocrinologists (those who study glands and hormones in children) as one worrisome example of the trend’s implications in light of a national childhood obesity epidemic and related increases in Type II diabetes. She said pediatric subspecialties are among the smallest medical specialties in the United States.

Researchers combined data from the American Board of Pediatrics with a national ZIP code database to calculate straight-line distances between each ZIP code and the nearest board-certified subspecialist. They used those sources to estimate the percentage of hospital referral regions with providers and calculate physician-to-population ratios for each of the 16 pediatric medical subspecialties included in the analyses.

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Note: Mayer can be reached at (919) 966-7666 or

Health policy and administration contact: Gene Pinder, (919) 966-9756 or

News Services contact: Becky Oskin, (919) 962-8596 or

School of Public Health contact: Ramona DuBose, (919) 966-4555 or



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