Foreign Born Physician Interstate Migration and Minority Population Distribution

Background: Foreign-born medical graduates (FBMGs) make up a significant proportion of physician workforce in the US and have contributed immensely to the care of rural, underserved and minority populations.  However, little is known about their migratory patterns and factors influencing their destination choice. This study assesses the relationship between state-level variations in minority populations and FBMGs destination choice. This study important because the minority population benefit significantly from ACA’s expanded health insurance coverage, it is worth knowing if their health care demands are going to be met.

Methods: Data for this study was obtained from the US census long form data and from the American Community Surveys. FBMGs were defined as physicians born outside of the US. To evaluate the influence of minority populations on destination decisions, aggregated dissimilarity indices were computed and compared for origin and destination states respectively, for the decades of 1990, 2000 & 2010. A dissimilarity index closer to 1 indicates a high level of segregation of minority population and FBMGs.

Results: Interstate movers were more likely to be male, married and between 30-39 years. Departure and destination dissimilarity indices were, respectively, 0.33 and 0.23 for 1990; 0.37 and 0.19 for 2000 and; 0.34 and 0.26 for 2010. The findings suggest that FBMGs tended to move to destinations with lower segregation.

Conclusion: Study suggests FBMGs move to states with higher minority populations and they can be readily tapped to respond to the ACA expanded minority population needs