Access to neuro-specialty care varies geographically. Driven by a neurologist shortage, disparities in care access are exacerbated by social drivers of health (SDoH). To analyze this underserved population and develop targeted interventions, we identified neurology and multiple sclerosis (MS) care deserts, visualizing them with demographic and Deloitte HealthPrism™ SDoH data.

Neurologists were identified from the CMS Services file. Neurologist density=neurologists/ 100,000 adults with a served/underserved threshold of the county-level mean. Travel time was from the county population center, with a variable close/far determination based on CMS Time/Distance specialty standards. Neurology deserts were defined by county-level neurologist density (served/underserved) and driving time to a neurologist (close/far). MS Specialists were defined by the National MS Society. MS Specialist deserts used driving time. The chi-square was used for statistical tests.

Three percent of the population—and ~29,000 people with MS— live in neurologist deserts with a median 70-minute drive to a neurologist. Over 3.5 million people and half of those living in deserts reside in suburban areas. Limited neurologist access was associated with an older population, increased risk of chronic vascular conditions, depression, smoking and less racial diversity. Almost a quarter of the population lives in MS specialist deserts, equating to 200,000 people with MS that cannot reach a specialist in less than an hour’s drive.

Limited access to neurologists is associated with specific demographic and SDoH variables. Identifying and visualizing care deserts may help in designing innovative interventions to increase access to neuro-specialty care to all those affected by MS.