{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:34:40Z","timestamp":1788950080833,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":58,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01DA053435"],"award-info":[{"award-number":["K01DA053435"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To assess county\u2010level and specialty\u2010level age differences between urban and rural physicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We linked the 2008\u20132021 Medicare Data on Provider Practice and Specialty (MD\u2010PPAS) dataset with the 2024 Doctors and Clinicians national downloadable file. We assessed specialty\u2010level differences in the age of rural versus urban physicians using Rural\u2013Urban Continuum Codes (RUCC) with four groups: urban (RUCC 1\u20133), large rural (RUCC 4\u20135), small rural (RUCC 6\u20137), and isolated rural (RUCC 8\u20139). We analyzed the relationship between rurality and physician age using choropleth graphs, spatial clustering, and univariable regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Our final cohort comprised 571,886 physicians. The mean ages of physicians were higher in rural counties (large rural: 53.1 years; small rural: 53.3 years; isolated rural: 53.5 years) than urban counties (52.5 years; <jats:italic>p<\/jats:italic> value &lt;0.001). Some specialties including medical oncology, palliative care, and thoracic surgery showed particularly large age differences with older physicians in more rural areas. There were clusters of older physicians in the South and clusters of younger physicians in the Mountain West and Midwest. Rurality was strongly associated with clusters of older physicians (odds ratio [OR]: 3.8; 95% confidence interval [CI], 2.6\u20135.5), and the percentage of households with broadband internet subscription was strongly associated with clusters of younger physicians (OR: 2.6; 95% CI, 2.2\u20133.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Rural physicians were older than urban physicians with certain specialties and regions demonstrating large age disparities. The aging of rural physicians could worsen existing urban\u2013rural health care disparities. Initiatives focusing on recruiting and retaining rural physicians should target specific regions and specialties to ameliorate these inequities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.70054","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T03:44:46Z","timestamp":1753847086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Urban\u2013rural differences in the age of US physicians"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1482-5631","authenticated-orcid":false,"given":"Ryan J.","family":"Crowley","sequence":"first","affiliation":[{"name":"Department of Population Health New York University Grossman School of Medicine  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jag S.","family":"Lally","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Kline","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M.","family":"Bunting","sequence":"additional","affiliation":[{"name":"Department of Population Health New York University Grossman School of Medicine  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.5334"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3798\/tia.1937-0237.2109"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.1.113-JMS0102-7-1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001203"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.22605\/RRH7050"},{"key":"e_1_2_7_7_1","first-page":"255","volume-title":"International Handbook of Rural Demography","author":"Sparks PJ","year":"2011"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.26372"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.00924"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M22\u20102504"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1900808"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.33994"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12577"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2011.03335.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2013.04.080"},{"issue":"417","key":"e_1_2_7_16_1","first-page":"1","article-title":"Trends in death rates in urban and rural areas: United States, 1999\u20132019","author":"Curtin SC","year":"2021","journal-title":"NCHS Data Brief"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.017089"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010015\u20103380\u20109"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgz031"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgz030"},{"key":"e_1_2_7_21_1","unstructured":"Medicare Data on Provider Practice and Specialty (MD\u2010PPAS) | ResDAC. 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