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<p>There is consensus that urban residents have better access to healthcare than rural residents in the USA, yet this knowledge is based mostly on primary care services. Here we put forward a multidimensional examination of healthcare access to 75 medical specialties in 898 US cities. Leveraging urban scaling theory, economic geography and network science, we confirm the expectation that residents in large cities have access to a more diverse range of specialists. Concurrently, we register a surprising sublinear scaling of the prevalence of most specialty providers: the larger the city, the less the provision of specialized healthcare per capita and per unit area. We propose that the trade-off between diversity and provision is related to economic clustering in the healthcare sector and high patient loading of providers in large cities. These findings suggest the need for city-specific strategies to address emerging inequalities in healthcare services.</p>

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Trade-off between diversity and provision of specialized healthcare in US cities

  • 期刊论文

  • 发表日期：

    2025年9月17日

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  • Tian Gan,
  • Tanisha Dighe,
  • Maurizio Porfiri

摘要

There is consensus that urban residents have better access to healthcare than rural residents in the USA, yet this knowledge is based mostly on primary care services. Here we put forward a multidimensional examination of healthcare access to 75 medical specialties in 898 US cities. Leveraging urban scaling theory, economic geography and network science, we confirm the expectation that residents in large cities have access to a more diverse range of specialists. Concurrently, we register a surprising sublinear scaling of the prevalence of most specialty providers: the larger the city, the less the provision of specialized healthcare per capita and per unit area. We propose that the trade-off between diversity and provision is related to economic clustering in the healthcare sector and high patient loading of providers in large cities. These findings suggest the need for city-specific strategies to address emerging inequalities in healthcare services.